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- Impact of work and personal life conciliation problems on healthcare workersPublication . Fonte, Carla; Barros, Carla; Baylina, Pilar; Alves, Sónia; Moreira, Paulo; BAYLINA MACHADO, PILARWork life balance, a significant issue in the healthcare sector, recognizes that individuals are engaged in several tasks in their private and professional lives. Literature highlights the harmful consequences of conflicts between personal and professional life for organizations and workers. This study investigates the prevalence of work life balance problems and presence of psychosocial work factors and analyzes their impact on health complaints in the Portuguese healthcare sector. A cross-sectional study of 640 healthcare professionals was conducted using two data collection instruments: INSAT (Inquérito Saúde e Trabalho), a health and work survey to assess psychosocial work factors, and the Portuguese version of the Nottingham Health Profile that evaluates the subjective physical, emotional, and social aspects of health. The data show that healthcare professionals have a very high prevalence of work life balance problems and are exposed to several psychosocial risk factors including high demands and work intensity, working hours, emotional demands, and work characteristics. These experiences are related to professionals’ health revealing a state of emotional vulnerability. Thus, Portuguese health organizations should formulate appropriate workplace policy to reduce work life conflict and enable employees to be more effective in their work and other roles.
- The implementation of HFMEA in a primary care emergency service of the portuguese national health systemPublication . Macedo, José Mário; Sá, Sara; Gestoso, Álvaro; Ramalho, Susana; Luís, Carla; Martins-Mendes, Daniela; Pereira, Ana Cláudia; Fernandes, Rúben; Baylina, Pilar; BAYLINA MACHADO, PILAROne of the main priorities for healthcare institutions is to provide better and more advanced services that contribute to prolonging the lives of those who seek their care, as well as improving their quality of life as long as it lasts. Both their patients and the professionals who work in those institutions need to feel protected against adverse effects that may affect them physically, mentally, or socially. As such, both at national and international levels, healthcare governing bodies have made decisions and implemented measures aimed at reducing the risk of adverse effects for the patients who use their services. The main objective of this work was to develop and implement a risk management system based on HFMEA in a basic emergency service (primary care), to promote patient safety and the safety of healthcare professionals. A prospective, explanatory, and descriptive case study was applied to a basic emergency service, using ISO 31000 – risk management in organisations, and the healthcare failure mode and effects analyses (HFMEA) support tool. There were identified 57 possible failures associated with 88 different effects, with risk magnitudes classified as severe (1 cases), very severe (18 cases), and intolerable (38 cases). Failures whose effects impact patients were mentioned 2,6 times more than those primarily affecting professionals. The study allowed the identification of different failures in some of its work processes, for which corrective measures were determined to be carried out by the team and the governing entities of the service, to be implemented as soon as possible, ensuring greater safety in its services.
- O sangue dos inocentes pelos olhos dos ímpios: entre fobias e cegueiras ideológicasPublication . Rodrigues, Ricardo; CARDOSO RODRIGUES, RICARDO ALEXANDREDesde quando abandonamos os rostos e as suas lágrimas? Desde quando vibramos com a morte, com a dor e o sofrimento alheios? Quantos e quantas deixamos prostrados, deixamos para trás? Haverá corpos, identidades e famílias mais dignos; culturas e religiões, per se, sacralizáveis, condenáveis, demonizáveis ou impuras; “enfermos” menos merecedores de cuidados? Desde quando os nossos “eus” se tornaram pontos de referência para os “eus” dos outros? Onde moram as nossas ancestralidades e as nossas descendências nas narrativas e nos discursos? Desde quando nos concebemos produtos acabados? Desde quando deixamos de reconhecer o estrangeiro que habita em nós? Que partes do outro entendemos por estranhas? Quanto de estranho consideramos relevante para a sua desumanização? E nesse espaço de não ser, quanto valeria a sua dor e o seu sofrimento; como significar as suas lágrimas, perdas e lutos; qual a medida certa; como mensurar; qual a fórmula exata? Seria bastante uma simples perceção; uma singela perceção forjada numa singela manchete; de qualquer agência ou veículo? Uma perceção pelo valor de uma vida?Desde quando abandonamos os rostos e as suas lágrimas? Desde quando vibramos com a morte, com a dor e o sofrimento alheios? Quantos e quantas deixamos prostrados, deixamos para trás? Haverá corpos, identidades e famílias mais dignos; culturas e religiões, per se, sacralizáveis, condenáveis, demonizáveis ou impuras; “enfermos” menos merecedores de cuidados? Desde quando os nossos “eus” se tornaram pontos de referência para os “eus” dos outros? Onde moram as nossas ancestralidades e as nossas descendências nas narrativas e nos discursos? Desde quando nos concebemos produtos acabados? Desde quando deixamos de reconhecer o estrangeiro que habita em nós? Que partes do outro entendemos por estranhas? Quanto de estranho consideramos relevante para a sua desumanização? E nesse espaço de não ser, quanto valeria a sua dor e o seu sofrimento; como significar as suas lágrimas, perdas e lutos; qual a medida certa; como mensurar; qual a fórmula exata? Seria bastante uma simples perceção; uma singela perceção forjada numa singela manchete; de qualquer agência ou veículo? Uma perceção pelo valor de uma vida?
- Translation and cultural adaptation of the HFMEA into European PortuguesePublication . Santos, Paula Machado; Morais, Carminda; Baylina, Pilar; BAYLINA MACHADO, PILARHealth organizations are faced with daily challenges, requiring them to provide a quality service, ensuring effectiveness and efficiency. Risk management is one of the conditioning factors to achieve this purpose, ensuring preventive actions for all processes, promoting the identification of risk to the mitigation of its consequences for the patient, professionals, or organization. Patient safety is a priority and healthcare organizations should be concerned with the implementation of methodologies and tools to promote risk management, such as Healthcare Failure Mode and Effects Analysis (HFMEA). HFMEA has a high potential for risk management in healthcare organizations, with a proactive, prospective, and continuous approach to improvement. Translation and adaptation of the HFMEA instrument into European Portuguese. A methodological study was carried out based on the proposal presented by Beaton and followed the recommendations of the International Test Commission and World Health Organization. The HFMEA 2021 was linguistically translated and culturally adapted to the new context ensuring reliability, content validity was assured by a group of experts, which ensured semantic, idiomatic, experimental, and conceptual equivalence between the original instrument and the translation. HFMEA 2021 was successfully translated and adapted to European Portuguese, allowing its application.
- A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancerPublication . Luís, Carla; Dias, João; Firmino‑Machado, João; Fernandes, Rute; Pereira, Deolinda; Baylina, Pilar; Fernandes, Rúben; Soares, Raquel; BAYLINA MACHADO, PILAR; Fernandes, RúbenObesity and breast cancer are two major pathologies closely associated with increasing incidence and mortality rates, especially amongst women. The association between both diseases have been thoroughly discussed but much is still to uncover. The aim of this study is to analyse tumour characteristics and clinical outcomes of overweight and obese women to disclosure potential associations and better understand the impact of obesity in breast cancer. Clinicopathological information of 2246 women were extracted from the institutional database of comprehensive cancer centre in Portugal diagnosed between 2012 and 2016. Women were stratifed according to body mass index as normal, overweight, and obese. Patients’ demographic information and tumour features (age, family history, topographic localization, laterality, histological type, and receptor status) were taken as independent variables and overall survival, tumour stage, diferentiation grade and bilaterality were considered clinical outcomes. The main results reveal that overweight and obesity are predominantly associated with worse outcomes in breast cancer patients. Obese patients present larger (p-value: 0.002; OR 1.422; 95% CI 1.134–1.783) and more poorly diferentiated tumours (p-value: 0.002; OR 1.480; 95% CI 1.154–1.898) and tend to have lower overall survival although without statistical signifcance (p-value: 0.117; OR 1.309; 95% CI 0.934–1.833). Overweighted women are more likely to have bilateral breast cancer (p-value: 0.017; OR 3.076; 95% CI 1.225–7.722) than obese women. The results also reveal that overweight women present less distant metastasis (p-value: 0.024; OR 0.525; 95%CI 0.299–0.920). Topographic localization and laterality did not achieve statistical signifcance.
- A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancerPublication . Luís, Carla; Dias, João; Firmino‑Machado, João; Fernandes, Rute; Pereira, Deolinda; Baylina, Pilar; Fernandes, Rúben; Soares, Raquel; BAYLINA MACHADO, PILARObesity and breast cancer are two major pathologies closely associated with increasing incidence and mortality rates, especially amongst women. The association between both diseases have been thoroughly discussed but much is still to uncover. The aim of this study is to analyse tumour characteristics and clinical outcomes of overweight and obese women to disclosure potential associations and better understand the impact of obesity in breast cancer. Clinicopathological information of 2246 women were extracted from the institutional database of comprehensive cancer centre in Portugal diagnosed between 2012 and 2016. Women were stratifed according to body mass index as normal, overweight, and obese. Patients’ demographic information and tumour features (age, family history, topographic localization, laterality, histological type, and receptor status) were taken as independent variables and overall survival, tumour stage, diferentiation grade and bilaterality were considered clinical outcomes. The main results reveal that overweight and obesity are predominantly associated with worse outcomes in breast cancer patients. Obese patients present larger (p-value: 0.002; OR 1.422; 95% CI 1.134–1.783) and more poorly diferentiated tumours (p-value: 0.002; OR 1.480; 95% CI 1.154–1.898) and tend to have lower overall survival although without statistical signifcance (p-value: 0.117; OR 1.309; 95% CI 0.934–1.833). Overweighted women are more likely to have bilateral breast cancer (p-value: 0.017; OR 3.076; 95% CI 1.225–7.722) than obese women. The results also reveal that overweight women present less distant metastasis (p-value: 0.024; OR 0.525; 95%CI 0.299–0.920). Topographic localization and laterality did not achieve statistical signifcance.
- Bilateral breast cancer and the influence of body mass index in clinicopathological features and overall survivalPublication . Luís, Carla; Fernandes, Rute; Dias, João; Pereira, Deolinda; Firmino-Machado, João; Baylina, Pilar; Fernandes, Rúben; Soares, Raquel; BAYLINA MACHADO, PILARBreast cancer (BC) and obesity are two closely associated pathologies with increasing incidence and mortality rates. Bilateral Breast Cancer (BBC) displays a low incidence rate within BC and obesity represents a major risk factor. The aim of this study is to analyzed BBC clinicopathological features distribution and determine the potential influence of obesity in BBC in these same features and overall survival. Clinicopathological information was obtained from 42 cases of women with BBC diagnosed in IPO-Porto. To evaluate the frequency distribution of the clinicopathological data, a chi-square goodness of fit test was performed for BBC cases. A chi-square test of independence was applied for BMI stratification. Cox regression was performed for overall survival. Statistical significance was set at p-value < 0.05. Distribution of BBC clinicopathological features was found to be statistically significant in family history (p-value < 0.001), BBC type (p-value < 0.001), stage (p-value = 0.005), differentiation grade (p-value < 0.001), receptor expression (pvalue < 0.001) and histological type (p-value = 0.031). In comparison to the statistical expected results, we observed an increased cases of absence of family history and less cases of metachronous BBC. Histological types between tumours of BBC were mostly concordant. All cases presented concordant receptor expression. Analysis stratified by BMI revealed that obese women were diagnosed later, although without statistical significance. All obese women presented poor differentiation grade (n = 6). Overweight patients display a tendency to a better overall survival with lower tumour stages and lower differentiation grades. Our results reveal the same receptor expression between contralateral tumours. Also, most tumours share the same histological type. When stratified by BMI, we observed a tendency for overweight women to have improved overall survival.
- On risk analysis of the use of Cannabinoids compounds as therapy in DementiaPublication . Pereira, Eduardo; Fernandes, Rúben; Luís, Carla; Baylina, Pilar; BAYLINA MACHADO, PILARNowadays dementia pharmaceutical treatment has an unfavourable risk-benefit relation. New therapeutic approaches’ adoption is need due to the high prevalence of this condition. To evaluate the risk of using cannabinoids compounds as nonharmful therapeutic approach in dementia. A systematic literature review based on PRISMA was performed. PubMed and Clinical Trials database were used to collect articles between 2012 and 2022. Cochrane and Consort instruments were used to evaluate the methodology quality and report quality of adverse effects. Tetrahydrocannabinol and Nabilone were associated to a moderate effectiveness in the symptomatology related with Dementia and to favourable safety and tolerability profiles. Evidence obtained shows the importance of these two compounds as a new approach to dementia treatment.
- O futuro dos discursos: para uma reconexão simbióticaPublication . Rodrigues, RicardoEscrever e falar sobre liberdades em exercício implica necessariamente discorrer sobre relações de poder no tempo e no espaço, exige deslindar as malhas dos discursos e transcorrer sobre localização e representatividade. A violência de género, entre outras manifestações conexas, como contra identidades LGBTQIAPN+, a violência étnico-racial, a xenofobia, entre tantas outras expressões identitárias abafadas, neutralizadas pelo social, pelo todo, por subjetivismos perniciosos, perenes formas estruturais e multifacetadas, perpassando subtilmente a filigrana de propósitos de sistemas e tecnologias geneticamente infetados. Tratam-se, pois de manifestações persistentes de desigualdades históricas, estruturais e culturais, alavancadas por discursos de ódio (sentido amplo) direcionados, oportunamente amplificados por líderes políticos, de viés carismático (como Donald Trump, Jair Bolsonaro, Viktor Orbán, André Ventura, Marine Le Pen, Giorgia Meloni, etc.), personalidades veículo (como Richard Spencer e Alex Jones, etc.), magnatas (como Mark Zuckerberg, Elon Musk, Robert Mercer, Steven Bannon, Rupert Murdoch, etc.), feixes de interesses obscuros, sustentados por holofotes mediáticos e mecanismos mercadológicos de validação social.
- A sublimação do profano na teotecnocracia das virtudesPublication . Rodrigues, Ricardo; Cardoso Rodrigues, Ricardo AlexandreÀs ninfas o espírito do adamastor, ora, entre crenças e fés distópicas, veículos perniciosos de legitimação de um poder opressor, embiocado sob o manto diáfano da moralidade e da tradição. Uma quase espiritualidade, onde não há espaço para a transcendência e a interrogação. Um efetivo instrumento de dominação que reforça desigualdades estruturais, explorando máximas despóticas (v. fortes com os fracos, fracos com os fortes). A captura das narrativas religiosas e pseudocientíficas por elites ávidas consolida um paradigma de subjugação paulatino de vulneráveis presas (reféns), entre agentes mobilizados, os ungidos, e individualidades não hegemónicas ou contra-hegemónicas, rotuladas ameaças, a poderosas e inspiradoras deidades, semidivindades, intangíveis, absolutamente inquestionáveis