O Serviço Social numa Comissão Social de Freguesia: uma abordagem preliminar deste novo espaço sócio ocupacional

Aprofundar o conhecimento do Serviço Social no âmbito das Comissões Sociais de Freguesia, refletindo sobre a prática do Serviço Social, nomeadamente na Comissão Social de Freguesia da Guia, é o objetivo deste relatório. O processo de criação e implementação do Programa Rede Social, como política social baseada nos fundamentos da descentralização de poderes e responsabilidades do Estado e a sua intensificação em parcerias entre o setor público e o setor privado, assentam numa lógica de desenho de políticas sociais neoliberais. O Serviço Social revela ser um importante recurso profissional para as autarquias, nomeadamente para as freguesias, desempenhando um trabalho de proximidade com as populações, facilitando-lhes o acesso a alguns direitos sociais e executando os seus deveres cívicos. No entanto, esta atuação de natureza assistencialista, pretende a resolução emergencial da situação de pobreza e das desigualdades sociais da população de determinada freguesia. Ora, estes fenómenos não estão circunscritos a uma pequena área territorial, são problemas estruturais e universais, como tal não podem ser tratados apenas como locais. Tendo como ponto de partida, a experiência vivenciada pela assistente social que fez parte da organização da Comissão Social de Freguesia da Guia e que desenhou o seu modelo de intervenção social, é feita uma análise a este novo espaço. Conclui-se, atestando que para a efetivação como espaço sócio profissional e que legitime a profissão, a política social que define as CSF terá que sofrer algumas alterações e melhorias, partindo ao encontro do projeto profissional do Serviço Social, ao mesmo tempo que potencia o enfrentamento à pobreza e desigualdades sociais ao nível local

Trajectory pathways for depressive symptoms and their associated factors in a Chinese primary care cohort by growth mixture modelling

© 2016 Chin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background The naturalistic course for patients suffering from depressive disorders can be quite varied. Whilst some remit with little or no intervention, others may suffer a more prolonged course of symptoms. The aim of this study was to identify trajectory patterns for depressive symptoms in a Chinese primary care cohort and their associated factors. Methods and Results A 12-month cohort study was conducted. Patients recruited from 59 primary care clinics across Hong Kong were screened for depressive symptoms using the Centre for Epidemiologic Studies Depression Scale (CES-D) and monitored over 12 months using the Patient Health Questionnaire-9 items (PHQ-9) administered at 12, 26 and 52 weeks. 721 subjects were included for growthmixture modelling analysis. Using Akaike Information Criterion, Bayesian Information Criterion, Entropy and Lo-Mendell-Rubin adjusted likelihood ratio test, a seven-class trajectory pathmodel was identified. Over 12 months, three trajectory groups showed improvement in depressive symptoms, three remained static, whilst one deteriorated. A mild severity of depressive symptoms with gradual improvement was the most prevalent trajectory identified.Multivariate, multinomial regression analysis was used to identify factors associated with each trajectory. Risk factors associated with chronicity included: female gender; not married; not in active employment; presence ofmultiple chronic disease co-morbidities; poor self-rated general health; and infrequent health service use. Conclusions Whilst many primary care patients may initially present with a similar severity of depressive symptoms, their course over 12 months can be quite heterogeneous. Although most primary care patients improve naturalistically over 12 months, many do not remit and it is important for doctors to be able to identify those who are at risk of chronicity. Regular followup and greater treatment attention is recommended for patients at risk of chronicity.published_or_final_versio

Syngas production from glycerol-dry (CO2) reforming over La-promoted Ni/Al2O3 catalyst

A 3 wt% La-promoted Ni/Al2O3 catalyst was prepared via wet co-impregnation technique and physicochemically-characterized. Lanthanum was responsible for better metal dispersion; hence higher BET specific surface area (96.0 m2 g−1) as compared to the unpromoted Ni/Al2O3 catalyst (85.0 m2 g−1). In addition, the La-promoted catalyst possessed finer crystallite size (9.1 nm) whilst the unpromoted catalyst measured 12.8 nm. Subsequently, glycerol dry reforming was performed at atmospheric pressure and temperatures ranging from 923 to 1123 K employing CO2-to-glycerol ratio from zero to five. Significantly, the reaction results have yielded syngas as main gaseous products with H2:CO ratios always below than 2.0 with concomitant maximum 96% glycerol conversion obtained at the CO2-to-glycerol ratio of 1.67. In addition, the glycerol consumption rate can be adequately captured using power law modelling with the order of reactions equal 0.72 and 0.14 with respect to glycerol and CO2 whilst the activation energy was 35.0 kJ mol−1. A 72 h longevity run moreover revealed that the catalyst gave a stable catalytic performance

Assessment of rainfall pattern and future change for Kelantan River Basin, Malaysia using statistically downscaled local climate models

Climate change has been discussed frequently in recent decades, and it has increased the probability of extreme flood occurrence. This study aims to provide an analysis of future rainfall patterns and flood occurrences specifically for the Kelantan River Basin which is identified as one of flood prone areas in Malaysia. The study area was divided into five regions of the Kelantan River Basin,-Kota Bharu (Northern), Kuala Krai (Center), Pos Lebir (Southeastern), Pos Hua (Southwestern) and Pos Gob (Northwestern). The historical rainfall data (1986-2019) was then retrieved from the Malaysian Meteorological Department (MMD) based on the five regions. The statistical approach was applied to downscaled climate model data from the CanESM2 GCM forced by the Representative Concentration Pathway (RCP) 4.5 and 8.5. The reliability assessment using a Cronbach’s Alpha, Linear Regression and Pearson Correlation results show that local climates (2006-2019) forced by RCP4.5 have a similar trend to historical rainfall within the same period. The spatial analysis outcomes showed that the northeastern region of the Kelantan River Basin received its highest average annual rainfall (5,000 mm) in 1990 and caused severe flooding in the area. However, there is a significant change of rainfall pattern in all regions, with a steady increase in annual rainfall in the southwestern region (2021-2100)

Evaluation of the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing acute and chronic wounds

© 2016 John Wiley & Sons Ltd. Aim: To examine the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing the healing progress in acute and chronic wounds. Background: It is important to establish the responsiveness of instruments used in conducting wound care assessments to ensure that they are able to capture changes in wound healing accurately over time. Design: Prospective longitudinal observational study. Method: The key study instrument was the PUSH tool. Internal responsiveness was assessed using paired t-testing and effect size statistics. External responsiveness was assessed using multiple linear regression. All new patients with at least one eligible acute or chronic wound, enrolled in the Nurse and Allied Health Clinic-Wound Care programme between 1 December 2012 - 31 March 2013 were included for analysis (N = 541). Results: Overall, the PUSH tool was able to detect statistically significant changes in wound healing between baseline and discharge. The effect size statistics were large. The internal responsiveness of the PUSH tool was confirmed in patients with a variety of different wound types including venous ulcers, pressure ulcers, neuropathic ulcers, burns and scalds, skin tears, surgical wounds and traumatic wounds. After controlling for age, gender and wound type, subjects in the 'wound improved but not healed' group had a smaller change in PUSH scores than those in the 'wound healed' group. Subjects in the 'wound static or worsened' group had the smallest change in PUSH scores. The external responsiveness was confirmed. Conclusion: The internal and external responsiveness of the PUSH tool confirmed that it can be used to track the healing progress of both acute and chronic wounds.published_or_final_versio

Antidepressants for treatment of depression in primary care:A systematic review and meta-analysis

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Health-related quality of life mediates associations between multi-morbidity and depressive symptoms in Chinese primary care patients

© The Author 2015. Background. Qualifying the relationship between multi-morbidity, health-related quality of life (HRQOL) and depressive symptoms in primary care can help to inform the development of appropriate interventions and services which can help to enhance HRQOL in patients with chronic disease. Objective. The objective of this study was to determine whether the physical aspect of HRQOL mediates the relationship between chronic disease multi-morbidity and depressive symptoms in Chinese primary care patients. Methods. A cross-sectional survey was conducted on patients recruited from the waiting rooms of 59 primary care clinics distributed across Hong Kong. About 9259 subjects were included for the mediation model analysis. The primary outcome was level of depressive symptoms as measured by the Patient Health Questionniare 9. The mediation model was tested using a bootstrapping method. Results. The prevalence of chronic disease was 50.4%, with 25.4% having two or more comorbidities. The relationship between multi-morbidity and depressive symptoms was found to be mediated by the Physical Component Summary score of the SF-12 v2. Further analysis found the general health (GH) and role physical domains of the SF-12 were the strongest mediators, followed by bodily pain and physical functioning (PF). Conclusion. To enhance the functional capacity of primary care patients with co-existing chronic disease and depressive symptoms, health care interventions should be directed at improving the physical aspects of HRQOL, in particular enhancing patients' GH perception, role functioning and PF, and to better manage chronic pain.Link_to_subscribed_fulltex

Age-Specific Associations of Usual Blood Pressure Variability With Cardiovascular Disease and Mortality: 10-Year Diabetes Mellitus Cohort Study.

Background The detrimental effects of increased variability in systolic blood pressure (SBP) on cardiovascular disease (CVD) and mortality risk in patients with diabetes mellitus remains unclear. This study evaluated age-specific association of usual SBP visit-to-visit variability with CVD and mortality in patients with type 2 diabetes mellitus. Methods and Results A retrospective cohort study investigated 155 982 patients with diabetes mellitus aged 45 to 84 years without CVD at baseline (2008-2010). Usual SBP variability was estimated using SBP SD obtained from a mixed-effects model. Age-specific associations (45-54, 55-64, 65-74, 75-84 years) between usual SBP variability, CVD, and mortality risk were assessed by Cox regression adjusted for patient characteristics. After a median follow-up of 9.7 years, 49 816 events (including 34 039 CVD events and 29 211 mortalities) were identified. Elevated SBP variability was independently, positively, and log-linearly associated with higher CVD and mortality risk among all age groups, with no evidence of any threshold effects. The excess CVD and mortality risk per 5 mm Hg increase in SBP variability within the 45 to 54 age group is >3 times higher than the 70 to 79 age group (hazard ratio, 1.66; 95% CI, 1.49-1.85 versus hazard ratio, 1.19; 95% CI, 1.15-1.23). The significant associations remained consistent among all subgroups. Patients with younger age had a higher association of SBP variability with event outcomes. Conclusions The findings suggest that SBP visit-to-visit variability was strongly associated with CVD and mortality with no evidence of a threshold effect in a population with diabetes mellitus. As well as controlling overall blood pressure levels, SBP visit-to-visit variability should be monitored and evaluated in routine practice, in particular for younger patients

Physical properties and stability evaluation of fish oil-in-water emulsions stabilized using thiol-modified β-lactoglobulin fibrils-chitosan complex

Fish oil-in-water emulsions containing fish oil, thiol-modified β-lactoglobulin (β-LG) fibrils, chitosan and maltodextrin were fabricated using a high-energy method. The results showed that chitosan coating induced charge reversal; denoting successful biopolymers complexation. A significantly (p < 0.05) larger droplet size and lower polydispersity index value, attributed to the thicker chitosan coating at the oil-water interface, were observed. At high chitosan concentrations, the cationic nature of chitosan strengthened the electrostatic repulsion between the droplets, thus conferring high oxidative stability and low turbidity loss rate to the emulsions. The apparent viscosity of emulsions stabilized using thiol-modified β-LG fibrils-chitosan complex was higher than those stabilized using β-LG fibrils alone, resulting in the former's higher creaming stability. Under thermal treatments (63 °C and 100 °C), emulsions stabilized using thiol-modified β-LG fibrils-chitosan complex possessed higher heat stability as indicated by the consistent droplet sizes observed. Chitosan provided a thicker protective layer that protected the oil droplets against high temperature. Bridging flocculation occurred at low chitosan concentration (0.1%, w/w), as revealed through microscopic observations which indicated the presence of large flocs. All in all, this work provided us with a better understanding of the application of protein fibrils-polysaccharide complex to produce stable emulsion

Formation and characterization of thiol-modified fibrillated whey protein isolate solution with enhanced functionalities

The effect of thiolation using propanethiol on the functionalities of fibrillated whey protein isolate (WPI) solution at different pH values was studied. Fibrillated WPI solutions were thiolated at different molar ratios of propanethiol:carboxyl group (0.5:1, 1:1, 2:1, 3:1, 4:1) and the highest esterification extent ratio was obtained at 4:1 (pH 9). We also found that the thiolation process improved the foaming capacity and foam stability. TEM micrographs evidenced aggregation of thiol-modified fibrillated WPI. A network of shortened fibrils attached to each other was formed upon thiolation, suggesting good physical interaction. This was coherent with the increment of zeta potential values, indicating a greater repulsion force to retard fibrils aggregation. Thiolation enhanced emulsifying stability index of thiol-modified fibrillated WPI solution (pH 8) and diminished its susceptibility to pH changes. This has broadened the potential application of fibrils as food ingredients