Maternal self-efficacy in newborn care: influence of maternal variables

Aim: To analyze the influence of sociodemographic, obstetric, childbirth, and breastfeeding variables on maternal self-efficacy in newborn care. Design: Descriptive cross-sectional study. Methods: The study was conducted in three hospital units in the Northern region of Portugal, with a non-probabilistic sample composed of 340 women recruited at postnatal wards on the day of hospital discharge. A questionnaire including the mother’s sociodemographic, obstetric, childbirth, and breastfeeding data was used. For the analysis of maternal self-efficacy in newborn care, the Scale of Perceived Parental Self-Efficacy in Child Care was used. The scale is a 20-item self-report instrument developed to identify women with low levels of self-efficacy in newborn care. Descriptive and inferential statistics were used for data analysis. Results: Significant differences concerning maternal self-efficacy in newborn care were found with regard to level of education and parity, with multiparous women and women with lower levels of education presenting higher levels of self-efficacy in newborn care. Conclusion: The analysis of these variables could be valuable in building new knowledge to support the development of an action model that would allow at-risk women to be highly confident in their parenting role.info:eu-repo/semantics/publishedVersio

Medidas não farmacológicas no alívio da dor no trabalho de parto

Enquadramento: A dor do parto resulta de complexas interações, de caráter inibitório e excitatório e, apesar de os seus mecanismos serem análogos aos da dor aguda, há fatores próprios do trabalho de parto de natureza neurofisiológica, obstétrica, psicológica e sociológica que intervêm no seu limiar. Neste sentido, os métodos não farmacológicas podem auxiliar a parturiente no alívio da dor, reduzir os níveis de stresse e ansiedade e, consequentemente promover uma maior satisfação. Objetivos: Demonstrar evidência científica de se os métodos não farmacológicos usados no alívio da dor no trabalho de parto são mais eficazes quando comparados com a não utilização de nenhum método, placebo ou qualquer outro método; verificar o uso de medidas não farmacológicas no alívio da dor do parto; averiguar quais as variáveis sociodemográficas, variáveis contextuais da gravidez e contextuais do parto que interferem no recurso a medidas não farmacológicas no alívio da dor do parto. Métodos: No estudo empírico I seguiu-se a metodologia de revisão sistemática da literatura. Foi realizada uma pesquisa na EBSCO, PubMed, Scielo e RCAAP, de estudos publicados entre 1 janeiro de 2010 e 2 de janeiro de 2015. Os estudos encontrados foram avaliados de acordo com os critérios de inclusão previamente estabelecidos e, posteriormente, foi feita uma apreciação da qualidade dos estudos, por dois revisores, utilizando a “Grelha para avaliação crítica de um artigo descrevendo um ensaio clínico prospetivo, aleatorizado e controlado” (Bugalho & Carneiro, 2004). No final, foram incluídos no corpus do estudo 4 artigos. O estudo empírico II enquadra-se num estudo quantitativo, transversal, descritivo e retrospetivo, desenvolvido no serviço de Obstetrícia do Centro Hospitalar Cova da Beira, segundo um processo de amostragem não probabilística por conveniência (n = 382). A recolha de dados efetuou-se através da consulta de processos clínicos de mulheres com idade ≥ 18 anos, que tiveram um parto vaginal com feto vivo após as 37 semanas de gestação. Resultados: Os métodos não farmacológicos usados no alívio da dor no trabalho de parto são mais eficazes quando comparados com a não utilização de nenhum método, placebo ou qualquer outro método. Numa amostra constituída por 382 mulheres, com uma idade média de 30,95 anos (±5,451 anos), em 34,6% dos casos foram aplicadas as medidas não farmacológicas no alívio da dor no trabalho de parto, sobressaindo a respiração e o relaxamento (86,3%). Em alguns casos, ainda que em menor número, foi aplicada a hidroterapia isolada (6,9%) ou associada à respiração e ao relaxamento (5,3%), bem como a hipnose (0,8%) e a associação entre respiração e massagem (0,8%). Conclusão: De acordo com os resultados obtidos e com base na evidência científica disponível, importa referir que é essencial que os cuidados não farmacológicos de alívio da dor no parto sejam explorados, por serem mais seguros e acarretarem menos intervenções. Desta feita, os profissionais de saúde que prestam assistência às mulheres durante o trabalho de parto e parto têm de ter acesso ao conhecimento acerca desses métodos e os seus potenciais benefícios, a fim de os poderem aplicar com maior segurança, o que resultará indiscutivelmente numa maior humanização do parto, caminhando-se no sentido de uma maternidade mais segura. Palavras-chave: Trabalho de parto; dor de parto; terapias complementares; terapias alternativasAbstract Background: Labor pain is the result of complex interactions of inhibitory and excitatory character and although their mechanisms are similar to those of acute pain, there are specific factors of labor of neurophysiological nature, obstetric, psychological and sociological involved in their threshold. In this sense, non-pharmacological methods can help the mother in relieving pain, reduce stress and anxiety levels and thus foster greater satisfaction. Objectives: Demonstrate scientific evidence of non-pharmacological methods used for pain relief during labor are more effective compared to not using any method, placebo or any other method; check the use of non-pharmacological methods to relieve labor pain; determine which sociodemographic variables, contextual variables of pregnancy and contextual delivery that interfere with the use of non-pharmacological methods to relieve labor pain. Methods: In the empirical study we followed the systematic review methodology literature. A survey was carried out in EBSCO, PubMed, Scielo, e RCAAP, of studies published between January 1, 2010 and January 2, 2015. The studies found were evaluated according to the inclusion criteria previously established and subsequently an appreciation of quality of studies was made, by two reviewers using the "Grid to critically appraise an article describing a prospective, randomized and controlled" (Bugalho & Carneiro, 2004). In the end, we were included in the study corpus 4 articles. The empirical study II is part of a quantitative, cross-sectional, descriptive and retrospective study, developed in Obstetrics Service of Cova da Beira Hospital, according to a non-probability sampling process for convenience (n = 382). Data collection was made through the medical records of women consultation with age ≥ 18 years, who had a vaginal delivery with a live fetus after 37 weeks of gestation. Results: The non-pharmacological methods used for pain relief during labor are more effective compared to not using any method, placebo or any other method. In a sample of 382 women with an average age of 30.95 years (± 5.451 years), in 34.6 % of cases were applied non-pharmacological methods for pain relief in labor, highlighting breathing and relaxation (86.3 %). In some cases, although to a lesser extent, was applied to hydrotherapy isolated (6.9%) or associated with breathing and relaxation (5.3%) and hypnosis (0.8%) and the association between breathing and massage (0.8%). Conclusion: According to the results and based on scientific evidence available, it should be noted that it is essential that non-pharmacological care relief in childbirth pain are exploited because they are safer and tend to carry fewer interventions. This time, the health professionals who assist women during labor and childbirth must have access to knowledge about these methods and their potential benefits in order to be able to apply them with greater safety, which will result in an arguably more humanization of birth, walking up towards safer motherhood. Keywords: Labor; pain; complementary therapies; alternative therapies

Desenvolvimento sustentável, governação local algorítmica e cidades de proximidade: o futuro (da cidade inteligente) é hoje

[Excerto] Estamos certos de que as cidades e o seu consequente desenvolvimento representam, por muitas razões, um dos maiores desafios do século XXI. Por um lado, é o desenvolvimento desbragado e a urbanização crescente que traz consigo problemas de diversa natureza e preocupações de acolhimento de modelos de territórios do futuro com implementação de estratégias e políticas sustentáveis, onde até a cidade de proximidade, como seja a cidade 15 minutos, é apresentada como solução amiga do ambiente e de sociedade inclusiva e participativa; por outro, é a constante aceleração da aplicação das Tecnologias de Comunicação e Informação à Governação Pública que obriga a pensar como estas podem servir necessidades de acesso ao serviço e a bens que a pandemia Covid-19 acentuou, pondo a descoberto a falta de resiliência de tantas cidades, não planeadas, frágeis do ponto de vista da implementação das TIC e, em suma, pouco precavidas para a catástrofe, estando, por isso, aquém do standard europeu de resiliência e longe de alcançar os objetivos traçados pelas Nações Unidas para 2030. “Não deixar ninguém para trás” é o lema da Agenda 2030 para o Desenvolvimento Sustentável das Nações Unidas

Study of hearing processing in seniors before and after hearing training

Introduction: The Central Auditory Processing (CAP) corresponds to the perception of the hearing information in the Central Nervous System and to the neurobiological activity involved and is carried out through a set of stages characterized by specific abilities on which the person depends to interpret what he hears. With aging, alterations at the level of perception and detection of the sound in the central and peripheral system occur and have effects on the senior’s communication process. The hearing process permits to minimize the difficulties in the information processing and to enhance the identification and discrimination of sound patterns. This study aims at evaluating the effect of hearing training on the seniors speaking comprehension skills. Methods: The sample consists of 16 people, aged from 58 to 91. All the people have undergone an otoscopy, a tympanogram, a pure tone audiogram screening and the speech in noise test. The people who presented otoscopy without alterations and tympanogram Type A have been included in the study. After the initial evaluation, all the people have undergone a hearing training programme of 10 sessions during 5 weeks, where 8 have undergone the speech in noise test (G1) and 8 have undergone the training with a filtered speech test (G2). Results: Comparing the results obtained before and after the hearing training, we can verify statistically significant differences in the speech in noise test in all the conditions of the test (relation signal/noise10dB, 15 dB and total) in both ears (p<0,05). As far as the training type is concerned, the G1 reveals statistically significant differences in all the conditions of the test (p<0,01). As far as the G2, only statistically significant differences are observed in the left ear in the condition signal/noise 10dB (p=0,006). Conclusion: The hearing training revealed improvement in the hearing processing abilities, namely in the discrimination of speaking in noisy ambiance in seniors.info:eu-repo/semantics/publishedVersio

Da atuação da Defensoria Pública para Promoção e Defesa dos Direitos da Mulher

This study analyses the actions of public defense, mainly the state of São Paulo public defense, in favor of women, especially those victims of domestic and familiar violence, considering the vulnerabilities that feature gender relations.O presente artigo pretende tratar da atuação da Defensoria Pública Estadual, sobretudo a Defensoria Pública paulista, em favor das mulheres, especialmente aquelas vítimas de violência doméstica e familiar, considerando as vulnerabilidades que permeiam as relações de gênero

Associations between quality of life and central auditory processing in seniors: preliminary results

Introduction: Several health-related conditions have been reported to be important for quality of life (QoL) (Raggi et al., 2016). Central auditory processing (CAP) corresponds to the perceptual processing of the auditory information in the central nervous system (Musiek & Baran, 2007). With aging, alterations at the level of perception and detection of the sound in the central and peripheral system occur and have effects on the senior’s QoL. Objectives: To analyze associations between CAP and QoL, considering sociodemographic variables. Methods: This study was conducted in a cross-sectional and descriptive design. Ethical requirements are respected. Participants: 19 seniors with average age of 81.6 (SD=9.5), 68.4% are females and 68.4% live alone. Measures: Socio-demographic data survey, Portuguese version of World Health Organization Quality of Life Instrument-Older Adults and an audiological evaluation constituted by an otoscopy, a tympanogram, a pure tone audiogram and the speech in noise test. Statistical analysis was performed using software IBM SPSS version 24. Nonparametric test were used. Results: When the elderly live alone, results showed significant positive associations between CAP and QoL (total score). There was positive correlations between QoL and the speech in noise test in the relation signal/noise10dB (r=0.573; p=0.041), and total (r=0.573; p=0.040) for right ear. The same result was observed in the left ear when the relation signal/noise10dB (r=0.572; p=0.041), and total (r=0.583; p=0.037). No significant results were obtained when the seniors don’t live alone. Conclusion: The results evidenced the importance of sociodemographic factors, such as “live alone” in the relation between CAP and QoL in older adults. Probably when we live alone the discrimination of speaking in noisy ambiance is a predictor factor of quality of life in seniors. Future studies are needed in order to clarify this relation.info:eu-repo/semantics/publishedVersio

Polymyalgia Rheumatica After COVID-19 Vaccination: Data from the EudraVigilance Database

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Common polymorphic OTC variants can act as genetic modifiers of enzymatic activity

Understanding the role of common polymorphisms in modulating the clinical phenotype when they co-occur with a disease-causing lesion is of critical importance in medical genetics. We explored the impact of apparently neutral common polymorphisms, using the gene encoding the urea cycle enzyme, ornithine transcarbamylase (OTC), as a model system. Distinct combinations of genetic backgrounds embracing two missense polymorphisms were created in cis with the pathogenic p.Arg40His replacement. In vitro enzymatic assays revealed that the polymorphic variants were able to modulate OTC activity both in the presence or absence of the pathogenic lesion. First, we found that the combination of the minor alleles of polymorphisms p.Lys46Arg and p.Gln270Arg significantly enhanced enzymatic activity in the wild-type protein. Second, enzymatic assays revealed that the minor allele of the p.Gln270Arg polymorphism was capable of ameliorating OTC activity when combined in cis with the pathogenic p.Arg40His replacement. Structural analysis predicted that the minor allele of the p.Gln270Arg polymorphism would serve to stabilize the OTC wild-type protein, thereby corroborating the results of the experimental assays. Our findings demonstrate the potential importance of cis-interactions between common polymorphic variants and pathogenic missense mutations and illustrate how standing genetic variation can modulate protein function