A dor na pessoa com ferida crónica

Apesar de a dor ser considerada como 5º sinal vital e do Ministério da Saúde ter definido um Plano de Luta Nacional contra a Dor, a avaliação e valorização da mesma continuam a não ser consideradas prioritárias, nomeadamente no âmbito do tratamento de feridas. A avaliação e controlo da dor na pessoa com ferida crónica é prioritário pois, para além das dificuldades e angústias provocadas pela ferida crónica, a dor é sinónimo de sofrimento, comprometendo a qualidade de vida e interferindo nas diferentes Atividades de Vida da pessoa. No entanto, verifica-se uma focalização na cicatrização da ferida, em detrimento da avaliação da dor e do seu impacto, não só no momento de realização do penso, mas também nas atividades do dia-a-dia. Por estas razões, e pretendendo analisar as vivências da dor na pessoa com ferida crónica, compreender o impacto da mesma nas diferentes Atividades de Vida e identificar os fatores que influenciam a dor e o seu controlo em feridas crónicas, elaborámos o presente estudo, visando contribuir para a qualidade dos cuidados de saúde prestados à pessoa com ferida cónica e com dor associada. Este estudo enquadra-se no paradigma qualitativo, sendo o mesmo descritivo e transversal. Realizámos doze entrevistas, a pessoas com ferida crónica e dor associada à mesma, que correspondiam aos critérios de seleção da amostra, nos Centros de Saúde de Torres Novas (incluindo Sede, extensão de Riachos e Brogueira), Entroncamento e Alcanena. Nos resultados obtidos, verificámos que a dor provoca diferentes sentimentos negativos na pessoa, sendo o conformismo relativamente à mesma, um sentimento patente nas entrevistas, o que não seria expectável atualmente, devido às normas definidas, as quais valorizam a avaliação e controlo da dor. O impacto da dor verifica-se praticamente em todas as Atividades de Vida e nas relações sociais, contribuindo para que se instalem sentimentos de tristeza, depressão e angústia. A diminuição do poder económico familiar é uma consequência associada à incapacidade em desenvolver uma atividade profissional, por causa da dor associada à ferida, e por outro lado coloca em causa a evolução da ferida por incapacidade em manter a terapêutica recomendada. A equipa de enfermagem surge como uma fonte de apoio para ultrapassar aspetos negativos da vivência da dor, apesar de se continuar a verificar lacunas na avaliação e controlo da dor por parte dos profissionais de saúdeEven though pain is considered the fifth vital sign and the Health Ministry defined a National Plan against it, the evaluation and appreciation of pain still isn’t considered a priority, particularly in wound care. The evaluation and control of pain in the person with a chronic wound is a priority because, besides the difficulties and anxieties caused by the chronic wound, pain means suffering, compromising the quality of life and interfering in the person’s different Life’s Activities. However, there is a focalization in wound healing, ignoring the evaluation of pain and its impact, not only in the moment when the wound is treated, but also in the daily activities. For these reasons and intending to analyze the experiences of pain in the person with chronic wound, understand its impact in the different Life’s Activities and identify the factors that influence pain and its control in chronic wounds, we developed this study, intending to contribute to the quality of health care, given to the person with a chronic wound and associated pain. This study is qualitative, descriptive and transversal. We conducted twelve interviews with people with chronic wound and pain associated, that corresponded to the sample selection criteria, in the Health Centers of Torres Novas (including the headquarters, extension of Riachos and Brogueira), Entroncamento e Alcanena. The results obtained, revealed that pain causes different negative feelings, being the conformism towards it, a feeling present in the interviews, which shouldn’t be expected nowadays, due to the guidelines defined, that value evaluation and pain control. The impact of pain is notorious in almost every Life’s Activities and in the social relationships, contributing to feelings of sadness, depression and anguish. The reduction of the family’s economic power is a consequence of the inability to develop an occupation, because of the pain associated to the wound, and puts the evolution of the wound at risk, because of the inability to maintain the recommended medication. The nursing staff is considered a source of support to overcome negative aspects of living with pain, although there are still some gaps in the evaluation and control of pain by the health professionals

A Dor na Pessoa com Ferida Crónica

Apesar de a dor ser considerada como 5º sinal vital e do Ministério da Saúde ter definido um Plano de Luta Nacional contra a Dor, a avaliação e valorização da mesma continuam a não ser consideradas prioritárias, nomeadamente no âmbito do tratamento de feridas. A avaliação e controlo da dor na pessoa com ferida crónica é prioritário pois, para além das dificuldades e angústias provocadas pela ferida crónica, a dor é sinónimo de sofrimento, comprometendo a qualidade de vida e interferindo nas diferentes Atividades de Vida da pessoa. No entanto, verifica-se uma focalização na cicatrização da ferida, em detrimento da avaliação da dor e do seu impacto, não só no momento de realização do penso, mas também nas atividades do dia-a-dia. Por estas razões, e pretendendo analisar as vivências da dor na pessoa com ferida crónica, compreender o impacto da mesma nas diferentes Atividades de Vida e identificar os fatores que influenciam a dor e o seu controlo em feridas crónicas, elaborámos o presente estudo, visando contribuir para a qualidade dos cuidados de saúde prestados à pessoa com ferida cónica e com dor associadaN/

Distribuição de Cinema Independente pela Web

A Distribuição de Cinema Indepenente pela Web pretende falar sobre a transição da distribuição de cinema para a era digital, onde os realizadores/produtores utilizam a Internet como ferramenta de marketing e divulgação dos seus projetos. As plataformas digitais que vieram a elimar os intermediários – os distribuidores e exibidores, e tornaram possível que os proprietários do conteúdo o distribuíssem de acordo com os seus interesses. O que despoletou o meu interesse por este tema foi observar-me na posição de consumidor que utiliza a Internet para ver conteúdo. Logo, como produtora de uma curtametragem que iria fazer uso da Internet para promoção, surgiu-me esta temática de formas e processos de distribuição pela web. A problemática deste tipo de distribuição deve-se à dificuldade que ainda existe em confiar nestes serviços enquanto realizador e utilizar estes serviços enquanto consumidor. O consumidor do século XXI não está focado na legalidade e menospreza as plataformas legais que existem para a distribuição deste conteúdo. Desta forma, existe um grande atraso nesta transição e os estúdios de cinema continuam relutantes. A pirataria é uma grande ameaça ao crescimento destas plataformas. Para introduzir esta temática, recuo umas décadas no cinema, até ao nascimento do cinema independente, que é o foco da distribuição que quero analisar. O cinema independente andou sempre de mãos dadas com a evolução tecnológica, por isso, o meu foco é em como se aproveitou da distribuição digital. As tecnologias estão em constante mudança, tornando-se cada vez mais alcançáveis e baratas, o que facilita a produção de cinema independente e dificulta a sua distribuição de um modo tradicional. Esta tecnologia contemporânea está a mudar por completo a forma como as pessoas vêm cinema. Há mais autonomia e independência, que não deixa o espetador nas mãos da autoridade da televisão e dos exibidores

Dendritic cell quiescence during systemic inflammation driven by LPS stimulation of radioresistant cells in vivo

Dendritic cell (DC) activation is a prerequisite for T cell priming. During infection, activation can ensue from signaling via pattern-recognition receptors after contact with pathogens or infected cells. Alternatively, it has been proposed that DCs can be activated indirectly by signals produced by infected tissues. To address the contribution of tissue-derived signals, we measured DC activation in a model in which radioresistant cells can or cannot respond to lipopolysaccharide (LPS). We report that recognition of LPS by the radioresistant compartment is sufficient to induce local and systemic inflammation characterized by high circulating levels of tumor necrosis factor (TNF) α, interleukin (IL) 1β, IL-6, and CC chemokine ligand 2. However, this is not sufficient to activate DCs, whether measured by migration, gene expression, phenotypic, or functional criteria, or to render DC refractory to subsequent stimulation with CpG-containing DNA. Similarly, acute or chronic exposure to proinflammatory cytokines such as TNF-α ± interferon α/β has marginal effects on DC phenotype in vivo when compared with LPS. In addition, DC activation and migration induced by LPS is unimpaired when radioresistant cells cannot respond to the stimulus. Thus, inflammatory mediators originating from nonhematopoietic tissues and from radioresistant hematopoietic cells are neither sufficient nor required for DC activation in vivo

The European Portuguese version of the Reproductive Concerns After Cancer Scale (RCACS): a psychometric validation for young adult female cancer survivors

Purpose: The purpose of this study was to evaluate the psychometric properties of the Portuguese version of the 18-item Reproductive Concerns After Cancer Scale (RCACS) among young adult female cancer survivors. Methods: The psychometric validation was conducted based on a convenience sample of 192 cancer survivors aged between 18 and 40 years. An exploratory factor analysis (EFA) was used to test the factor structure of the Portuguese version of RCACS and reliabilities were examined. Convergent and discriminant validity was also used to assess the construct validity. The Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORT QLQ-C30) and the need for parenthood and rejection of child-free lifestyle subscales of the Fertility Problem Inventory (FPI) were used as convergent measures. Results: A five-factor model was obtained with acceptable fit indexes and internal consistencies (.72 < α < .89): (1) fertility potential, (2) children's health risk and future life, (3) partner disclosure, (4) barriers to getting pregnant/having children and (5) acceptance. Overall, convergent and discriminant validities were confirmed. Levels of anxiety and depression symptoms as well as health-related quality of life (QoL) had weak-to-moderate associations with reproductive concerns. Women who had a child or did not want a biological child were less concerned. Conclusion: This scale proved to be a reliable and valid measure of reproductive concerns for the Portuguese population with potential relevance for application in clinical practice.publishe

Sialyl Lewis x expression in canine malignant mammary tumours: correlation with clinicopathological features and E-Cadherin expression

<p>Abstract</p> <p>Background</p> <p>Sialyl Lewis x (sLe^x) antigen is a carbohydrate antigen that is considered not only a marker for cancer but also implicated functionally in the malignant behaviour of cancer cells. Overexpression of sLe^xis associated with enhanced progression and metastases of many types of cancer including those of the mammary gland. Canine mammary tumours can invade and give rise to metastases via either lymphatic or blood vessels.</p> <p>E-Cadherin is specifically involved in epithelial cell-to-cell adhesion. In cancer, E-Cadherin underexpression is one of the alterations that characterizes the invasive phenotype and is considered an invasion/tumour suppressor gene. Partial or complete loss of E-Cadherin expression correlates with poor prognosis in canine malignant mammary cancer.</p> <p>The aim of this study was to analyse the sLe^xexpression in canine malignant mammary tumours and to evaluate if the presence of sLe^xcorrelates with the expression of E-Cadherin and with clinicopathological features.</p> <p>Methods</p> <p>Fifty-three cases of canine mammary carcinomas were analysed immunohistochemically using monoclonal antibodies against sLe^x(IgM) and E-Cadherin (IgG). The clinicopathological data were then assessed to determine whether there was a correlation with sLe^xtumour expression. Double labelled immunofluorescence staining was performed to analyse the combined expression of sLe^xand E-Cadherin.</p> <p>Results</p> <p>sLe^xexpression was consistently demonstrated in all cases of canine mammary carcinomas with different levels of expression. We found a significant relationship between the levels of sLe^xexpression and the presence of lymph node metastases. We also demonstrated that when E-Cadherin expression was increased sLe^xwas reduced and vice-versa. The combined analysis of both adhesion molecules revealed an inverse relationship.</p> <p>Conclusion</p> <p>In the present study we demonstrate the importance of sLe^xin the malignant phenotype of canine malignant mammary tumours. Our results support the use of sLe^xas a prognostic tumour marker in canine mammary carcinomas. Furthermore, we showed that sLe^xand E-Cadherin expression were inversely correlated. Future studies are warranted to clarify the molecular mechanism underlying the relation between sLe^xand E-Cadherin in canine mammary carcinoma cells which represents an important comparative model to woman breast cancer.</p

Grupo de trabalho e interversão em psicologia na procriação medicamente assistida - GIPPMA

With a view to improving provision of care in the field of Psychology in the context of Medically Assisted Procreation (PMA), the GIPPMA - Working Group and Intervision in Psychology at PMA was created in 2019. This informal group includes Psychologists who carry out their work activities in a hospital of the SNS (North Zone) and a professor/researcher. The GIPPMA emerged on the personal initiative of these professionals with the central assumption of creating a shared practical approach, overcoming some of the difficulties present in clinical practice. The group's objectives are: to build standardized psychological protocols in the field of PMA (pre-treatment evaluation, treatment and post-treatment protocols), as well as to develop, evaluate and propose work initiatives aimed at disseminating solutions and good practices in this area. GIPPMA has been emphasizing joint scientific research, seeking to contribute to knowledge on the subject, crucial as a basis for intervention. Similar to other areas of Psychology, which are undergoing rapid development and change, requiring professionals to be constantly updated/trained, this group also includes Clinical Intervision. Taking advantage of the geographical proximity and formal relations between institutions and following what the Portuguese Psychologists Association has been highlighting, GIPPMA considers this area of its activity as relevant in promoting well-being and self-care of professionals, in facilitating training and continuous development, as well as a safe and quality professional practice.info:eu-repo/semantics/publishedVersio

Associação entre a percepção de stress relacionado com a infertilidade em mulheres e relacionamento diádico em homens

info:eu-repo/semantics/draf

Feasibility and acceptability of psychosocial care for unsuccessful fertility treatment

Introduction: Many people undergo fertility treatment to have biological children, but around four in ten patients complete all treatment cycles without having the children they desire. This triggers intense grief from which patients report taking on average 2 years to recover. Fertility guidelines and regulators stress the need to support patients through this process, but there is a scarcity of evaluated interventions to this end and evidence about when and how to offer care is lacking. This study explored patients' and healthcare professionals' (HCPs) experiences of and views about provision of psychosocial care (to patients facing unsuccessful fertility treatment, i.e., care provided by a mental health professional to address the emotional, cognitive, behavioural, relational and social needs that patients have at this stage of treatment). Methods: Five qualitative online focus groups were conducted with Portuguese participants: three with patients waiting to initiate or undergoing their last cycle of in vitro fertilization/intracytoplasmic sperm injection or having completed it within the last 2 months without achieving a pregnancy and two with HCPs working at fertility clinics. Focus groups were recorded and transcribed verbatim, and data were analysed with Framework Analysis. Results: Thirteen patients and nine HCPs participated. Analysis resulted in 1293 codes, systematically organized into 13 categories, 4 themes and 1 metatheme. The latter showed high consensus about the need for psychosocial care for unsuccessful treatment, but perceived challenges in its implementation. Themes reflected (1) consensual demand for psychosocial care at all stages of treatment but particularly at the end, (2) high perceived acceptability of integrating preventive care initiated during treatment with early psychosocial care only for those patients who experience unsuccessful treatment, (3) perceived challenges of implementing psychosocial care for unsuccessful treatment at clinics and (4) suggestions to promote its acceptability and feasibility. Conclusion: Patients and HCPs perceive that clinics should improve care provision across the whole treatment pathway and in particular for unsuccessful fertility treatment. Suggestions were made to inform future research focusing on the development and evaluation of psychosocial interventions to this end. Patient or Public Contribution: Patients and HCPs participated in the focus groups. Two HCPs also revised the manuscript