4,299 research outputs found

    Words of welcome

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    Dear Colleagues, dear Friends; It is a pleasure to welcome you to the 18th World Congress of the European Association for Palliative Care in Rotterdam. This 2023 congress is the first face-to-face congress organized by the EAPC since 2019. Like other EAPC congresses, this congress is the result of two years of planning, organisation, meetings, reflection, and decision-making. Finally, here we are! It has been my honour to co-chair the Scientific Committee of this congress together with my colleague Agnes Csikos. For the first time, as far as I remember, the Scientific Committee, composed of a dedicated group of colleagues (thank you Alberto Alonso, Augusto Caraceni, Fin Craig, Jeroen Hasselaar, Martin Loucka, Wendy Oldenmenger, Christoph Ostgathe, Danai Papadatou, Nancy Preston, Audrey Roulston, and Rainer Simader), was co-chaired by two women who have the particularity of living in the South and Eastern parts of Europe. Under the theme “Equity and Diversity in Palliative Care”, the EAPC 2023 congress focuses on understanding health inequities and diversity in palliative care. Through a rich and diversified program, this congress draws attention to the utmost need and goal of creating equity of fair access, opportunity, and advancement in palliative care for all people in need of this care, within a context of diversity. We will have the opportunity to reflect on ways to better understand why and how inequities in palliative care occur, develop strategies aimed at reducing those inequities, and identify which challenges and policies could help to improve equity in palliative care. That is why, determining the prominent factors in the production of inequities in palliative care and deciding which ones are most amenable to change is paramount. As an operational definition of equity in palliative care, we adapted the definition proposed by the International Society for Equity in Health. Equity in palliative care is the absence of systematic and potentially remediable differences in one or more aspects of palliative care outcomes across socially, demographically, or geographically defined population groups. There is no basis for expecting a single characteristic or set of characteristics to be most influential in causing inequities in palliative care. Evidence suggests otherwise. To complement the understanding of health inequities in palliative care, we need to take diversity in palliative care into account. The definition of diversity encompasses variety and the condition of being different or having differences. Rarely are diverse influences simultaneously explored in the literature to better understand and tackle plausible explanations for inequities in palliative care. Sometimes, diversity is used as a euphemism for “outside the majority” or “different from the dominant group”. Yet, as human beings, diversity is part of who we are. We are inherently diverse, and evidence shows that when reflecting on and discussing palliative care, there is no “one size fits all”. Are we promoting equity in palliative care? If not, why are we failing on equity in palliative care? Do we spend inadequately or inappropriately on palliative care provision? Why in a world now much more aware of the impact of the social determinants of health are the world’s most vulnerable persons still missing out? Why are we still failing in providing increased or augmented palliative care services for socially, demographically, or geographically defined population groups with greater palliative care needs? How can diversity help to understand and tackle inequities in palliative care? These are just a few examples of questions that will certainly become “food for thought” during our days together in Rotterdam. And, we are so grateful to all and each one of you for your contributions to the scientific programme. The 18th World Congress of the European Association for Palliative Care gives us the opportunity to reconnect and share all the exiting work that is being developed within our worldwide palliative care community. These days together offer us the amazing chance to meet colleagues and friends, to be inspired and inspire others, and to re-energise ourselves to face the future challenges for palliative care.Promoting equity and taking diversity into account is not only the theme of the 18th World Congress of the EAPC. They should also be at the heart of palliative care practice, organisation, research, education, advocacy, and policy. I wish you a wonderful and exciting congress and look forward to meeting you in Rotterdam.info:eu-repo/semantics/acceptedVersio

    Comunicação organizacional eficaz e tecnologias da informação e da comunicação

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    Tese apresentada para cumprimento dos requisitos necessários à obtenção do grau de Doutoramento em Sociologia da ComunicaçãoA presente pesquisa versa um campo ainda pouco debatido no nosso País: a comunicação organizacional e a avaliação da sua eficácia. Nesta Era digital na qual as empresas em Portugal se encontram no limiar de uma mudança de paradigma a nível dos seus processos e modelos comunicacionais, pretende averiguar-se se as tecnologias de informação e de comunicação (TIC) jogam um papel fundamental no desenvolvimento de uma comunicação organizacional eficaz. Os crescentes desafios colocados às empresas inovadoras pelos rápidos e complexos progressos tecnológicos, levam-nos a reflectir sobre o impacto das TIC no modo como a comunicação organizacional contribui para o sucesso dessas mesmas empresas. Através de um estudo comparativo levado a cabo junto de um grupo empresas inovadoras em Portugal, conseguiu criar-se um „Modelo de Avaliação da Eficácia da Comunicação Organizacional na Era Digital‟, capaz de dar conta de diferentes estádios de eficácia associados ao nível de incorporação das TIC na função de comunicação organizacional. Com esta pesquisa respondemos a questões como, por exemplo: Que papel desempenha a comunicação organizacional nas empresas inovadoras em Portugal? Como comunicam as empresas inovadoras? Uma empresa inovadora desenvolve uma comunicação organizacional eficaz? A função de comunicação organizacional nas empresas inovadoras está a adaptar-se às actuais exigências estratégicas da economia da informação e do conhecimento? Quais os recursos tecnológicos em que mais se aposta na comunicação organizacional? Que suportes de comunicação digitais são mais utilizados? Com a resposta a estas e outras questões, conseguimos no final desta pesquisa deixar algumas pistas às empresas inovadoras em Portugal para que desenvolvam uma comunicação organizacional eficaz.ABSTRACT: The present research focuses a field of study that is yet poorly discussed in our country: organizational communication and the assessment of its effectiveness. In this digital Era in which Portuguese enterprises find themselves at the edge of a paradigm turnover both in their processes and communication models, we want to know if information and communication technologies (ICT) play an important role in the development of organizational communication effectiveness. As we speak growing challenges are being presented to these innovative enterprises by complex and fast technological progresses, forcing us to reflect upon the impact of ICT in the way organizational communication contributes for the success of those same enterprises. Through a comparative study made with a group of Portuguese innovative enterprises we have create an „Assessment Model of Organizational Communication Effectiveness in the Digital Era‟, capable of identifying different effectiveness states associated with different levels of ICT incorporation in the organizational communication function. This research intends to answer questions such as: What role does organizational communication plays in Portuguese innovative enterprises? In which ways these innovative enterprises communicate? Does an innovative enterprise develop an organizational communication that is effective? Organizational communication function in innovative enterprises manages to adapt to current strategic demands of the information and knowledge economy? Which technological resources are being used in organizational communication function? And which digital communication instruments are trendier? The response to these and other questions will enable us to give some clues at the end of this research to help Portuguese innovative enterprises to strive for organizational communication effectiveness

    Clinical impact of sarcopenia on gastrointestinal tumors

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    Preoperative risk stratification in cancer surgery is important to improve treatment and outcome. Sarcopenia is defined by progressive and generalized loss of skeletal muscle mass and strength and is now getting attention as a poor prognostic factor. The purpose of this review was to explore the impact of sarcopenia on short and long-term outcomes in patients undergoing surgical resection of gastrointestinal tumors. Recent studies suggest that sarcopenia contributes to postoperative complications and overall survival. The relatively simple evaluability, as well as its modifiable nature, provides an intriguing potential for sarcopenia to be included in standard preoperative clinical evaluation. Such evaluations can provide physicians with important information to target high-risk individuals with prophylactic measures and eventually improve surgical outcomes

    Ethical challenges of outcome measurement in palliative care clinical practice: a systematic review of systematic reviews

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    Several outcome measures have been systematically implemented to be used in palliative care. However, routine use in clinical practice is not without ethical challenges, which are not commonly addressed. The objectives of this study are therefore (I) to identify the ethical challenges/issues of outcome measurement in palliative care and (II) to understand how these ethical challenges/issues are addressed in palliative care clinical practice. The study consisted of a systematic review of systematic reviews, which is a type of review that brings together a summary of reviews in one place. We searched PubMed, Web of Science, EBSCOhost searching CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, from inception to January 2018. Out of 159 articles screened, only two [2] articles were included for analysis. The main ethical challenge/issue identified in these two reviews was cognitive impairment, particularly in patients with dementia. This challenge was addressed via proxy (family carers or health professionals) reporting outcome measurement. Ethical challenges/issues are poorly addressed in the existing systematic reviews about outcome measurement in palliative care clinical practice. Only two systematic reviews addressed ethical challenges/issues, namely cognitive impairment, particularly in persons with dementia. Further research is needed on this subject and to foster the use of outcome measurement among this vulnerable group of patientsinfo:eu-repo/semantics/publishedVersio

    Enhancing ethical decision-making at the end-of-life: empowering conditions or team empowerment?

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    Background: Healthcare professionals are increasingly making end-of-life decisions (ELDs), which have become an integrated dimension of contemporary palliative and end-of-life care. ELDs are medical decisions made at the end of life that may have a potentially life-shortening effect. These situations are very often moments of high vulnerability with a profound impact on patients' ability to exercise their autonomy. Healthcare professionals perceive end-of-life decision-making as complex, difficult, and stressful. Evidence shows that making ELDs is frequently associated with burnout and moral distress. Strategies need to be implemented to enhance ethical decision-making at the end-of-life. Aim: To explore and discuss strategies on how to promote team empowerment within interdisciplinary teams to support and enhance ethical decision-making processes surrounded by uncertainty, risk, and asymmetry of information. Methods: This presentation is based on the work developed within project DELiCare: Decisions, Decision-making, and End-of-Life Care: Ethical Framework and Reasoning. The knowledge, experiences, and evidence from different fields will be mobilized and integrated to build theoretical and empirical frameworks. The structure and processes that can enhance ethico-clinical decision-making processes and their effectiveness in palliative and end-of-life care will be explored. Results: The need to make ELDs requires healthcare professionals and teams, as well as patients and family members, to embrace ethico-clinical decision-making processes under uncertainty, risk, and asymmetry of information. Shared decision-making is a cooperative process among healthcare professionals, patients, and families that enables a way of decision-making combining both the professionals’ expertise and the patient’s values, preferences, and goals. Shared decision-making processes should integrate information exchange, a deliberation period and making a decision. Communication among all stakeholders is paramount. Conclusions: Shared decision-making processes helps teams to bring together information and views, anticipate scenarios, and prepare a joint and common approach to the decision that needs to be made. This team empowering strategy fosters the sense of both individual and teamwork meaning, a core dimension of empowerment. By fostering shared decision-making processes, professionals and teams feel more empowered and are more effective in meeting patients’ values, wishes and preferences.info:eu-repo/semantics/acceptedVersio

    Sarcopenia as a risk factor of morbimortality in colorectal cancer surgery

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    Background: Colorectal cancer (CRC) surgery is associated with high rates of postoperative morbimortality. Sarcopenia has been identified as an independent predictor of these surgical outcomes. Methods: A sample of 272 patients who underwent CRC surgery between January 2005 and May 2010 at Braga Hospital, was selected. Sarcopenia was defined by the skeletal muscle mass index, measured by preoperative computed tomography (CT), at L3 level, using ImageJ® software. Associations between sarcopenia and qualitative variables were analyzed by Chi-Square Test (χ2) or Fisher’s Exact Test and, for quantitative variables, by Mann-Whitney Test. A multivariate logistic regression was performed to assess if sarcopenia was an independent predictor of major morbidity. The overall and recurrence-free survivals were analyzed by Kaplan-Meier method and multivariate Cox regression was performed for recurrence-free survival. Results: The prevalence of sarcopenia was 19.1%. Sarcopenia was associated with male gender, no CRC family history and colon tumour (p p = 0.029 and p = 0.017, respectively). The presence of sarcopenia was associated with postoperative morbidity Clavien–Dindo classification (p = 0.003), and sarcopenia was an independent predictor for major complications (grade ≥ III) (p = 0.003). Conclusions: The evaluation of sarcopenia in patients undergoing CRC surgical resection allows to predict a higher probability of major postoperative morbimortality.This research received no external funding

    In the game of adjustments: questions about memory construction in interviews

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    Reflexão teórico-metodológica em torno do uso da entrevista na recolha de relatos orais em dois estudos que cruzam perspetivas no campo da comunicação no espaço ibero-americano (Portugal e Brasil).N/
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