Deficiência de Vitamina B12 no pós-operatório de Cirurgia Bariátrica

A obesidade é uma doença crônica caracterizada por excesso de gordura corporal que se tornou a doença nutrológica mais comum em países desenvolvidos e em nosso meio. Com isso é crescente o número de pacientes submetidos à cirurgia bariátrica. No pós-operatório podem ocorrer deficiências de determinados micronutrientes, sendo um deles a deficiência de vitamina B12. Adeficiência de vitamina B12 pode levar a anemia grave e contribuir silenciosamente para problemas cardíacos, e neurológicos, desde os de ordem sensoriais até distúrbios psiquiátricos e da aprendizagem. Assim, as deficiências nutricionais servem para nos alertar sobre a importância da vigilância nutricional após a cirurgia bariátrica

Currículo y evaluación: las pruebas estandarizadas

O trabalho realiza um estudo comparado entre o ensino secundário em Portugal e o ensino médio no Brasil. Com metodologia qualitativa e o recurso à análise documental, objetiva-se analisar a relação entre currículo e avaliação, para compreender como os testes estandardizados têm conformado o currículo. Nos resultados averiguamos se os exames nacionais, organizados na base de lógicas de estandardização e uniformização e cuja regulação obedece a uma agenda globalizada, contribuem para estreitar o currículo nacional do ensino secundário/médio, confinando-o a uma lista de conteúdos e competências.The paper makes a comparative study between secondary school in Portugal and high school in Brazil. With a qualitative methodology and the use of document analysis, it is aimed to analyze the relationship between curriculum and assessment to understand how standardized tests have conformed the curriculum. In the results it was examined whether the national tests, organized in logical base of standardization and uniformity and whose regulation follows a global agenda contribute to strengthening the national curriculum of secondary/ high school, restricting it to a list of content and skills.El trabajo hace un estudio comparativo entre la educación secundaria en Portugal y la escuela media en Brasil. La metodología cualitativa y el uso de análisis de documentos, con el fin de analizar la relación entre el currículo y evaluación para entender cómo las pruebas estandarizadas han dado forma al plan de estudios. Los resultados se examinaron si las pruebas nacionales, organizados en base lógica de la estandarización y la uniformidad y cuyo sigue una agenda global regulación contribuir a restringir el currículo nacional de la escuela secundaria / alta, confinarlo a una lista de contenidos y competencias.info:eu-repo/semantics/publishedVersio

Trauma sensitive framework for organizations assessment: development and validity of a scale

Background. Trauma-sensitive approaches are usually based on general knowledge of the negative effects of traumatic stress, particularly in high risk contexts or where the impact is higher. However, we still need a robust and complete framework for organizational assessment.Objective. This presentation aims to present an instrument and framework for organizational trauma sensitive care assessment and promotion, with four transversal dimensions, adjustable to multiple contexts.Method. Based on a four dimensions model: training, policies and practices, physical environment and supervision, this team developed a scale firstly applied to residential care and schools. This approach provided a consolidated version composed of 42 Likert items adjusted to most contexts and adaptable to include extra items saturating context-specific topics. This scale was applied to 130 workers from the welfare system in Portugal.Results. Results for mean overall results are 136,3 (SD=30,0) internal consistency provides a Cronbach alpha of 0,96 for the whole scale, ranging from 0,87 to 0,97. The exploratory factor analysis has almost perfect fit with the expected structure, except for the training factor where some items saturated on policies and practices factor. The overall structure explains 58,7% of variance.Conclusions. There is good evidence of both reliability and validity of the scale. This scale will be useful for deep diagnosis of organizations’ needs and to evaluate effects of trauma-sensitive programs and for organizations' trauma sensitive care certification. Another advantage is its adaptability for several contexts like the ongoing efforts in refugees support organizations or health related hospital services.info:eu-repo/semantics/publishedVersio

Inference in credal networks: branch-and-bound methods and the A/R+ algorithm

AbstractA credal network is a graphical representation for a set of joint probability distributions. In this paper we discuss algorithms for exact and approximate inferences in credal networks. We propose a branch-and-bound framework for inference, and focus on inferences for polytree-shaped networks. We also propose a new algorithm, A/R+, for outer approximations in polytree-shaped credal networks

Metropolitan Morphology and Discontinuities

The main purpose of this research consists in the development and validation, through the application to a case study, of new methods for the definition of territorial discontinuities and morphologies, using the most recent scientific and technological developments that have been made in the fields of remote sensing, geographical information systems and statistics in general. These methods should allow the development of applications for environmental planning and land management. Due to its large dynamics and constant mutation, the Lisbon Metropolitan Area (AML) was chosen as a case study. This research is being conducted in the Geography and Regional Planning Department of the New University of Lisbon (DGPR/UNL) in a close direct relationship with the AML.info:eu-repo/semantics/publishedVersio

Trauma-sensitive residential care: perspectives of Portuguese professionals to spark change

Despite global pressure for deinstitutionalization of children in care, and recent legislative changes, Portugal remains a country with very high prevalence of residential care amongst at-risk children. These children were exposed to multiple traumatic events that can disrupt development. Thus, the expansion toward a truly sensitive approach to trauma is valuable, as it aims to increase awareness of its effects and ensure the best empathic care, providing a safe and healthy environment, with consequences also for the wellbeing of residential care staff. The present study aims to characterize the quality of residential care environments in Portugal through the lens of trauma-sensitive care, and to map professionals understanding of main domains, priorities and obstacles to change in this area. The study adopts a mixed method design, reporting on the perceptions of 85 professionals. Main findings show that professionals demonstrate better perceptions regarding physical environment but consider training and supervision as fragile dimensions. Qualitative data bring detail to these views, reinforcing the call for training to all staff and for continuous support to demanding job roles. This exploratory study highlights major aspects that urge to ensure trauma-sensitive residential care – supportive of professionals, to meet the needs of children and youth.info:eu-repo/semantics/acceptedVersio

Enfermagem de reabilitação e a pessoa com fibrose quística no domicilio

Dissertação de Mestrado em Enfermagem de Reabilitação apresentada na Escola Superior de Saúde do Instituto Politécnico de Viana do CasteloA fibrose quística (FQ) é uma doença monogenética multissistémica, hereditária, com padrão autossómico recessivo, grave e potencialmente fatal. O espectro de apresentações clínicas é muito variado, mas com particular incidência ao nível dos sistemas respiratório, gastrointestinal e reprodutor. O tratamento da fibrose quística visa a preservação da função pulmonar, otimização do estado nutricional, minimização das complicações e manutenção do bem-estar psicossocial. Este estudo teve como principal objetivo compreender os benefícios decorrentes de cuidados especializados de enfermagem de reabilitação, no domicílio, à pessoa com fibrose quística e respetiva família. Tendo por base uma abordagem qualitativa, recorreu-se a uma entrevista semi-estruturada, tendo sido entrevistadas oito mães de crianças/ adolescentes com idade igual ou inferior a 17 anos com fibrose quística. O método utilizado para o tratamento de dados foi a análise de conteúdo, emergindo sete áreas temáticas, vinte e seis categorias e vinte e nove subcategorias. Os resultados apontam para a necessidade da importância do diagnóstico correto e atempado da doença, em simultâneo com o suporte de uma rede pós-hospitalar. O apoio técnico dos profissionais de saúde no domicílio foi considerado um importante pilar do tratamento, nomeadamente ao nível da Reabilitação Respiratória em complementariedade com a medicação. O papel do enfermeiro foi encarado como muito importante nos cuidados no domicílio, sendo que além das intervenções especializadas no âmbito da enfermagem de reabilitação, sobressai a articulação com os serviços de saúde, que foi considerada deficitária e presa a burocracias. Os resultados sugerem a necessidade de melhorar as condições dos doentes com fibrose quística em Portugal, bem como as suas famílias, nomeadamente ao nível da articulação dos serviços de saúde, apoio psicossocial e económico e disponibilização de mais recursos para intervenção no domicílio, tais como a enfermagem de reabilitação.Cystic fibrosis is a hereditary multisystem monogenetic disease with severe and potentially fatal recessive autosomal pattern. The spectrum of clinical presentations is very varied, but with particular focus on the respiratory, gastrointestinal and reproductive systems. The treatment of cystic fibrosis aims at preserving pulmonary function, optimizing nutritional status, minimizing complications and maintaining psychosocial well-being. The main objective of this study was to understand the benefits of specialized rehabilitation nursing care at home for people with cystic fibrosis and their families. Based on a qualitative approach, a semi-structured interview was used, and eight mothers of children / adolescents aged 17 years and under with cystic fibrosis were interviewed. The method used for data treatment was content analysis, emerging seven areas, twenty-six categories and twenty-nine subcategories. The results point to the need for the importance of the correct and timely diagnosis of the disease, simultaneously with the support of a post-hospital network. Technical support from home health professionals was considered an important pillar of treatment, namely at the level of respiratory kinesitherapy, in complementarity with medication. The role of the nurse was seen as very important in home care, and in addition to specialized interventions in the field of rehabilitation nursing, stands out the articulation with health services, which was considered deficient and tied to bureaucracies. The results suggest the need to improve the conditions of cystic fibrosis patients in Portugal, as well as their families, namely in terms of the articulation of health services, psychosocial and economic support and the availability of more resources for home intervention, such as rehabilitation nursing

NIETZSCHE E O SENTIDO HISTÓRICO: uma ruptura com o fundamento metafísico dos valores

A genealogia da moral pode ser lida como uma investigação da proveniência e a contínua transformação dos valores morais no vir a ser histórico. Nietzsche se recusa a buscar na metafísica o fundamento último dos valores morais. Para isso, o filósofo se mune do que ele denomina de “filosofia histórica”, com o propósito de questionar a origem dos valores e estabelecer um novo método investigativo, capaz de se opor ao pensamento metafísico vigente. O sentido histórico auxilia o procedimento genealógico, na medida em que solapa os fundamentos transcendentes dos valores e os colocam de volta no tempo e no espaço, ou seja, no lugar histórico natural onde os sentimentos morais nascem, modificam-se e desaparecem nas mais diversas culturas