Estimativa das Necessidades de Energia dos doentes críticos

Dissertação de Mestrado em Nutrição Clínica apresentada à Faculdade de Ciências da Nutrição e Alimentação da Universidade do PortoResumo da dissertação:Objectivo: Este estudo teve o intuito de verificar a adequabilidade do uso do peso referido e do peso estimado, em equações preditivas do gasto/necessidade de energia, identificando aquela com melhores resultados frente os valores medidos pela calorimetria indirecta respiratória (CIR). Procurou-se, também, identificar alguns dos parâmetros com influência sobre o gasto energético e avaliar a situação do fornecimento efectivo de energia, aos doentes. Material e método: Em estudo observacional e prospectivo, o gasto energético de 22 doentes críticos adultos foi medido, pela CIR, e comparado aos valores estimados por cinco equações preditivas, aplicando-se peso referido e peso estimado. Obtiveram-se as correlações entre o gasto energético medido e alguns parâmetros antropométricos, clínicos e bioquímicos, e avaliou-se a percentagem de energia fornecida aos doentes, com base no gasto energético medido. Resultados: A equação de Penn-State (2003), com aplicação do peso referido, foi a que mostrou melhores resultados. Destacou-se a associação entre o GER e o sexo, o peso, a altura, a temperatura corporal, o volume corrente, o volume minuto, a proteína C-reactiva e o grau de sedação. O fornecimento efectivo de energia abaixo de 80% das necessidades medidas foi prevalente, e sua adequação variou de doente para doente e de dia para dia. Conclusão: Na falta da CIR, a equação de Penn-State (2003) com o peso referido mostrou ser a melhor opção para a estimativa das necessidades de energia, devendo-se avaliar a tolerância dos doentes e a adequação do suporte nutricional, de maneira individual e constante. Vários parâmetros mostraram correlação significativa com o GER. Prevaleceu o fornecimento de energia em quantidades abaixo de 80% das necessidades medidas.Abstract: Objective: The aim of this study was to verify the suitability of applying referred and estimated weights on predictive equations of energy expenditure/energy needs, identifying the equation with the best results; identify some of the influencing factors of the energy expenditure; and analyze the situation of the effective caloric delivery. Methods: On this observational and prospective study, the energy expenditure of 22 critically ill adult patients on mechanical ventilation was measured and compared to estimated values by five predictive equations, applying referred and estimated weights. The correlation coefficient between measured energy expenditure and some clinical, laboratory and anthropometric data was obtained. It was also analyzed the proportion of calories delivered to patients, based on their measured energy expenditure/needs. Results: Among the equations considered, the Penn-State (2003), applying referred weight, showed the best results. It was highlighted the correlation between energy expenditure and gender, weight, height, body temperature, tidal volume, minute ventilation, C-reactive protein and deep of sedation on energy expenditure. In most cases, it was delivered less than 80% of caloric needs (energy expenditure), and its property changed from patient to patient and from day to day. Conclusions: The Penn-State (2003) equation with referred weight seems to be the best choice for estimating energy expenditure/caloric needs, when indirect calorimetry is not available. Despite the best results, the estimated values using this equation would cause underfeeding or overfeeding to some patients. This possibility shows the importance of planning and evaluating the nutrition support care plan frequently and on an individual basis. Some data had significant correlations with the measured energy expenditure. The delivery of less than 80% of energy needs was the most frequent situation

Comportamento alimentar infantil e atitudes parentais face à alimentação das crianças

A infância é um período crítico para o desenvolvimento de comporta - mentos relativos à alimentação e é considerada fulcral na prevenção do excesso de peso, da doença e na promoção da saúde [...]info:eu-repo/semantics/publishedVersio

Between tree lovers and tree haters. Drivers of public perception regarding street trees and its implications on the urban green infrastructure planning

Street trees can play an important role in the urban green infrastructure (UGI). However, changes in the urban fabric often have perverse effects on the structure, diversity, and performance of street trees, and, consequently, on their perception by the public. This research explores public perception of the current street tree adequacy in a coastal neighborhood of Porto that went through a major densification in its urban fabric during the second half of the 20th century. The research methodology included: i) a survey to evaluate public perception of tree services and disservices, and public perception of the adequacy of street trees in the study area; and ii) two Logit models relating public perception of tree services with the characteristics of respondents and streets. 96% of the respondents self-reported as tree lovers. However, more than 30% found the street trees of the study area inadequate to the present urban fabric and 5% have already made a complaint to the municipality. Characteristics of respondents and streets affect respondent’s perceptions. Education plays a key role in the acknowledgment of tree services. Older respondents are more likely to perceive trees as dangerous. Respondents who live on streets dominated by Black Poplar are more likely to dislike trees. Results implications on UGI planning and design advise an adjustment of tree dimensions to street dimensions, an increase in street tree diversity, and an improved street planting design. Results also suggest that an investment in education and information could lead to conflict mitigation.info:eu-repo/semantics/acceptedVersio

Between tree lovers and tree haters: drivers of public perception regarding street trees and its implications on green infrastructure planning

info:eu-repo/semantics/publishedVersio

Influence of Internal Communication on the Organizations’ Performance: Proposition of Model

The aim of study was to develop a model to identify the influence of communication, organizational identification and trust on the organizations’ performance and proposition of model. The research was descriptive and quantitative, and it was conducted in a soft drink Industry, in Brazil. Hypotheses (n=9) were raised and was applied a questionnaire for 310 employees, considering the constructs: Internal Communication, Trust in the Co-workers, Trust in the Manager, Organizational Identity and Performance. The results showed that the hypotheses H1, H3 and H7 were confirmed. The higher the organizational identification, the greater will be the trust in the manager and the performance. In H4, the study confirmed that there is a lower influence of the Internal Communication on Performance. Thus, the Internal Communication does not support the Performance. Although the direct effect on Performance is contrary (-0.139), the indirect effect was positive (0.476), generating a total effect of 0.337

Desafios colocados pelas estratégias neoliberais de precarização do trabalho para a pesquisa-intervenção voltada para a transformação das situações de trabalho

This article presents the theoretical and methodological references that support our studies, interventions and academic combats in work psychology in the face of neoliberal strategies articulated with reflections on research and intervention. The neoliberal policies adopted today have generated important effects of precariousness in life, and specifically in the work environment, generating some perverse subjective effects that function as challenges to be faced by workers in the continuous invention of their life and protection of their health. We discuss how the tools of work clinics assist in transforming life and work situations by expanding the workers’ power to act. We propose to continue in debates in the field of work and organizational psychology in Brazil—strategies that aim to transform, and not just know.Este artigo apresenta os referenciais teóricos e metodológicos que dão suporte a nossos trabalhos e combates acadêmicos em face das estratégias neoliberais, sendo aqueles articulados a uma reflexão sobre pesquisa e intervenção em psicologia do trabalho. As políticas neoliberais adotadas na atualidade têm gerado efeitos importantes de precarização da vida e em especial nos meios de trabalho, resultando em alguns efeitos subjetivos perversos que se apresentam como desafios a serem enfrentados pelos trabalhadores na contínua invenção de sua vida e proteção de sua saúde. Discutimos como as ferramentas das clínicas do trabalho auxiliam a transformação das situações de vida e trabalho por meio da ampliação do poder de agir dos trabalhadores. Propomos, por fim, seguir nos debates do campo da psicologia do trabalho e organizacional no Brasil – sobre essas estratégias que visam transformar, e não apenas conhecer

Biochemical and physiological parameters in rats fed with high-fat diet : the protective effect of chronic treatment with purple grape juice (bordo variety)

High-fat-diet (HFD) has been related to metabolic and cardiovascular diseases. Consumption of grapes and their byproducts containing phenolic compounds has been reported due to the benefits they produce for human health. The purpose of this study was to investigate the antioxidant and protective effect of chronic intake of purple grape juice on certain biochemical and physiological changes promoted by the consumption of HFD. Forty male rats were randomly divided into four groups to receive standard or HFD diet and/or conventional (CGJ) or organic grape juice (OGJ) for three months. Dietary intake, body weight gain, cardiometabolic parameters, and serum lipoperoxidation were investigated. Results showed that consumption of CGJ and OGJ changed the pattern of food and drink intake of the animals. There was a reduction in the body weight of animals that consumed grape juices and an increase in the weight gain in HFD and OGJ rats. HFD increased abdominal fat and the abdominal fat/weight ratio, and both grape juices prevented these modifications. HFD increased hepatic enzymes levels (aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT)) and reduced urea. Purple grape juices prevented some of these changes. HFD enhanced lipid peroxidation (thiobarbituric acid reactive substances (TBARS)) in serum and CGJ and OGJ prevented this increase. The consumption of purple grape juice has the potential to prevent and ameliorate most of the alterations provoked by HFD, therefore regular intake of grape products could promote beneficial effects