[RE]PLACE - AN INTERVENTION PROPOSAL TO BEMPOSTA

This paper addresses the problems of rural development in Portugal, especially in the north-east, and specifically in Bemposta, in Mogadouro. Therefore, it is necessary to explore the role that architecture has been playing in the rehabilitation and conversion of uses as an intervention tool in depopulated rural centers. It is in this context that the re-place term acquires greater importance, functioning as a set of approaches in rural areas, enabling the reuse of old structures, reusing the existing materiality and, thus, seeking a less invasive approach in the existing building - the ruin - respecting the past and its historical and social value. This article was elaborated from a wider research that coincided with my master’s thesis, held at Lusíada University of Porto, under the theme “[RE] PLACE: USANDO A MATÉRIA DO LUGAR - Bemposta”, guided by Professor Alexandra Maria Saraiva, in 2013|2014. The conversion uses emerges as a highly important instrument for the maintenance of the place memory. It is important to highlight the multi functionality of rural areas, recognizing the potential of their resources as strategic elements for promoting balanced and integrated territorial development. The proposed project translates into an intervention that focuses on the reuse of local architecture and targeted for tourism in rural areas (TER), along with the Cultural, interpretive and Housing Center of Bemposta (CCIHB)

Sarcoidose hepática : a propósito de um caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021A sarcoidose é uma doença multissistémica inflamatória, caracterizada pela formação de granulomas não caseosos. A etiologia da sarcoidose não está esclarecida, no entanto, pensa-se que possam estar envolvidos na sua expressão, quer fatores ambientais, quer fatores genéticos. A prevalência mundial da sarcoidose é de 2-60 indivíduos em 100 000 habitantes, afetando tipicamente jovens e adultos entre os 20 e os 40 anos. Neste trabalho, apresenta-se um caso raro de um doente do sexo masculino, de 57 anos, diagnosticado aos 22 anos com sarcoidose pulmonar, que nos últimos 12 anos evoluiu do ponto de vista clínico para sarcoidose hepática, com o aparecimento de cirrose hepática, ascite, peritonite bacteriana espontânea, rotura de varizes esofágicas e trombose da veia porta. Culminou com a necessidade de transplante hepático em agosto de 2020. No presente momento, o doente encontra-se assintomático, autónomo nas atividades de vida diária e refere acentuada melhoria na qualidade de vida. Entre os órgãos mais frequentemente afetados na sarcoidose incluem-se o sistema linfático, os pulmões, a pele, os olhos e o fígado, ainda que possa afetar virtualmente qualquer órgão. O diagnóstico de sarcoidose assenta na identificação de achados clínicos, imagiológicos e histopatológicos compatíveis e na exclusão de outras doenças granulomatosas. A sarcoidose hepática está documentada em cerca de 50-80% dos doentes com afeção sistémica. Tende a ser uma doença silenciosa, com manifestações clínicas apenas em cerca de 20% dos doentes.Sarcoidosis is a multisystem inflammatory disease, characterized by the presence of noncaseating granulomas. The etiology of sarcoidosis is not clear, however, it is thought that either environmental or genetic factors may be involved in its expression. The worldwide prevalence of sarcoidosis is 2-60 individuals per 100 000 inhabitants, typically affecting young people and adults between 20 and 40 years of age. This work presents the rare case of a 57-year-old male patient with sarcoidosis, diagnosed at 22 years of age with pulmonary sarcoidosis, that in the last 12 years, it evolved from a clinical point of view to liver cirrhosis with ascites, spontaneous bacterial peritonites, rupture of esophageal varices and portal vein thrombosis, culminating in the need for liver transplantation. At the present time, the patient is asymptomatic, autonomous and reports a marked improvement in quality of life. Among the organs most frequently affected in sarcoidosis are included the lymphatic system, the lungs, the skin, the eyes and the liver, although it can affect virtually any organ. The diagnosis of sarcoidosis is based on the identification of compatible clinical, imaging and histopathological findings and on the exclusion of other granulomatous diseases. Hepatic sarcoidosis is documented in about 50-80% of patients with systemic disease. It tends to be a silent disease, with clinical manifestations in only about 20% of patients

Prosecutorial decision-making regarding offenders’ social reintegration programs in intimate partner violence cases. A Portuguese study

Intimate partner violence is one of the most challenging and demanding problems that the criminal justice system has to face. Given the severe consequences of intimate partner violence, it is imperative that intervention from the criminal justice system, regarding perpetrators, be effective to prevent further victimization and recurrences. In Portugal, it is up to the state prosecutor to decide which cases will be subject to a social reintegration program as a pretrial diversion program. This study aims to explore the variables that might influence the state prosecutor’s decision-making process. We have examined 283 intimate partner violence cases in which provisional suspension of criminal proceedings was applied. The decision as to whether defendants should be referred for social reintegration program attendance (G1) or not (G2) was made by the state prosecutor. Differences between G1 and G2 were identified: the victim’s age, couple living in a current relationship, drug-addicted defendant, intimate partner violence child exposure. However, defendants’ unemployment and drug abuse were the only two variables identified as a determinant for state prosecutor decisions. We believe that the effectiveness of state prosecution decision-making would benefit from: (a) systematically taking into account all intimate partner violence risk factors; (b) an index or checklist detailing what science reveals useful in intimate partner violence offenders’ social reintegration; (c) rehabilitation solutions based on the needs of each offender instead of a “one-size-fits-all” approachS

(Un)Broken: Lateral violence among hospital nurses, user violence, burnout, and general health: A structural equation modeling analysis

Introduction Workplace violence is a social problem yet to be solved. Although it is present in virtually all work environments, its prevalence in healthcare settings stands out, being perceived as something inherent to the job. Most studies in this context have focused on user violence against professionals. However, it has been observed that violence among colleagues in these types of jobs is a risk factor for the health of workers and has rarely been studied as a whole. Among the main consequences of exposure to violence reported in the literature, burnout syndrome, depression, anxiety, or somatic problems have been among the most studied. On the one hand, some authors claim that being exposed to workplace violence can increase the associated physical and psychological pathology and lead to a picture congruent with burnout. On the other hand, it has been hypothesized that violence is associated with burnout, which can trigger physical and psychological symptoms. Taking into account this background, the aim of this study is to explore workplace violence in health personnel, symptomatology, and burnout syndrome through mediation models that allow us to know the interrelationships between the variables.MethodsA cross-sectional design with a double descriptive-associative strategy was used. The sample was composed of 950 nursing professionals from public hospitals. The scales of physical and non-physical violence from users to professionals HABS-U, personal, social, and occupational violence among co-workers using the Health Aggressive Behavior Scale – Co-workers and Superiors (HABS-CS) scale, the burnout scale Maslach Burnout Inventory – General Survey (MBI-GS) which evaluates professional exhaustion, efficacy and cynicism, and the factors referring to depression, anxiety, somatization, and dysfunction of the GHQ-28 scale were applied. In order to calculate the models, workplace violence was used as a predictor of symptomatology, using the burnout variables as mediators. Regression coefficients with and without mediation model, direct and standardized estimates were obtained. For statistical power, Bootstrap analysis was used to calculate direct mediation effects.ResultsAfter controlling the mediation effects of burnout and cynicism, physical and non-physical user violence toward healthcare personnel were significant predictors of the GHQ-28 scores. These same results were obtained when assessing the relationship between social, occupational, and personal violence among co-workers and GHQ-28 scores.ConclusionOur results contribute to increase the evidence about the effects of violence on the health of professionals and to advance in the characterization of the possible consequent psychological damage. Regardless of the type of violence experienced, exposure to violence can lead to anxious, depressive or somatization symptoms, among others. Violence is also a predictor of burnout syndrome, which in turn accentuates the rest of the consequences studied. Despite the limitations of the proposed model, these results serve to highlight the complexity of the situation experienced by healthcare professionals. Moreover, it serves as a basis for proposing intervention/prevention programs to raise awareness and protect professionals from these risks. To this end, self-care tools should be proposed with which professionals take care of their own health through the management of violent situations and/or the improvement of occupational health

REPRODUCTIVE PLANNING AND INSERTION OF INTRAUTERINE DEVICES BY PHYSICIANS AND NURSES IN BRAZIL

Objective: to analyze the records referring to reproductive planning consultations and to intrauterine device insertion performed in 2021 by nurses and physicians in Primary Health Care in Brazil.Method: this is a quantitative, cross-sectional and descriptive study that resorted to secondary data from the Health Information System for Primary Care and submitted to simple descriptive statistics data analysis.Results: a total of 18,243 procedures about IUD insertion were recorded in the country, with prevalence of physicians, except for the state of Roraima; as well as 54,186 reproductive planning consultations with predominance of 41,184 (76%) nurses in relation to physicians (13,002; 24%).Conclusion: there is a need to invest in the training of physicians and nurses in order to expand access and the right to sexual life care of the women living in the country. Nursing care is a way to consolidate women's right to sexual and reproductive life care

O uso do perfil geoecológico da aldeia indígena Kyikatêjê como proposta no ensino de geografia física

O perfil geoecológico constitui-se como uma técnica de interpretação integrada das condições ambientais, sendo esta uma ferramenta para análises e diagnósticos sobre a paisagem. O presente trabalho tem por objetivo apresentar o perfil geoecológico da aldeia indígena Kyikatêjê como uma proposta de ensino de geografia na referida aldeia. Sendo elaborado com a o auxílio e uso das tecnologias de informações geográficas, o software CorelDraw como ferramenta de edição e elaboração do desenho para se construir o perfil geoecológico. A contribuição do perfil se mostra como auxilio para construção de materiais didáticos a serem utilizados nas aulas de geografia física na escola da respectiva aldeia. A elaboração do perfil geocologico possibilitou uma análise mais precisa da paisagem local e a compreensão da dinamica natural e social, subsidiando futuros trabalhos no ensino de geografia física

PROMOVER TERRITÓRIOS RESILIENTES E SAUDÁVEIS NUM CLIMA EM MUDANÇA: IMPACTOS DAS ALTERAÇÕES CLIMÁTICAS NA SAÚDE HUMANA NUMA REGIÃO VULNERÁVEL DO SUL DA EUROPA

With the aim of analysing the impacts of climate change on human mortality in one of the southern European regions with the most pessimistic socio-ecological scenarios and projections, the region of Coimbra, in central Portugal, the study considered data on heat waves and extreme cold waves, available at IPMA, the Climate Portal and the IPCC, and data on morbidity and mortality, available at INE, occurring in the same region over a period of 35 years (between 1982-2017). The results show that mortality increases with the intensity or longer duration of heat waves or extreme cold, being exacerbated in urban environments by the so-called heat island effect, in the case of heat waves, affecting especially vulnerable groups. The worsening consequences expressed in terms of morbidity and mortality result from this worsening and instability of biophysical conditions as a result of climate change, as well as from living conditions, socioeconomic deprivation and inequalities in access to health services. Climate change presents itself as a public health issue that cannot be postponed and requires policies that take into account all these factors and their exacerbated impacts on risk groups.Com o objetivo de analisar os impactos das alterações climáticas sobre a mortalidade humana numa das regiões do sul da europa com os cenários projeções e projeções socioecológicas mais pessimistas, a região de Coimbra, no Centro de Portugal, o estudo considerou os dados relativos às ondas de calor e de frio extremo, disponibilizados no IPMA, no Portal do Clima e no IPCC, e os dados de morbilidade e de mortalidade, disponíveis no INE, ocorridos na mesma região durante um período de 35 anos (entre 1982-2017). Os resultados revelam que a mortalidade aumenta com a intensidade ou maior duração das ondas de calor ou de frio extremo, sendo exacerbadas em ambientes urbanos pelo chamado efeito de ilha de calor, no caso das ondas de calor, afetando especialmente grupos vulnerabilizados. O agravamento das consequências expressas ao nível da morbilidade e mortalidade resultam deste agravamento e instabilidade das condições biofísicas em resultado das alterações climáticas, bem como das condições de vida, das privações socioeconómicas e das desigualdades no acesso aos serviços de saúde. As alterações climáticas apresentam-se como uma questão de saúde pública, inadiável e que exigem políticas que tenham em conta todos estes fatores e seus impactos exacerbados nos grupos de risco.Con el objetivo de analizar los impactos del cambio climático sobre la mortalidad humana en una de las regiones del sur de Europa con proyecciones y escenarios socioecológicos más pesimistas, la región de Coimbra, en el centro de Portugal, el estudio consideró datos sobre olas de calor y frío extremo, disponibles en el IPMA, el Portal del Clima y el IPCC, y datos de morbilidad y mortalidad, disponibles en el INE, ocurridos en la misma región durante un período de 35 años (1982-2017). Los resultados muestran que la mortalidad aumenta con la intensidad o mayor duración de las olas de calor o frío extremo, y se agrava en entornos urbanos por el denominado efecto isla de calor en el caso de las olas de calor, afectando especialmente a colectivos vulnerables. El empeoramiento de las consecuencias expresadas en términos de morbilidad y mortalidad es el resultado de este empeoramiento e inestabilidad de las condiciones biofísicas como consecuencia del cambio climático, así como de las condiciones de vida, las privaciones socioeconómicas y las desigualdades en el acceso a los servicios sanitarios. El cambio climático es un problema de salud pública inaplazable que requiere políticas que tengan en cuenta todos estos factores y su impacto exacerbado en los grupos de riesgo.Com o objetivo de analisar os impactos das alterações climáticas sobre a mortalidade humana numa das regiões do sul da europa com os cenários projeções e projeções socioecológicas mais pessimistas, a região de Coimbra, no Centro de Portugal, o estudo considerou os dados relativos às ondas de calor e de frio extremo, disponibilizados no IPMA, no Portal do Clima e no IPCC, e os dados de morbilidade e de mortalidade, disponíveis no INE, ocorridos na mesma região durante um período de 35 anos (entre 1982-2017). Os resultados revelam que a mortalidade aumenta com a intensidade ou maior duração das ondas de calor ou de frio extremo, sendo exacerbadas em ambientes urbanos pelo chamado efeito de ilha de calor, no caso das ondas de calor, afetando especialmente grupos vulnerabilizados. O agravamento das consequências expressas ao nível da morbilidade e mortalidade resultam deste agravamento e instabilidade das condições biofísicas em resultado das alterações climáticas, bem como das condições de vida, das privações socioeconómicas e das desigualdades no acesso aos serviços de saúde. As alterações climáticas apresentam-se como uma questão de saúde pública, inadiável e que exigem políticas que tenham em conta todos estes fatores e seus impactos exacerbados nos grupos de risco