ABSTRACT
Resumo Enquadramento: As psicoses são caraterizadas por distorções do pensamento, da perceção e emoções inadequadas. Em contexto forense, cabe ao enfermeiro especialista em saúde mental e psiquiátrica prevenir comportamentos violentos através de intervenções psicoterapêuticas. Objetivo: Caraterizar a situação clínica dos participantes relativamente às variáveis: funcionamento social, atividades socialmente úteis, relações pessoais e sociais, comportamento perturbador e agressivo, assertividade e sinais precoces de agressão; avaliar a eficácia de um programa de intervenção para treino de competências sociais e diminuição de preditores de violência. Metodologia: Estudo pré-experimental, com delineamento de pré e pós-teste com grupo único, cuja amostra foram 15 doentes internados em serviços de psiquiatria forense. Resultados: O programa demonstrou-se eficaz, observando-se mudanças estatisticamente significativas a nível das relações pessoais, dos comportamentos perturbadores e agressivos e dos sinais precoces de agressão. Conclusão: O treino de habilidades sociais e de autocontrolo traduziu-se na melhoria dos indicadores clínicos e na reabilitação psicossocial dos participantes, contribuindo para uma melhor (re)integração na família e na comunidade.
Abstract Background: Psychosis is characterized by distortions of thinking and perception, as well as inappropriate emotions. In forensic settings, psychiatric mental health nurses are responsible for preventing violent behaviors through psychotherapeutic interventions. Objective: To characterize participants' clinical situation based on the following variables: social performance, socially useful activities, personal and social relationships, disturbing and aggressive behavior, assertiveness, and early signs of aggression; and To assess the effectiveness of an intervention program for training social skills and reducing predictors of violence. Methodology: Pre-experimental study with a one-group pretest-posttest design. The sample consisted of 15 patients admitted to forensic psychiatric wards. Results: The intervention proved effective, with statistically significant changes in personal relationships, disturbing and aggressive behaviors, and early signs of aggression. Conclusion: Training social skills and self-control improved participants' clinical indicators and psychosocial rehabilitation and contributed to better (re)integrating them into their families and communities.
Resumen Marco contextual: La psicosis se caracteriza por distorsiones del pensamiento, de la percepción y de las emociones inapropiadas. En el contexto forense, es responsabilidad del enfermero especialista en salud mental y psiquiátrica prevenir las conductas violentas mediante intervenciones psicoterapéuticas. Objetivo: Caracterizar la situación clínica de los participantes en cuanto a las siguientes variables: funcionamiento social, actividades socialmente útiles, relaciones personales y sociales, comportamiento disruptivo y agresivo, asertividad y signos tempranos de agresión. Evaluar la eficacia de un programa de intervención para entrenar las competencias sociales y reducir los predictores de violencia. Metodología: Estudio preexperimental, con diseño antes y después de la prueba con un único grupo, cuya muestra estaba compuesta por 15 pacientes ingresados en los servicios de psiquiatría forense. Resultados: El programa demostró ser eficaz y se observaron cambios estadísticamente significativos en las relaciones personales, el comportamiento disruptivo y agresivo, y los primeros signos de agresión. Conclusión: El entrenamiento de las competencias sociales y del autocontrol se tradujo en la mejora de los indicadores clínicos y en la rehabilitación psicosocial de los participantes, lo que contribuyó a una mejor (re)integración en la familia y la comunidad.
ABSTRACT
BACKGROUND: Tobacco cessation intervention has a positive impact on quality of care. For health professionals, limited competency in this area may be associated with poor training during their academic programs. There is a clear need to further develop and implement training programs to improve tobacco cessation knowledge, skills, and attitudes among healthcare students. OBJECTIVES: The aim of this study was to assess the effectiveness of the innovative online training program "Brief Intervention in Smoking Cessation" for healthcare students to improve their knowledge, skills, and attitudes. DESIGN: A pre-post evaluation study with a satisfaction assessment tool was used. SETTING: Seven universities from four European countries, including Belgium, Portugal, Spain, and the United Kingdom, participated. PARTICIPANTS: One thousand and seventy-two (1072) undergraduate students participated, with 851 completing the online program. METHODS: All participants completed the "Brief Intervention in Smoking Cessation" online program, which consisted of five theoretical modules, five videos, and three virtual simulation cases between January 2020 and June 2022. Knowledge was assessed by a multiple-choice test, and practical skills were assessed by a simulation algorithm, both of which were developed by education and smoking cessation experts. Competency was achieved when students successfully completed both assessments. Satisfaction was measured using an ad hoc 16-item questionnaire. Pre-post changes in knowledge were assessed using a paired Student's t-test. RESULTS: Eighty-six percent of the students achieved smoking cessation competency. Students significantly improved their knowledge score on a scale of 0 to 10 points, with a mean pre-program score of 3.79 vs a mean post-program score of 7.33 ([-3.7 - -3.4] p < 0.001), acquiring sufficient attitudes and skills (simulation mean of 7.4 out of 10 points). Students were highly satisfied with the program (8.2 out of 10) and recommended it to other students (8.4 out of 10). CONCLUSIONS: The "Brief Intervention in Smoking Cessation" online training program is effective for the acquisition of smoking cessation competencies among European health profession students.
Subject(s)
Crisis Intervention , Smoking , Humans , Europe , Students , Educational StatusABSTRACT
Resumo Enquadramento: O transtorno do espectro autista implica adequações no quotidiano de cuidado da criança. Neste cenário, as intervenções assistidas por animais parecem atuar como facilitador na manutenção da qualidade de vida destes indivíduos. Objetivo: Desenvolver um modelo de programa de intervenções assistidas por animais aplicável às crianças com transtorno do espectro autista (PIAAC-TEA). Metodologia: Estudo metodológico para a construção de um programa de intervenções assistidas por animais, aplicável às crianças com transtorno do espectro autista, baseado no modelo de intervenções complexas do Medical Research Council que consiste em quatro etapas: identificação da evidência, identificação e desenvolvimento da teoria, processo de modelagem, avaliação da eficácia. Resultados: O processo de desenvolvimento do PIAAC-TEA resultou, até ao momento, na construção da versão 1 do programa que consta dos seguintes itens: planeamento do programa, planeamento da sessão, implementação, notas de campo e avaliação final. Conclusão: A versão 1 do PIACC-TEA apresenta formatação alinhada às características do seu público-alvo, ancoradas em dados primários de investigação em campo e bibliográfica atualizada. A sua eficácia e validação será avaliada em etapas posteriores.
Abstract Background: Autism spectrum disorder implies adjustments in the daily care of the child. In this scenario, animal-assisted interventions seem to act as a facilitator in maintaining the quality of life of these individuals. Objective: To develop an animal-assisted intervention program for children with autism spectrum disorder (AAIPC-ASD). Methodology: Methodological study for the construction of a program of animal-assisted interventions, applicable to children with autism spectrum disorder, based on the model of complex interventions of the Medical Research Council that consists of four stages: identifying the evidence base, identifying/developing theory, modeling process, and assessing effectiveness. Results: The AAIPC-ASD development process has resulted in the construction of Version 1 of the program, consisting of the following items: program planning, session planning, implementation, field notes, and final evaluation. Conclusion: The structure of Version 1 of the AAIPC-ASD is aligned with the characteristics of its target group, based on primary field research data and updated bibliographic data. Its effectiveness and validation will be assessed in later stages.
Resumen Marco contextual: El trastorno del espectro autista implica ajustes en el cuidado diario del niño. En este escenario, las intervenciones asistidas con animales parecen actuar como un facilitador para mantener la calidad de vida de estas personas. Objetivo: Desarrollar un programa modelo de intervenciones asistidas con animales aplicable a niños con trastorno del espectro autista (PIAAC-TEA). Metodología: Estudio metodológico para construir un programa de intervenciones asistidas con animales, aplicable a niños con trastorno del espectro autista, basado en el modelo de intervenciones complejas del Consejo de Investigación Médica, que consta de cuatro fases: identificación de la evidencia, identificación y desarrollo de la teoría, proceso de modelización, evaluación de la eficacia. Resultados: El proceso de desarrollo del PIAAC-TEA ha dado lugar hasta ahora a la construcción de la versión 1 del programa, que consta de los siguientes elementos: planificación del programa, planificación de la sesión, implementación, notas de campo y evaluación final. Conclusión: La versión 1 del PIACC-TEA presenta un formato alineado con las características de su público objetivo, basadas en los datos primarios de la investigación de campo y en la bibliografía actualizada. Su eficacia y validación se evaluarán en fases posteriores.
ABSTRACT
Adolescence is a critical life phase for mental health and anxiety an emerging challenge for adolescents. Psychoeducational interventions to promote mental health literacy (MHL) on anxiety in adolescents are needed. This study aimed to test the primary outcome of a future full-scale trial: improvement of adolescents' anxiety MHL components on recognition, prevention strategies, and self-help strategies. A sample of 38 adolescents, 24 (63.2%) females and 14 (36.8%) males, with an average age of 14.50 years (SD = 0.89) participated in this study. Each class was allocated to the intervention group (IG, n = 21) or the waiting list control group (WLCG, n = 17) with single-blinded randomization. MHL was assessed using the QuALiSMental. The ProLiSMental psychoeducational intervention consists of four or eight weekly sessions of 90 or 45 min for adolescents, using different active pedagogical methods and techniques. There also are initial and final sessions with adolescents, legal guardians, and teachers. There was a significant improvement with a small to relatively strong effect size in many dimensions of anxiety MHL components. This study suggests the progression to the full-scale trial and values the important role of mental health and psychiatric nurses in the adolescents' empowerment for MHL in schools.
Subject(s)
Health Literacy , Mental Health , Adolescent , Anxiety/prevention & control , Female , Humans , Male , Pilot Projects , SchoolsABSTRACT
The main aims of the study are to a) evaluate the effectiveness of a three session program of "art therapy" on changing emotional indicators (depression, anxiety, stress, and psychological well-being) in individuals with mental illness and b) analyze the meanings attributed to creative self-expression. We performed a pre-experimental mixed approach study, with a pretest-posttest design, with twelve Portuguese male subjects, admitted to an acute psychiatry unit. The instruments used were Depression, Anxiety and Stress Scale [DASS-21]; and Ryff Scales of Psychological Well-Being [SPWB - 18] and a semi-structured interview. Comparison of the pre- and posttest indicated improvement in anxiety, stress, self-acceptance, purpose of life, and overall psychological well-being. The categories resulting from the thematic analysis of the interviews revealed the usefulness of the program in the participant recovery process. This type of psychosocial intervention in specialized clinical practice in Mental Health Nursing minimizes the disease's impact in an organizational culture that should increasingly be oriented toward recovery.
Subject(s)
Art Therapy , Mental Disorders/psychology , Mental Disorders/therapy , Mental Health Recovery , Adult , Anxiety , Depression , Emotions , Hospitalization , Humans , Male , Middle Aged , Pilot Projects , Portugal , Self Concept , Stress, PsychologicalABSTRACT
Incluir conhecimentos de saúde mental no cuidado integral ao ser humano e conseguir identificar quando a pessoa-alvo dos seus cuidados necessita de apoio de Enfermagem especializada em Saúde Mental e Psiquiatria são competências essenciais de qualquer enfermeiro de cuidados gerais, sendo importante perceber como integrar esse conhecimento nos planos de estudo dos enfermeiros de cuidados gerais. Este artigo tem como objetivos descrever a concepção e o planejamento da aprendizagem da Enfermagem de Saúde Mental e Psiquiatria dos estudantes do Curso de Licenciatura em Enfermagem, em Coimbra, Portugal, caracterizar as unidades curriculares de Enfermagem de Saúde Mental e Psiquiatria que integram o plano de estudos e analisar os seus contributos para a formação de competências dos enfermeiros de cuidados gerais.
Generalist nurses should be able to apply mental health knowledge to the comprehensive care of the human being and to understand when patients need specialized support from mental health and psychiatric nurses. Therefore, it is important to understand how this knowledge can be integrated into the curricula of generalist nurses. This article aims to describe the process of designing and planning how BSN students learn about Mental Health and Psychiatric Nursing in Coimbra, Portugal, to characterize the course units on mental health and psychiatric nursing in this BSN curriculum, and to analyze their contribution to the acquisition of generalist nurses skills.
Incluir el conocimiento de la salud mental en la atención integral de los seres humanos y ser capaz de identificar cuando la persona cuidada necesita apoyo de enfermería especializada en salud mental y psiquiatría son habilidades esenciales para cualquier enfermera general, así es importante entender cómo integrar este conocimiento en los planes de estudio de las enfermeras de cuidados generales. Este artículo objetiva describir el diseño y planificación del aprendizaje de Enfermería de Salud Mental y Psiquiatría de los estudiantes de Licenciatura en Enfermería de Coimbra, Portugal, caracterizar las disciplinas de enfermería en salud mental y psiquiatría que incluye el plan de estudio y analizar su contribución a la formación de las habilidades de las enfermeras de cuidados generales.
Subject(s)
Psychiatric Nursing , Curriculum , Education, NursingABSTRACT
This study presents morphological and molecular evidence for the establishment of a new species of Lulworthia based on the evaluation of 11 isolates of Lulworthiales collected in two marinas on the west coast of Portugal initially classified as Lulworthia sp. Maximum likelihood and Bayesian methods were applied to obtain phylogenetic trees for 18S-28S and internal transcribed spacer (ITS1-5.8S-ITS2 = internal transcribed spacer [ITS]) nuc rDNA. The isolates consistently grouped together in a distinct and highly supported clade; all other Lulworthiales analyzed, including the available sequences of Lulworthia spp., segregated separately. These results were supported by common and distinctive morphological characters and enabled recognition and description of the new species Lulworthia atlantica. Two Portuguese isolates were confirmed as Lulworthia cf. purpurea, and two were confirmed as asexual morphs of Zalerion maritima.
Subject(s)
Ascomycota/classification , Genetic Variation , Phylogeny , Aquatic Organisms/classification , Aquatic Organisms/cytology , Aquatic Organisms/genetics , Ascomycota/cytology , Ascomycota/genetics , Bayes Theorem , DNA, Fungal/genetics , DNA, Ribosomal/genetics , DNA, Ribosomal Spacer/genetics , Mycological Typing Techniques , Portugal , Species Specificity , Spores, Fungal/cytologyABSTRACT
Takotsubo cardiomyopathy is characterized by acute and transient dysfunction of the apical segment of the left ventricle usually after an intense physical or emotional stress, mimicking an acute coronary syndrome. Because this is a rare syndrome, the differential diagnosis is particularly important and a high level of suspicion is essential. Obstetricians should be aware to diagnose and deal with this unexpected event. Treatment is essentially supportive, with spontaneous and complete reversal of the changes within days or weeks. The occurrence of complications may dictate a less benign prognosis. We report a case of Takotsubo cardiomyopathy in a 39-year-old woman who underwent Cesarean delivery. She presented with bradycardia, chest pain and pulmonary edema immediately after the delivery. Her echocardiography showed and apical ballooning. Cardiac biomarkers and electrocardiogram were altered and echocardiogram showed severe left ventricular dysfunction with hypokinesia of the anterior wall. Coronary angiography excluded obstructive coronary artery disease.
Subject(s)
Puerperal Disorders , Takotsubo Cardiomyopathy , Adult , Female , Humans , Puerperal Disorders/diagnosis , Puerperal Disorders/drug therapy , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/drug therapyABSTRACT
Ocorrendo habitualmente após um stress físico ou emocional intenso, a miocardiopatia de Takotsubo caracteriza-se por disfunção aguda e transitória do segmento apical do ventrículo esquerdo, mimetizando uma síndrome coronária aguda. Essa é uma síndrome rara, na qual o diagnóstico diferencial assume particular importância. Um elevado nível de suspeição é essencial, pelo que obstetras e o restante da equipe devem estar preparados para diagnosticar e lidar com esse evento inesperado. O tratamento é fundamentalmente de suporte, verificando-se reversão espontânea e completa das alterações num intervalo de dias a semanas. A ocorrência de complicações podem ditar um prognóstico menos benigno. Apresentamos o caso de uma mulher de 39 anos, sem antecedentes relevantes. Submetida à cesariana por suspeita de sofrimento fetal. Terminada a intervenção iniciou quadro de bradicardia e precordialgia, com edema pulmonar. Apresentava alterações de enzimas cardíacas e do electrocardiograma. O ecocardiograma revelou disfunção sistólica do ventrículo esquerdo com hipocinésia de toda a parede anterior. O cateterismo cardíaco excluiu doença coronária obstrutiva.
Takotsubo cardiomyopathy is characterized by acute and transient dysfunction of the apical segment of the left ventricle usually after an intense physical or emotional stress, mimicking an acute coronary syndrome. Because this is a rare syndrome, the differential diagnosis is particularly important and a high level of suspicion is essential. Obstetricians should be aware to diagnose and deal with this unexpected event. Treatment is essentially supportive, with spontaneous and complete reversal of the changes within days or weeks. The occurrence of complications may dictate a less benign prognosis. We report a case of Takotsubo cardiomyopathy in a 39-year-old woman who underwent Cesarean delivery. She presented with bradycardia, chest pain and pulmonary edema immediately after the delivery. Her echocardiography showed and apical ballooning. Cardiac biomarkers and electrocardiogram were altered and echocardiogram showed severe left ventricular dysfunction with hypokinesia of the anterior wall. Coronary angiography excluded obstructive coronary artery disease.
Subject(s)
Humans , Female , Adult , Puerperal Disorders , Takotsubo Cardiomyopathy , Puerperal Disorders/diagnosis , Puerperal Disorders/drug therapy , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/drug therapyABSTRACT
We present a methodology to assess cell level alterations on the human retina responsible for functional changes observable in the Optical Coherence Tomography data in healthy ageing and in disease conditions, in the absence of structural alterations. The methodology is based in a 3D multilayer Monte Carlo computational model of the human retina. The optical properties of each layer are obtained by solving the Maxwell's equations for 3D domains representative of small regions of those layers, using a Discontinuous Galerkin Finite Element Method (DG-FEM). Here we present the DG-FEM Maxwell 3D model and its validation against Mie's theory for spherical scatterers. We also present an application of our methodology to the assessment of cell level alterations responsible for the OCT data in Diabetic Macular Edema. It was possible to identify which alterations are responsible for the changes observed in the OCT scans of the diseased groups.
Subject(s)
Retina/diagnostic imaging , Tomography, Optical Coherence , Aged , Diabetic Retinopathy/diagnosis , Humans , Macular Edema , Models, TheoreticalABSTRACT
Subinhibitory concentrations of vancomycin are known to induce a cell-wall stimulon in some Gram-positive pathogens, but this has never been studied in the genus Enterococcus. In this study, Enterococcus faecalis V583 strain was submitted to a subinhibitory concentration of vancomycin. DNA microarray technology was used to analyse the transcriptomic changes induced by this antibiotic. EF2292, annotated as a hypothetical protein in the E. faecalis V583 genome, was highly induced in response to vancomycin exposure, to similar levels as the vanB operon genes. We investigated further and provide evidence for co-transcription of ef2292 with vanY(B)WH(B)BX(B) genes. It was also demonstrated that expression of ef2292 is under the control of vanR(B)S(B) and it is proposed to name it vanV. This gene was found not to be required for vancomycin resistance under the conditions tested, thus coding for another accessory protein in the vanB operon. vanV was detected in some, but not all, E. faecalis carrying the vanB operon, suggesting that this operon can have different composition amongst E. faecalis isolates.
Subject(s)
Enterococcus faecalis/drug effects , Enterococcus faecalis/genetics , Genes, Bacterial , Operon , Transcriptional Activation , Vancomycin Resistance , Vancomycin/pharmacology , Anti-Bacterial Agents/pharmacology , Gene Expression Profiling , Microarray AnalysisABSTRACT
BACKGROUND: Cerebral malaria (CM) represents a severe outcome of the Plasmodium falciparum infection. Recent genetic studies have correlated human genes with severe malaria susceptibility, but there is little data on genetic variants that increase the risk of developing specific malaria clinical complications. Nevertheless, susceptibility to experimental CM in the mouse has been linked to host genes including Transforming Growth Factor Beta 2 (TGFB2) and Heme oxygenase-1 (HMOX1). Here, we tested whether those genes were governing the risk of progressing to CM in patients with severe malaria syndromes. METHODOLOGY/PRINCIPAL FINDINGS: We report that the clinical outcome of P. falciparum infection in a cohort of Angolan children (n = 430) correlated with nine TGFB2 SNPs that modify the risk of progression to CM as compared to other severe forms of malaria. This genetic effect was explained by two haplotypes harboring the CM-associated SNPs (Pcorrec. = 0.035 and 0.036). In addition, one HMOX1 haplotype composed of five CM-associated SNPs increased the risk of developing the CM syndrome (Pcorrec. = 0.002) and was under-transmitted to children with uncomplicated malaria (P = 0.036). Notably, the HMOX1-associated haplotype conferred increased HMOX1 mRNA expression in peripheral blood cells of CM patients (P = 0.012). CONCLUSIONS/SIGNIFICANCE: These results represent the first report on CM genetic risk factors in Angolan children and suggest the novel hypothesis that genetic variants of the TGFB2 and HMOX1 genes may contribute to confer a specific risk of developing the CM syndrome in patients with severe P. falciparum malaria. This work may provide motivation for future studies aiming to replicate our findings in larger populations and to confirm a role for these genes in determining the clinical course of malaria.
