Browsing by Issue Date, starting with "2021-04-01"
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- UPSA: avaliação do desempenho funcional nos diferentes estádios de declínio cognitivoPublication . Cardoso, Susana; Ribeiro, Filipa Correia; Nunes, Maria Vânia SilvaIntrodução: A demência é uma síndrome clínica adquirida, caracterizada pelo declínio progressivo de várias funções cognitivas. Os défices são persistentes e têm gravidade suficiente para interferir nas relações sociais e na capacidade para realizar de um modo autónomo as actividades de vida diária. Vários estudos demonstraram que défices nas actividades instrumentais de vida diária (AIVD) predizem significativamente o desenvolvimento de demência. Para avaliar as AIVD, os instrumentos baseados no desempenho são os mais sensíveis na diferenciação do desempenho entre indivíduos cognitivamente saudáveis e indivíduos com declínio cognitivo. Objectivo: Traduzir e adaptar a segunda versão da UCSD-Performance-Based Skills Assessment (UPSA-2), um instrumento baseado no desempenho que avalia as AIVD, bem como verificar se existem diferenças no desempenho funcional, nos diferentes estádios do declínio cognitivo. Materiais e métodos: A amostra foi composta por 81 participantes, 34 participantes do grupo cognitivamente saudáveis, 23 participantes do grupo com alterações cognitivas ligeiras e 24 participantes do grupo com alterações cognitivas marcadas. Resultados: Os resultados totais da UPSA-2 foram significativamente inferiores nos indivíduos com alterações cognitivas marcadas, mais do que nos indivíduos com alterações cognitivas ligeiras, que por sua vez foram inferiores aos resultados dos indivíduos cognitivamente saudáveis. O resultado total da UPSA-2 está fortemente correlacionado com o resultado da Escala de Avaliação da Doença de Alzheimer, Subescala Cognitiva (ADAS-Cog) (r=-0.84/p<0.001). Verificou-se ainda que os indivíduos que não apresentaram alterações funcionais na IADL, apresentaram alterações em vários domínios da UPSA-2. Conclusões: A UPSA-2 tem propriedades discriminativas relativamente ao desempenho funcional dos indivíduos sem alterações cognitivas, dos indivíduos com alterações cognitivas ligeiras e marcadas. Este estudo veio demonstrar que a UPSA-2 tem maior sensibilidade na avaliação das AIVD, do que um instrumento de autoavaliação. Permite ainda evidenciar a existência de uma forte associação entre o desempenho cognitivo e o desempenho funcional.
- Biocompatibility and effectiveness of a novel, organic olive oil-based denture adhesive: a multicenter randomized and placebo-controlled clinical trialPublication . Azevedo, Luís; Correia, André; Almeida, Carlos F.; Molinero-Mourelle, Pedro; Correia, Maria; Highsmith, Jaime del RíoTo assess the clinical efficacy of a novel, organic olive oil-based denture adhesive and its effect on Candida albicans growth in maxillary edentulous individuals wearing complete dentures, individuals were selected from two dental schools in Portugal and Spain. Twenty-eight complete dentures were relined, following a standardized protocol. The novel product (test) was compared with a commercialized adhesive (control) and Vaseline (placebo) randomly assigned in a cross-study design. The retention resistance was measured with a gnathometer and a dynamometer. The patients related outcome evaluations with a five-point questionnaire, and the Candida albicans growth in a Sabouraud dextrose agar (SDA) medium was used to evaluate differences between the placebo and experimental product. Twenty-three participants were included. The dynamometer evaluation showed significant differences between not using a denture adhesive and using either (experimental, p = 0.03; control, p = 0.04) and no significant differences between the two adhesives (p > 0.05). In the subjective analysis, the experimental adhesive showed a significantly longer effectiveness (p = 0.001), and the control reported better results in taste (p = 0.03) and in chewing (p = 0.001). The test adhesive showed better (p < 0.001) Candida albicans growth inhibition. The experimental adhesive showed longer effectiveness than the control and the placebo with a better inhibition capacity for the growth of Candida albicans. Patients reported better abilities for speech, chewing, taste, and retirement in the control adhesive.
- Sleep and awakening quality during COVID-19 confinement: complexity and relevance for health and behaviorPublication . Paiva, Teresa; Reis, Cátia; Feliciano, Amélia; Canas-Simião, Hugo; Machado, Maria Augusta; Gaspar, Tânia; Tomé, Gina; Branquinho, Cátia; Silva, Maria Raquel; Ramiro, Lúcia; Gaspar, Susana; Bentes, Carla; Sampaio, Francisco; Pinho, Lara; Pereira, Conceição; Carreiro, Alexandra; Moreira, Susana; Luzeiro, Isabel; Videira, Gabriela; Fonseca, Júlio; Bernarda, Ana; Castro, Joana Vaz; Rebocho, Sofia; Almondes, Katie; Canhão, Helena; Matos, Margarida GasparObjective: The aim of this study was to evaluate sleep and awakening quality (SQ and AQ) during COVID-19 in a large and diversified population in order to identify significant associations and risks in terms of demography, health and health-related behaviors, sleep variables, mental health, and attitudes. Methods/Results:Online surveys were used for data collection, received from 5479 individuals from the general population, sleep disorder patients, and COVID-involved (medical doctors (MDs) and nurses) and COVID-affected professionals (teachers, psychologists, and dentists). SQ and AQ were worse in adults, females, and high-education subjects. Feeling worse, having economic problems, depression, anxiety, irritability, and a high Calamity Experience Check List (CECL) score during COVID were significantly associated with poor SQ and AQ. Shorter sleep duration, increased latency, poor nutrition, low physical activity, increased mobile and social network use, more negative and less positive attitudes and behaviors were associated with poor AQ. Conclusions: The SQ logistic regression showed gender, morbidities, CECL, and awakenings as relevant, whereas, for AQ, relevant variables further included age and physical activity. Aiming to have a high stress compliance, each individual should sleep well, have important control of their mood, practice positive behaviors while dismissing negative behaviors and attitudes, practice exercise, have adequate nutrition, and beware of technologies and dependences.
- Longitudinal evaluation of diastema closure in patients submitted to labial frenectomy in different phases of the mixed dentition: a historical cohortPublication . Rafael, M. Pereira; Helvécio, Marangonn; Tamara, K.; Cassio, J. Alencar; Cacio, Moura Netto; Carolina, V. AnnaThere is a controversy in the literature concerning the indications for frenectomy to treat interincisal diastema. Aims and Objectives: The aim of this study was to evaluate the spontaneous closure of the interincisal diastema in patients submitted to upper labial frenectomy (ULF) during the mixed dentition. Materials and Methods: Records from patients treated between 2009 and 2014 in the course of Pediatric Dentistry Surgery at Fundecto-USP were evaluated to select those that were submitted to ULF during the mixed dentition using the Chelotti technique. Initial clinic characteristics and radiographic data related to the abnormal upper labial frenum were collected. The patients were called for a return visit to evaluate the diastema closure. The prevalence of children with diastema reduction after the frenectomy was determined by descriptive analysis. Logistic regression was used to evaluate the association between exposure factors and diastema reduction. Results: From 449 eligible records, 53 were selected and 25 were in a return visit. It was not possible to find association between the exposure factors and diastema closure. Conclusion: There is no relation between the time of surgery intervention and diastema closure. However, the intervention during the mixed dentition led to a partial diastema reduction in 80% of the cases.
- Protective factors in the use of electronic media according to youth and their parents: an exploratory studyPublication . Campos, Luísa; Veríssimo, Lurdes; Nobre, Bárbara; Morais, Catarina; Dias, PedroThe use of electronic media (EM) by youths has been widely described in the literature, indicating the relevance of understanding the factors that can protect against its risks. We aimed to explore the protective role of participating in extracurricular activities (ECAs) and of parental mediation in the use of EM by young people. A total of 1413 people (729 students, aged between 11 and 17 years old, and one of their parents) participated in this study. Youths who engaged in ECAs spent significantly less time per week on EM and perceived that the use of EM devices had less of a negative impact. When parents and their children presented a congruent notion of how much time youth spent on EM, parents perceived EM to have less of a negative impact on their children compared to dyads with discrepant assessments. The hierarchical regression results indicated that regardless of time spent per week on EM, engaging in ECAs was a significant predictor of perceiving a less negative impact, playing a role as a protective factor regarding the use of EM. The ubiquity of EM reinforces the importance of the focus of this study, and its results contribute to creating specific guidelines for parental education and educational policies.
- The sorptivity and durability of gelling fibre dressings tested in a simulated sacral pressure ulcer systemPublication . Lustig, Adi; Alves, Paulo; Call, Evan; Santamaria, Nick; Gefen, AmitWound-dressing performances are affected by exudate viscosity, resistance to flow because of gravity, and bodyweight loads, the level of which is related to the body position. Here, we focussed on two dressing properties: (a) Sorptivity—the ability of dressings to transfer exudate away from the wound bed by capillary action—and (b) Durability—the capacity of dressings to maintain their integrity over time and during their removal. Both properties are critically important for avoiding further tissue damage but require the development of new laboratory tests for their measurement. A computercontrolled phantom of an exuding sacral pressure ulcer has therefore been developed and used to compare the performances of Exufiber (Mölnlycke Health Care) vs an alternative market-leading dressing. Sorptivity was determined using weight tests, and durability was measured through tensile tests of the used dressings. For a supine configuration, the Exufiber dressing demonstrated three times higher sorptivity and better durability, withstanding five times greater strain energy than the other product before failure occurred. This work paves the way for quantitative, standardised testing of dressings in all aspects of exudate management. The reported tests are further suitable for testing dressing combinations or how dressings interact with negative pressure wound therapy.
- “Quando ninguém se entende”: conflitos bioéticos num caso real de fim de vidaPublication . Rodrigues, Ricardo Lucas de Souza; Magnos, Marta Alexandra de Almeida; Covas, Sofia Marques Inglês Gomes; Castro, Valéria Guedes Ferreira da Silva; Chagas, Valquiria Cardoso AlvesIntrodução: A evolução técnico-científica das últimas décadas traduz-se no alargamento da expectativa de vida, na diminuição da taxa de mortalidade por doenças infectocontagiosas e no aumento da mortalidade devido às doenças crônico-degenerativas. Soma-se a isso a formação da educação médica, dotada cada vez mais de um modelo orientado para o uso de tecnologias altamente sofisticadas, parecendo negligenciar o tradicional campo da relação médico-utente. Quando o objetivo final é a cura, a morte passa a ser considerada um fracasso, um resultado inaceitável. Apesar de todo o esforço e tecnologia usada, a morte continua sendo um desfecho inevitável. A pessoa doente, quando em segundo plano, deixa de ser o protagonista da sua história. A bioética é um ramo do conhecimento que visa indicar os limites e as finalidades da intervenção do homem sobre a vida, tendo como fundamento o reconhecimento pela dignidade da Pessoa Humana. “o que devo fazer frente ao que posso fazer?” Os cuidados de fim de vida comumente envolvem questões éticas que levam os profissionais de saúde, pacientes e familiares a enfrentarem dilemas, conflitos. Objetivo: O presente trabalho propõe mostrar o quanto pode ser desafiador o processo de tomada de decisão para os envolvidos, nomeadamente os profissionais de saúde, familiares e utentes. Materiais e métodos: Diante de um caso real, os princípios éticos são apresentados e desenvolvidos respeitando a ótica da bioética. Resultados: A começar pelas concepções de dignidade, assim como suas possíveis fragilidades, perpassando aspectos mais técnicos como a adequação de esforço terapêutico e proporcionalidade de intervenções, contemplando os conceitos de obstinação e futilidade terapêutica, explorando a dimensão da autonomia (inclusive alguns de seus aspectos legais) e encerrando no campo da justiça e equidade, faz-se clara a complexidade que o processo de tomada de decisões ganha quando o aspecto humano e multifacetado da pessoa que sofre, o utente (e família), é posto em causa. Conclusão: As ponderações elencadas pelos princípios bioéticos auxiliam-nos a fundamentar o nosso agir profissional, de forma a considerar o mundo do utente, de seus familiares e/ou pessoas próximas e o nosso enquanto equipa assistencial. Como resultado, é suposto o abandono de certezas dogmáticas e simplistas, o abrandamento das incertezas inerentes ao processo e a eleição de uma melhor resposta possível: individualizada para aquele utente, por aquela equipa, naquele contexto. Aproximando-se do caso em questão, nas situações de fim de vida, a filosofia dos cuidados paliativos destaca-se como ferramenta de semelhante impacto.
- Racionalidade e dialética hermenêutica. De Hegel a RicoeurPublication . Marcelo, GonçaloO objetivo deste artigo é o de refletir, no contexto de uma investigação sobre a racionalidade, sobre o que poderá ser uma dialética hermenêutica e mencionar algumas das suas caracte- rísticas e domínios de aplicação. O artigo analisa os conceitos de dialética e de hermenêutica, apresentando a versão forte da dialética tal como ela aparece em Hegel e mencionando de que forma, a partir de uma leitura da hermenêutica ricœuriana, é possível compreender a especificidade da dialética hermenêutica e os efeitos que ela tem no alargamento da noção de racionalidade.
- A qualitative study about college students' attitudes, knowledge and perceptions regarding sugar intakePublication . Prada, Marília; Godinho, Cristina A.; Garrido, Margarida V.; Rodrigues, David L.; Coelho, Inês; Lopes, DinizExcessive sugar intake has been associated with multiple health conditions (e.g., higher risk for non-communicable diseases). Hence, health organizations have issued guidelines defining the maximum daily intake of free or added sugars. However, data from several countries suggests that these guidelines are rarely met, particularly by young adults. For example, almost half of Portuguese adolescents and young adults exceed the recommended sugar intake. In this work, we aim to further explore college students' attitudes, knowledge, and perceptions about sugar intake, as well as about sugar intake guidelines. A thematic analysis on data from five focus groups (N = 40) indicated that participants reported difficulty in the comprehension of added/free sugars definition and sugar intake recommendations. Overall, attitudes toward sugar were ambivalent. Sugar was simultaneously perceived as pleasurable and needed, but also as addictive and harmful. Although aware of the potential negative health outcomes associated with excessive sugar intake, most participants did not perceive being at risk due to their youth, exercise habits, or type of diet. The few concerns expressed were mostly associated with the negative impact of high sugar intake on body image (e.g., weight gain). The main barriers to reducing sugar intake identified were environmental (e.g., time restrictions, food available at the university). Still, participants could identify several individual strategies to effectively regulate sugar intake. By identifying knowledge gaps and sources of bias related to sugar consumption, our findings are useful to inform future interventions aiming to address the problem of high sugar intake among university students.
- Can prior hospitalisation experiences influence satisfaction with nursing care? Results in a school-aged children samplePublication . Loureiro, Fernanda; Charepe, ZaidaIntroduction: Patient satisfaction is considered an important and relevant patient outcome in the nursing field [1], and prior hospitalisation experiences have impact in the overall satisfaction with care [2]. Regarding children satisfaction, authors conceptualise satisfaction through the comparison of previous experiences [3]. This study aims to identify if prior hospitalisation experiences influences satisfaction with nursing care, in school-aged children (7–11 years). Materials and Methods: An observational, cross-sectional, exploratory-descriptive study with a convenience sample was performed. Data were collected from January 2015 to December 2016. The "Children Care Quality at Hospital" [4] instrument was used after translation and validation to Portuguese [5]. In this questionnaire children were asked to rate nursing care from 1(less satisfied) to 5 (more satisfied). Statistical analysis was performed using SPSS statistical tool (version 24.0). In order to verify the association between the variable’s prior to hospitalisation experience and patient satisfaction, Student's t-test was applied with a 95% confidence interval. Authorisation was obtained from ethics committees in each of the 6 hospitals were the study was applied, and also from the National Data Protection Commission. Results: In this sample (n = 252) children mean age was 8.9 years (SD = 1.4), and it mainly consisted of boys (52.8%, n = 133). Most children had prior hospitalisation experiences (63.5%, n = 160), 35.7% (n = 90) have never been hospitalised before, and 2 children answered, “I do not know”. Nursing care was rated with a score of 4.51 (SD = 0.645). There was no significant difference between having or not having prior hospitalisation experiences and the score attributed by children (t = 1.47; p =.821). Discussion and conclusions: In this sample, children are satisfied with nursing care provided during hospitalisation. In previous studies with adult population, prior experiences seem to have a negative effect on the overall satisfaction [2,6]. Specifically in school-aged children, previous experiences positively influences satisfaction with nursing care [4]. However, this was not verified in our study. We suggest that further studies should be developed some time after the hospitalisation experience, for example 6 months, to understand the most relevant experiences and their influence on the satisfaction with hospital nursing care.