Performing PET/CT studies: do they create anxiety?

Introduction: Anxiety is a common problem in primary care and specialty medical settings. Treating an anxious patient takes more time and adds stress to staff. Unrecognised anxiety may lead to exam repetition, image artifacts and hinder the scan performance. Reducing patient anxiety at the onset is probably the most useful means of minimizing artifactual FDG uptake, both fat brown and skeletal muscle uptake, as well patient movement and claustrophobia. The aim of the study was to examine the effects of information giving on the anxiety levels of patients who are to undergo a PET/CT and whether the patient experience is enhanced with the creation of a guideline. Methodology: Two hundred and thirty two patients were given two questionnaires before and after the procedure to determine their prior knowledge, concerns, expectations and experiences about the study. Verbal information was given by one of the technologists after the completion of the first questionnaire. Results: Our results show that the main causes of anxiety in patients who are having a PET/CT is the fear of the procedure itself, and fear of the results. The patients who suffered from greater anxiety were those who were scanned during the initial stage of a disease. No significant differences were found between the anxiety levels pre procedural and post procedural. Findings with regard to satisfaction show us that the amount of information given before the procedure does not change the anxiety levels and therefore, does not influence patient satisfaction. Conclusions: The performance of a PET/CT scan is an important and statistically generator of anxiety. PET/CT patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. The creation of a guideline may reduce the stress of not knowing what will happen, the anxiety created and may increase their satisfaction in the experience of having a PET/CT scan

Oncological patient anxiety in imaging studies: the PET/CT example

The purpose of this study was to investigate the subjective perception of anxiety pre- and post-procedure, and explore the relationship between demographic, clinical variables and cancer patients' anxiety during a positron emission tomography/computed tomography (PET/CT) scan. Two hundred and thirty-two oncological out patients, with clinical indication for performing an (18)F-2-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/CT scan and attending a nuclear medicine (NM) department, participated in the study. Patients' anxiety and subjective experience of PET/CT were examined using two self-report questionnaires. The pre-procedure questionnaire focused on demographic information, level of knowledge regarding the scan and subjective perception of anxiety before the procedure. The post-procedure questionnaire included the subjective perception anxiety after the procedure, information adequacy and satisfaction with the NM department. The self-reported data indicate that patients were anxious during PET/CT. Furthermore, our data revealed a significant difference between the anxiety pre-procedure and post-procedure (z = -3909, p < 0.05), in which the anxiety pre-procedure has significantly higher values. No significant correlation was found between anxiety and age of the patients, education levels, adequacy of information or satisfaction with the NM Department. Perception of anxiety post-procedure differs between gender (U = 5641, p = 0.033). In conclusion, PET/CT generated anxiety levels in oncological patients, especially before the procedure. Although patients seemed to be satisfied with information delivered by staff and with the NM Department, attention has to be focused on effective interventions strategies that help patients to reduce anxiety

Influência de factores locais no uso das galerias ripícolas por carnívoros num ambiente mediterrânico

Tese de mestrado. Biologia (Biologia da Conservação). Universidade de Lisboa, Faculdade de Ciências, 2013As galerias ripícolas são elementos estruturantes das paisagens Mediterrânicas e a sua importância para os carnívoros tem sido amplamente demonstrada, já que lhes proporcionam refúgio, alimento e água. Contudo, a humanização da paisagem tem conduzido à degradação destes elementos paisagísticos com consequências que importa explorar. Com o intuito de avaliar, de forma expedita, a qualidade destes elementos paisagísticos, foi criado o índice da Qualidade das Galerias Ripícolas (QBR) que avalia a cobertura total ripícola, estrutura e qualidade da cobertura e alterações do canal. Neste estudo, realizado na Companhia das Lezírias, foi desenvolvida uma adaptação deste índice considerando os requisitos dos mesocarnívoros. Analisaram-se as variações de qualidade em sectores sucessivos de uma galeria ripícola, através da avaliação da cobertura total ripícola, estrutura da cobertura, factores de perturbação e disponibilidade de alimento, considerando neste último parâmetro, frutos, insectos, lagostins, pequenos mamíferos e lagomorfos. Foi testada a associação entre a qualidade da galeria ripícola e o seu uso pelos carnívoros considerados, tendo este sido avaliado através de foto-armadilhagem e contagem de indícios de presença. De um modo geral, o uso da galeria pelos carnívoros apresentou flutuações espaciais mas não temporais. No total foram detectadas 6 espécies de carnívoros, sendo que a que mais utiliza a galeria é a raposa, correspondendo possivelmente à sua maior abundância na área. As flutuações na qualidade do habitat entre os diferentes sectores pareceram coincidir com as flutuações encontradas no uso das galerias pelos carnívoros. Assim, quando se consideraram as quatro estações do ano, as pontuações do QBR adaptado mostraram-se positivamente correlacionadas com o uso das galerias pelos carnívoros, havendo uma tendência para locais com melhor qualidade serem mais utilizados pelos carnívoros. Uma tendência semelhante foi observada quando se considerou o QBR original. Quando se compararam as pontuações do índice QBR original com as do QBR adaptado, verificou-se que são positivamente correlacionadas o que sugere que o Índice QBR original poderá ser um bom indicador para avaliar a qualidade do habitat para os mesocarnívoros. A avaliação das características ambientais ligadas à sobrevivência ou presença das espécies pode servir como orientação para a prática da conservação, beneficiando as populações de mamíferos carnívoros das paisagens Mediterrânicas. Contudo, para abordagens espacialmente mais vastas, a utilização do QBR original pode servir como um bom indicador da presença de mesocarnívoros e ser útil na definição de estratégias de investigação e monitorização.Riparian galleries are structural elements of Mediterranean landscapes and their importance for carnivores has been widely demonstrated, since they provide shelter, food and water. However, the humanization of the landscape has led to the degradation of these landscape elements with consequences that should be explored. In order to evaluate, in an expeditious manner, the quality of these landscape elements, the quality of riparian galleries index was created (QBR) which evaluates the total riparian cover, structure and quality of the cover and channel alterations. In this study, in “Companhia das Lezírias”, an adaptation of the QBR index was developed, considering the requirements of mesocarnivores. The changes of quality were analyzed in successive sectors of a riparian gallery, through the assessment of total riparian cover, cover structure, disturbance factors and food availability, being consided, in the latter parameter, fruits, insects, crayfish, small mammals and lagomorphs. The association between the quality of the riparian gallery and its use by carnivores was tested, being the latter evaluated through photo trapping and evidence of presence. In general, the use of the gallery showed spatial fluctuations but not temporal. In total there were found 6 species of carnivores, and the specie that most used the gallery was the fox, possibly corresponding to its greater abundance in the area. Fluctuations in habitat quality between sectors seemed to coincide with the fluctuations found in the use of riparian galleries by carnivores. Thus, when considering all the four seasons, the scores of the adapted QBR were positively correlated with the use of the galleries by carnivores with a tendency for places with better quality to be more used by carnivores. A similar trend was observed when considering the original QBR. When comparing the scores of the original QBR with the scores from the adapted QBR it was found a positive correlation, suggesting that the original QBR may be a good indicator for evaluating the quality of habitat for mesocarnivores. The assessment of the environmental characteristics related to the presence or survival of species can serve as guidance for the practice of conservation, benefiting the populations of carnivorous mammals of Mediterranean landscapes. However, for spatially wider approaches, using the original QBR can serve as a good indicator for the presence of mesocarnivores, being useful in the development of strategies for research and monitoring

Psychological impact of diagnostic exams

Introduction: Anxiety is a common problem in primary care and specialty medical settings. Treating an anxious patient takes more time and adds stress to staff. Unrecognized anxiety may lead to exam repetition, and impedance of exam performance. Objective: The aim of the study was to examine the anxiety levels of patients who are to undergo diagnostic exams related to cancer diagnostic: PET/CT and mammography. Methods: Two hundred and thirty two patients who undergo PET/CT and one hundred thirteen women who undergo mammography filled out one questionnaire after the procedure to determine their concerns, expectations and perceptions of anxiety. Results: Our results show that the main causes of anxiety in patients who are having a PET/CT is the fear of the procedure itself and fear of the results. Patients who suffered from greater anxiety were those who were scanned during the initial stage of an oncological disease. On the other hand, the diagnostic is the main cause of anxiety in women who are requiring a mammography. 28% of the women reported having experienced pain or intense pain. Conclusions: The performance of diagnostic exams related to cancer diagnostic like a PET/CT and a mammography are important and statistically generators of anxiety. Patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. These results provide expertise that can be used in the development of future training programs to integrate post-graduate courses of health professionals

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Reliability within and between judges in measuring the oral diadochokinetic rate in children

Objetivo: O objetivo deste estudo é o de verificar a fidedignidade intra e inter-juízes na avaliação da taxa diadococinética oral, em dois momentos de avaliação (com duas semanas de intervalo). Métodos: Cinco terapeutas da fala avaliaram registos áudio (através do programa Audacity™ e de auscultadores SENNHEISER HD201) com cinco tarefas diadococinéticas (três ciclos monossilábicos, um ciclo dissilábico e um ciclo trissilábico) de trinta e duas crianças, num primeiro e num segundo momento. Os resultados para a fidedignidade inter-juízes foram obtidos através do Alfa de Cronbach e para a fidedignidade intra-juízes foi utilizado o coeficiente de correlação intraclasse para a obtenção dos resultados. Resultados: Embora os resultados da variável “duração” não tenham sido todos ótimos (α entre 0.54 e 0.98), é possível constatar que nas variáveis “número de sílabas” (α entre 0.96 e 1) e “taxa diadococinésia” (α entre 0.94 e 0.99) existe concordância inter e intra-juízes com qualidade excelente. O coeficiente de correlação intraclasse obteve sobretudo resultados de fidedignidade excelente em todas as variáveis, apresentando também alguns resultados de fidedignidade satisfatória. Conclusão: Os resultados obtidos são discrepantes ao nível da avaliação inter-juízes na variável “duração”, mas foi observado que a “taxa diadococinética” e o “número de ciclos”, seguindo as regras padronizadas no presente estudo, apresentaram uma excelente fidedignidade.info:eu-repo/semantics/publishedVersio

Effectiveness of educational videos on patient’s preparation for diagnostic procedures: systematic review and meta-analysis

Projeto IPL/2020/VEDPET_ESTeSLAlthough diagnostic procedures are crucial for secondary prevention and patient disease control, they often trigger fear and anxiety. These reactions highlight the need to adopt effective interventions to improve patients' experience and satisfaction. Recently, educational videos have been employed in preparing diagnostic procedures; however, there is no integrated understanding of their effects. This systematic review and meta-analysis aimed to assess the effectiveness of educational videos on patients' anxiety and satisfaction regarding preparation for diagnostic procedures. Three scientific databases (PubMed; Web of Science, Scopus), were used in this systematic review. Studies about educational videos as a form of preparation for patients undergoing diagnostic procedures published between 2000 and 2021 were included. A meta-analysis was also conducted. Sixteen studies met the inclusion criteria for systematic review, and seven were included in the meta-analysis. Nine studies of the total sample were about vascular procedures and seven studies about other medical image procedures. Of the fourteen studies that evaluated the use of educational videos on patients' anxiety, nine proved to reduce it significantly. Of the thirteen studies that evaluated satisfaction, seven showed a significant increase in the experimental group. Studies included in the meta-analysis show that educational video patient groups had lower anxiety levels than the control groups after the procedure. Although future studies are required, the results suggest that educational videos effectively prepare patients for diagnostic procedures, improving care quality.info:eu-repo/semantics/publishedVersio

Experiences with remote communication in adult intensive care units during the COVID-19 pandemic: a systematic review protocol

Objective: The objective of this review is to explore the lived experiences of critically ill adults, their families, or health care professionals with remote communication in intensive care units (ICUs) during the COVID-19 pandemic. Introduction: Family visiting restrictions in ICUs during the COVID-19 pandemic imposed significant challenges to communication between critically ill adults, their families, and the health care team. Evidence shows that several communication strategies were developed and implemented in ICUs during the COVID-19 pandemic to promote family engagement; however, the experiences of critically ill adults, their families, and health care professionals with these strategies are scattered across primary qualitative studies. Inclusion criteria: This review will consider qualitative studies that include critically ill adults, their families, or health care professionals, focusing on their experiences with remote communication strategies in ICUs during the COVID-19 pandemic. Methods: This review will be conducted in accordance with JBI methodology. The search strategy will aim to locate both published and unpublished qualitative studies in English, Spanish, and Portuguese. Studies published after January 2020 will be included. Study selection, critical appraisal, and data extraction will be performed independently by 2 reviewers. Data will be presented in narrative format and synthesized using the JBI meta-aggregation process. A ConQual Summary of Findings will be presentedinfo:eu-repo/semantics/publishedVersio

Cutaneous Manifestations in Four Patients with COVID-19

As the numbers of SARS-CoV-2 infections increased globally, reports of cutaneous manifestations started to emerge. We describe several patients with COVID-19 who presented with skin changes. We noted such manifestations in four out of 110 patients (3.63%) and describe the clinical situation of each of these patients. Each patient had either a maculopapular or a urticariform rash. These manifestations have a broad differential diagnosis and it was difficult to exclude drug reactions. We hope to raise awareness of this possible manifestation of COVID-19 in order to raise suspicion of this diagnosis among clinicians when they encounter patients with fever and rash. Larger series that also include patients with mild disease and skin biopsies may be useful