Care and Caregivers: the contribution of rehabilitation nursing care on preparing discharge in patients after stroke

A transição demográfica, que continua a ocorrer por todo o mundo ocidental, tem implícita a sobrevivência das pessoas com idade avançada por muitos anos, expondo-as de um modo acrescido ao risco de acidente vascular cerebral. É reconhecido, tanto pelos profissionais de saúde como pelo público, o esforço dos decisores políticos e de saúde no sentido de dotar as unidades de saúde de recursos que permitam o encaminhamento e atendimento mais rápido destes doentes, que associado à terapêutica trombolítica, tem permitido em muitos casos evitar sequelas graves e dependência de terceiros. Contudo, um número significativo de pessoas acometidas por este problema fica fora dos critérios destas abordagens, resultando da sua doença sequelas mais ou menos graves com graus de dependência muito variados. Nestes doentes, a diminuição do tempo médio de internamento é uma realidade tanto associada à optimização do desempenho das unidades de saúde, como a algum desinteresse suscitado pela evolução lenta do seu restabelecimento e pela reserva no prognóstico. Dos 9,6 dias de demora média em 1990, passou-se para uma meta de 6 dias de internamento como estabelecia o Plano Nacional de Saúde 2004-2010. O mesmo plano, refere a insuficiência nas respostas existentes, relativamente às pessoas que se encontram em situação de perda de funcionalidade ou com níveis de dependência que as fazem necessitar de apoio para a satisfação das suas necessidades mais básicas, tanto por número insuficiente de respostas como pela frágil articulação entre as mesmas, configurando-se a família como um recurso fundamental. As famílias em Portugal continuam a ser a principal fonte de cuidados e a responsabilidade de cuidar dos dependentes, continua a ser da família, que se vê de repente confrontada com as necessidades acrescidas e exposta a desequilíbrios diversos. Com o presente artigo de revisão pretende-se reflectir sobre alguns aspectos relacionados com continuidade de cuidados, após um episódio de doença aguda, o acidente vascular cerebral salientando a importância da família neste processo, e rever, elencando, um conjunto de intervenções relacionadas com os cuidados de enfermagem de reabilitação à família na transição para o seu novo papel. Duas ideias centrais nortearam a reflexão: a família e a gestão da dependência e os cuidados de enfermagem de reabilitação no planeamento da alta

Application of the S=1 underscreened Anderson lattice model to Kondo uranium and neptunium compounds

Magnetic properties of uranium and neptunium compounds showing the coexistence of Kondo screening effect and ferromagnetic order are investigated within the Anderson lattice Hamiltonian with a two-fold degenerate $f$-level in each site, corresponding to $5f^2$ electronic configuration with $S=1$ spins. A derivation of the Schrieffer-Wolff transformation is presented and the resulting Hamiltonian has an effective $f$-band term, in addition to the regular exchange Kondo interaction between the $S=1$ $f$-spins and the $s=1/2$ spins of the conduction electrons. The obtained effective Kondo lattice model can describe both the Kondo regime and a weak delocalization of $5f$-electron. Within this model we compute the Kondo and Curie temperatures as a function of model parameters, namely the Kondo exchange interaction constant $J_K$, the magnetic intersite exchange interaction $J_H$ and the effective $f$-bandwidth. We deduce, therefore, a phase diagram of the model which yields the coexistence of Kondo effect and ferromagnetic ordering and also accounts for the pressure dependence of the Curie temperature of uranium compounds such as UTe.Comment: 9 pages, 4 figure

The effects of a biocide and a surfactant on the detachment of Pseudomonas fluorescens from glass surfaces

Application of antimicrobial chemicals is a general procedure in the cleaning and disinfection of food-contacting surfaces. Adhesion to glass surfaces and chemically induced detachment of Pseudomonas fluorescens ATCC 13525T were studied in situ, under flow conditions, in a well-controlled parallel plate flow chamber (PPFC). Ortho-phthalaldehyde (OPA) and cetyltrimethyl ammonium bromide (CTAB) were applied separately, at several concentrations, to attached bacteria and their subsequent detachment was monitored. Following treatments the remaining adhered bacteria were characterized in terms of viability and cell size. Simultaneously, the planktonic cell surface was characterized in order to correlate PPFC results with thermodynamic approaches for adhesion evaluation, and surface free energy of chemically treated cells with adhesion strength. About 2.8 × 106 cells/cm2 adhered to the glass surface after 30 min of bacterial flow, although thermodynamic analyses evidenced unfavourable adhesion. The independent application of OPA and CTAB promoted bacterial detachment to a small extent (16% of total cells). The remaining adhering bacteria were totally non-viable for OPA ≥ 0.75 mM and CTAB ≥ 0.25 mM, showing a lack of correlation between bacterial viability and detachment. The cellular size decreased as attachment proceeded and with chemical treatment. Both chemicals altered the cell surface properties, increasing the cell-glass adhesion strength, and promoting the emergence of polar characteristics. The overall results emphasize that OPA and CTAB were markedly ineffective in removing glass-attached P. fluorescens, demonstrating that bacteria can be non-viable but remain strongly attached to the adhesion surface.Fundação para a Ciência e a Tecnologia (FCT) - Project CHEMBIO – POCI/BIO/61872/2004; SFRH/BD/ 31661/2006; SFRH/BPD/20582/2004

Cellulitis at GLP-1 Agonist Injection Site: Rare But Relevant

We present a case of cellulitis complicating with abscess formation as a possible complication of treatment with injectable GLP-1 agonists on a sixty-one-year-old woman. Pus cultures showed isolation of Streptococcus anginosus and clindamycin was started as targeted therapy but absence of improvement prompted a consultation with the surgery department and a manual surgical debridement was performed. A second isolate of Eikenella corrodens, which is frequently resistant to clindamycin, was identified. We opted for a switch to ceftriaxone and after nineteen days, having achieved clinical improvement, plans were made for her to continue to change her wound dressing at her local health center and for a short-term revaluation at a surgery outpatient consultation. Caring for social needs and assuring continuity across multiple care levels can be fundamental in preventing adverse effects from self-injectable drugs.info:eu-repo/semantics/publishedVersio

Measurement and determinants of health poverty and health richness: evidence from Portugal

The analysis of health inequalities is a critical topic for health policy. With data for Portugal, we propose an algorithm to convert information provided by the official National Health Survey to EuroQol. Based on these data, we make two contributions. First, we extend measures and methods commonly applied in other fields of economic research in order to quantify the phenomena of health poverty, richness, and inequality. Second, using an ordered probit model, we evaluate the determinants of health inequalities in Portugal. The results show that there is a remarkable level of health inequality, with significant rates of poverty (11.64 %) and richness (22.64 %). The econometric study reveals that gender, age, education, region of residence, and eating habits are among the most critical determinant factors of health.info:eu-repo/semantics/acceptedVersio

Association of albumin or protamine to lipoplexes: enhancement of transfection and resistance to serum

The successful application of gene therapy depends on the availability of carriers to efficiently deliver genetic material into target cells. Such efficacy is strongly related to key parameters including serum resistance and protection of DNA.The complexes were tested in terms of their biological activity, in the absence or presence of serum, by following transfection activity. Interaction with plasma proteins was evaluated by immunoblotting, while cytotoxicity was assessed by the Alamar Blue assay. Extent of DNA protection was determined both by using ethidium bromide intercalation and DNase I digestion assays.Our results show that, depending on the charge ratio and on the lipid composition, albumin and protamine can be used (either individually or co-associated) to generate cationic liposome/DNA complexes fulfilling in vivo requirements, while exhibiting high levels of transfection activity. In the present work a novel cationic lipid was tested. It was demonstrated that 1-palmitoyl-2-oleoyl-sn-glycero-3-ethylphosphocholine (EPOPC):cholesterol (Chol) liposomes constitute a very promising carrier for gene delivery as illustrated by their enhancing effect on transfection, as compared with DOTAP-containing liposomes. Moreover, the biological activity of EPOPC-containing complexes is significantly improved upon association of albumin, even in the presence of 60% serum (namely for the 4/1 lipid/DNA charge ratio). Nevertheless, our studies also show that transfection activity mediated by DOTAP-containing complexes can be significantly enhanced upon pre-condensation of DNA with protamine.Co-association of HSA and protamine to lipoplexes ensures a high degree of DNA protection and results in high levels of transfection activity even in the presence of serum. Copyright © 2004 John Wiley & Sons, Ltd

Gas proportional scintillation counter pulse-signature analysis using digital techniques

The use of short shaping time-constants (50 ns) followed by digital sampling of gas proportional scintillation counter pulses is investigated. Such short shaping time causes each pulse to closely resemble the scintillation light burst, allowing for an effective pulse-signature analysis. Pulse amplitude is obtained by numerical integration of the digital pulse samples. The shorter total pulse durations, lead to pulse-height distributions that are much less dependent on the total interaction rate occurring in the detector. Total interaction rates up to 12 k s-1 can be tolerated without significant degradation of the obtained pulse-height distribution. It was also verified that the maximum throughput achieved by the digital pulse-height analyser improves from 1 to 1.7 k s-1 when using the short shaping time-constants.http://www.sciencedirect.com/science/article/B6TJM-3VR1CVW-2F/1/2e9e952e1c3752048a2954b0dbbdec2