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- The effect of home palliative care on patient dignity: a scoping reviewPublication . Valentim, Flávia de Araújo Cordeiro; Oliveira, Nádia Marisa Sotério de; Alves, Vicente Paulo; Capelas, Manuel LuísIntroduction: Home-based palliative care plays a vital role in preserving the dignity of terminally ill patients and their families. However, the factors influencing this experience from the perspective of patients, family caregivers, and healthcare professionals are not fully understood. Aim: To map existing evidence on the effects of home-based palliative care on patient dignity, considering the perspectives of patients, family caregivers, and health professionals. Methods: A literature search was conducted in PubMed, Scopus, Web of Science, Cochrane, CINAHL, and PsycINFO, including studies published until December 2024. Eligible studies addressed dignity in the context of home-based palliative care. Opinion reports, case reports, and gray literature were excluded. Results: Five studies that used qualitative methods were included. Key factors supporting the preservation of dignity include patient autonomy and self-determination, family support, effective symptom management, and supportive care environments. Challenges include caregiver burden, organizational barriers, and lack of infrastructure in home care services. Conclusion: Home-based palliative care can contribute to preserving patient dignity when structured support is provided and patient autonomy is respected. However, structural and organizational challenges remain significant barriers. Future research should explore strategies to enhance health service integration and caregiver support to promote humane and equitable home-based palliative care.
- Recommendations and statements of good practice for risk assessment of pressure injuries in adults admitted to intensive care unitsPublication . Picoito, Ricardo; Manuel, Tânia; Vieira, Sofia; Azevedo, Rita; Alves, Paulo; Nunes, ElisabeteBackground: the prevention of pressure injuries depends on early and correct assessment of at-risk patients. Since risk assessment is more than identifying it using a risk factor instrument, we intend to map the existing recommendations and statements of good practice for pressure injury risk assessment in adults admitted to intensive care units, as well as identifying the strengths of evidence and recommendations. Methods: scoping review, by Joanna Briggs Institute, adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews as a guide for writing the study. Results: the search was carried out in six databases, resulting in 741 studies, of which 15 were included. The recommendations and statements of good practice were grouped into five categories: risk assessment instruments, skin assessment, medical device surveillance, other alternatives to risk assessment and implement the best practices in clinical settings. The strengths of evidence and recommendation were identified, when available in the literature. Conclusions: the mapping showed that the evidence is sufficient to indicate the recommendations and statements of good practice to risk assessment of pressure injuries in adults admitted to an intensive care unit. The protocol was retrospectively registered in the Open Science Framework on the 4th of august of 2023 (https:
- Do clear aligners release toxic chemicals? - a systematic reviewPublication . Ferreira, Mariana; Costa, Hélder; Veiga, Nélio; Correia, Maria J.; Gomes, Ana T. P. C.; Lopes, Pedro C.The use of advanced polymer materials in clear aligners, such as polyurethane and PET-G, has gained widespread acceptance due to their mechanical properties, biocompatibility and aesthetic appeal. However, concerns persist regarding their potential to release chemical compounds. Our goal is to understand the impact of the toxicity of clear aligners on oral cavity of orthodontic patients. An extensive systematic search was conducted in electronic databases PubMed, Scopus and Cochrane, to identify articles with relevant data. This systematic review will be conducted following the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines to answer a question formulated according to the Population, Intervention, Com-parison and Outcomes strategy. Four hundred and thirteen articles potentially relevant were identified and after applying PRISMA guidelines 7 articles were included in this review. Our results suggest that clear aligners are generally safe, concerns remain regarding the chemical leaching of thermoplastic materials, bacterial accumulation due to reduced saliva flow, and mild inflammatory responses. Our review empha-sizes that although most materials are biocompatible, some exhibit moderate cytotoxicity, underscoring the need for continued research and improvements in material composition.
- O papel da nutrição na prevenção e tratamento de feridasPublication . Borges, Cátia; Albuquerque, Luísa; Alves, Paulo; Ramos, Paulo; Teixeira, Abílio; Magalhães, Bruno; Mendes, Diana
- (Des)cobrir a ferida malignaPublication . Rocha, Ana; Moura, Anabela; Vicente, Helena; Matos, Marisa; Alves, Paulo; Ramos, Paulo; Carvalhal, Sara; Gomes, Sylvie
- Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in Portuguese tertiary carePublication . Mendes, José Leão; Ferreira, Rita Quaresma; Mata, Inês; Barreira, João Vasco; Rodrigues, Ysel Chiara; Dias, David Silva; Capelas, Manuel; Mäkitie, Antti; Guerreiro, Inês; Pimenta, Nuno; Ravasco, PaulaBackground/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (± 11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (< 49.96 cm2/m2 for men; < 34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Conversely, Prado et al. definition lacked prognostic value. Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.
- Abordagem à pessoa com lesões de pele associadas à humidadePublication . Almeida, Armando; Sousa, Filomena; Grilo, Liliana; Alves, Paulo; Ramos, PauloA preservação da integridade cutânea está considerada, à luz dos conhecimentos atuais, como um forte indicador da qualidade dos cuidados de saúde prestados, nomeadamente ao nível da prevenção de lesões. As Lesões de Pele Associadas à Humidade (LPAH) são causadas pela prolongada exposição da pele a fluidos e seus constituintes, de várias fontes. Existe um conjunto de mecanismos que interagem entre si, de forma a manter a homeostasia cutânea, impedindo a sua lesão. Contudo, em situações agudas ou crónicas, este equilíbrio fica comprometido e é necessária a intervenção externa para a prevenção e tratamento das lesões cutâneas. A APTFeridas elaborou este documento, com o apoio da 3M, como guia de orientação para as melhores práticas de prevenção e tratamento de Lesões Associadas à Humidade da Pele. Neste documento, para além de uma revisão da literatura, também encontrará instrumentos que ajudam na prática clínica, constituindo uma mais valia para a melhoria dos cuidados prestados à pessoa em risco ou com lesão de pele associada à humidade.
- Lived experience of comfort on sexuality and fertility for survivors of hematopoietic stem cell transplants: phenomenological studyPublication . Bacalhau, Lúcia; Pontífice-Sousa, PatríciaPurpose: To grasp the scope of sexuality and fertility within the lived experiences of comfort and discomfort among allogeneic stem cell transplant survivors. Methods: We employed a qualitative approach through van Manen's phenomenology of practice. The phenomenon was revealed via phenomenological interviews, incorporating narratives and illustrative episodes that captured the lived experiences of 20 survivors. We gathered descriptions of these experiences from participants from July 2020 to May 2021. During our phenomenological reflection on these accounts, we adhered to stages like epoché, reduction, and vocative, as outlined by van Manen (1). Results: The exploration of comfort within the realms of sexuality and fertility yielded several themes: desire and the relationship; immunosuppression as a limitation on sexual activit; the body does not correspond to desire; the future: fertility and the couple's relationship; the challenges of disclosure and intervention. Conclusion: The findings indicate that survivors have long-term challenges with sexual expression and activity, stemming from the physical constraints of GVHD, perceptions of their immunosuppression, and the significance of their partnership, all of which translate into requirements for nursing care. Implications for Cancer Survivors Considering the experiences of these participants and the observed comfort linked to the sexuality of AHSCT survivors, we can contemplate the care practices and recognize sexuality as a field of action for nurses in this context to enhance comfort for these individuals.
- Online holistic program to foster health amongst students: a pilot study in a Portuguese university during COVID-19 pandemicPublication . Veiga, Elisa; Duarte, Raquel; Capela, Inês; Pinto, Elisabete; Silva, Margarida; Sá, Cristina; Sá, Luís; Kunz, Sahra; Serra, Sofia; Pereira, Henrique; Machado, Bárbara C.; Gomes, Ana; Pimenta, Ana; Almeida, Armando; Silva, Patrícia O.; Correia, MartaDuring the COVID-19 pandemic, several preventive mental health interventions took place to increase the psychological well-being of university students due to the high levels of stress, anxiety and negative emotions experienced in that period. This context reinforced the role of universities in supporting students and preventing the mental health risk factors they faced. In this context a multidisciplinary team of professionals (psychologists, nurses, nutritionists, and artists) in the Portuguese Catholic University, gathered efforts and developed an holistic intervention program for university students based on a mind and body integrated approach. This program of 8 online sessions aims to improve students’ resilience to the psychosocial consequences of COVID-19 pandemic and promote their wellbeing. The twenty university students that participated in this pilot study reported that this intervention improved their emotional self-awareness, their ability to apply self-care strategies, as well as they believed it promoted healthier lifestyle changes. These findings suggest that this program consists in an innovative approach with the potential to promote the psychological health and well-being of university students in adverse circumstances.
- 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; Hisghsmith, 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 crossstudy design. The retention resistance was measured with a Gnathometer and a dynamometer, the patient related outcome evaluations with a 5-points questionnaire and the Candida albicans growth in a Sabouraud dextrose agar (SDA) medium in order to evaluate differences between the placebo and experimental product. Twenty-three participants were included. Dynamometer evaluation showed significant differences between not using a denture adhesive and using either (experimental, p = .03; control, p = .04), no significant differences between the two adhesives (p > .05). In the subjective analysis, the experimental adhesive showed a significantly longer effectiveness (p = .001); the control reported better results at taste (p = .03) in chewing (p = .001). The test adhesive showed better (p < .001) Candida albicans growth inhibition. The experimental adhesive showed longer effectiveness than the control and 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.