Health assistance in advanced disease: resource and responses of health professionals

Hoy en día crece la ilusión o esperanza de que la muerte pueda ser controlada, postergada o incluso vencida. Es por eso que estas ideas se vinculan frecuentemente a los profesionales de la salud. El objetivo de este trabajo es entender cómo estos profesionales experimentan el cuidado al paciente en estado de enfermedad avanzada o terminal, así como conocer los recursos personales utilizados para este propósito. El estudio se realizó con la colaboración de profesionales de la salud que trabajan en Unidades de Cuidados Continuados de la región de Tras-os-Montes y Alto Douro (Portugal), siendo un total de 147 personas. Se utilizó una encuesta de caracterización sociodemográfica y profesional, así como el Inventario de Respuestas y Recursos Personales (BPS/IRRP, Copyright, de Evaluación Automatizada, traducido y validado para la población portuguesa por McIntyre y Silvério, 1995). Algunas de las conclusiones a las que se llegó es que los profesionales de la salud que atienden a pacientes con enfermedades terminales requieren de u mayor apoyo. Y, aunque muchos recurren a la espiritualidad, la formación académica y profesional es una variable estadísticamente significativa en la preparación y ayuda de estos profesionales

Recursos e respostas pessoais dos diferentes profissionais de saúde dos cuidados continuados para lidarem com a morte

A evolução da ciência e das tecnologias fez o Homem acreditar que podia controlar todos os fenómenos, acreditando que podia ser imortal. “ A morte sempre foi o mais visível porto do périplo humano. Só que nos nossos dias cresce a ilusão ou a esperança de que ela possa ser controlada, adiada...ou vencida.”( Oliveira,2008,p.73 ). Esta forma de pensar está muito vincada nos profissionais de saúde, pois estes foram instruídos para lutarem pela vida a todo o custo, sendo a morte vista como um fracasso a nível profissional. Compreender como os profissionais de saúde vivenciam o processo de doença terminal e morte, bem como, conhecer que recursos pessoais são adotados para lidar com situações de fim de vida. Este estudo foi constituído por uma população de 293 profissionais de saúde que exercem a sua actividade laboral nas unidades de cuidados continuados da região de Trás-os-Montes e Alto Douro. O instrumento de recolha de dados utilizado foi o questionário constituído pelo Inventário de Recursos e Respostas Pessoais (BPS/IRRP) e por questões para caracterização sociodemográfica e profissional da população. Resultados: Analisando as escalas de recursos de coping a confiança no coping (78,9%) e os recursos espirituais/existenciais (75,5%) são as dimensões com os maiores scores, ao contrário do que se verifica na dimensão suporte social (32,7%).Existem diferenças estatisticamente significativas na ansiedade, na confiança no coping e no índice crítico agudo e crónico. Os inquiridos com licenciatura apresentam um score significativamente maior na ansiedade e no índice crítico agudo e crónico. Por outro lado os inquiridos com mestrado perfilam-se com um score de confiança no coping significativamente maior. Conclusões: O BPS/ IRRP é um instrumento fiável para avaliar as respostas pessoais da população em estudo. Neste estudo verificamos que os profissionais de saúde dos cuidados continuados da região de Trás-os-Montes e Alto Douro têm pouco apoio a nível social para lidarem com a morte, refugiando-se na espiritualidade. Desta forma seria bom criar espaços para debater e falar nas dificuldades sentidas perante a morte

A systematic review protocol: Examining the evidence of whole body vibration produced by mining equipment

Whole body vibration (WBV) is an emerging issue for the mining industry, occuring from the exposure due to many mining operations. This systematic review protocol intends to give answer to the question "what mining equipment contributes the most to occupational whole body vibration and under what conditions?". For that, the main engineering and health databases were selected (i.e Scopus, Science Direct and PubMed) and a set of keywords was defined to latter combination. The selection process of the papers was also described in an attempt to contribute to the general research on this field. All of the data treatment is detailed, including the risk of bias and attempts to deal with it.*x0D; The protocol for the systematic review is registered in PROSPERO under the code CRD42018087629.*x0D;  </jats:p

Prevalence of Heart Disease Risk Factors in the Azores

Abstract(157) de Comunicação em Painel apresentada em "81st European Atherosclerosis Society (AES) Congress", 2013, 2-5 Jun, Lyon, France.BACKGROUND and AIMS: In the Azores age adjusted death rates from coronary heart disease (CHD) are two-fold higher than in mainland Portugal. We determined the prevalence of standard and emerging CHD risk factors in 206 female and 146 male Azorean subjects (mean age 41 years)

Portuguese local government relative efficiency: a dea approach

It is widely accepted that performance measurement in the Public Sector is a difficult task, either in terms of efficiency or in terms of effectiveness. The most important reason for this relates to the lack of objective measures, given the market-aside operation of governmental activities. Therefore traditional methods of performance measurement, such as those based on the operating statement and the net income, tend fail. It is typical that public bodies’ outputs are multiple and qualitative and consequently do not have the physical characteristic of being countable or divisible. Portuguese Local Government has, in the last decade, undergone considerable management changes under the flag of efficiency improvement, namely additional competencies, supplementary and more diverse financial resources and a new accounting system. In this context, this paper assesses the efficiency of Portuguese Continental municipalities, using year 2004 data and following a data envelopment analysis (DEA) methodology in order to provide a relative efficiency indicator. The analysis compares the ratio between resources as inputs (“undertaken commitments”) and the activities accomplished as outputs, considering the functional classification used in municipalities’ accounting and financial system. This research adds to the knowledge of local authorities’ performance the possibility of establishing a functioning ranking, nowadays increasingly important in what concerns financing issues. The preliminary results show that larger municipalities tend to be more efficient.Fundação para a Ciência e a Tecnologia (FCT

Tsunami vulnerability assessment of Casablanca-Morocco using numerical modelling and GIS tools

Earthquakes and tsunamis along Morocco's coasts have been reported since historical times. The threat posed by tsunamis must be included in coastal risk studies. This study focuses on the tsunami impact and vulnerability assessment of the Casablanca harbour and surrounding area using a combination of tsunami inundation numerical modelling, field survey data and geographic information system. The tsunami scenario used here is compatible with the 1755 Lisbon event that we considered to be the worst case tsunami scenario. Hydrodynamic modelling was performed with an adapted version of the Cornell Multigrid Coupled Tsunami Model from Cornell University. The simulation covers the eastern domain of the Azores-Gibraltar fracture zone corresponding to the largest tsunamigenic area in the North Atlantic. The proposed vulnerability model attempts to provide an insight into the tsunami vulnerability of building stock. Results in the form of a vulnerability map will be useful for decision makers and local authorities in preventing the community resiliency for tsunami hazards

O ócio nas culturas contemporâneas: teorias e novas perspectivas em investigação

O foco desta publicação — que acolhe diversos estudos e assume uma perspectiva transdisciplinar — é o de apresentar uma reflexão sobre o ócio, os tempos livres e o lazer nas culturas contemporâneas. Atravessados por um tema que demanda refletir sobre os mecanismos da vida social, caracterizar as grandes categorias e dinâmicas das sociedades modernas tardias e interrogar sobre o sentido de um quotidiano diluído nas correrias do consumo e do trabalho, os artigos que compõem a presente obra propõem pontos de vista teoricamente inovadores, convidam a repensar o mundo em que vivemos e proporcionam uma meditação sobre o significado das nossas práticas, cada vez mais afastadas de um pensamento integral e não instrumental.publishe

Health status perception and airflow obstruction in five Latin American cities: the PLATINO study

Background: COPD is a highly prevalent disease but underdiagnosed, undertreated and possibly under-recognized by patients. Limited information exists regarding patients' perception of COPD severity. We compared patients' general, health status perception, degree of breathlessness and physical activity limitation with the severity of their respiratory condition measured by airway obstruction, in a population-based sample.Methods: We used postbronchodilator FEV(1)/FVC < 0.70 to define COPD. Patients' perception of their general. health status was derived from the question in general, you would say that your health is: excellent, very good, good, fair or poor?Results: Spirometry was performed in 5314 subjects: an FEV(1)/FVC ratio below 0.70 was found in 759 subjects. in persons with COPD, general. health status decreased with increasing GOLD stages. Over one-half of subjects with stage 2 and one third of those with stages 3 and 4 reported their health status as good to excellent. There was also a disparity between airway obstruction severity and breathlessness intensity. Although the more severe COPD stages were frequently associated with significant compromise of work and everyday activities, patients often tended to provide an optimistic self evaluation of their health status.Conclusions: the discrepancy observed between general health status, dyspnea severity, physical activity limitation and airway obstruction most likely reflect patients' underperception of disease severity, emphasizing the need for improving case-finding measures and multi-component evaluation of COPD subjects. (C) 2009 Elsevier B.V. All rights reserved.Boehringer Ingelheim GmbHCent Univ Venezuela, Hosp Univ Caracas, Serv Neumonol, Caracas 1030, VenezuelaUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90066 USAInst Resp Dis, Mexico City 14080, DF, MexicoUniv Republica, Hosp Maciel, Montevideo, UruguayUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilPontificia Univ Catolica Chile, Dept Salud Publ, Santiago, ChilePontificia Univ Catolica Chile, Catedra Neumol, Santiago, ChileUniv Fed Pelotas, Fac Med, BR-96030002 Pelotas, RS, BrazilUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilWeb of Scienc

Chronic obstructive pulmonary disease and body mass index in five Latin America cities: the PLATINO study

Background: the body mass index (BMI) is a prognostic factor for chronic obstructive pulmonary disease (COPD). Despite its importance, little information is available regarding BMI alteration in COPD from a population-based study. We examined characteristics by BMI categories in the total and COPD populations in five Latin-American cities, and explored the factors influencing BMI in COPD.Methods: COPD was defined as a postbronchodilator forced expiratory volume in the first second/forced vital capacity (FEV(1)/FVC)= 30.0 kg/m(2)).Results: Interviews were completed in 5571 subjects from 6711 eligible individuals, and spirometry was performed in 5314 subjects. There were 759 subjects with COPD and 4555 without COPD. Compared with the non-COPD group, there was a higher proportion of COPD subjects in the underweight and normal weight categories, and a lower proportion in the obese category. Over one-half COPD subjects had BMI over 25 kg/m(2). No differences in BMI strata among countries were found in COPD subjects. Factors associated with lower BMI in mates with COPD were aging, current smoking, and global initiative for chronic obstructive lung disease (GOLD) stages III - IV, whereas wheeze and residing in Santiago and Montevideo were associated with higher BMI. in females with COPD, current smoking, lower education, and GOLD stages II - IV were associated with lower BMI, while dyspnea and wheeze were associated with higher BMI.Conclusions: BMI alterations are common in COPD with no significant differences among countries. Current smoking, age, GOLD stages, education level, residing in Santiago and Montevideo, dyspnea and wheeze were independently associated with BMI in COPD. (c) 2008 Elsevier B.V. All rights reserved.Cent Univ Venezuela, Fac Med, Hosp Univ Caracas, Serv Neumonol, Caracas 1030, VenezuelaInst Resp Dis, Mexico City 14080, DF, MexicoUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilUniv Republica, Hosp Maciel, Fac Med, Montevideo 2610, UruguayPontificia Univ Catolica Chile, Fac Med, Dept Salud Publ, Santiago, ChileUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90066 USAUniv Fed Pelotas Duque Caxias, Fac Med, Pelotas, RS, BrazilUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilWeb of Scienc