Intervenções de enfermagem de reabilitação na mulher com disfunção do pavimento pélvico

O presente Relatório de Estágio surge na conclusão do Mestrado em Enfermagem na Área de Especialização em Enfermagem de Reabilitação, demonstrando o percurso formativo realizado. Este documento tem como objetivos demonstrar o desenvolvimento de competências na prestação de cuidados de enfermagem de reabilitação à mulher com disfunção do pavimento pélvico, evidenciar o percurso de desenvolvimento de competências no âmbito da enfermagem especializada em reabilitação e demonstrar o desenvolvimento de competências conducentes ao Grau de Mestre. Como tema central do Relatório de Estágio desenvolveu-se a “Intervenção do Enfermeiro Especialista em Enfermagem de Reabilitação na Mulher com Disfunção do Pavimento Pélvico”. Esta é uma problemática que afeta mulheres de todas as idades, com consequências físicas, psicológicas, sexuais, sociais e financeiras. Foi realizada uma revisão narrativa da literatura tendo como questão de investigação quais as intervenções de enfermagem de reabilitação implementadas na mulher com disfunção do pavimento pélvico. Observa-se que o Enfermeiro de Reabilitação encontra neste âmbito uma oportunidade de intervenção, através de um leque de intervenções identificadas na literatura. O referencional teórico norteador deste percurso foi o Modelo de Enfermagem de Roper-Logan-Tierney, pois oferece uma terminologia e fundamentos alinhados com as Competências e Padrões de Qualidade dos cuidados especializados. A construção do documento obedece a uma metodologia descritiva das atividades desenvolvidas nos contextos de estágio, ligada à reflexão acerca da importância das mesmas para consecussão dos objetivos propostos e desenvolvimento das competências preconizadas para este percurso formativo, nomeadamente as Competências Comuns do Enfermeiro Especialista, as Competências Específicas do Enfermeiro Especialista em Enfermagem de Reabilitação e as competências conducentes à obtenção do Grau de Mestre.The present Internship Report comes at the conclusion of the Master's in Nursing in the Area of Specialization in Rehabilitation Nursing, exhibiting the training path carried out. This document aims to demonstrate the development of skills in the provision of rehabilitation nursing care to women with pelvic floor dysfunction, highlight the course of skills development within the scope of specialized rehabilitation nursing and demonstrate the development of skills leading to obtaining the Master’s Degree. As the central theme of the Internship Report, the “Rehabilitation Nursing Interventions in the Woman with Pelvic Floor Dysfunction” was developed. This is a problematic that affects women of all ages, with physical, psychological, sexual, social and financial consequences. A narrative review of the literature was carried out, having as a research question which rehabilitation nursing interventions were implemented in the woman with pelvic floor dysfunction. In this scope, it is observed that the Rehabilitation Nurse finds an opportunity for intervention, through a range of interventions identified in the literature. The theoretical framework guiding this path was the Roper-Logan-Tierney Model of Nursing, as it offers the terminology and foundations in line with the Competencies and Quality Standards of specialized care. The construction of the document follows a descriptive methodology of the activities carried out in the internship environment, linked to the reflection on their importance for the achievement of the proposed objectives and development of the recommended skills for this training path, namely the Common Skills of the Specialist Nurse, the Specific Skills of the Nurse Specialist in Rehabilitation Nursing and the competences leading to obtaining a Master's Degree

o cuidado promotor de uma transição segura para a comunidade

Os enfermeiros passam grande parte do tempo a prestar cuidados a pessoas que experienciam uma ou várias transições, que afetam a sua saúde e a sua qualidade de vida. Assim sendo, torna-se essencial desenvolver intervenções, que confiram o suporte e o apoio necessário a uma transição segura (Meleis & Trangenstein, 2010; Meleis, 2010a), promovendo a qualidade de vida, a saúde e o bem-estar. A criança em idade escolar com Diabetes Mellitus tipo 1 (DM1) e a sua família, vivenciam vários processos de transição, influenciados pelos vários contextos onde a criança se insere, interferindo com o seu processo de desenvolvimento, de adaptação, adesão terapêutica e controlo metabólico da DM1. Esses contextos podem nem sempre possuir as condições favoráveis a uma transição segura. O regresso à comunidade, depois do diagnóstico de DM1, é considerado na literatura como um ponto crítico na transição, pelo que a articulação de cuidados entre níveis setoriais, a promoção da continuidade de cuidados e da transição segura, o suporte à família e a capacitação para a adequada gestão terapêutica da DM1, são focos de intervenção a repensar e promover no exercício profissional de enfermagem. Esta questão da articulação e suporte na comunidade, tem sido uma inquietação pessoal e profissional, à qual procuro dar resposta. Este relatório foi construído tendo por base um projeto formativo, elaborado sob a metodologia de projeto, numa ótica de resposta à problemática identificada no contexto de trabalho. Para dar resposta a esse projeto e no sentido de se mobilizarem e desenvolverem competências comuns de Enfermeiro Especialista e específicas de Enfermeiro Especialista de Enfermagem de Saúde Infantil e Pediátrica, foi utilizada uma metodologia construtivista, baseada na reflexão e na análise crítica da prática, com o confronto da evidência científica, experienciada nos vários contextos de estágios que contribuíram para este percurso. Foi desenvolvida uma proposta para um programa promotor da transição segura da criança em idade escolar com DM1 para a comunidade. O objetivo é a qualidade dos cuidados, a excelência profissional e futuramente a sua expansão para todas as crianças com doenças crónicas e com necessidade de cuidados especiais.Nurses spend much of their time caring for people who experience one or several transitions that affect their health and quality of life. Therefore is important to develop interventions that provide the necessary support for a safe transition (Meleis & Trangenstein, 2010; Meleis, 2010a), promoting quality of life, health, and well-being. School-age children with Type 1 Diabetes Mellitus (DM1) and their families experience several transition processes, influenced by the various contexts where the child is inserted, interfering with their development process, adaptation, therapeutic adherence, and metabolic control of DM1, which may not always have favorable conditions for a safe transition. The return to the community after the diagnosis of DM1 is considered, in literature, to be a critical point in the transition, thus the articulation of care between sectoral levels, which promotes continuity of care and safe transition, family support, and the empowerment for an adequate therapeutic management of DM1, are intervention priorities to be rethought and promoted in the nursing professional practice. This issue of articulation and support in the community has been a personal and professional concern, to which I try to provide answers. This report was built based on a formative project, developed under the project methodology, with a view to responding to the problem identified in the work context. To respond to this project and in order to mobilize and develop the common competencies of Specialist Nurses and the specific competencies of Specialist Child Health and Paediatric Nursing, a constructivist methodology was used, based on reflection and critical analysis of practice, with the confrontation of scientific evidence, experienced in the various internship contexts that contributed to this journey. A proposal for a program to promote the safe transition of school-age children with DM1 into the community was developed. The goal is quality care, professional excellence, and future expansion to all children with chronic diseases and in need of special care

Pons Calcifications and Striatal Necrosis in ADAR1 Aicardi‐Goutières Syndrome

info:eu-repo/semantics/publishedVersio

The Agrostion castellanae Rivas Goday 1957 corr. Rivas Goday & Rivas- Martínez 1963 alliance in the southwestern Iberian Peninsula

The water courses of southern Portugal are ecosystems subject to constant fluctuations between periods of flooding and desiccation associated with seasonal dryness. In these unstable ecological conditions, a considerable diversity of riparian plant communities occurs. The objective of this study, carried out in the Monchique Sierran and Andévalo Districts, is to compare the perennial grasslands community dominated by Festuca ampla Hack, using a phytosociological approach (Braun-Blanquet methodology) and numerical analysis (hierarchical cluster analysis and ordination). From these results, a new hygrophilous community of perennial grasslands type was identified, Narcisso jonquillae-Festucetum amplae, as a result of the floristic, ecological and biogeographical differences from other associations already described within the Agrostion castellanae alliance, in the southwestern Iberian Peninsula. The association occurs in the thermomediterranean to mesomediterranean belts under dry to sub-humid ombrotypes, on siliceous soils that have temporary waterlogging. This new association corresponds with priority 6220 Habitat - Pseudo-steppe with grasses and annuals of the Thero-Brachypodietea, under the Natura 2000 code

Best management practices to face degradated territories occupied by Cistus ladanifer shrublands – Portugal case study

Land degradation in Mediterranean Basin is clearly connected to the resilience of perturbed ecosystems, contributing to land abandonment, recurrent fires and biodiversity loss, with the prevalence of secondary shrublands that tend to occupy large areas. This is the case of Cistus ladanifer .shrublands, one of the most widespread shrub communities in Iberian Peninsula and a poor, uniform and resilient system. Here we analyze the impact of several management practices in the recovery of territories largely occupied by this shrublands. We tested “nonintervention”, “cut”, “fire”, “mechanical mobilization” and “pasture” in 100 m2 plots of Cistus ladaniferus L., in Central Portugal, being followed since 1993. Flora was analyzed using Braun–Blanquet’s methodology and the plots compared with hierarchical cluster analysis and PCA. An ANOVA analysis was also performed to investigate differences in management practices, between plots and between two periods of time. The results show that extensive grazing or continuous cut have a high impact on plant diversity and community structure, been extensive grazing, the best way to improve plant diversity in a short period of time, using less resource

Geobotanical aspects of Cytisus oromediterraneus and Genista cinerascens Serra da Estrela (Portugal) in

In this paper we present the results of a geobotanical study carried out on the communities of Cytisus oromediterraneus and Genista cinerascens in Serra da Estrela, two species that in the Central Iberian Peninsula lead the associations Cytiso oromediterranei-Genistetum cinerascentis and Pteridio aquilini-Cytisetum oromediterranei. The prime objective was to describe their geographical and main ecological features, floristic structure and composition, as well as local dynamics. The sampling analyses were carried out using Braun–Blanquet’s methodology, and respective outco- mes were studied using the phytosociological methodology, combined with a statistic analysis performed through the Vegana package. The results indicate that the Portuguese community of Cytisus oromediterraneus and Genista cinerascens represents a new association, that we called Teucrio salviastri-Cytisetum oromediterranei. This is an association endemic from the Estrelensean territories, siliceous, hyperhumid to ultrahyperhumid, present in supra-orotemperate territories with evident Mediterranean influence

Sintaxonomic concerns on Genista polyanthos R. Roem. ex Willk. broomlands

As result of several field trips following PhD researches in Marianic-Monchiquensean Sector, we describe a new broomland association named Genistetum triachanthi-polyanthi as a thermomediterranean, oceanic and sub-humid to humid, schistose association. The 26 relevés analysis, combining phytosociologic methodology with hierarchical cluster analysis (Ward's Hierarchical Clustering, based on Bray-Curtis distance) allowed the segregation of this Monchiquense association. Appearing as a regressive stage, or fringe, of secondary or edaphoxerophilous cork oak and, punctually, holm oak woodlands, it reveals a high sinecological value, in a wide variety of edaphoclimatic typologies, despite its poorest species number, since it includes restrict distribution taxa with high conservational value. At last, sintaxonomic issues are highlighted as these hyperxerophilous broomlands detach themselves easily from main Cytisetea scopario-striati diagnosis, being intermixed in contrasting ecological diagnosis, with major frequency of Calluno vulgaris-Ulicetea minoris elements, under extremely different edaphoclimatic envelopes, different landscapes and serial dynamics