How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries.

Mestrado em Saúde PúblicaMaster Degree Course in Public Healt

The relationship between presenteeism, quality of life and social support in higher education professionals: A cross-sectional path analysis

Presenteeism is the practice of being present at workplace, but not being able to carry out all the tasks due to health problems. Social support globally associated with health and wellbeing might positively influence presenteeism and consequently, the quality of life of these professionals. With this in mind, the aim of this study was to investigate the relationships between presenteeism, quality of life and social support in the work of non-teaching and non-research professionals within the context of higher education. A cross-sectional study was conducted, in which sociodemographic data were collected and the Portuguese versions of the Stanford Presenteeism Scale (SPS-6) (which includes the dimensions workcompleted and distraction avoided) and Quality of Life Index (EUROSHIS-QOL-8) and the subscales of Supervisor’s Social Support and Peers’ Social Support of the Copenhagen Psychosocial Questionnaire (COPSOQ) were used. The questionnaire was applied online, and 322 professionals from a public university higher education institution in Northern Portugal participated in the study. Presenteeism was reported by 97 (30.1%) professionals. The peers’ social support was positively associated with quality of life. The supervisor’s social support was positively associated with distraction avoided and work completed and positively indirectly associated with quality of life, and the association was mediated by distraction avoided. We conclude that implementing strategies that can promote social support in the work context, namely strengthening networks between colleagues and competent and well-trained supervisors may prevent or reduce presenteeism in higher education professionals, as well as, provide a better quality of life.info:eu-repo/semantics/publishedVersio

Presenteeism in Non-Academic Staff in a Public University Context: Prevalence, Associated Factors, and Reasons to Work While Sick during the COVID-19 Pandemic

Abstract: Presenteeism negatively affects worker performance. We aimed to know the prevalence of presenteeism in non-academic university staff, identify health problems and associated factors, as well as explore the reasons that led to presenteeism during the COVID-19 pandemic. A cross-sectional study was conducted with a convenience sample of 332 non-academic staff. The Portuguese version of the Stanford Presenteeism Scale (SPS-6) was used, and socio-demographic and occupational data were collected. Participants were divided into groups according to the presenteeism cut-off score (no presenteeists, presenteeists with high job performance, presenteeists with low job performance). Multinomial regression was used to identify occupational and demographic characteristics associated with presenteeism. An open question replies analysis made it possible to explore the reasons for going to work while sick. Presenteeism was experienced by 30.1%. Presenteeism with high job performance was not associated with socio-demographic and work factors. Professionals who performed only physical work (OR = 9.4; 95% CI: 1.7; 51.0) and those who conducted hybrid work (OR = 4.1; 95% CI: 1.8; 9.6) showed a higher risk of belonging to the presenteeist group with low job performance. Financial reasons led professionals to work while sick. This study raises the importance of evaluating presenteeism in non-academic staff to create conditions for them to maintain high performance despite presenteeism and to intervene when there is low performance due to presenteeism.info:eu-repo/semantics/publishedVersio

How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries.

Mestrado em Saúde PúblicaMaster Degree Course in Public Healt

Stress echocardiography in coronary artery disease

A ecodopplercardiografia é uma metodologia simples, rápida e não invasiva para identificar anormalidades regional e global da função do ventrículo esquerdo, podendo ser considerado o método não invasivo de maior aplicabilidade dentro das técnicas de imagem. A ecocardiografia sob estresse é utilizada para diagnóstico, estratificação de risco, prognóstico e avaliação da viabilidade miocárdica na doença arterial coronariana. Várias são as formas de se submeter o coração ao estresse para o estudo ecocardiográfico. Para indivíduos com capacidade física preservada, utiliza-se o teste com esteira ou bicicleta e para aqueles sem condições de se exercitar, são usados os testes farmacológicos. Apesar da boa acurácia diagnóstica e do valor prognóstico com os dois métodos já referidos, novas técnicas vêm sendo estudadas, como a utilização do contraste ecocardiográfico com microbolhas para avaliação das bordas do endocárdio e o estudo da perfusão miocárdica. _________________________________________________________________________________________ ABSTRACT: Doppler echocardiography is a simple, fast and non-invasive method to identify abnormal regional and global left ventricular function. One could consider this non-invasive method to be the best approach within imaging techniques. Stress echocardiography techniques are used for the diagnosis, risk stratification, prognosis and the study of myocardial viability in the ischemic heart disease. There are many ways to subject the heart to stress for echocardiographic studies. For physically fit patients exercise stress testing using a treadmill or bicycle is unemployed and patients who are unable to exercise undergo pharmacological tests. Although accurate diagnosis and a high prognosis value are achivied with both methods, there are new techniques under study, including the utilization of echocardiographic contrast with microbubbles for endocardial edge evaluation and for myocardial perfusion studies

How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries

<p>Abstract</p> <p>Background</p> <p>A global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools.</p> <p>Methods</p> <p>The information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country.</p> <p>Results</p> <p>The order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043).</p> <p>Conclusions</p> <p>The reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses.</p

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.&nbsp; Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities. &nbsp; Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.&nbsp; The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.&nbsp; The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.&nbsp; &nbsp;&nbsp; Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.&nbsp;&nbsp;&nbsp; Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

Intervenção nutricional num doente com cancro gástrico: caso clínico : trabalho de investigação : Nutritional support in a gastric cancer patient

Contém um relatório de estágio curricular realizado no Serviço de Alimentação e Nutrição do Instituto Português de Oncologia, EPE,Porto, no âmbito da licenciatura em Ciências da Nutrição pela Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto. O exemplar do relatório de estágio existe apenas em formato papel e está disponível para consulta na Biblioteca da FCNAUPTese de licenciatura em Ciências da Nutrição apresentada à Faculdade de Ciências da Nutrição e Alimentação da Universidade do PortoResumo da tese:O cancro gástrico é uma patologia com dimensão mundial, e durante o século XX foi a maior causa de morte relacionada com o cancro. Actualmente, estima-se que surjam 875 000 novos casos por ano, em todo o mundo. No doente oncológico, pela patologia, pelo tratamento ou pela resposta do organismo a estes, são comuns alterações ao nível da nutrição (ingestão, digestão, absorção e excreção). Estas podem, e na realidade condicionam, o estado nutricional do doente, com impacto na sua evolução clínica. O suporte nutricional surge, assim, de forma a aumentar a funcionalidade e a qualidade de vida destes doentes. Não obstante, nos cuidados intensivos prestados ao doente em estado crítico, a nutrição não é uma prioridade, sendo várias as incoerências encontradas no suporte nutricional instituído, pelo que, recentemente, tem sido sugerida a implementação, em rotina clínica, de protocolos de actuação.Thesis abstract:Gastric cancer is a global disease, and during the twentieth century was the major cause of death related to cancer. Currently, an estimated of 875,000 new cases occur per year worldwide. In cancer patients, the pathology, the treatment or the body's response to these, are common changes in nutrition (ingestion, digestion, absorption and excretion). They can, and actually influence, the nutritional status of patients, with impact on their clinical evolution. The nutritional support, appears thus as a way to increase the functionality and the quality of life of these patients. However, in intensive care provided to patients in critical condition, nutrition is not a priority, and a number of incoherencies found in nutritional support established and, recently, the nutritional protocols have been suggested for implementation in clinical routine