A hospitalização domiciliária como fator facilitador no processo de transição saúde/doença

Background: home Hospitalization (HD) was created as an alternative to conventional hospitalization and it is intended to be a model of care at home with the mission of contributing to the best level of health and well-being of the sick person, who are in temporary need of care hospital level, with a focus on promoting the person's autonomy and functional recovery. Objectives: understand the health/illness transition process of people on HD. Methodology: qualitative and descriptive study. The sample was selected for convenience and intentionally. Data collection was carried out through a focus group, composed of five specialist nurses performing functions in home hospitalization units distinct from the north and center of the country. Results: four categories emerged: Admission criteria, Benefits of home hospitalization, Difficulties in implementation and Nursing interventions. Conclusion: as nursing therapies for the person undergoing home hospitalization, the training of the person/caregiver through personalized teaching, the effectiveness in the management of the therapeutic regime, the prevention of falls and the promotion of self-care are highlighted. With the implementation of these therapies, nurses facilitate health/illness transition processes, with a significant impact on improving the quality of life of people targeted by home hospitalization.Marco contextual: la Hospitalización Domiciliaria (HD) se creó como una alternativa a la hospitalización convencional y se pretende que sea un modelo de prestación de cuidados cuya misión es contribuir al mejor nivel de salud y bienestar del enfermo, con foco en promover la autonomía y recuperación funcional de la persona. Objetivos: comprender el proceso de transición salud / enfermedad para personas en HD. Metodología: estudio cualitativo y descriptivo. La muestra fue seleccionada por conveniencia e intencionalmente. La recolección de datos se realizó a través de un grupo focal, integrado por cinco enfermeras especializadas que laboran en diferentes unidades de hospitalización domiciliaria en las regiones norte y centro del país Resultados: surgieron cuatro categorías: Criterios de admisión, Beneficios de la HD, Dificultades en la implementación de la HD e Intervenciones de Enfermería. Conclusión: como terapias de enfermería para personas en HD, se destaca la formación de la persona / cuidador a través de la enseñanza personalizada, la efectividad en el manejo del régimen terapéutico, la prevención de caídas y la promoción del autocuidado. Esta implementación facilita los procesos de transición salud / enfermedad, con un impacto significativo en la mejora de la calidad de vida.Enquadramento: a Hospitalização Domiciliária (HD) foi criada como alternativa ao internamento convencional e pretende-se que seja um modelo de prestação de cuidados tendo por missão contribuir para o melhor nível de saúde e bem-estar da pessoa doente, que necessitem transitoriamente de cuidados de nível hospitalar, com enfoque na promoção da autonomia e recuperação funcional da pessoa. Objetivos: compreender o processo de transição saúde/doença da pessoa em HD. Metodologia: estudo qualitativo e descritivo. A amostra foi selecionada por conveniência e de forma intencional. A recolha de dados foi efetuada através da realização de um focus group, composto por cinco enfermeiros especialistas a exercer funções em unidades de hospitalização domiciliária distintas da região norte e centro do país. Resultados: emergiram quatro categorias: Critérios de admissão, Benefícios da HD, Dificuldades na implementação de HD e Intervenções de Enfermagem. Conclusão: como terapêuticas de enfermagem à pessoa em HD salienta-se a capacitação da pessoa/cuidador através do ensino personalizado, a eficácia na gestão do regime terapêutico, a prevenção de quedas e a promoção do autocuidado. Com a implementação destas terapêuticas facilita-se os processos de transição saúde/doença, com impacto significativo na melhoria da qualidade de vida das pessoas alvo de HD. 

Large interstitial del(13)(q13q14.3): the importance of detailed clinical information in cytogenetic studies

Interstitial deletions of chromosome 13 are known to be associated with retinoblastoma. A wider syndrome may accompany the deletion, including mental retardation and craniofacial dysmorphism. The severity of the phenotype depends on the extent of the deletion. Retinoblastoma is a malignant tumor in the retina and is the most common ocular cancer in children. The association of most cases of retinoblastoma with an interstitial del(13q) has led to the localization of the retinoblastoma gene in 13q14. We report a case of a boy aged 8 referred for cytogenetic studies, presenting with mild mental retardation, craniofacial dysmorphism, delayed intrauterine growth (IUGR) and retinoblastoma. The karyotype was obtained from peripheral blood lymphocyte cultures using high-resolution GTG banding and standard techniques. Fluorescence in situ hybridization was performed using the LSI 13 (RB1) probe (Vysis) for region 13q14 spanning the RB1 gene. The chromosomal analysis revealed a large interstitial deletion of the long arm of chromosome 13. Although the exact breakpoints were difficult to establish, the deleted region did not appear to encompass the band which includes the retinoblastoma gene. Molecular cytogenetic techniques showed that the retinoblastoma gene was deleted. This confirmed the clinical indication of retinoblastoma and defined the deletion breakpoints more precisely. Final karyotype: 46,XY,del(13)(q13q14.3).ish del(13) (q14.1q14.3)(RB1−). Except for the presence of IUGR, the clinical description of this patient is in agreement with other reports in the literature. We would like to emphasize the importance of detailed clinical information that, together with classical and molecular cytogenetic techniques, could be useful in better defining the breakpoints, establishing correct genotype/phenotype correlation and thus providing appropriate genetic counselling. The blood samples of the parents were requested for karyotype analysis in order to clarify this chromosome deletion

Outdoor tourism demand segmentation: a case study from North of Portugal

This research aimed to segment the market of visitors who practise outdoor activities in the North region of Portugal based on their motivations. An online survey was conducted between June to September of 2021, with a sample of 200 tourists who realised the region's outdoor activities during this period. The data collected allowed determining factor analysis and the clusters. Two factors: services/hospitality and nature experiences, and three clusters: soft practitioners, radicals, and enthusiasts were delimited. The results show that these groups differ in motivations and practised activities. Segmentation of outdoor tourism demand in North of Portugal should set out marketing and promotion strategies in different destinations, attracting demand from outside the region, and according to their preferences.info:eu-repo/semantics/publishedVersio

Productivity measurement: the case of nature tourism firms in Portugal

Productivity measurement in the tourism sector has been raising increasing interest among researchers and is recognised as an important indicator for understanding the strengths and weaknesses of the sector and for enhancing its spillover effects on the economy. However, studies for Portugal and the particular activities included in the set of nature tourism activities are scarce. To overcome this research gap, this paper calculates the labour productivity and total factor productivity (TFP) measures of nature tourism firms to compare firms’ productivity performance across NUTS II regions in mainland Portugal during 2014–2017. Using data from SABI, Quadros do Pessoal, INE and the National Tourism Registry, the sample consists of 369 firms, representing 55% of firms operating in nature tourism in the mainland. Results show that the levels of TFP, unlike to labour productivity, are uneven over time and space. In 2015, a year of change in the business cycle, all regions experienced a negative increase in TFP except the Metropolitan Region of Lisbon, which seems to indicate that nature tourism in most of the country is less resilient to external economic shocks, performing better in periods of prosperity. Labour productivity growth does not present, in general, consistently positive results.info:eu-repo/semantics/publishedVersio

Geochemistry and mineralogy of auriferous tailings deposits and their potential for reuse in Nova Lima Region, Brazil

Since the mid-nineteenth century, gold ores, mainly hosted in sulfides, have been processed at metallurgical plants located in Nova Lima, Brazil. The generated wastes have been accumulated over the years in tailings dams or in piles. These materials represent wasted from old circuits, as well as from plants still in production. In this study, geochemical, mineralogical, 3D modelling, and metallurgical analyses wastes were carried out to evaluate potential reuse of these wastes. The performed characterization detected residues of very fine grain size containing sulfides and oxides. The wastes show high grades of Au hosted in different minerals. In addition to Au, samples contain S, Fe, Zn, Pb, Sc, Si, and As. The 3D modelling for spatial definition of Au was performed using ordinary kriging with dimensional variograms. The results indicated the occurrence of Au enrichment zones and allowed to reveal the most attractive tailing deposits in terms of Au content. Metallurgical tests showed recovery of 70% of Au and suggested other potential reuse of the wastes, such as aggregates for the civil construction sector and recovery of other metals. The present work highlights the importance of an integrative characterization within the scope of the circular economy and the value of tailings in the production chain of the mineral sector

Construção de um roteiro teórico-prático para simulação clínica

OBJECTIVE To develop a theoretical-practical script based on the opinion of experts to be used in simulated clinical activities. METHOD Qualitative study through analysis of content of interviews with experts on the theme in order to develop the proposed script. Of the 24 invited experts, 12 specialists from educational institutions in Brazil and abroad participated in the study in compliance with the ethical precepts. The experts responded to questions on the characterization of their study attributes and described the items required for the development of a simulated scenario. In view of the responses obtained, data content was analyzed and classified into units and subunits of significance. RESULTS The items mentioned for the development of the script generated seven units of significance. The units and subunits of significance were gathered in three stages of the main components of the simulated scenario: prior, preparation, and finals. CONCLUSION This study enables an innovative, stimulating teaching experience, making it easier for professors to use the simulation resource as a learning process in an effective and objective manner, as a guide to professors and researchers in the area of clinical simulation.OBJETIVO Construir, com base na opinião de peritos, roteiro teórico-prático para uso em atividade clínica simulada. MÉTODO Trata-se de um estudo qualitativo por meio de análise de conteúdo de entrevistas de peritos no assunto para construção do roteiro proposto. Seguido os preceitos éticos, entre os 24 peritos convidados pertencentes a instituições de ensino do Brasil e do exterior. Os peritos responderam a questões sobre a caracterização dos seus atributos de estudo e descreveram os itens imprescindíveis à construção de um cenário simulado. Diante das respostas obtidas, os dados foram analisados em relação ao seu conteúdo e organizados em unidades e subunidades de significância. RESULTADOS Participaram 12 especialistas. Os itens mencionados para construção do roteiro originaram sete unidades de significância. As unidades e suas subunidades de significância foram ainda reunidas em três fases dos componentes principais do cenário simulado: prévios, preparo e finais. CONCLUSÃO Este estudo permite um ensino inovador, estimulante e possibilita a facilidade ao professor, quanto à utilização do recurso de simulação, como processo de aprendizagem de maneira eficiente e objetiva, sendo um norteador aos docentes e pesquisadores na área de simulação clínica.OBJETIVO Construir, con base en la opinión de expertos, un guión teórico-práctico para empleo en actividad clínica simulada. MÉTODO Se trata de un estudio cualitativo por medio de análisis de contenido de entrevistas de expertos en el asunto para construcción del guión propuesto. Seguidos los preceptos éticos, entre los 24 expertos invitados, participaron 12 expertos pertenecientes a instituciones de enseñanza de Brasil y del extranjero. Los expertos respondieron a cuestiones acerca de la caracterización de sus atributos de estudio y describieron los puntos imprescindibles para la construcción de un escenario simulado. Ante las respuestas obtenidas, los datos fueron analizados con relación a su contenido y ordenados en unidades y subunidades de significación. RESULTADOS Participaron 12 especialistas. Los puntos mencionados para la construcción del guión originaron siete unidades de significación. Las unidades y sus subunidades de significación fueron asimismo reunidas en tres fases de los componentes principales del escenario simulado: previos, preparación y finales. CONCLUSIÓN Este estudio permite una enseñanza innovadora, estimulante, y posibilita la facilidad al profesor en cuanto a la utilización del recurso de simulación, como proceso de aprendizaje de manera eficiente y objetiva, siendo un orientador para los docentes e investigadores en el área de simulación clínica

Exames de tomografia computadorizada e cintilografia para diagnóstico e plano de tratamento de osteocondroma condilar: relato de caso

PURPOSE: To report an uncommon case of osteochondroma affecting the mandibular condyle of a young patient and to illustrate the important contributions of different imaging resources to the diagnosis and treatment planning of this lesion. CASE DESCRIPTION: A 24-year-old female patient with the chief complaint of an increasing facial asymmetry and pain in the left pre-auricular region, revealing a reduced mouth opening, mandibular deviation and posterior cross-bite over a period of 18 months. Panoramic radiography revealed an enlargement of the left condyle, whereas computed tomography (CT) sections and three-dimensional CT showed a well-defined bone growth arising from condylar neck. The scintigraphy exam showed an abnormal osteogenic activity in the left temporomandibular joint. The condyle was surgically removed and after 18 months follow-up the panoramic radiography and CT scans showed no signs of recurrence. CONCLUSION: Although osteochondroma is a benign bone tumor that rarely arises in cranial and maxillofacial region, it should be considered in the differential diagnosis of slow-growing masses of the temporomandibular area and the use of different imaging exams significantly contribute to the correct diagnosis and treatment planning of this pathological condition.OBJETIVO: Relatar um caso incomum de osteocondroma afetando o côndilo mandibular de uma paciente jovem e ilustrar as importantes contribuições dos diferentes exames por imagem para o diagnóstico e plano de tratamento desta lesão. DESCRIÇÃO DO CASO: Paciente do sexo feminino, 24 anos, com queixa principal de uma crescente assimetria facial e dor na região pré-auricular esquerda, além de apresentar redução da abertura bucal, desvio de mandíbula e mordida cruzada posterior, por um período de 18 meses. A radiografia panorâmica revelou um aumento do côndilo esquerdo, enquanto secções de tomografia computadorizada e reconstrução 3D exibiram um crescimento ósseo bem definido originando-se do côndilo. O exame de cintilografia revelou uma atividade osteogênica anormal na região de articulação tempormandibular esquerda. O côndilo foi cirurgicamente removido e após 18 meses de acompanhamento a radiografia panorâmica e a tomografia computadorizada não revelaram nenhum sinal de recorrência. CONCLUSÃO: Apesar de o osteocondroma ser um tumor ósseo benigno que raramente surge na região crânio maxilofacial, ele deve ser considerado como diagnóstico diferencial para massas de crescimento lento na área temporomandibular e o uso de diferentes exames por imagem contribuem significativamente para o correto diagnóstico e plano de tratamento desta condição patológica

Outdoor tourism in the North of Portugal from the perspective of tourist entertainment companies (TEC)

Based on the perception of those responsible for Tourist Entertainment Companies (TEC), the objective of the research is to contribute to the characterization of Outdoor Tourism (OT). Exploratory qualitative research was carried out through 38 in-depth individual interviews. The territory geography, the experiences, and the internal market were considered relevant aspects. In addition, seasonality and climate were identified as significant factors in defining the offer, which can favour the preservation of the environment. Moreover, the risk of the activities was considered low. The interviewees suggested integrating everyone involved in a network to explore the region's potential, as well as to support activities and promote the region. The radical experience, adventure, and getting out of the routine were identified as motivations for the search, as well as contact with nature and the landscape. The research is limited to the North Region of Portugal, and it brings together the most different needs, desires, and expectations for tourism demand. Strengthening OT can favour employability and, consequently, economic and social balance while promotion of the activity can be explored through the customers' previous experience. The evaluations, testimonials, and word of mouth (WOM) being added value that can be optimized through social networks and digital marketing.This project is being carried out within the scope of the TURNOUT Project-Development of Outdoor Tourism of Northern Portugal, POCI-01-0145-ERDF-032289, financed by the European Investment Fund Regional Development (ERDF) through the Operational Program of Competitiveness and Innovation (POCI) and the Foundation for Science and Technology, IP (OE). UNIAG, R&D unit funded by the FCT-Portuguese Foundation for the Development of Science and Technology, Ministry of Science, Technology and Higher Education. “Project Code Reference: UIDB/04752/2020”. This project also thanks to the reviewers of the ICTR21 conference for their improvement inputs to the paper.info:eu-repo/semantics/publishedVersio

A methodology for the identification and assessment of the conditions for the practice of outdoor and sport tourism related activities: the case of Northern Portugal

Tourists’ demand for outdoor sport-related activities has been growing in the last decade, leading to the recognition of the outdoor tourism potential of the development of rural and urban areas where the activities could take place. While the literature has recognized this potential, its features and the existing conditions for its practice are often not fully comprehended, mainly due to the lack of measurement systems and performance indicators. This study addresses this gap by proposing a wide-ranging assessment matrix of nine outdoor-related activities, employing northern Portugal as a study area. Based on an exploratory qualitative analysis employing semi-structured interviews with key stakeholders (public, private and third sector), the main contribution of this study lies in the development of the outdoor tourism assessment matrix (OTAM) to collect data. The OTAM matrix aims to identify and assess the conditions, namely the infrastructure and resources, for the practice of outdoor and sport tourism-related activities within the sustainable development pillars. The nine matrices comprising the OTAM allow the identification of the places where the outdoor activities can be practiced, and the conditions under which they can contribute to the definition of the development strategies of outdoor tourism.info:eu-repo/semantics/publishedVersio

Chromosome 1p36 deletion syndrome: a report on 4 cases

Chromosome 1p36 deletion syndrome (MIM #607872) was first described in 1997 by Shapira et al. This condition is compatible with a monosomy of the 1p36 band in the distal region of the short arm of chromosome 1 and is the most common terminal deletion in humans, with an estimated prevalence of approximately 1 in 5,000 live births. This constitutional deletion is associated with mental retardation, developmental delay, seizures, hypotonia and heart defects. The syndrome is also characterized by several distinct dysmorphic features, including large anterior fontanels, microcephaly, brachycephaly, deep-set eyes, flat nose and nasal bridge, and pointed chin. The 1p36 band is not very clearly visible using classical cytogenetics, and it is therefore difficult to detect these deletions in banded karyotypes. Fluorescence in situ hybridization (FISH) and multiplex ligation-dependent probe amplification (MLPA) analysis have increasingly been used, in addition to classical cytogenetic analysis, in children with mental retardation in order to identify this chromosomal abnormality. The authors present four patients between 1 month and 14 years of age with apparently normal karyotypes. Using molecular cytogenetic techniques, all cases showed a “pure” 1p36 deletion: three were detected by FISH (CEB108/T7, located at 1p36.3, Vysis) and are “de novo”; the fourth was detected by MLPA (P036 and P070, MRC Holland) analysis, and its origin is still unknown. The phenotypes of these patients are described and compared with other cases having this syndrome, described in the literature. We also emphasize the importance of good clinical characterization in order to establish the best cytogenetic strategy to assure accurate diagnosis