Deterioro cognitivo leve tipo amnésico y la enfermedad de Alzheimer: implicaciones de la función ejecutiva y la atención dividida en la marcha

[ES]El presente trabajo de Tesis Doctoral tiene como objectivo estudiar la relación entre las funciones ejecutivas (FE) y la atención dividida con el riesgo de caídas en la marcha en pacientes con Deterioro Cognitivo Leve tipo amnésico (DCLa) y en aquellos con Demencia Tipo Alzheimer (DTA) leve y conocer si dicho riesgo se puede predecir a partir de variables sociodemográficas, de la actividad física, del grupo de participantes, de las FE, y de las condiciones de la doble tarea al caminar, aplicando diferentes pruebas de evaluación del riesgo de caídas. Metodología: La muestra se ha constituido por 216 participantes: 72 con DCLa, 68 con DTA leve y 76 sin afectación neurocognitiva que constituyen un grupo de comparación (GC). Todos los participantes fueron evaluados con un protocolo sociodemográfico y clínico, con pruebas de evaluación neuropsicológica, que incluyen pruebas de cribaje cognitivo, funcionalidad, severidad de afectación neurocognitiva y de los rendimientos ejecutivos, así como pruebas de la atención dividida (paradigma de la doble tarea durante la marcha) y tres pruebas de evaluación del riesgo de caídas. Resultados: Los DTA leve presentaron peores rendimientos ejecutivos, peores rendimientos en los diferentes paradigmas de la doble tarea y mayor riesgo de caídas, respecto al grupo DCLa y GC, no observándose diferencias significativas entre esto dos últimos grupos en la mayoría de los resultados. Las variables fluencia semántica verbal, memoria de trabajo, doble tarea (caminar conversando), edad y sedentarismo predicen significativamente el riesgo de caídas. Conclusiones: Los pacientes con mayor deterioro neurocognitivo presentan peores resultados ejecutivos, una velocidad más lenta al caminar, una mayor interferencia de la atención dividida sobre la marcha y mayor riesgo de caídas. Las variables que mejor predicen el riesgo de caídas son diferentes en función de la prueba aplicada para analizar dicho riesgo, en la muestra analizada.[EN]This PhD aims to study the relationship between executive functions (EF) and divided attention with the risk of falls in gait, in patients with amnestic mild cognitive impairment (aMCI) and in patients with mild Alzheimer-type dementia (DA) and know if this risk can be predicted from sociodemographic variables, physical activity, group of participants, EF and the conditions of the dual task when walking, applying different tests to assess the risk of falls. Methodology: The sample consisted of 216 participants: 72 with aMCI, 68 with mild DA and 76 without neurocognitive involvement, that constitute a comparison group (CG). All the participants were evaluated with a sociodemographic and clinical protocol, with neuropsychological assessment tests, which include tests of cognitive screening, functionality, severity of neurocognitive impairment and executive performance, as well as tests of divided attention (paradigm of dual task during the gait) and three tests to assess the risk of falls. Results: The mild DA presented worse executive performance, worse performance in the different paradigms of the dual task and higher risk of falls, compare to the aMCI group and CG, not observing significant differences between these last two groups in the majority of the results. The variables semantic verbal fluency, working memory, dual task (walking while talking), age and sedentary lifestyle significantly predicts the risk of falls. Conclusions: Patients with greater neurocognitive impairment present worse executive results, a slower walking speed, a greater interference of divided attention on the gait and greater risk of falls. The variables that best predict the risk of falls are different depending on the test applied to investigate said risk, in the sample analyzed

Perceções sobre o empreendedorismo em enfermagem : perspetivas, incentivos e obstáculos à atividade empreendedora no texto nacional

Dissertação de mestrado em Gestão das Unidades de SaúdeO presente estudo tem como objetivo abordar as perceções do empreendedorismo em Enfermagem, no sentido de conhecer quais os principais incentivos e obstáculos à sua implementação. Dada a importância que se tem dado ao empreendedorismo como forma de amenizar as dificuldades que surgem no mercado de trabalho, marcadas pela elevada taxa de desemprego, pela escassez de ofertas de emprego e pela precariedade dos contratos laborais. A emergência de uma atividade empreendedora é, então, percebida como uma forma de recuperar a economia e resolver o problema do desemprego. Esta instabilidade faz-se sentir, também, no âmbito da saúde onde as medidas governamentais visam uma redução de custos que afeta, impreterivelmente, a contratação de profissionais de saúde, o que parece criar alguma legitimidade “para se falar” de empreendedorismo em Enfermagem. Considerando o objetivo central e o caráter exploratório do estudo, utilizamos uma metodologia qualitativa com recurso a 18 entrevistas realizadas a Enfermeiros empreendedores da zona norte de Portugal. O empreendedorismo em Enfermagem parece apresentar uma relação paradoxal quando confrontado com a perspetiva económica, surgindo a ideia de um conceito hibrido que se depara com a necessidade de obtenção de lucro mas também com a necessidade de prestar serviços sociais como resposta a necessidades concretas da população. Claro está que o empreendedorismo em Enfermagem não deixa de ser uma atividade económica em que é importante a sua viabilidade financeira. Assim, os apoios mais valorizados pelos empreendedores entrevistados referem-se: ao apoio logístico; ao acesso ao financiamento; ao processo de desburocratização e às estratégias de marketing. Por outro lado, os obstáculos mais mencionados centram-se: na incapacidade de resposta por parte dos serviços; no excesso de burocracia; na elevada carga tributária a que as empresas estão sujeitas e na conjuntura económica que o país atravessa. Este estudo vem, assim, contribuir para o desenvolvimento do conhecimento do empreendedorismo em Enfermagem e poderá promover a implementação de políticas de empreendedorismo, mais adequadas às necessidades dos empreendedores, por parte das organizações responsáveis.The present study aims to address the perceptions of entrepreneurship in nursing, in order to know what the main incentives and barriers to implementation. Given the importance that has been given to entrepreneurship as a way to ease the difficulties that arise in the labor market, marked by high unemployment, scarcity of jobs and the precariousness of labor contracts. The emergence of entrepreneurial activity is then perceived as a way to revive the economy and solve the unemployment problem. This instability makes also sense in the context of health where government measures aimed at reducing costs affecting the latest, the recruitment of health professionals, which seems to create some legitimacy "to speak" of entrepreneurship in nursing. Whereas the main objective and exploratory nature of the study, we used a qualitative methodology using 18 interviews with entrepreneurs Nurses northern Portugal. Entrepreneurship in nursing seems to have a paradoxical relationship when faced with the economic perspective, the emerging idea of a hybrid concept that is faced with the need to make a profit but also with the need to provide social services in response to specific needs of the population. Is clear that entrepreneurship in nursing is nonetheless an economic activity that is important to their financial viability. Thus, support most valued by entrepreneurs interviewed refers: logistical support; access to financing; to reduce bureaucracy and marketing strategies process. On the other hand, the most mentioned obstacles focus: the inability to answer by the services; in the excessive bureaucracy; the high tax burden that companies are subject and the economic situation facing the country. This study has thus contribute to the development of knowledge of entrepreneurship in nursing and may promote the implementation of more appropriate to the needs of entrepreneurs by the organizations responsible for policy entrepreneurship

Clínica e cirurgia de equinos

O presente trabalho retrata as atividades desenvolvidas ao longo dos estágios realizados na Equimuralha, sob a orientação do Dr. Tomé Fino, e na HorseCare, sob a orientação da Drª. Constança Moreira da Fonseca. Na primeira parte do relatório encontra-se descrita e quantificada a casuística assistida. Neste primeiro capítulo, categorizado pelas várias áreas da medicina de equinos, apresentamse sumariamente os casos/procedimentos, seguidos do desenvolvimento de um caso relevante ou representativo. A segunda parte é composta por uma monografia centrada numa revisão bibliográfica sobre o desequilíbrio medio-lateral associado à extremidade distal dos equinos. Por fim, apresenta-se um estudo, realizado sob a orientação do Dr. Tomé Fino, que visa apresentar a incidência desta condição na população de equinos acompanhada durante o estágio realizado na Equimuralha, e avaliar a sua relação com o desenvolvimento de claudicação; Equine Clinics and Surgery Abstract: This report describes the activities carried out during the externship at Equimuralha and HorseCare, under the supervision of Dr Tomé Fino and Dr Constança Moreira da Fonseca, respectively. The first part of the report describes and quantifies all the cases observed. This first chapter, organized into various areas of equine medicine, includes a synopsis of the different cases/procedures observed, followed by a more detailed discussion of a relevant or representative case. The second part has two sections: a monography centered on a review of the bibliography about the mediolateral imbalance associated with the distal limb of the equine species and a study, supervised by Dr Tomé Fino, which aims to analyze the incidence of this condition in the equine population observed during the externship at Equimuralha and assess its relationship with the development of lameness

Molecular, morphological and chemical diversity of two new species of Antarctic Diatoms, Craspedostauros ineffabilis sp. nov. and Craspedostauros zucchellii sp. nov.

The current study focuses on the biological diversity of two strains of Antarctic diatoms (strains IMA082A and IMA088A) collected and isolated from the Ross Sea (Antarctica) during the XXXIV Italian Antarctic Expedition. Both species presented the typical morphological characters of the genus Craspedostauros: cribrate areolae, two “fore-and-aft” chloroplasts and a narrow “stauros”. This classification is congruent with the molecular phylogeny based on the concatenated 18S rDNArbcL-psbC alignment, which showed that these algae formed a monophyletic lineage including six taxonomically accepted species of Craspedostauros. Since the study of the evolution of this genus and of others raphe-bearing diatoms with a “stauros” is particularly challenging and their phylogeny is still debated, we tested alternative tree topologies to evaluate the relationships among these taxa. The metabolic fingerprinting approach was implemented for the assessment of the chemical diversity of IMA082A and IMA088A. In conclusion, combining (1) traditional morphological features used in diatoms identification, (2) phylogenetic analyses of the small subunit rDNA (18S rDNA), rbcL and psbC genes, and (3) metabolic fingerprint, we described the strains IMA082A and IMA088A as Craspedostauros ineffabilis sp. nov. and Craspedostauros zucchellii sp. nov. as new species, respectivelyinfo:eu-repo/semantics/publishedVersio

SABERES-FAZERES ARTÍSTICOS-CULTURAIS E PEDAGÓGICOS NUMA ESCOLA QUILOMBOLA DO CAMPO

Este artigo apresenta a fase inicial da pesquisa-formação para inserção dos saberes-fazeres quilombolas na escola do campo em Uibaí, na Bahia, através de diálogos artístico-culturais. A comunidade de Caldeirão é reconhecida pela Fundação Cultural Palmares desde o ano de 2004. Contudo, os documentos da escola abordam timidamente sua identidade quilombola campesina. A metodologia da pesquisa se ancorou na pesquisa qualitativa de vertente teórico-filosófica hermenêutica, para interpretação das práticas artístico-culturais desenvolvidas pela escola, visando a sua ressignificação. Nessa tessitura buscou, com inspiração na etnopesquisa articulada com a pesquisa-formação – etnoformação -, tomar a prática pedagógica como objeto de estudo. Foram utilizados como dispositivo de investigação nesta fase a análise documental, seguida da entrevista semiestruturada. O movimento da pesquisa mobilizou os/as participantes para a fase seguinte, compreendendo-a como imprescindível para elaboração de uma proposta formativa continuada e em exercício, partindo da ação para a ela retornar

Coping, executive functioning, inhibitory control and decision-making in a sample of depressed suicidal patients

Introduction: Suicidal behavior has been associated with several risk factors, including depression, maladaptive coping, and neuropsychological dysfunction. This study aimed to evaluate coping orientations, executive functioning, attentional capabilities and decision-making in depressed suicidal patients.  Methods: Two groups were selected: 32 depressed patients with history of suicide attempt and 30 depressed patients without history of suicide attempt. The Beck Depression Inventory and the COPE Inventory scales were applied, as well as the following neuropsychological tests: Wisconsin Card Sorting Test, Stroop Test, and a modified Iowa Gambling Task.  Results: The results indicate a higher level of dysfunction in the executive functioning, mental control, and decision-making domains, and lower levels of orientation to active and reflective coping strategies, humor, and positive signification in the suicidal group. Conclusions: These results indicate that there are neuropsychological differences between depressed patients with and without history of suicide attempt, which may contribute significantly to the occurrence of suicidal behavior. However, the processes involved and the way they contribute to the phenomenon are aspects that still need further clarification

Detection of Keratoconus With a New Biomechanical Index

To evaluate the ability of a new combined biomechanical index called the Corvis Biomechanical Index (CBI) based on corneal thickness profile and deformation parameters to separate normal from keratoconic patients

Grupo de trabalho e interversão em psicologia na procriação medicamente assistida - GIPPMA

With a view to improving provision of care in the field of Psychology in the context of Medically Assisted Procreation (PMA), the GIPPMA - Working Group and Intervision in Psychology at PMA was created in 2019. This informal group includes Psychologists who carry out their work activities in a hospital of the SNS (North Zone) and a professor/researcher. The GIPPMA emerged on the personal initiative of these professionals with the central assumption of creating a shared practical approach, overcoming some of the difficulties present in clinical practice. The group's objectives are: to build standardized psychological protocols in the field of PMA (pre-treatment evaluation, treatment and post-treatment protocols), as well as to develop, evaluate and propose work initiatives aimed at disseminating solutions and good practices in this area. GIPPMA has been emphasizing joint scientific research, seeking to contribute to knowledge on the subject, crucial as a basis for intervention. Similar to other areas of Psychology, which are undergoing rapid development and change, requiring professionals to be constantly updated/trained, this group also includes Clinical Intervision. Taking advantage of the geographical proximity and formal relations between institutions and following what the Portuguese Psychologists Association has been highlighting, GIPPMA considers this area of its activity as relevant in promoting well-being and self-care of professionals, in facilitating training and continuous development, as well as a safe and quality professional practice.info:eu-repo/semantics/publishedVersio