Avaliação da perceção de discriminação em pessoas idosas

Es fundamental formar a las personas sobre el proceso de envejecimiento, ya que con frecuencia surgen situaciones de marginación de las personas mayores en base al edaísmo o discriminación por edad. El objetivo de este estudio es analizar la percepción de la discriminación que las personas mayores sienten. Para ello, se utilizó la encuesta de escala de discriminación por edad (Palmore de 2001 adaptarse. Pop. Portugués Ferreira-Alves & New, 2006). Participaron en el estudio 698 sujetos con edades comprendidas entre los 60 y 98 años, 491 residentes en la comunidad y 205 en el país. Los resultados sugieren la existencia de la percepción de la discriminación por edad para los ancianos. Las situaciones que más a menudo se perciben como de discriminación se refieren a contextos de salud. No hubo diferencias estadísticamente significativas entre los ancianos que viven en asilos y en la comunidad. Este estudio muestra, la presencia / conciencia de la discriminación por edad y, por lo tanto, la necesidad de investigaciones e intervenciones en este área para que las personas mayores puedan vivir con más calidad su proceso de envejecimiento.It is essential to train people in the aging process, as they often arise situations of discrimination against older people based on age discrimination or ageism. The aim of this study is to analyze the perception of discrimination that older people feel. To do this, the survey scale of ageism (2001 Palmore adapts. Pop. Portuguese Ferreira-Alves & New, 2006) was used. Participated in the study 698 subjects aged between 60 and 98 years, 491 community residents and 205 in the country. The results suggest the existence of perception of age discrimination for the elderly. The most often situations that are perceived as discrimination are related to health contexts. There were no significant statistically differences among elderly living in nursing homes and in the community. This study shows the presence / awareness of age discrimination and therefore the need for research and interventions in this area so that older people can live with more quality their aging process.É fundamental esclarecer as pessoas sobre o processo de envelhecimento, uma vez que surgem, frequentemente, situações discriminação em relação às pessoas idosas baseadas na idade–ageism ou idadismo. O objetivo deste estudo é analisar a perceção da discriminação que os idosos sentem. Para tal, foi utilizada a escala Ageism Survey (Palmore, 2001, adapt. pop. portuguesa por Ferreira-Alves & Novo, 2006). Participaram no estudo 698 sujeitos, com idades entre os 60 e os 98 anos, 491 residentes na comunidade e 205 em lar. Os resultados sugerem a existência de perceção de discriminação baseada na idade por parte dos idosos. As situações de discriminação mais frequentemente percecionadas reportam-se a contextos de saúde. Não foram encontradas diferenças estatisticamente significativas entre os idosos residentes em lares e na comunidade. Este estudo alerta, assim, para a presença/percepção de ageism e, consequentemente, para a necessidade de investigações e intervenções nesta área para que as pessoas idosas possam viver com mais qualidade o seu processo de envelhecimento.peerReviewe

O PERFIL SIBILANTE DA PERSONAGEM QUINA N’A SIBILA DE AGUSTINA BESSA-LUÍS

A sibila, romance de Agustina Bessa-Luís, publicado em 1954, vencedor dos prêmios Delfim Guimarães e Eça de Queirós, apresenta em seu título uma das figuras clássicas da mitologia greco-romana, as sibilas, mulheres virgens, sacerdotisas de Apolo, detentoras de saberes e poderes especiais, capazes de realizar profecias. A obra de Bessa-Luís traça o perfil de Quina, uma espécie de sibila contemporânea, detentora de sabedoria única, que instaura um matriarcado e reconstrói o patrimônio perdido de sua família. Este trabalho propõe investigar o simbólico no romance de Bessa-Luís, de modo a contrastar a imagem da sibila Quina com as sibilas da Antiguidade Clássica. Para tanto, embasamo-nos em Araújo e Fonseca (2015), Beauvoir (2016), Kury (2009) e Moisés (2001, 2013)

Estágio supervisionado de enfermagem em pediatria no contexto da COVID-19: impactos e limitações

The aim was to develop several professional skills that result in aptitude for development in the professional environment in health services: public, philanthropic, or private. The professional nurse, inserted in health work, must adopt an innovative posture, be critical-creative, and aware of their responsibilities. For this, the development of general skills, during the supervised internship, provides opportunities for the association of theory with practice. The student needs to develop all the skills, and for this it is essential that they have theoretical and practical classes linked to the Supervised Curriculum Internships (ECS) in different health services. Therefore, the present work is an experience report, built from the experience of a teacher and a group of students from the internship of the Nursing Course of a private college in the COVID-19 pandemic scenario in ​​Child Health and Adolescents, in the tenth period of graduation. Through the students' reports, the expressions insecurity, fear of personal and family contagion, limitations in approaching patients, were frequent.Objetivou-se desenvolver diversas capacidades profissionais que resultem em aptidão para o desenvolvimento no ambiente profissional em serviços de saúde: público, filantrópico ou privado. O profissional enfermeiro, inserido no trabalho em saúde, deve apropriar-se de uma postura inovadora, ser crítico-criativo, e consciente de suas responsabilidades. Para isso o desenvolvimento de competências gerais, durante o estágio supervisionado é que se oportuniza a associação da teoria com a prática. O discente carece desenvolver todas as competências, e para isso torna-se imprescindível que ele tenha aulas teóricas e práticas atreladas aos Estágios Curriculares Supervisionados (ECS) nos diferentes serviços de saúde. Diante disso o presente trabalho trata-se de um relato de experiência, construído a partir da vivência de uma docente e grupo de discentes do estágio do Curso de Enfermagem de uma faculdade particular no cenário da pandemia da COVID-19 na área de Saúde da Criança e do Adolescente, no décimo período da graduação. Através dos relatos dos discentes as expressões insegurança, medo de contágio pessoal e familiar, limitações de abordagens aos pacientes, foram frequentes

Estágio supervisionado de enfermagem em pediatria no contexto da COVID-19: impactos e limitações

The aim was to develop several professional skills that result in aptitude for development in the professional environment in health services: public, philanthropic, or private. The professional nurse, inserted in health work, must adopt an innovative posture, be critical-creative, and aware of their responsibilities. For this, the development of general skills, during the supervised internship, provides opportunities for the association of theory with practice. The student needs to develop all the skills, and for this it is essential that they have theoretical and practical classes linked to the Supervised Curriculum Internships (ECS) in different health services. Therefore, the present work is an experience report, built from the experience of a teacher and a group of students from the internship of the Nursing Course of a private college in the COVID-19 pandemic scenario in ​​Child Health and Adolescents, in the tenth period of graduation. Through the students' reports, the expressions insecurity, fear of personal and family contagion, limitations in approaching patients, were frequent.Objetivou-se desenvolver diversas capacidades profissionais que resultem em aptidão para o desenvolvimento no ambiente profissional em serviços de saúde: público, filantrópico ou privado. O profissional enfermeiro, inserido no trabalho em saúde, deve apropriar-se de uma postura inovadora, ser crítico-criativo, e consciente de suas responsabilidades. Para isso o desenvolvimento de competências gerais, durante o estágio supervisionado é que se oportuniza a associação da teoria com a prática. O discente carece desenvolver todas as competências, e para isso torna-se imprescindível que ele tenha aulas teóricas e práticas atreladas aos Estágios Curriculares Supervisionados (ECS) nos diferentes serviços de saúde. Diante disso o presente trabalho trata-se de um relato de experiência, construído a partir da vivência de uma docente e grupo de discentes do estágio do Curso de Enfermagem de uma faculdade particular no cenário da pandemia da COVID-19 na área de Saúde da Criança e do Adolescente, no décimo período da graduação. Através dos relatos dos discentes as expressões insegurança, medo de contágio pessoal e familiar, limitações de abordagens aos pacientes, foram frequentes

A amamentação como prevenção da obesidade infantil: Uma revisão narrativa / Breastfeeding as prevention of childhood obesity: A narrative review

Objetivo: Avaliar a relação entre o aleitamento materno e a obesidade infantil, bem como suas consequências. Referencial bibliográfico: A alimentação recebida no início da vida impacta diretamente na origem dos desvios nutricionais na infância, sabe-se que o leite humano reúne os componentes ideais, com balanceamento adequado de nutrientes, sendo desnecessária a oferta de outros alimentos antes dos seis meses de vida. Por outro lado, a introdução alimentar precoce e consequentemente o desmame, pode acarretar sobrepeso, obesidade, doenças crônicas, alergias, diarreias, comorbidades gastrointestinais e respiratórias. A introdução precoce do leite não materno está relacionada a um excesso de oferta proteica, além disso a introdução alimentar muitas vezes é feita de forma inadequada com alimentos com potencial obesogênico, acarretando desta forma os distúrbios nutricionais. Considerações finais: A obesidade é um fator de risco para o desenvolvimento de inúmeras doenças e complicações, sendo cada vez mais prevalente na população infantil. Há uma relação direta desse distúrbio, com o desmame precoce e alimentação complementar inadequada e/ou precoce. Portanto faz-se necessário o incentivo à amamentação, como medida de prevenção ao sobrepeso e obesidade infantil

Sugar, acid and furfural quantification in a sulphite pulp mill: Feedstock, product and hydrolysate analysis by HPLC/RID

Waste from pulp and paper mills consist of sugar-rich fractions comprising hemicellulose derivatives and cellulose by-products. A complete characterisation of the waste streams is necessary to study the possibilities of an existing mill. In this work, four chromatographic methods have been developed to obtain the most suitable chromatographic method conditions for measuring woody feedstocks, lignocellulosic hydrolysates and cellulose pulp in sulphite pulping processes. The analysis of major and minor monosaccharides, aliphatic carboxylic acids and furfurals has been optimised. An important drawback of the spent liquors generated after sulphite pulping is their acidic nature, high viscosity and adhesive properties that interfere in the column lifetime. This work recommends both a CHO-782Pb column for the sugar analysis and an SH-1011 resin-based cross-linked gel column to separate low-molecular-weight chain acids, alcohols and furfurals. Such columns resulted in a good separation with long lifetime, wide pH operating range and low fouling issues.The authors gratefully acknowledge the financial support of the European Union for this research by the BRIGIT “New tailor-made biopolymers produced from lignocellulosic sugars waste for highly demanding fire-resistant applications” research project under the seventh framework program www.brigit-project.eu

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an