Sudden Infant Death Syndrome: What healthcare professionals and parents know about how to prevent it

Introdução: Síndrome da Morte Súbita no Lactente (SMSL) é definida como a morte inesperada e inexplicável de uma criança com menos de 1 ano após uma extensa investigação que inclua necropsia. Nos países desenvolvidos, o SMSL é a primeira causa de morte no primeiro ano de vida das crianças, excluindo o período neonatal (primeiros 28 dias), e é a terceira principal causa de morte infantil no mundo. Certos fatores de risco relacionados com o SMSL já foram identificados, e a maioria encontra-se relacionado com a posição e o ambiente de em que as crianças dormem. A equipa de SMSL da Academia Americana de Pediatria publicou em 2016 uma atualização das recomendações para um ambiente seguro para as crianças dormirem, a fim de reduzir o risco de todas as mortes infantis relacionadas com o sono. Objetivo: Este estudo tem como objetivo avaliar o conhecimento dos pais de crianças nascidas no Centro Hospitalar Universitário São João (CHUSJ) sobre os fatores de risco para SMSL e de profissionais de saúde que cuidam de recém-nascidos no mesmo hospital. Materiais e Métodos: Foram utilizados dois questionários estruturados de auto-preenchimento com o objetivo de avaliar o conhecimento dos pais e profissionais de saúde sobre a prevenção do SMSL e os seus fatores de risco. A análise estatística das respostas aos questionários foi realizada utilizando o STATA. Resultados: No geral, 67,7% dos pais e 100% dos profissionais de saúde sabiam o que é o SMSL. Além disso, 82,3% dos profissionais de saúde e 47,5% dos pais reconheceram o decúbito dorsal como a posição mais segura durante o sono para prevenir o SMSL. Para cada uma das 13 perguntas do questionário sobre fatores de risco para SMSL, a maioria dos profissionais de saúde identificou a resposta correta, enquanto que, entre os pais, apenas 7 perguntas foram respondidas corretamente pela maioria dos participantes. Apenas 37,2% dos profissionais de saúde e 8,7% dos pais responderam corretamente a 75% ou mais das 13 questões sobre os fatores de risco para SMSL. Profissionais de saúde com filhos com idade igual ou inferior a 5 anos têm maior probabilidade de ter um conhecimento mais forte sobre os fatores de risco para SMSL do que os restantes participantes (p = 0,032) e os médicos têm maior probabilidade que os enfermeiros de ter conhecimento menos correto sobre os fatores de risco para SMSL (p = 0.028 e 0.012, respetivamente). Discussão e Conclusão: Os profissionais de saúde não estão tão bem informados sobre o SMSL quanto deveriam e, possivelmente devido à auto-perceção deste facto, têm pouca confiança em discutir questões relacionadas com o SMSL. Isto demonstra o quão crucial é a capacitação dos profissionais de saúde sobre este tópico e que o papel de portadores (parciais) desta informação para os pais deve ser fortalecido com o apoio adequado. Ao alinhar o conhecimento e o comportamento com as mais recentes políticas de prevenção do SMSL, os profissionais de saúde poderiam efetivamente transmitir as mensagens corretas aos pais e, consequentemente, contribuir para diminuir o número de casos de SMSL.Background: Sudden Infant Death Syndrome (SIDS) is defined as the death of an infant of less than 1 year that is unexpected and unexplained after an extensive investigation including necropsy. In developed countries, SIDS is the first cause of mortality in the first year of life, excluding the neonatal period (first 28 days), and is the third leading cause of infant death in the world. Risk factors related to SIDS have already been identified, most of them related with the infant's sleep position and environment. The Task Force on Sudden Infant Death Syndrome of the American Academy of Pediatrics published in 2016 an update on the Recommendations for a Safe Infant Sleeping Environment in order to reduce the risk of all sleep-related infant deaths. Objective: This study aims at assessing the knowledge about SIDS risk factors of parents of infants born in the Centro Hospitalar Universitário São João (CHUSJ) and of healthcare professionals taking care of newborns in the same hospital. Materials and Methods: This study used two structured self-administered questionnaires aiming at evaluating the knowledge of parents and healthcare professionals about SIDS prevention and its risk factors. A statistical analysis of the responses was performed using STATA. Results: Overall, 67.7% of parents and 100% of healthcare professionals knew what SIDS stands for. Besides, 82.3% of healthcare professionals and 47.5% of parents recognized the supine position as the safest sleep position to prevent SIDS. For each of the 13 questions in the questionnaire about SIDS risk factors, the majority of healthcare professionals identified the correct answer whereas among parents only 7 questions were correctly answered by the majority of respondents. Only 37.2% of healthcare professionals and 8.7% of parents responded correctly to 75% or more of the 13 questions about SIDS risk factors. Healthcare professionals with children aged 5 or less are more likely to have stronger knowledge about SIDS risk factors than the other respondents (p = 0.032) and doctors are more likely than nurses to have less correct knowledge about SIDS risk factors (p = 0.028 and 0.012, respectively). Discussion and Conclusion: Healthcare professionals are not as well informed about SIDS as they should and, possibly due to their self-awareness of this, they have little confidence in discussing SIDS-related issues. This highlights how crucial the training of healthcare professionals about this topic is, and that their role of (partial) gatekeepers of this information for parents should be strengthened with appropriate support. By aligning their knowledge and behaviour with the latest SIDS prevention policies, they could effectively pass on to parents the correct messages, and consequently contribute to decrease the number of SIDS cases

Ativação funcional da Default Mode Network na sintomatologia depressiva e ansiosa

Dissertação de mestrado integrado em Psicologia (área de especialização em Psicologia Clínica e da Saúde)Resumo: As redes cerebrais no estado de repouso têm sido amplamente investigadas, nomeadamente a Default Mode Network (DMN) cujas funções sustentam a cognição espontânea, bem como, os estados emocionais internos e os processos autorreferentes. Neste estudo colocou-se a hipótese de que as áreas corticais mediais da DMN poderiam apresentar maior ativação durante os estados de ansiedade e humor depressivo. A amostra foi constituída por 24 adultos saudáveis. Os participantes foram avaliados com as escalas HDRS e HARS e realizaram um exame de ressonância magnética funcional no estado de repouso com a duração de 5 minutos. Foi realizada uma análise de regressão múltipla que revelou a relação entre a ativação das áreas da DMN e a variação dos scores de ansiedade e depressão. Verificou-se uma correlação positiva entre a ativação de porções anteriores da DMN, tipicamente envolvidas em pensamento autorreferente e processamento emocional e os scores de ansiedade e depressão. Ao contrário, as áreas posteriores da DMN apresentaram uma correlação negativa com os scores de ansiedade e depressão. Este estudo demonstra que na ansiedade e depressão, os indivíduos apresentam um elevado foco introspetivo e uma regulação emocional disfuncional.Abstract: Brain networks in the resting state have been widely investigated, namely the Default Mode Network (DMN), whose functions sustain spontaneous cognition, as well as, internal emotional states and self-referential processes. In this study it was hypothesized that the cortical areas of the medial DMN might present greater activation during anxiety states and depressed mood. The sample of healthy adults consisted of 24 healthy subjects. Participants were assessed using HARS and HDRS scales and completed a 5 minutes restingstate functional magnetic resonance imaging scan. Multiple regression was performed and revealed which areas of the DMN were being recruited depending on the variation of anxiety and depression scores. It was found a positive correlation between the activation of the anterior portions of DMN involved in self-referential thought and emotional processes and the anxiety and depression scores. However posterior areas were negatively correlated with anxiety and depression scores. The present study demonstrates that anxious and depressed individuals are strongly engaged in introspection and might present dysfunctional emotion regulation

Nutritional status and quality of life in HIV-infected patients

Introduction: Nutritional status and the progression of the human immunodeficiency virus (HIV) are interlinked; though some studies have looked at the impact nutritional status has on quality of life (QoL) in patients with chronic diseases, few have studied this in HIV-infected individuals. Objective: To investigate the relationship between nutritional status and QoL in adults with a recent HIV diagnosis. Methods: Individuals with an HIV diagnosis performed in the fourteen months prior to a medical visit to one of Lisbon’s central hospitals were eligible. Nutritional status was assessed by anthropometry, body composition analysis, and dietary intake. QoL was assessed using the WHOQOLHIV-BREF questionnaire. Sociodemographic and clinical data were also considered. Results: Fifty-one subjects were eligible for enrollment; the majority were male, Caucasian, employed, single, and under highly active antiretroviral therapy (HAART). Lower QoL scores were observed in subjects with inadequate energy intakes, reported weight loss, and a high waist circumference in bivariate analysis (p < 0.05); the same variables influenced QoL negatively after adjusting for confounders in multivariate analysis (p < 0.05). Various sociodemographic characteristics such as level of education, age, gender, and current health problems also predicted QoL significantly (p < 0.05). Conclusion: Various aspects of nutritional status were responsible for the variations observed in QoL, suggesting a potential for nutritional intervention in improving QoL in this population.info:eu-repo/semantics/publishedVersio

Liderança proativa e satisfação laboral : estudo exploratório

O papel dos líderes, nos dias de hoje, é bastante diferente quando comparado com o que encontramos em anos transatos, atualmente afirma-se que o sucesso e a eficácia das organizações são sujeitos aos estilos de liderança que são aplicados pelos diferentes líderes, os líderes eficazes têm a aptidão de modelar e minimizar as perceções políticas das organizações, aumentando assim a satisfação do trabalhador no seu posto de trabalho, o que torna cada vez mais pertinente o estudo destes construtos. O presente estudo tem como objetivo perceber de que forma a liderança proactiva pode afetar a satisfação dos trabalhadores. A revisão bibliográfica foi realizada através da consulta de artigos científicos de repositórios nacionais e internacionais de acesso livre. Na recolha dos dados foram utilizados três instrumentos, o Questionário Sociodemográfico, a Escala de Liderança Proativa e o Questionário de Satisfação Laboral (S20/23). Este estudo é de natureza quantitativa, realizado com uma amostra de 143 trabalhadores ativos no momento da recolha, e os dados analisados através do SPSS, versão 22, os resultados permitiram compreender que existe uma correlação estatisticamente significativa entre as dimensões da liderança proativa e a satisfação laboral.now said that the success and effectiveness of organizations are subject to the styles of leadership that are applied by different leaders. Effective leaders have the ability to model and minimize the political perceptions of organizations, thus increasing the satisfaction of the workers in their workplace, which makes it increasingly relevant to study these constructs. The present study aims to understand how proactive leadership can affect employee satisfaction. The bibliographic review was carried out through the consultation of scientific articles from national and international repositories of free access. In the data collection, three instruments were used: the Sociodemographic Questionnaire, the Proactive Leadership Scale and the Job Satisfaction Questionnaire (S20 / 23). This study is of a quantitative nature, performed with a sample of 143 active workers at the time of collection, and data analyzed through SPSS, version 22, the results allowed to understand that there is a statistically significant correlation between the dimensions of proactive leadership and labor satisfaction

ADENOPATIA CERVICAL COMO MANIFESTAÇÃO DE CANCRO DO CÓLON

Introduction: Colorectal cancer is one of the most frequent cancers worldwide, being the third most common cancer diagnosed and corresponding to the second cause of death by cancer. Approximately 25% of patients have already disseminated disease at the time of diagnosis. Case Report: We present the case of a 68-year-old female patient presented with complaints of cervical mass. She was then submitted to a biopsy of the cervical adenopathy that revealed metastatic adenocarcinoma tissue with probable gastrointestinal origin. A work-up was performed and revealed a sigmoid colon adenocarcinoma. Due to associated morbidities she was submitted to supportive treatment. Discussion: This case demonstrates the singularity of metastatic pattern in colon carcinoma. The mechanism of distant lymph node metastases in colorectal cancer still remains uncertain, nevertheless this represents an advanced stage of the disease that bears a poor prognosis. Conclusion: Few reports in the literature showed a good outcome with primary tumor excision and adjuvant chemotherapy but this decision should be discussed in a multidisciplinary team in order to decide the best treatment option for each patient.Introdução: O cancro colorectal é um dos cancros mais frequentes a nível mundial, sendo o terceiro cancro mais frequentemente diagnosticado e corresponde à segunda causa de morte por cancro. Cerca de 25% dos doentes apresentam doença disseminada à data de diagnóstico. Caso Clínico: Os autores apresentam o caso de uma doente de 68 anos, do sexo feminino, que se apresentou com queixas de uma tumefacção cervical. Foi posteriormente submetida a biópsia excisional que revelou a presença de metástase de adenocarcinoma provavelmente intestinal. Foi realizado o estudo complementar com identificação de um adenocarcinoma do cólon sigmoide. Devido às morbilidades associadas foi oferecido tratamento de suporte. Discussão: Este caso representa a singularidade do padrão de metastização do cancro do cólon. O mecanismo de metastização ganglionar à distância não se encontra totalmente esclarecido, no entanto, representa um estadio de doença avançado com um mau prognóstico associado. Conclusão: Alguns casos na literatura demonstraram bons resultados com a excisão do tumor primário seguida de quimioterapia adjuvante, esta decisão deve ser realizada por uma equipa multidisciplinar de forma a avaliar a melhor opção terapêutica para cada doente

Hábitos alimentares dos estudantes da Escola Superior de Saúde

Atualmente, tem vindo a constatar-se numa diminuição de consumo de alimentos saudáveis tais como produtos hortícolas, fruta e cereais. Em detrimento desta situação os estudantes tem registado um aumento de consumo significativo de snacks e produtos calóricos pouco ricos em nutrientes. Os hábitos alimentares consistem no tipo de escolhas e consumo de alimentos por um indivíduo ou grupo, em resposta das influências fisiológicas, psicológicas, culturais e sociais.info:eu-repo/semantics/publishedVersio

“The ark of rights”: development of a board game to empower older adults regarding their rights

There is an urgent need to ensure the rights of older adults. In particular, there is a lack of awareness of human rights by older adults themselves, for which intervention strategies should be developed. Due to the need for intervention at this level, a board game was created to empower older adults regarding their rights using a dynamic and interactive method. This article aims to describe the development stages of the board game “The Ark of Rights”® up to its pilot study. Its development followed three stages: A first phase to review the scientific literature and benchmarks on the rights of older persons, a second phase to define the game design and collect statements from older people for the game, and a third phase to test the game. The European Portuguese Validation of the System Usability Scale (SUS) was used to assess the latter phase. Approximately 200 older people contributed to the game’s contents (second phase), and 74 participated and positively evaluated the game’s usability and their satisfaction with its use (third phase). In summary, the game “The Ark of Rights” revealed itself to be a resource for empowering older adults regarding their rights. It also enables the identification of possible human rights violations among older adults and subsequent intervention.This research was funded by POISE/CIG 03 4436 FSE OO1051 under typology 3. 16, Financial and Technical Support to Non-Profit Civil Society Organizations, under Portugal 2020, specifically Priority Axis 3

S100B inhibition protects from chronic experimental autoimmune encephalomyelitis

© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Studies have correlated excessive S100B, a small inflammatory molecule, with demyelination and associated inflammatory processes occurring in multiple sclerosis. The relevance of S100B in multiple sclerosis pathology brought an emerging curiosity highlighting its use as a potential therapeutic target to reduce damage during the multiple sclerosis course, namely during inflammatory relapses. We examined the relevance of S100B and further investigated the potential of S100B-neutralizing small-molecule pentamidine in chronic experimental autoimmune encephalomyelitis. S100B depletion had beneficial pathological outcomes and based on promising results of a variety of S100B blockade strategies in an ex vivo demyelinating model, we choose pentamidine to assay its role in the in vivo experimental autoimmune encephalomyelitis. We report that pentamidine prevents more aggressive clinical symptoms and improves recovery of chronic experimental autoimmune encephalomyelitis. Blockade of S100B by pentamidine protects against oligodendrogenesis impairment and neuroinflammation by reducing astrocyte reactivity and microglia pro-inflammatory phenotype. Pentamidine also increased regulatory T cell density in the spinal cord suggesting an additional immunomodulatory action. These results showed the relevance of S100B as a main driver of neuroinflammation in experimental autoimmune encephalomyelitis and identified an uncharacterized mode of action of pentamidine, strengthening the possibility to use this drug as an anti-inflammatory and remyelinating therapy for progressive multiple sclerosis.This work was funded by grants from Ordem dos Farmacêuticos (AF), Merck KGaA (AF) and Fundação de Ciênciase Tecnologia (UIDB/04138/2020; UIDP/04138/2020) (iMed.ULisboa).info:eu-repo/semantics/publishedVersio