Interrupção voluntária da gravidez, satisfação conjugal e apoio social : que impacto?

Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde - Núcleo de Psicologia Clínica Dinâmica), Universidade de Lisboa, Faculdade de Psicologia, 2010A recente implementação legal da liberalização da prática da interrupção voluntária da gravidez em Portugal, trouxe consigo inúmeras questões e ambiguidades, que continuam a ser debatidas em vários âmbitos. O objectivo essencial deste estudo foi encetar caminho no universo psicológico das mulheres que realizam a IVG, pelas actuais preocupações com a sua adaptação psicológica. Não é ainda clara a razão para os diferentes níveis de estabilidade emocional nestas mulheres. Parecem também ser alvo de preocupação, as potenciais consequências psicossociais deste procedimento para as mulheres e casais. Tendo a literatura realçado o importante papel das relações interpessoais no bem-estar e saúde mental, procurou averiguar-se uma possível relação de protecção entre a satisfação conjugal e o apoio social percebido, para com os níveis de adaptação psicológica, mais precisamente com o desenvolvimento de estados emocionais de stress, ansiedade e depressão, no momento em que estas mulheres recorrem ao serviço para interromper a gravidez. Os dados obtidos permitem concluir que a satisfação conjugal e a percepção de apoio social podem ter um papel protector e de alguma forma preditor de estados emocionais negativos, como o stress, a ansiedade e a depressão, nas mulheres que vão realizar uma IVG. Outros elementos adicionais são discutidos.The recent law regarding the liberalization of induced abortion in Portugal has brought along several questions and complexities, which continue to be debated in various matters. The main goal of this study was to enter the psychological universe of women who decide to make an abortion, due to the actual concerns about their psychological adjustment. It is still not clear the reason why emotional stability can be so diverse in these women. It also appears to be a reason of concern, the psychological and social consequences that can occur due to this procedure, for both women and couples. Because research has enhanced the major role of interpersonal relationships in the well-being and mental health, we have searched for a possible relation of protection between romantic relationship satisfaction and perceived social support, and the development of emotional states of stress, anxiety and depression, by the time these women go to health services to end their pregnancy. Results indicate that both romantic relationship satisfaction and perceived social support can have a protective and predictive role regarding negative emotional states, such as stress, anxiety and depression, in women who are going to have an induced abortion. Further additional elements are discussed

A problemática dos credores controladores

No contexto da Corporate Governance das Sociedades Anónimas é tradicionalmente relevante abordar a figura do acionista e a do administrador enquanto influenciadores ou atores da gestão e controlo societário. No entanto, certas fontes legitimam o intervencionismo do credor e são suceptíveis de explorar a vulnerabilidade destas empresas. Propomo-nos a fazer a análise destes mecanismos e discutir a suscetibilidade de responsabilização por uma atuação abusiva do credor e em que termos, por meio das soluções doutrinárias existentes e princípios orientadores do Direito das Sociedades Comerciais Português.In the context of the Corporate Governance of Public limited companies, it is traditionally relevant to approach the shareholder and the administrator as influencers or actors in management and corporate control. However, certain sources legitimize the creditor's intervention and are likely to exploit the vulnerability of these companies. We propose to analyze these mechanisms and to discuss the susceptibility of liability for an abusive performance by the creditor and under what terms, through existing doctrinal solutions and guiding principles of Portuguese Corporate Law

Record linkage of population-based cohort data from minors with national register data : A scoping review and comparative legal analysis of four European countries

Funding Information: We would like to acknowledge Evert-Ben van Veen from the MLC Foundation, Dagelijkse Groenmarkt 2, 2513 AL Den Haag, the Netherlands. The results on the country-specific text on the Netherlands was based on his contribution. Publisher Copyright: © 2021 Doetsch JN et al.Background: The GDPR was implemented to build an overarching framework for personal data protection across the EU/EEA. Linkage of data directly collected from cohort participants, potentially serving as a prominent tool for health research, must respect data protection rules and privacy rights. Our objective was to investigate law possibilities of linking cohort data of minors with routinely collected education and health data comparing EU/EEA member states. Methods: A legal comparative analysis and scoping review was conducted of openly accessible published laws and regulations in EUR-Lex and national law databases on GDPR's implementation in Portugal, Finland, Norway, and the Netherlands and its connected national regulations purposing record linkage for health research that have been implemented up until April 30, 2021. Results: The GDPR does not ensure total uniformity in data protection legislation across member states offering flexibility for national legislation. Exceptions to process personal data, e.g., public interest and scientific research, must be laid down in EU/EEA or national law. Differences in national interpretation caused obstacles in cross-national research and record linkage: Portugal requires written consent and ethical approval; Finland allows linkage mostly without consent through the national Social and Health Data Permit Authority; Norway when based on regional ethics committee's approval and adequate information technology safeguarding confidentiality; the Netherlands mainly bases linkage on the opt-out system and Data Protection Impact Assessment. Conclusions: Though the GDPR is the most important legal framework, national legislation execution matters most when linking cohort data with routinely collected health and education data. As national interpretation varies, legal intervention balancing individual right to informational self-determination and public good is gravely needed for health research. More harmonization across EU/EEA could be helpful but should not be detrimental in those member states which already opened a leeway for registries and research for the public good without explicit consent.Peer reviewe

Biliary Peritonitis in a Dog after Perforation of the Gallbladder during Laparoscopic Cholecystectomy

Background: Iatrogenic gallbladder perforation during laparoscopic cholecystectomy (LC) is a common complication and occurs in at least one third of human patients undergoing LC. This is attributed to the fragility of the gallbladder wall associated with mucocele and cholecystitis, in addition to the need for repetitive gripping and traction of the gallbladder during its manipulation with laparoscopic instruments. As complications from this event are rare in human patients, conversion to laparotomy is not routinely indicated and the adverse consequences of bile spillage are minimized by abundant irrigation of the peritoneal cavity and adequate antimicrobial therapy. On the other hand, there is little information regarding the outcome of laparoscopic management of this complication in laparoscopic cholecystectomies in dogs, particularly since most surgeons indicate conversion in these cases. Thus, we describe a case of biliary peritonitis that developed in a dog after laparoscopic management of iatrogenic perforation of the gallbladder during a laparoscopic cholecystectomy, in a case of gallbladder mucocele. To the best of our knowledge, there are no reports of biliary peritonitis following laparoscopic management of iatrogenic gallbladder perforation during LC in dogs. Case: A 14-year-old Poodle was referred for clinical evaluation with selective appetite, recurrent episodes of hyporexia, and abdominal discomfort. Ultrasound findings characterized chronic liver disease and gallbladder mucocele. The patient was referred for laparoscopic cholecystectomy, during which the gallbladder was iatrogenically perforated, with extravasation of a large volume of bile content. This complication was managed by copious abdominal irrigation via laparoscopic access and antimicrobial therapy. On the second postoperative day, the patient started to present apathy, hyporexia, emesis, and jaundice. The patient remained hospitalized in the intensive care unit for stabilization and monitoring through hematological examinations and serial abdominal ultrasound. Due to progressive worsening of the clinical picture, an exploratory laparotomy was performed ten days after the initial surgical procedure. This examination showed multiple adhesions and the presence of bile residues adhered to numerous points on the peritoneal surface. Despite the intensive treatment instituted, death occurred 10 h after the second surgical procedure. Discussion: The high risk of gallbladder perforation during laparoscopic cholecystectomies correlates with the dissection step or repetitive grasping and traction of the gallbladder with laparoscopic instruments. Conversion is not routinely indicated and laparoscopic management is considered effective in humans. However, in this case, the presence of a large volume of extravasated semisolid bile content and its adherence to the mesothelial surface made it impossible to remove it in its entirety despite the abundant irrigation of the abdominal cavity, resulting in a picture of biliary peritonitis in the postoperative period. In view of the reported negative outcome, the authors encourage the adoption of measures that minimize the risk of gallbladder perforation when performing LC in dogs. These include the use of atraumatic instruments or aspiration of bile content before surgical manipulation. Cases in which such a complication is recorded should be carefully monitored to enable early diagnosis and treatment of biliary peritonitis. Furthermore, conversion should be considered when there is extravasation of large volumes of bile, particularly in the presence of gallbladder mucocele, until future studies establish the safety and effectiveness of laparoscopic management of this complication. Keywords: gallbladder mucocele, minimally invasive surgery, laparoscopic cholecystectomy, dogs

A PRÁTICA DE UM PROGRAMA PREVENTIVO MELHORA A CAPACIDADE FUNCIONAL DE MEMBROS INFERIORES EM ATLETAS

O objetivo desse estudo foi analisar os efeitos de um programa preventivo sobre a capacidade funcional de membros inferiores em atletas jovens de handebol feminino. Este estudo experimental incluiu uma amostra por conveniência de 17 atletas com idade de 12 a 16 anos, integrantes de um time de handebol feminino amador. As jovens foram divididas em dois grupos, sendo, o grupo intervenção (GI), integrando as atletas que praticaram o programa preventivo associado ao treino regular do handebol (n=9), e o grupo controle (GC), cujas jovens praticaram apenas o treinamento esportivo na equipe (n=8). Foi aplicado um questionário inicial, mensurado os dados antropométricos e a capacidade funcional dos membros inferiores foi avaliada através do Single Leg Hop Test, Timed Hop Test e Side Hop Test. O programa consistiu de aproximadamente 20 minutos de exercícios de aquecimento, força, agilidade e pliometria e equilíbrio, antes do treino regular do esporte, duas vezes por semana, durante oito semanas, totalizando 16 sessões. O GI apresentou melhorias significativas pós-intervenção em todos os testes realizados (p<0,05), em ambos os membros inferiores, diferentes do GC, no qual os resultados foram mais limitados. Oito semanas de treinamento de um programa preventivo melhorou significativamente a capacidade funcional de jovens atletas de handebol feminino, indicando que este tipo de intervenção é capaz de modificar positivamente os fatores de risco para o desenvolvimento de lesões de membros inferiores destas atletas

Delirium diagnostic and screening instruments in the emergency department: An up-to-date systematic review

Background: Emergency care systems are at the core of modern healthcare and are the “point-of-entry/admission” into the hospital for many older/elderly patients. Among these, it is estimated that 15% to 30% will have delirium on admission and that over 50% will develop it during their stay. However, appropriate delirium diagnostic and screening still remains a critical area of need. The goal of this review is to update the field, exploring target areas in screening methods for delirium in the Emergency Department (ED), and/or acute care units, in the older population. Methods: A systematic review was conducted to search screening/diagnostic methods for delirium in the ED and/or acute care units within the ED. Results: Seven different scales were identified. Of the identified instruments, the Confusion Assessment Method (CAM) for the Intense Care Unit (CAM-ICU) was the most widely used. Of note, a brief two-step approach for delirium surveillance was defined with the Delirium Triage Screen (DTS) and the Brief Confusion Assessment Method (bCAM), and the diagnostic accuracy of the Richmond Agitation-Sedation Scale (RASS) for delirium had a good sensitivity and specificity in older patients. Conclusion: The CAM-ICU appears as the potential reference standard for use in the ED, but research in a global approach of evaluation of actual and past cognitive changes is still warranted.This work was funded by the European Commission (FP7): “SwitchBox” (Contract HEALTH-F2-2010-259772), and co-financed by the Portuguese North Regional Operational Program (ON.2—O Novo Norte), under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER), and by the Fundação Calouste Gulbenkian (Portugal) (Contract grant number: P-139977; project “Better mental health during ageing based on temporal prediction of individual brain ageing trajectories (TEMPO)”). TCC is a recipient of a doctoral fellowship from the Portuguese Foundation for Science and Technology (FCT, Portugal; SFRH/BD/90078/2012) and NCS of a Research Assistantship by FCT through the “FCT Investigator Programme (200 Ciência)”.info:eu-repo/semantics/publishedVersio

Application of antimicrobial packaging based on modified calcium carbonate and EOs for RTE meat products

Highly porous modified calcium carbonate (MCC) powder has been successfully integrated into packaging material as a coating and the coated packaging films were loaded with 5, 10 or 30 wt % thyme and rosemary essential oil (EO). Resulting MCC labels were applied as labels and showed antimicrobial activities against L. innocua in in vitro test. After 6 days MCC labels with 10 and 30 wt % thyme EO showed significant reductions in in vitro tests (2.9 and > 8.5 log CFU/filter). When MCC labels with rosemary EO were used, only 30 wt % loading showed a significant reduction (1.6 log CFU/filter). Subsequently, the antimicrobial activity of MCC labels with 30 wt % EOs against L. innocua on ready to eat meat product were studied under normal atmosphere and modified atmosphere (MA). Use of MCC labels with 30 wt % thyme EO loading combined with MA packaging showed a significant microbial reduction of 1.2 log CFU/g on cooked ham after 21 days (compared to untreated MCC labels packaged under MA). On the other hand, use of MCC labels loaded with 30 wt % rosemary EO (with MA) showed significant reductions of L. innocua on sliced cooked chicken breast (2.6 log CFU/g) as well as cooked ham (1.3 log CFU/g)

Barreiras impostas na relação entre puérperas e recém-nascidos no cenário da pandemia do COVID-19

A new vírus called Sars-CoV-2, or COVID-19, appeared attheend of 2019 and caused several changes world wide. In view of this, countries have established preventive measures against this pandemic, such as social isolation, use of personal protective equipment (PPE's) and care for individuals within the so-called risk groups, such as the elderly, hypertensive, chronically ill and recently, pregnant women and puerperal women were included. For puerperal women, breastfeeding is an essential moment, which, in addition to a moment of natural feeding, is na opportunity to strengthen the mother-baby bond. Aiming at a more cautious attention to a possible transmission of COVID-19 during breastfeeding, preventive measures for this act can hinder this binomial and bring harm to both.Um novo vírus denominado Sars-CoV-2, ou COVID-19, surgiu no final do ano de 2019 e causou diversas modificações em todo o mundo. Diante disso, os países estabeleceram medidas preventivas contra essa pandemia, tais quais o isolamento social, uso de equipamentos de proteção individual (EPI’s) e cuidado com indivíduos enquadrados nos chamados grupos de risco, como idosos, hipertensos, doentes crônicos e recentemente, as gestantes e puérperas foram inclusas. Para as puérperas, a amamentação é um momento primordial, que, além de um momento de alimentação natural, é uma oportunidade de fortalecer o vínculo mãe-bebê. Visando uma atenção mais cautelosa para uma possível transmissão de COVID-19 durante a amamentação, as medidas preventivas para esse ato podem dificultar esse binômio e trazer prejuízos para ambos