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- A scoping review of person-centred care strategies used in diagnostic Nuclear MedicinePublication . Champendal, M.; Grima, K. Borg; Costa, Pedro; Andersson, C.; Baun, C.; Gorga, R.G.; Murphy, S.; Kedves, A.; Santos, A.; Geao, A.Person-centred care (PCC) emphasises the need for the health care professional to prioritise individual patient needs, thereby fostering a collaborative and emphatic environment that empowers patients to actively participate in their own care. This article will explore the purpose of PCC in Nuclear Medicine (NM), while discussing strategies that may be used to implement PCC during diagnostic NM examinations performed on adult patients. The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was performed on PubMed, Embase and Cinhal in June 2023 and included studies in English, Spanish, Portuguese and Italian. The research equation combined keywords and Medical Subject Heading terms (MeSH) related to person-centred care (PCC), for all types of nuclear medicine diagnostic examinations performed. Three independent review authors screened all abstracts and titles, and all eligible full-text publications were included in this scoping review. Fifty-three articles, published between 1993 and 2022, met the inclusion criteria for this scoping review. Seven articles were published in 2015 while 56.6 % of all included studies were performed in Europe. Most studies (n = 39/53) focused on the patients only, with the identified patient benefits being: improve patient experience (67.9 %), increase patient comfort (13.2 %), increase patient knowledge (5.7 %), reduction of patient anxiety (9.4 %) and reduction of waiting/scan time (3.8 %). The scoping review identified a lack of research investigating the use of person-centred care strategies in NM. Future research will focus on using an international survey to explore this topic in nuclear medicine departments overseas.
- Worker's exposure to radiation in fluoroscopy, assessing and instruments: A systematic literature reviewPublication . Videira, Sara; Rodrigues, Matilde; Silva, Manuela Vieira daThis review aims to identify and analyze the instruments employed for assessing the overall performance of workers exposed to fluoroscopy during surgical procedures and/or interventional procedures, using the PRISMA methodology. The studies were located through searches conducted on PubMed, Web of Science, Lilacs, ScienceDirect, B-ON, EBSCOhost, and EBSCO Discovery Service on March 27, 2023. Additional studies were identified using backward and forward citation techniques. The PEO strategic model was followed. The search spanned studies published between 2012 and 2022. The quality of the studies underwent assessment using the Joanna Briggs Institute checklist for analytical cross-sectional studies. Out of the 23 studies identified, encompassing 3604 individuals, 12 (52%) addressed the reliability and/or validity of the instruments, while 3 (13%) focused on the development and psychometric testing of the instruments. Only 5 instruments (23%), validated and reliable, exclusively evaluated occupational radiological protection. The predominant dimension covered was knowledge (82%, n = 19). The population was assessed in 18 studies, pre- and post-intervention in 2 studies, and 21 studies provided recommendations or tools for improvement. Individuals in the studies utilized passive dosimeters (ranging from 5% to 98%), thyroid shields (15% to 98%), and aprons or lead skirts/coats (28% to 99%). The evidence quality was moderate (6/8). This study underscores the imperative to enhance compliance with protective and monitoring equipment. Furthermore, additional information is warranted concerning the validity and reliability of the instruments used, as well as the development of instruments that are both valid and reliable.
- Knowledge about type 2 diabetes: its impact for future managementPublication . Ferreira, Pedro L. ; Morais, Carminda ; Pimenta, Rui; Ribeiro, Inês ; Amorim, Isabel ; Alves, Sandra Maria; Santiago, LuizDiabetes can cause several long-term complications. Knowledge about this disease can play an important role in reducing diabetes-related complications. In addition, the lack of awareness leads to misconceptions, which joined with inadequate knowledge, are relevant barriers to proper diabetes management. In this study, we aimed to assess the diabetes knowledge of a type 2 diabetes (T2D) population and identify major knowledge gaps, in order to prevent complications and to increase quality of life. In a cross-sectional, observational study in a convenience sample, we identified individuals diagnosed with T2D attending ambulatory visits from five health settings, older than 18 years, with a time diagnosis of at least 1 year, and attending multidisciplinary visits for at least 3 months. To assess the knowledge of T2D individuals, we applied the Portuguese version of the Diabetes Knowledge Test. The sample included a total of 1,200 persons, of whom almost half were female. The age range of the participants varied from 24 to 94 years old, and the mean age was 65.6 ± 11.4 years. Most of the sample had a level of education under secondary and lived with someone. In our sample, 479 (39.9%) were insulin-treated. The percentage of correct answers was 51.8% for non-insulin vs. 58.7% for insulin treated (p < 0.05). There were three items with a percentage of correct answers lower than 15%; the item with the lower value of correct answers was the one related to the identification of signs of ketoacidosis with only 4.4% of correct answers, the errors presented a random pattern; the item related to the identification of which food should not be used to treat low blood glucose with 11.9%, where 56.9% of the sample’s participants considered that one cup of skim milk would be the correct answer (53.1% in non-insulin patients and 62.6% in insulin treated patients; p < 0.001). The item regarding the knowledge of free food presented a 13.3% of correct answers (10.8% non-insulin group vs. 17.1% insulin group; p < 0.01). Two of the three items with lower value of correct answers were related to glycemic control and health status monitoring, the other was related to diet and food.
- Monitoramento e avaliação de programas de extensão nos Institutos Federais de Educação Profissional, Científica e Tecnológica da região Centro-OestePublication . Santos, Elenice dos Reis; Bernardes, Óscar Tiago FontesA ordenança da Lei nº 11.892/2008 de realizar ações de extensão para promoção do desenvolvimento socioeconômico e cultural local bem como a limitação dos recursos orçamentários e financeiros destinados a estas ações, torna necessário que, além de bem formulados, que programas de extensão sejam bem monitorados e avaliados para garantir que o investimento público seja realmente efetivo, eficaz e eficiente tanto na solução de problemas sociais quanto no aproveitamento de oportunidades de desenvolvimento local. Esta dissertação tem por objetivo identificar como os Institutos Federais de Educação Profissional, Científica e Tecnológica da Região Centro-Oeste realizam o monitoramento e a avaliação do recorte das ações de extensão denominado de programas institucionais de extensão, realizando análise de legislações nacionais e documentos institucionais como planos de desenvolvimento institucional, relatórios de gestão, regulamentações internas, manuais que tratam do tema, além de propor um mapeamento de processo para facilitar o desenvolvimento de software que facilite a realização dos procedimentos desde a criação até a avaliação dos programas institucionais de extensão. Os resultados demonstram que a estrutura jurídica e/ou orientativa institucional está melhor apresentada no IFMS – Instituto Federal de Mato Grosso do Sul que possui 04 (quatro) programas institucionais em andamento, lista de indicadores, critérios de avaliação, instância própria para realizar tais atividades, definidas desde a política de extensão até uma instrução normativa, mas não apresenta orientações quanto a criação de novos indicadores e critérios de avaliação, seguido do IFMT – Instituto Federal de Mato Grosso que apesar de não possuir lista de indicadores e critérios de avaliação, tem 05 (cinco) programas em andamento, um instrumento jurídico e um guia estabelecendo procedimentos e instância própria para realizar estas atividades. O mapeamento do processo sugerido nesta pesquisa considerou os documentos analisados, mas, principalmente, o Regulamento de Programas de Extensão do IFMT e o Guia Metodológico: Formulação de Programas de Extensão do IFMT.
- Ictal and interictal source connectivity during gelastic seizures in a focal cortical dysplasia of the cingulate gyrusPublication . Borges, Daniel Filipe; Dias, Daniela; Cordeiro, Helena; Leal, AlbertoGelastic seizures are rare manifestations of epilepsy often associated with hypothalamic hamartomas (HH). In the absence of HH, localization of the origin is more difficult and there are several less well-established possibilities. Non-invasive assessment is often complicated by the deep localization of the epileptogenic area and the complex dynamics of spike activity. Robust neurophysiologic methods and careful validation of intrinsically epileptogenic lesions detected by RM can improve the validity of scalp EEG analysis. To analyze the dynamics of epileptic activity in gelastic seizures associated with cortical dysplasia. A 26-year-old girl with daily refractory gelastic seizures since the age of 6 underwent a neurophysiological assessment with long-term EEG recordings (24h, 31 channels) and an MRI of the brain. She had previously been rejected in an epilepsy surgery program because no structural brain lesion had been found and the EEG information was not informative enough. A recent 3T MRI showed cortical dysplasia in the cingulate gyrus, which was highly suspicious as an epileptogenic focus. We analyzed the 31-channel EEG (ictal and interictal) using source and functional connectivity methods to obtain a solid computer model of the origin and dynamics of epileptic activity and correlate it with the anatomical information of the MRI. Source analysis of interictal activity revealed multiple sources that dominated at different time points, indicating considerable dynamics that prevented clear source identification. The ictal recordings demonstrated barely late rhythmic activity over the frontal areas, but no early focalization. Connectivity analysis, which revealed the flow of information between cortical sources, showed a consistent origin of epileptic activity in the vicinity of cortical dysplasia for both interictal and ictal activity. EEG connectivity analysis significantly improves the performance of non-invasive methods for determining intracranial dynamics of epileptic activity and correlation with structural lesions.
- Exploring geographical influences on physicochemical characteristics of honey: the Montesinho Natural Park scenarioPublication . Soares, Sónia; Magalhães, Leandro; Moreira, Manuela M.; Rede, Diana; Fernandes, Virgínia Cruz; Viegas, Olga; Pinto, Edgar; Almeida, Agostinho; Azevedo, Rui; Delerue-Matos, CristinaIn recent years, there has been a substantial increase in the global consumption of honey, driven by the high demand for natural products that offer health benefits. Consequently, consumers show a preference for honey, recognised for its superior quality, namely honey with a Protected Designation of Origin (PDO) or honey produced in protected areas, as it is associated with superior attributes and characteristics. Portugal is one of the leading countries in the production of PDO honey, with Montesinho Natural Park (MNP) being an excellent example of high-quality Portuguese honey, known for its distinctive attributes. However, environmental threats pose a double challenge, leading to a decline in honey production and compromising its overall quality. This study aimed to assess the specific physicochemical parameters and nutritional characteristics of MNP honey and investigate their correlation with the different locations of apiaries. MNP honey samples (n=13) were obtained from local producers or purchased at supermarkets. Standard physicochemical parameters, such as 5-hydroxymethylfurfural, diastase activity, moisture and ash content, free acidity, electrical conductivity and pH, were determined according to honey legislation. Additionally, colour parameters, protein, low-molecular-weight carbohydrates (mono- and disaccharides), and mineral content were determined. The results obtained were consistent with the requirements outlined in the legislation and those described in the literature. The results suggest that geographical factors within the park and boundaries do not contribute to variations in the analysed parameters. A significant level of homogeneity was evident in all parameters evaluated among the MNP honey samples. This is the first comprehensive study of the physicochemical properties of honey from various apiaries within the MNP.
- Estágio no P.PORTO - Assessoria e ComunicaçãoPublication . Gouveia, Nicole de Freitas; Gonçalves, Zita Maria Alves Romero de OliveiraO objetivo principal deste relatório é apresentar a intervenção e a experiência adquirida em contexto de estágio na instituição do Politécnico do Porto, mais concretamente na assessoria administrativa ao Serviço de Relações Públicas e Comunicação dos Serviços da Presidência do P.PORTO. A escolha do local de estágio deveu-se essencialmente por ser uma organização de elevada reputação, pela oportunidade de conhecer melhor a orgânica da qual o Instituto Superior de Contabilidade e Administração do Porto (ISCAP) faz parte, e pela sua boa localização que facilitou a minha deslocação diária para o estágio. Por outro lado, pareceu-me uma possibilidade de adquirir competências num contexto organizacional e colocar em prática os conhecimentos desenvolvidos ao longo do mestrado, de maneira a auxiliar a entidade a atingir os resultados definidos. O período de estágio, contabilizou setecentas horas (quatro meses e meio), com início a 26 de janeiro de 2023 e fim a 5 de junho de 2023 e centrou-se na estruturação e organização de um plano de comunicação para o ano letivo completo, e outro, focado exclusivamente no mês de maio (Mês Europeu da Diversidade), ambos associados ao plano de ação do P.PORTO, a Missão Equidade, Diversidade e Inclusão (MEDI) 2022-2026. Durante a realização do estágio, uma das funções exercidas foi ser responsável pela estrutura dos planos de comunicação, bem como a sugestão de atividades que pudessem ser incluídas, sempre em conformidade com os parâmetros definidos no plano de ação da Missão Equidade, Diversidade e Inclusão (MEDI) e assegurar o cumprimento das mesmas. Sendo assim, diversas ações foram criadas para que a estratégia da organização fosse concretizada e pudesse ser bem interpretada, tanto a nível interno, pelos colaboradores do P.PORTO, como a nível externo, pela comunidade académica.
- Feasibility, clinical efficacy, and maternal outcomes of a remote exercise program in pregnant women with obesity: The GROB randomized control pilot studyPublication . Bernardo, Diana; Bobadilla-Agouborde, Carolina; Festas, Clarinda; Carvalho, Carlos; Abdalla, Pedro Pugliesi; Amezcua-Prieto, Carmen; Naia-Entonado, Zeltia; Mesquita, Cristina; Mota, Jorge; Santos, Paula ClaraObesity is common in women of reproductive age and increases the risk during pregnancy. Exercising during this period reduces health complications. Home e-health programs are effective in overcoming exercise barriers as pregnant women use technology and the internet for health information. Methods: A single-blind randomized controlled feasibility study with pregnant women with obesity (body mass index [BMI] ≥≥30 kg/m22) was conducted in the University Hospital Center of São João between January and April 2023. Pregnant women were randomized to a control group with standard care and to an experimental group with 8-week remote exercise program using a Phoenix® biofeedback device. Feasibility outcome measures were recruitment rate (≥≥35%), loss to follow-up (≤≤15%), and program fidelity (≥≥1 session/week). Secondary outcomes were evaluated through Pregnancy Physical Activity Questionnaire, Oswestry Index on Disability, and weight assessments at baseline and at the end of the program. Results: Of the 63 eligible participants, 24 (38.1%) were successfully randomized and completed the baseline assessment. Of these, 3 (4.8%) from experimental group did not perform the initial onboarding. The control group had 8.3% of follow-up losses and for the experimental group there were no follow-up losses. Program fidelity (mean ≥≥1 session/week) was fulfilled by 66.7% of successfully randomized participants. Regarding secondary outcomes assessed between baseline and the 8th week, experimental group compared to control group had higher levels of physical activity for sports activities, a lower level of inactivity, and lower disability rates caused by low back pain. Conclusions: Based on the recruitment rate, losses to follow-up, and fidelity rate, the GROB (obesity in pregnancy) study was deemed feasible and worthy of consideration for a larger study. Moreover, the GROB study has the potential to improve maternal outcomes by reducing sedentarism and disability caused by low back pain.
- Navigating the countertransference experience: A transtheoretical specifist modelPublication . Barreto, João Francisco; Matos, Paula MenaThe attempt to identify and classify distinct experiences falling under the common designation of countertransference has been labelled the specifist tradition. In this paper, a model describing two dimensions differentiating four components of countertransference experience is proposed. For each experiential component (subjective countertransference, objective countertransference, therapeutic attitude and emerging experience), a brief description based on previous literature from diverse theoretical fields is offered, along with clinical implications and illustrations and an account of empirical literature explicitly or implicitly addressing the specific component. In conclusion, the model is presented as a heuristic guide that can serve different purposes across different therapeutic orientations, with valuable implications for practice, training and supervision.
- A meta-analysis on the role of sonication in the diagnosis of cardiac implantable electronic device-related infectionsPublication . Araújo, Daniela; Martins, João P.; Ferreira, Stephanie; Mota, Sandra; Ferreira, Pedro L. ; Pimenta, RuiOne of the biggest obstacles in diagnosing Implant-Associated Infections is the lack of infection criteria and standardized diagnostic methods. These infections present a wide range of symptoms, and their diagnosis can be hampered by the formation of microbial biofilms on the surface of implants. This study aimed to provide insight into the performance of sonication in the diagnosis of infections associated with Cardiac Implantable Electronic Devices, to help define a consensus on the algorithm for the microbial diagnosis of these infections. We carried out a systematic review with meta-analysis. The PRISMA methodology guidelines were followed, and an advanced search was carried out in PubMed and Web of Science, which enabled 8 articles to be included in the review, in which a meta-analysis was also carried out. QUADAS-2 was used to assess the risk of bias and effect measures were calculated to assess publication bias. The overall sensitivity of the method was 0.823 (95% CI: 0.682–0.910) and the specificity was 0.632 (95% CI: 0.506–0.743). These results suggest that sonication may offer advantages in diagnosing these infections. However, it is essential to approach these findings carefully and take into account the recommendations provided in the EHRA 2019 guidelines. This study highlights the importance of more effective diagnostic approaches for implantable medical device-associated infections to improve the quality of treatment and minimize the risks associated with these challenging medical conditions.