Autocompaixão, Bem-estar Subjetivo e Estado de Saúde em Idosos

O crescente aumento da população envelhecida constitui um grande avanço na sociedade, mas também um grande desafio, impondo a necessidade de ações que visem promover um envelhecimento bem-sucedido com maior bem-estar subjetivo e melhor estado de saúde (Kanning & Schlicht, 2008; World Health Organization, 2002). O presente estudo apresenta os 3 seguintes objetivos: 1) analisar a autocompaixão, a satisfação com a vida, os afetos, o estado de saúde físico e mental na idade avançada e perceber a possível influência de variáveis sociodemográficas (idade, género, zona de residência (urbano vs. rural), estado civil, escolaridade, religião e tipologia de resposta social); 2) compreender de que forma é que a autocompaixão, a satisfação com a vida, os afetos, o estado de saúde físico e mental se encontram associados entre si na idade avançada; e 3) explorar quais as variáveis que melhor predizem a satisfação com a vida e o estado de saúde (físico e mental) em indivíduos com idade avançada. A amostra em estudo é constituída por 155 indivíduos (99 mulheres e 56 homens), com idades compreendidas entre os 65 e 94 anos (M = 76,06; DP = 7.15), institucionalizados e não institucionalizados dos distritos de Coimbra e Leiria. Os resultados obtidos demonstram correlações significativas e no sentido esperado entre alguns dados sociodemográficos (idade, escolaridade, meio de residência e resposta social) e as variáveis em estudo (Satisfação com a vida, afetos positivos, autocompaixão, estado de saúde físico e mental). Foram igualmente encontradas associações significativas e positivas entre a autocompaixão, bem-estar subjetivo e estado de saúde. Relativamente às análises de regressão, os modelos preditivos significativos revelaram que o estado de saúde física é melhor predito por uma maior satisfação com a vida e menor idade do idoso; o estado de saúde mental é melhor predito pelo aumento da satisfação com a vida, da autocompaixão e diminuição dos afetos negativos; e por último a satisfação com a vida é predita pela saúde física e autocompaixão, sendo esta associação das variáveis no sentido positivo. Para além da idade e da condição de saúde física, estes resultados sugerem a importância do desenvolvimento de estratégias psicológicas que permitam lidar de forma mais calorosa, tolerante e aceitante no sofrimento ou nos momentos difíceis típicos da idade avançada, e, simultaneamente, que permitam uma melhor regulação dos afetos negativos. Estes dados estão de acordo com a literatura que apoia o possível efeito benéfico das terapias focadas na compaixão junto desta população específica, nomeadamente na promoção da satisfação com a vida e saúde mental dos idosos portugueses. / The increase in aging population is a major advance in society, but also a great challenge, imposing the need for actions aimed at promoting successful aging with higher subjective well-being and better health (Kanning & Schlicht, 2008; World Health Organization, 2002). This study presents the following 3 objectives: 1) to analyze the self-compassion, satisfaction with life, the affections, the state of physical and mental health in old age and realize the possible influence of sociodemographic variables (age, gender, area of residence (urban vs. rural), marital status, education, religion and type of social response); 2) understand how is that self-compassion, satisfaction with life, the affections, the state of physical and mental health are associated with each other in old age; and 3) to explore which variables best predict satisfaction with life and health (physical and mental) in individuals with advanced age. The study sample consists of 155 individuals (99 women and 56 men) aged between 65 and 94 years (M = 76.06, SD = 7.15), institutionalized and non-institutionalized in district of Coimbra and Leiria. The results show significant correlations between some demographic (age, education, means of residence and social response) and the study variables (satisfaction with life, positive affect, self-compassion, physical and mental health status), which were expected. There were also found significant positive associations between self-compassion, subjective well-being and health. Regarding the regression analysis, the significant predictive models revealed that physical health is best predicted by greater life satisfaction and lower age of the elderly; the mental health status is best predicted by increased satisfaction with life, self-compassion and decreased negative affect; and last the life satisfaction is predicted by physical health and self-compassion, and this combination of variables in the positive direction. In addition to the age and physical health condition, these results suggest the importance of developing psychological strategies more warmly, tolerant and accepting suffering or in the typical hard times of old age, and simultaneously permitting better regulation of negative affect. These data are consistent with the literature that supports the possible beneficial effect of therapies focused on compassion with this specific population, in particular in promoting life satisfaction and mental health of the Portuguese elderly

Qualidade de Vida e Participação em Iniciativas de Base Comunitária: Um estudo num município da zona centro de Portugal

Face ao reconhecimento da importância da participação social como fator promotor de envelhecimento bem-sucedido, procura-se, através de um estudo de natureza quantitativo, analisar os efeitos de variáveis sociodemográficas e da participação social em atividades/programas de base comunitária, promovidas por um município da zona centro de Portugal, ao nível da qualidade de vida de pessoas com mais de 56 anos, residentes no concelho.info:eu-repo/semantics/publishedVersio

Intraoperative transfusion practices in Europe

Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl and increased to 9.8 (1.8) g dl after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold

Intraoperative transfusion practices in Europe

© 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold

Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

The demographic development suggests a dramatic growth in the number of elderly patients undergoing surgery in Europe. Most red blood cell transfusions (RBCT) are administered to older people, but little is known about perioperative transfusion practices in this population. In this secondary analysis of the prospective observational multicentre European Transfusion Practice and Outcome Study (ETPOS), we specifically evaluated intraoperative transfusion practices and the related outcomes of 3149 patients aged 65 years and older. Enrolled patients underwent elective surgery in 123 European hospitals, received at least one RBCT intraoperatively and were followed up for 30 days maximum. The mean haemoglobin value at the beginning of surgery was 108 (21) g/l, 84 (15) g/l before transfusion and 101 (16) g/l at the end of surgery. A median of 2 [1–2] units of RBCT were administered. Mostly, more than one transfusion trigger was present, with physiological triggers being preeminent. We revealed a descriptive association between each intraoperatively administered RBCT and mortality and discharge respectively, within the first 10 postoperative days but not thereafter. In our unadjusted model the hazard ratio (HR) for mortality was 1.11 (95% CI: 1.08–1.15) and the HR for discharge was 0.78 (95% CI: 0.74–0.83). After adjustment for several variables, such as age, preoperative haemoglobin and blood loss, the HR for mortality was 1.10 (95% CI: 1.05–1.15) and HR for discharge was 0.82 (95% CI: 0.78–0.87). Preoperative anaemia in European elderly surgical patients is undertreated. Various triggers seem to support the decision for RBCT. A closer monitoring of elderly patients receiving intraoperative RBCT for the first 10 postoperative days might be justifiable. Further research on the causal relationship between RBCT and outcomes and on optimal transfusion strategies in the elderly population is warranted. A thorough analysis of different time periods within the first 30 postoperative days is recommended

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved