Sintomas não-motores na doença de parkinson : estudo qualitativo exploratório

Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde, Núcleo de Psicologia da Saúde e da Doença), Universidade de Lisboa, Faculdade de Psicologia, 2018A Doença de Parkinson é reconhecidamente uma doença do movimento. Contudo, um conjunto de sintomas não-motores contribui para a morbilidade associada a esta doença. A investigação sobre os sintomas não-motores tem assentado numa perspetiva essencialmente biomédica. O presente estudo teve como objetivo explorar a vivência subjetiva dos sintomas não-motores, devido à escassez de investigação sobre os fatores psicológicos subjacentes aos mesmos. Utilizou-se uma amostra intencional de seis doentes de Parkinson, submetidos a uma entrevista semiestruturada em encadeamento com o Questionário de Sintomas Não-Motores (NMSQuest), sem procedimentos estatísticos associados. A Análise Fenomenológica Interpretativa resultou em oito categorias emergentes: 1) Vivência e explicação da doença; 2) Presença e ausência percebida de sintomas; 3) Impacto da doença e seus sintomas; 4) Vivência e explicação dos sintomas; 5) Atribuições causais; 6) Estratégias de coping; 7) Perceção de eficácia das estratégias de coping; 8) Reflexão sobre o eu, a espiritualidade e o futuro. Os resultados revelaram a idiossincrasia associada à vivência e explicação da doença e dos sintomas não-motores, e o impacto negativo que estes últimos têm na comunicação e relações interpessoais, na autonomia e funcionalidade e na realização de atividades de interesse. As dificuldades de memória e a obstipação foram os sintomas mais reportados. As múltiplas atribuições causais elaboradas destacaram a particularidade das significações de cada doente e a ausência de um caráter patognomónico dos sintomas nãomotores. Para sintomas disautonómicos e alterações do sono, os participantes reportaram utilizar, preferencialmente, estratégias de coping focadas no problema. Para sintomas psicológicos, foram elegidas as estratégias de coping focadas na emoção. A maior parte das estratégias referidas foram percecionadas como eficazes no controlo dos mesmos. Neste sentido, são discutidas implicações práticas para a intervenção psicológica, nomeadamente a psicoeducação e automonitorização.Parkinson's disease is known to be a movement disorder. However, a set of non-motor symptoms contributes to the morbidity associated with this disease. Research on nonmotor symptoms has been based on an essentially biomedical perspective. The present study aimed to explore the subjective experience of non-motor symptoms, due to lack of research on the underlying psychological factors. We used an intentional sample of six Parkinson's patients who underwent a semi-structured interview interlocking with the Non-Motor Symptom Questionnaire (NMSQuest), without associated statistical procedures. The Interpretative Phenomenological Analysis resulted in eight emerging categories: 1) Experience and explanation of the disease; 2) Perceived presence and absence of symptoms; 3) Impact of the disease and its symptoms; 4) Experience and explanation of symptoms; 5) Causal attributions; 6) Coping strategies; 7) Perceived effectiveness of coping strategies; 8) Reflection on self, spirituality and the future. The results revealed the idiosyncrasy related with the experience and explanation of the disease and non-motor symptoms, and the negative impact they have on communication and interpersonal relationships, on autonomy and functionality and on the performance of activities of interest. Memory difficulties and constipation were the most reported symptoms. The multiple causal attributions elaborated highlighted the particularity of the meanings of each patient and the absence of a pathognomonic feature of the non-motor symptoms. For dysautonomic symptoms and sleep disorders, participants reported using problem-focused coping strategies. For psychological symptoms, emotion-focused coping strategies were chosen. Most of the strategies were perceived as effective in symptom control. In this sense, practical implications for psychological intervention, namely psychoeducation, and self-monitoring are discussed

An Overview of the Environmental Applicability of Vermicompost: From Wastewater Treatment to the Development of Sensitive Analytical Methods

The use of vermicompost (humified material) for treating wastewaters, remediating polluted soils, improving agricultural productivity, protecting crop production, and developing sensitive analytical methods is reviewed here, covering the past 17 years. The main advantages of vermicompost, considering all applications covered in this paper, comprise (i) easy acquisition, (ii) low costs, (iii) structural, chemical, and biological characteristics responsible for exceptional adsorptive capacities as well as pollutant degradation, and (iv) the promotion of biocontrol. Specifically, for wastewater decontamination, a considerable number of works have verified the adsorption of toxic metals, but the application of vermicompost is still scarce for the retention of organic compounds. Problems related to the final disposal of enriched vermicompost (after treatment steps) are often found, in spite of some successful destinations such as organic fertilizer. For decontaminating soils, the use of vermicompost is quite scarce, mainly for inorganic pollutants. In agricultural productivity and biocontrol, vermicompost imparts remarkable benefits regarding soil aggregation, plant nutrition, and the development of beneficial microorganisms against phytopathogens. Finally, the use of vermicompost in sensitive analytical methods for quantifying toxic metals is the newest application of this adsorbent

Avaliação do estado nutricional de recém-nascidos pré-termo em unidade de terapia intensiva neonatal / Assessment of nutritional status of preterm newborns in the neonatal intensive care unit

O recém-nascido pré-termo (RNPT) é considerado aquele que nasce com idade gestacional inferior a 37 semanas. Devido à imaturidade fisiológica é frequente que esses recém-nascidos necessitem de cuidados intensivos e, portanto, sejam considerados pacientes em risco nutricional. A avaliação do estado do estado nutricional (AEN) possui a finalidade de identificar sinais de risco de desnutrição e promover a adequação da dietoterapia.  O objetivo deste estudo foi realizar uma revisão da literatura acerca dos métodos de AEN em RNPT internados em unidades de terapia intensiva neonatal. Trata-se de uma revisão narrativa, realizada por meio de consulta ao Scielo, ao PubMed, e aos manuais e diretrizes para a prática clínica. No ambiente de terapia intensiva neonatal a avaliação antropométrica deve ser adaptada ao estado clínico do RNPT, sendo realizada com maior periodicidade, observando-se os sinais que indiquem o risco de desnutrição. Conclui-se que o método para a realização da AEN do RNPT é dependente da condição clínica do paciente, sendo realizada regularmente a fim de promover a adequação da dietoterapia

POÉTICAS DO ISOLAMENTO

Esta obra é composta por textos de um grupo de professores, que no ano de 2020, reinventaram-se em suas ações pedagógicas, buscando por meio da extensão dar continuidade ao ensino com a comunidade acadêmica e externa. O momento de distanciamento, em função da pandemia do Coronavírus, nos levou a busca de meios que possibilitassem o desenvolvimento das ações pedagógicas a distância. Então, iniciamos o processo de ampliar o nosso repertório digital para aplicá-lo no desenvolvimento das aprendizagens propostas por meio de minicursos, seminários, palestras e performances artísticas

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030