Loyola Generativity Scale e Generative Behavior Checklist: Um estudo psicométrico com idosos espanhóis LGBT+ / Loyola Generativity Scale and Generative Behavior Checklist: A Psychometric Study with Spanish LGBT+ Older Adults / Loyola Generativity Scale y Generative Behavior Checklist: Un estudio psicométrico con personas mayores españolas LGBT+

Resumo Enquadramento: A generatividade tem sido associada à resiliência e à satisfação com a vida na velhice, incluindo entre a população lésbica, gay, bissexual e transgénero (LGBT+) mais velha. Objetivo: Analisar as propriedades psicométricas da Loyola Generativity Scale (LGS) e da Generative Behavior Checklist (GBC) para idosos espanhóis LGBT + (com mais de 50 anos). Metodologia: Foi realizado um estudo psicométrico com 141 idosos espanhóis LGBT+ com o objetivo de examinar a validade de construto (análise fatorial exploratória), a validade convergente e a fiabilidade (consistência interna) da LGS e da GBC. Resultados: Os métodos de análise paralela e a análise fatorial exploratória sugeriram um modelo de dois fatores para ambos os instrumentos com boa adequação da amostra. A LGS explicou 45,1% da variância e apresentou uma consistência interna de 0,78. O GBC explicou 41,76% da variância e apresentou uma consistência interna de 0,879. Foi encontrada uma correlação positiva e estatisticamente significativa entre a satisfação com a vida e as escalas generativas. Foi também observada uma correlação positiva e significativa (rs = 0,310) entre os dois instrumentos. Conclusão: Ambos os instrumentos demonstraram ser válidos e fiáveis para medir a generatividade em idosos espanhóis LGBT+.

Abstract Background: Generativity has been associated with resilience and life satisfaction in older age, including among lesbian, gay, bisexual, and transgender (LGBT+) older adults. Objective: To examine the psychometric properties of the Loyola Generativity Scale (LGS) and Generative Behavior Checklist (GBC) for Spanish LGBT+ older adults (over the age of 50). Methodology: A psychometric study was conducted with 141 Spanish LGBT+ older adults to examine the construct validity (exploratory factor analysis), convergent validity, and reliability (internal consistency) of the LGS and the GBC. Results: Parallel and exploratory factor analyses suggested a two-factor model with good sample adequacy for both scales. The LGS explained 45.1% of the variance and had an internal consistency of 0.78. The GBC explained 41.76 % of the variance and had an internal consistency of 0.879. A positive and statistically significant correlation was found between life satisfaction and the generative scales. A positive and significant correlation (rs = 0.310) was also observed between both instruments. Conclusion: Both instruments proved valid and reliable for measuring generativity in Spanish LGBT+ older adults.

Resumen Marco contextual: La generatividad se asocia con la resiliencia y la satisfacción con la vida en la vejez, incluidas las de las personas adultas lesbianas, gays, bisexuales y transexuales (LGBT+). Objetivo: Examinar las propiedades psicométricas de la Loyola Generativity Scale (LGS) y la Generative Behavior Checklist (GBC) en adultos mayores LGBT+ españoles (mayores de 50 años). Metodología: Estudio psicométrico con 141 adultos mayores LGBT+. Se analizó la validez de constructo (análisis factorial exploratorio), la validez convergente y la consistencia interna de cada escala. Resultado: Los análisis factoriales paralelos y exploratorios sugieren un modelo bifactorial para ambas escalas con una buena adecuación a la muestra. La LGS explica el 45,1% de la varianza y tiene una consistencia interna de 0,78. La GBC explica el 41,76% de la varianza y tiene una consistencia interna de 0,879. Se encontró una correlación positiva estadísticamente significativa entre la satisfacción con la vida y las escalas de generatividad. Las dos escalas mostraron una correlación positiva y significativa (rs = 0,310). Conclusión: Ambas escalas han demostrado ser válidas y fiables para medir la generatividad en adultos mayores LGBT+ españoles.

Validation of an evaluation matrix for the nursing process in the hospital context.

OBJECTIVE: To validate the content of an evaluation matrix for the nursing process in the hospital context. METHOD: A methodological study conducted in four stages, carried out from March to December 2022. Including: bibliographic research and selection of structuring foundations; construction of the logical model and analysis and judgment matrix; content validation by a committee of judges (n=11) using the Delphi technique; analysis of content validation data by calculating the Concordance Rate and Content Validity Index. RESULTS: At the end of the two rounds, the matrix had a concordance rate of 90% regarding format and 100% regarding other structural aspects. It also had a 100% concordance rate regarding the scope and representativeness of the matrix domains. Regarding the average Content Validity Index, the values were 0.97 and 0.98, for clarity and representativeness, respectively. CONCLUSION: The evaluation matrix - consisting of four dimensions and fourteen evaluation items referring to the necessary stages for the implementation and operationalization of the nursing process - demonstrated excellent content validity, which can contribute to supporting institutional initiatives for its consolidation in hospital nursing services.

Core Competencies for Gerontogeriatric Nursing: A Validation Study.

BACKGROUND: As the aging population grows, facing multifaceted health challenges and escalating care costs, equipping newly graduated nurses with the requisite skills for high-quality gerontogeriatric care becomes crucial. This study assesses the psychometric properties of a Gerontogeriatric Competency (GGC) scale to evaluate the competencies of newly graduated registered nurses (RNs). METHODS: Using a convenience sampling approach, a nationwide, observational prospective cohort study was conducted among 272 newly graduated RNs. The evaluation framework included a sociodemographic questionnaire, three groups of questions targeting gerontogeriatric nursing education aspects, and the GGC scale, with 64 competencies. Construct validity (via confirmatory factor analysis), known-group validity and reliability (assessed by Cronbach's α) were examined. RESULTS: The confirmatory factor analysis (CFA) showed an adequate index fit: the ratio of chi-square to degrees of freedom (χ2/df) = 2.785, the goodness-of-fit index (GFI) = 0.579, confirmatory fit index (CFI) = 0.864, the parsimony goodness-of-fit index (PGFI) = 0.526, the parsimony confirmatory-of-fit index (PCFI) = 0.809, the root mean square error of approximation (RMSEA) = 0.087, and the modified expected cross-validation index (MECVI) = 24.418. Differences were observed in gerontogeriatric competencies based on curriculum inclusion, self-confidence, knowledge in caring for older adults, and satisfaction with the nursing program content. The Cronbach's α coefficient was 0.992 for the overall scale and ranged from 0.935 to 0.983 for the GGC dimensions. CONCLUSIONS: The GGC scale is a valid and reliable tool for assessing the gerontogeriatric competencies of new graduate RNs, highlighting its potential to enhance education, training, and, ultimately, the quality of care provided to the older population.

Effects of high dietary inclusion of Arthrospira platensis, either extruded or supplemented with a super-dosing multi-enzyme mixture, on broiler growth performance and major meat quality parameters.

BACKGROUND: This investigation assessed the effects of high dietary inclusion of Spirulina (Arthrospira platensis) on broiler chicken growth performance, meat quality and nutritional attributes. For this, 120 male broiler chicks were housed in 40 battery brooders (three birds per brooder). Initially, for 14 days, a standard corn and soybean meal diet was administered. Subsequently, from days 14 to 35, chicks were assigned to one of the four dietary treatments (n = 10 per treatment): (1) control diet (CTR); (2) diet with 15% Spirulina (SP); (3) diet with 15% extruded Spirulina (SPE); and (4) diet with 15% Spirulina plus a super-dosing enzymes supplement (0.20% pancreatin extract and 0.01% lysozyme) (SPM). RESULTS: Throughout the experimental period, both SP and SPM diets resulted in decreased final body weight and body weight gain compared to control (p < 0.001), with the SPE diet showing comparable results to CTR. The SPE diet prompted an increase in average daily feed intake (p = 0.026). However, all microalga treatments increased the feed conversion ratio compared to CTR. Dietary inclusion of Spirulina notably increased intestinal content viscosity (p < 0.010), which was mitigated by the SPM diet. Spirulina supplementation led to lower pH levels in breast meat 24 h post-mortem and heightened the b* colour value in both breast and thigh meats (p < 0.010). Furthermore, Spirulina contributed to an increased accumulation of total carotenoids, n-3 polyunsaturated fatty acids (PUFA), and saturated fatty acids (SFA), while diminishing n-6 PUFA, thus altering the n-6/n-3 and PUFA/SFA ratios favourably (p < 0.001). However, it also reduced zinc concentration in breast meat (p < 0.001). CONCLUSIONS: The findings indicate that high Spirulina levels in broiler diets impair growth due to increased intestinal viscosity, and that extrusion pre-treatment mitigates this effect. Despite reducing digesta viscosity, a super-dosing enzyme mix did not improve growth. Data also indicates that Spirulina enriches meat with antioxidants and n-3 PUFA but reduces α-tocopherol and increases saturated fats. Reduced zinc content in meat suggests the need for Spirulina biofortification to maintain its nutritional value.

Competencia emocional y características sociodemográficas y profesionales de las enfermeras / Competência emocionais e características sociodemográficas e profissionais de enfermeiros / Emotional competence and sociodemographic and professional characteristics of nurses

Introducción: En los profesionales de la salud, las habilidades que les permitan lidiar con las emociones propias y ajenas garantizan la calidad de la atención brindada y una relación terapéutica eficaz. Por lo tanto, son fundamentales para los enfermeros, es decir, para aquellos que actúan en las unidades de salud de la familia. Objetivo: Analizar la relación entre la competencia emocional de las enfermeras que trabajan en unidades de salud de la familia en un grupo de centros de salud en el norte de Portugal y sus características sociodemográficas y profesionales. Método: Metodología cuantitativa, de tipo transversal descriptivo-correlacional. Datos recogidos a través de un cuestionario electrónico que constaba de dos partes: características sociodemográficas y profesionales de los participantes y cuestionario de competencia emocional. 66 enfermeras compusieron la muestra. Resultados: Las enfermeras del estudio mostraron altos niveles de competencia emocional (media = 205,1, desviación estándar = 20,9). No hubo diferencias estadísticamente significativas entre las características sociodemográficas y profesionales y la competencia emocional.Conclusiones: Aunque no está clara la relación entre la competencia emocional y las características sociodemográficas y profesionales, es cierta la importancia de la inteligencia emocional en la práctica asistencial. (AU)

Introdução: Em profissionais de saúde, competências que permitam lidar com as próprias emoções e com as dos outros garantem a qualidade dos cuidados prestados e uma relação terapêutica eficaz. Daí serem fundamentais para enfermeiros, nomeadamente para os que executem funções em unidades de saúde familiares. Objetivo: Analisar a relação entre a competência emocional dos enfermeiros das unidades de saúde familiar de um agrupamento de centros de saúde do norte de Portugal e as suas características sociodemográficas e profissionais. Método: Metodologia quantitativa, do tipo transversal descritivo-correlacional. Dados recolhidos através de um questionário eletrónico que consistia em duas partes: características sociodemográficas e profissionais dos participantes e questionário de competência emocional. 66 enfermeiros compuseram a amostra. Resultados: Os enfermeiros do estudo apresentaram elevados níveis de competência emocional (média = 205,1, desvio padrão = 20,9). Não se evidenciaram diferenças estatisticamente significativas entre as características sociodemográficas e profissionais e a competência emocional. Conclusões: Apesar de não ser clara a relação entre a competência emocional e as características sociodemográficas e profissionais, é certa a importância da inteligência emocional na prática de cuidados. (AU)

Introduction: In health professionals, skills that allow them to deal with their own emotions and those of others guarantee the quality of care provided and an effective therapeutic relationship. Hence, they are fundamental for nurses, namely for those who work in family health units. Objective: To analyze the relationship between the emotional competence of nurses working in family health units in a group of health centers in the north of Portugal and their sociodemographic and professional characteristics.Method: Quantitative methodology, of the transversal descriptive-correlational type. Data collected through an electronic questionnaire that consisted of two parts: sociodemographic and professional characteristics of the participants and emotional competence questionnaire. 66 nurses composed the sample.Results: The nurses in the study showed high levels of emotional competence (mean = 205.1, standard deviation = 20.9). There were no statistically significant differences between sociodemographic and professional characteristics and emotional competence. Conclusions: Although the relationship between emotional competence and sociodemographic and professional characteristics is unclear, the importance of emotional intelligence in care practice is certain. (AU)

Impact of high Spirulina diet, extruded or supplemented with enzymes, on blood cells, systemic metabolites, and hepatic lipid and mineral profiles of broiler chickens.

The impact of 15% dietary inclusion of Spirulina (Arthrospira platensis) in broiler chickens was explored, focusing on blood cellular components, systemic metabolites and hepatic lipid and mineral composition. From days 14 to 35 of age, 120 broiler chickens were divided and allocated into four dietary treatments: a standard corn and soybean meal-based diet (control), a 15% Spirulina diet, a 15% extruded Spirulina diet, and a 15% Spirulina diet super-dosed with an enzyme blend (0.20% porcine pancreatin plus 0.01% lysozyme). The haematological analysis revealed no significant deviations (p > 0.05) in blood cell counts across treatments, suggesting that high Spirulina inclusion maintains haematological balance. The systemic metabolic assessment indicated an enhanced antioxidant capacity in birds on Spirulina diets (p < 0.001), pointing toward a potential reduction in oxidative stress. However, the study noted a detrimental impact on growth performance metrics, such as final body weight and feed conversion ratio (both p < 0.001), in the Spirulina-fed treatments, with the super-dosed enzyme blend supplementation failing to alleviate these effects but with extrusion mitigating them. Regarding hepatic composition, birds on extruded Spirulina and enzyme-supplemented diets showed a notable increase in n-3 fatty acids (EPA, DPA, DHA) (p < 0.001), leading to an improved n-6/n-3 PUFA ratio (p < 0.001). Despite this positive shift, a reduction in total hepatic lipids (p = 0.003) was observed without a significant change in cholesterol levels. Our findings underscore the need for further exploration into the optimal inclusion levels, processing methods and potential enzymatic enhancements of Spirulina in broiler diets. Ultimately, this research aims to strike a balance between promoting health benefits and maintaining optimal growth performance in poultry nutrition.

"There's Still Time to be Happy": The Life Trajectories of Portuguese Transgender Women Who Transitioned at 50+ Years.

The process of transitioning involves making changes to align one's life with their authentic gender identity. This study explores the life trajectories of three Portuguese transgender women who transitioned later in life (50+ years old) by identifying key chapters in their life courses. Through inductive thematic analysis, six chapters were identified from the participants' interviews: (1) awareness of "something different in me," (2) locked into suffering, (3) finding comfort in something that is socially recognized, (4) "it is enough": it is time to recognize and embrace the woman I am, (5) living my life as a woman, and (6) building and leaving a legacy. Aging and the process of self-discovery played pivotal roles in participants' process of transitioning. The perception of finitude and the limitations associated with the time of life led them to realize that there was no time to waste and a sense of urgency to live authentically.

O processo de transição envolve mudanças para alinhar a vida com a identidade de género autêntica. Este estudo explora as trajetórias de vida de três mulheres transgénero portuguesas que fizeram a transição mais tardia (depois dos 50 anos), identificando capítulos-chave nos seus percursos de vida. Através da análise temática indutiva, foram identificados seis capítulos a partir das entrevistas dos participantes: (1) consciência de "algo diferente em mim," (2) fechada no sofrimento, (3) encontrar conforto em algo que é socialmente reconhecido, (4) "já chega:" é altura de reconhecer a mulher que sou, (5) viver a minha vida como mulher, e (6) construir e deixar um legado. O envelhecimento e o processo de autodescoberta desempenharam papéis fundamentais no processo de transição das participantes. A perceção da finitude e das limitações associadas ao tempo de vida levou-as a perceber que não havia tempo a perder, dando um sentido de urgência para viver de forma autêntica.

The Portuguese mertolenga cattle breed: a review.

This review summarizes the state of the art regarding the phylogenetic origins, recent history and present-day main traits and uses of the Mertolenga cattle breed from Southern Portugal, particularly those related to production performances and product quality. Named after the historical city of Mértola, in southern Portugal, the Mertolenga is one of the fifteen autochthonous bovine breeds of Portugal. It is a cattle breed thoroughly adapted to the poor Mediterranean pastures of the southern regions of the Iberian Peninsula. It is used predominantly in an extensive to semi-intensive sylvopastoral production system called montado, where pastures are combined with helm and cork trees. Its productive traits allow for a good adaptation to the intense dry heat and pasture shortage during the summer, and compensatory growth in autumn and spring, when pastures regenerate. They are small to medium sized animals, with well-balanced bodies, roan, red, or, less often, red-spotted coats, and known for their nervous temperament. Although this breed experienced a severe decline in numbers in the 1970s and classified as endangered in the 1990s, the work of a few breeders led to the establishment of larger Mertolenga breed inventories, starting from a limited base. For this reason, the entire breed has today a strong influence from a very few herds and sires. Reproduction is still mostly achieved using natural mating, and the males are often kept with the breeding females all year long. It is a heterogeneous breed both phenotypically and genetically. Recent phylogenetic studies have revealed the Mertolenga as a one of the most genetically diverse breeds in the country and in the Iberian Peninsula and helped classify this breed, once believed to be a variety of the Alentejana breed. These studies also showed genetic relations with other breeds in the Iberian Peninsula. Mertolenga beef currently benefits from several certifications, the most important one being the PDO - Protected Denomination of Origin.

Feature Extraction Based on Local Histogram with Unequal Bins and a Recurrent Neural Network for the Diagnosis of Kidney Diseases from CT Images.

Kidney disease remains one of the most common ailments worldwide, with cancer being one of its most common forms. Early diagnosis can significantly increase the good prognosis for the patient. The development of an artificial intelligence-based system to assist in kidney cancer diagnosis is crucial because kidney illness is a global health concern, and there are limited nephrologists qualified to evaluate kidney cancer. Diagnosing and categorising different forms of renal failure presents the biggest treatment hurdle for kidney cancer. Thus, this article presents a novel method for detecting and classifying kidney cancer subgroups in Computed Tomography (CT) images based on an asymmetric local statistical pixel distribution. In the first step, the input image is non-overlapping windowed, and a statistical distribution of its pixels in each cancer type is built. Then, the method builds the asymmetric statistical distribution of the image's gradient pixels. Finally, the cancer type is identified by applying the two built statistical distributions to a Deep Neural Network (DNN). The proposed method was evaluated using a dataset collected and authorised by the Dhaka Central International Medical Hospital in Bangladesh, which includes 12,446 CT images of the whole abdomen and urogram, acquired with and without contrast. Based on the results, it is possible to confirm that the proposed method outperformed state-of-the-art methods in terms of the usual correctness criteria. The accuracy of the proposed method for all kidney cancer subtypes presented in the dataset was 99.89%, which is promising.

Interventions to address mealtime support needs in dementia: A scoping review.

The decrease in cognitive and physical ability among people with dementia can significantly affect eating performance, resulting in mealtime support needs that could lead to inadequate oral intake, weight loss, malnutrition, and reduced functionality in activities of daily living. This scoping review aimed to identify and summarize available research literature on mealtime interventions for people with dementia, and their impact on older people with dementia living in a residential care setting, care staff, and care context/environment. A scoping review of available research published in English, French, Portuguese, or Spanish, was conducted according to the methodology established by The Joanna Briggs Institute. The search was conducted between November 2022 and February 2023 in the following databases: MEDLINE, Web of Science, Scopus, CINAHL Complete, and SciELO. A total of 275 articles were retrieved, of which 33 studies were selected according to inclusion criteria. The interventions were classified into four general categories: environmental, mealtime assistance, staff training, and multicomponent. Most studies demonstrated effectiveness in increasing oral intake and improving behaviors such as agitation and aggression in people with dementia. The impact of interventions on care staff was linked to greater knowledge and attitudes towards mealtime support needs. There is a lack of reporting on the impact of interventions on the care context/environment. Most interventions examined the effects exclusively on residents, focusing on their oral intake and behavioral patterns, particularly agitation among individuals with dementia. However, it is crucial to conduct studies that evaluate the impact on administrators, to comprehend the viewpoints of various hierarchical levels within an organization regarding challenges associated with mealtime. The findings of this scoping review can support the development of new supportive programs, or strategies to improve mealtime experience with positive impact according to the reality and needs of each person or institution.

Streamlining the biodesulfurization process: development of an integrated continuous system prototype using Gordonia alkanivorans strain 1B.

Biodesulfurization is a biotechnological process that uses microorganisms as biocatalysts to actively remove sulfur from fuels. It has the potential to be cleaner and more efficient than the current industrial process, however several bottlenecks have prevented its implementation. Additionally, most works propose models based on direct cultivation on fuel, or batch production of biocatalysts followed by a processing step before application to batch biodesulfurization, which are difficult to replicate at a larger scale. Thus, there is a need for a model that can be adapted to a refining process, where fuel is being continuously produced to meet consumer needs. The main goal of this work was to develop the first bench-scale continuous biodesulfurization system that integrates biocatalyst production, biodesulfurization and fuel separation, into a single continuous process, taking advantage of the method for the continuous production of the biodesulfurization biocatalysts previously established. This system eliminates the need to process the biocatalysts and facilitates fuel separation, while mitigating some of the process bottlenecks. First, using the bacterium Gordonia alkanivorans strain 1B, continuous culture conditions were optimized to double biocatalyst production, and the produced biocatalysts were applied in batch biphasic biodesulfurization assays for a better understanding of the influence of different factors. Then, the novel integrated system was developed and evaluated using a model fuel (n-heptane + dibenzothiophene) in continuous biodesulfurization assays. With this system strain 1B surpassed its highest biodesulfurization rate, reaching 21 µmol h-1 g-1. Furthermore, by testing a recalcitrant model fuel, composed of n-heptane with dibenzothiophene and three alkylated derivatives (with 109 ppm of sulfur), 72% biodesulfurization was achieved by repeatedly passing the same fuel through the system, maintaining a constant response throughout sequential biodesulfurization cycles. Lastly, the system was also tested with real fuels (used tire/plastic pyrolysis oil; sweet and sour crude oils), revealing increased desulfurization activity. These results highlight the potential of the continuous biodesulfurization system to accelerate the transition from bench to commercial scale, contributing to the development of biodesulfurization biorefineries, centered on the valorization of sulfur-rich residues/biomasses for energy production.

Haloperidol's introduction in the United States: A tale of a failed trial and its consequences.

Haloperidol, the first butyrophenone neuroleptic, was created in Europe by Janssen Pharmaceuticals in 1958 and was introduced swiftly throughout the continent with great enthusiasm. On September 15, 1959, at Janssen's headquarters in Belgium, teams from around Europe praised the effectiveness of haloperidol. In the United States, on the contrary, its introduction was a tremendous failure, plagued by accusations of inefficacy and patent disputes. A clinical trial in Manhattan has been blamed for this commercial failure. The results of the Manhattan trial were seen as radically different from the results obtained in continental Europe. This divide would have considerable impact not only with regard to haloperidol's path on both sides of the Atlantic, but also possibly on the practical experience and theoretical construction of psychiatry. This article tries to reconstruct the story of that trial based mainly on published papers and interviews. Exploring how societal changes and issues of gender and race shaped this process, this investigation attempts to understand and contextualize different possible reasons for this Atlantic rift.

Cuidadores familiares de pessoas com demência: Tradução, adaptação e validação da Escala de Limites Ambíguos / Family caregivers of people with dementia: Translation, adaptation, and validation of the Boundary Ambiguity Scale / Cuidadores familiares de personas con demencia: Traducción, adaptación y validación de la Escala de Límites Ambiguos

Resumo Enquadramento: Cuidar de pessoas com demência (PcD) é gerador de stresse entre cuidadores familiares (CF). Uma das situações geradoras desse stresse é a perda ambígua (PA). Objetivos: Traduzir, adaptar e validar a Escala de Limites Ambíguos (ELA) para português europeu e determinar as caraterísticas psicométricas da ELA. Metodologia: Estudo metodológico a partir de uma amostra de 88 CF de PcD. A consistência interna (CI) avaliada com o Coeficiente de Ômega de McDonald ((), a validade de constructo através da análise fatorial exploratória (AFE) e a validade de critério com a Escala de Perceção de Stresse (EPS). Resultados: A ELA apresentou validade conteúdo excelente. A AFE determinou um modelo de dois fatores, explicando 44% da variância, ( de 0,72. Os CF que residem com a PcD apresentam maior PA (t = 2,823, p < 0,01). Correlação significativa positiva e moderada entre a ELA e a EPS (r s = 0,578, p < 0,01). Conclusão: A ELA é um instrumento com propriedade psicométrica de CI e validade aceitáveis para a avaliação da PA.

Abstract Background: Caring for people with dementia generates stress among family caregivers. One of these stressor events is ambiguous loss. Objectives: To translate, adapt, and validate the Boundary Ambiguity Scale (BAS) into European Portuguese and assess its psychometric properties. Methodology: Methodological study with a sample of 88 family caregivers of people with dementia. Internal consistency was assessed using McDonald's omega coefficient ((). Construct validity was assessed through exploratory factor analysis (EFA) and criterion validity through the Perceived Stress Scale (PSS). Results: The BAS showed excellent content validity. The EFA revealed a two-factor model, explaining 44% of variance, and a ( of 0.72. Family caregivers who live with people with dementia had greater ambiguous loss (t = 2.823, p < 0.01). A statistically significant moderate positive correlation was found between the BAS and the PSS (r s = 0.578, p < 0.01). Conclusion: The BAS has acceptable validity and internal consistency for assessing ambiguous loss.

Resumen Marco contextual: El cuidado de personas con demencia (PcD) genera estrés entre los cuidadores familiares (CF). Una de las situaciones que generan este estrés es la pérdida ambigua (PA). Objetivos: Traducir, adaptar y validar la Escala de Límites Ambiguos (ELA) al portugués europeo y determinar las características psicométricas de la ELA. Metodología: Estudio metodológico basado en una muestra de 88 CF de PcD. La consistencia interna (CI) se evaluó mediante el coeficiente omega de McDonald ((), la validez de constructo mediante el análisis factorial exploratorio (AFE) y la validez de criterio mediante la Escala de Percepción del Estrés (EPS). Resultados: La ELA presentó una validez de contenido excelente. El AFE determinó un modelo de dos factores, que explican el 44% de la varianza, ( de 0,72. Los CF que residen con PcD presentan mayor PA (t = 2,823, p < 0,01). Correlación significativa positiva y moderada entre la ELA y la EPS (r s = 0,578, p < 0,01). Conclusión: La ELA es un instrumento con propiedades psicométricas de CI y validez aceptables para la evaluación de la PA.

A pessoa dependente, o cuidador familiar e os recursos utilizados: Estudo com famílias clássicas / The dependent person, the family caregiver, and the resources used: A study with standard families / La persona dependiente, el cuidador familiar y los recursos utilizados: Un estudio con familias clásicas

Resumo Enquadramento: As transições demográficas, epidemiológicas e sociais têm implicações na (in)dependência para o autocuidado. Objetivo: Caracterizar o familiar dependente (FD), o Membro Familiar Prestador de Cuidados (MFPC) e os recursos utilizados, no contexto das famílias clássicas. Metodologia: Estudo transversal e descritivo. Amostragem de Snowball. Utilizou-se o formulário "Famílias que Integram Dependentes no Autocuidado" em 60 MFPC. Resultados: Os FD são maioritariamente do género feminino. Os cuidadores são predominantemente mulheres idosas com baixa escolaridade. Os cuidados mais básicos (e.g. alimentar, dar de beber e vestir são realizados com alguma facilidade pelo MFPC e estão garantidos. Os cuidados com intervenção mais diferenciada, como a realização de exercícios dos membros inferiores e superiores e a estimulação das funções cognitivas não são realizados. O principal recurso utilizado é o centro de saúde. Conclusão: Este estudo revela a necessidade do Enfermeiro de Família intervir nos cuidados à família em contexto domiciliário através do ensino e da implementação de cuidados mais diferenciados (reabilitação motora e estimulação cognitiva), assim como, promover a acessibilidade aos cuidados e recursos de saúde.

Abstract Background: Demographic aging and the increase in chronic diseases are reflected in high levels of dependence for self-care. Objective: To characterize the Dependent Family member (FM), the Caregiving Family Member (CFM) and the resources used, in the context of classic families. Methodology: Quantitative and descriptive study. A Snowball sample was used. The "Families that Integrate Dependents in Self-care" form was used in 60 CFM.. Results: The FM are mostly female. Caregivers are predominantly elderly women with low education. The most basic care (e.g. feeding, giving drink and dressing are carried out with some ease by the CFM and are guaranteed. Care with a more differentiated intervention, such as performing exercises for the lower and upper limbs and activities to stimulate memory, do not are carried out. The main resource used is the health center. Conclusion: This study reveals the need for Family Nurses to intervene in family care at home through teaching and implementing more differentiated care (motor rehabilitation and cognitive stimulation), as well as promoting accessibility to care and health resources.

Resumen Marco contextual: Las transiciones demográficas, epidemiológicas y sociales repercuten en la (in)dependencia de los autocuidados. Objetivo: Caracterizar al familiar dependiente (FD), al familiar cuidador (MFPC) y los recursos utilizados, en el contexto de las familias clásicas. Metodología: Estudio transversal y descriptivo. Muestreo de bola de nieve (snowball). El formulario "Familias que integran a personas dependientes en el autocuidado" se utilizó en 60 MFPC. Resultados: Los FD son mayoritariamente mujeres. Los cuidadores son predominantemente mujeres mayores con bajos niveles de educación. Los cuidados más básicos (por ejemplo, alimentar, beber y vestirse) los realizan con cierta facilidad los MFPC y están garantizados. Los cuidados con intervención más especializada, como ejercitar los miembros inferiores y superiores, y estimular las funciones cognitivas no se realizan. El principal recurso utilizado es el centro de salud. Conclusión: Este estudio pone de manifiesto la necesidad de que el enfermero de familia intervenga en los cuidados familiares en el domicilio enseñando y aplicando cuidados más especializados (rehabilitación motora y estimulación cognitiva), así como promoviendo la accesibilidad a los cuidados y recursos sanitarios.

Perceção, crenças e conhecimentos dos enfermeiros família sobre violência conjugal: Um estudo exploratório / Perceptions, beliefs, and knowledge of family health nurses about domestic violence: An exploratory study / Percepción, creencias y conocimientos de los enfermeros de familia sobre la violencia conyugal: Un estudio exploratorio

Resumo Enquadramento: A violência conjugal (VC) representa um problema de saúde pública, sendo a intervenção dos enfermeiros influenciada pelas suas crenças e conhecimentos. Objetivo: Analisar as perceções, crenças e os conhecimentos dos enfermeiros de família (EF) sobre a VC. Metodologia: Estudo observacional, descritivo e correlacional, partindo de uma amostra não probabilística de 98 EF, através de questionário online, utilizando escalas sobre perceção, crenças e conhecimentos sobre VC. Resultados: Numa situação de VC, a maioria dos EF (78%) encaminha as vítimas para outros profissionais e apenas 16% faz a denúncia. Um terço dos EF fez formação nesta área. Como barreiras para a sua intervenção, identificaram a falta de preparação teórica e técnica e falhas ao nível da organização das unidades de saúde. Globalmente, apresentaram baixo nível de crenças (1,44 ± 0,45) e conhecimentos aceitáveis (2,90 ± 0,41). O sexo masculino influenciou significativamente o nível de crenças sobre VC. Conclusão: Os EF percecionam situações de VC, contudo necessitam de formação e de condições favoráveis nas unidades de saúde para intervirem de forma efetiva.

Abstract Background: Domestic violence (DV) constitutes a public health concern, and nurses' beliefs and knowledge influence their intervention. Objective: To analyze the perceptions, beliefs, and knowledge of family health nurses (FHN) about DV. Methodology: Observational, descriptive, and correlational study applied an online questionnaire to a non-probabilistic sample of 98 FHNs, including scales on perception, beliefs, and knowledge about DV. Results: In a DV situation, most FHNs (78%) refer the victims to other professionals, and only 16% report the crime. Only one third of FHNs had specific training in this area and identified as barriers to their intervention, the lack of theoretical and technical training and inadequate health unit organization. Globally, FHNs showed a low level of beliefs (1.44 ± 0.45) and acceptable knowledge (2.9 ± 0.41). There was a significant correlation between the male gender and the level of beliefs about DV. Conclusion: FHNs deal with DV situations but training and favorable conditions in health units are necessary to intervene effectively.

Resumen Marco contextual: La violencia conyugal (VC) representa un problema de salud pública, y la intervención de los enfermeros se ve influida por sus creencias y conocimientos. Objetivo: Analizar las percepciones, las creencias y los conocimientos de los enfermeros de familia (EF) sobre la VC. Metodología: Estudio observacional, descriptivo y correlacional, basado en una muestra no probabilística de 98 EF, en que se usó un cuestionario en línea, con escalas sobre percepción, creencias y conocimientos acerca de la VC. Resultados: En una situación de VC, la mayoría de los EF (78%) derivan a las víctimas a otros profesionales y solo el 16% lo denuncia. Un tercio de los EF han recibido formación específica en este ámbito. Como obstáculos a su intervención, señalaron la falta de preparación teórica y técnica, y las deficiencias en la organización de las unidades sanitarias. En general, presentaban bajo nivel de creencias (1,44 ± 0,45) y conocimientos aceptables (2,90 ± 0,41). El sexo masculino influyó significativamente en el nivel de creencias sobre la VC. Conclusión: Los EF detectan situaciones de VC, pero necesitan formación y condiciones favorables en las unidades sanitarias para intervenir eficazmente.

Operative Hysteroscopy Intravascular Absorption Syndrome - A Life-Threatening Complication.

Operative hysteroscopy intravascular absorption (OHIA) syndrome is a rare and potentially life-threatening complication related to irrigation fluid systemic absorption during hysteroscopy. It can lead to severe electrolyte disturbances, cerebral and pulmonary oedema, dysrhythmias and coagulopathy. We present the case of a 30-year-old woman who underwent a hysteroscopic myomectomy. After absorbing 2.5 l of normal saline, she experienced haemodynamic instability, respiratory distress and severe metabolic acidosis, initially mistaken for an anaphylactic or haemorrhagic shock. Insufficient monitoring of fluid deficit and irrigation fluid pressures contributed to the condition. This case underscores the importance of recognising OHIA and its risk factors to enable timely intervention and prevent adverse outcomes. Close fluid balance monitoring is vital in hysteroscopic surgeries to mitigate OHIA development. LEARNING POINTS: OHIA syndrome occurs due to the systemic absorption of the irrigation fluid used during hysteroscopic procedures.The presentation is diverse with encephalopathy, pulmonary oedema, dysrhythmias, electrolyte disturbances and coagulopathy.Fluid balance and irrigation fluid pressures should be monitored during hysteroscopic procedures to mitigate OHIA development.

Validation of the hospital resources assessment scale for the preservation of urinary continence in the elderly.

OBJECTIVES: to validate the internal structure of the Hospital Resources Assessment Scale for the Preservation of Urinary Continence in the Elderly. METHODS: validation study of the internal structure of a scale constructed based on the Donabedian conceptual model and an integrative review, with prior content validation. The scale was applied to the target population, and 124 nurses responded to the questionnaire. Exploratory Factor Analysis was performed using the FACTOR software, employing multiple techniques. RESULTS: a factorial model with 11 items organized into two dimensions (support for human resources and material resources) was obtained. The "physical structure" dimension was removed from the initial model and adopted as a complementary checklist to the instrument, as it was not possible to obtain a factorable model with this dimension. CONCLUSIONS: we provide a valid scale that can measure indicators, identifying weaknesses and/or strengths related to hospital resources for the preservation of urinary continence in the elderly.

A Systematic Approach to Intraoperative Venous Congestion in the Deep Inferior Epigastric Artery Perforator (DIEAP) Flap.

The deep Inferior epigastric artery perforator (DIEAP) flap is currently the gold standard for autologous breast reconstruction. This flap is susceptible to venous congestion, which can result in partial or complete flap loss. Apart from external causes, venous congestion may be caused by the flap's vascular architecture, either due to a dominance of the superficial venous system or due to impaired communication between the superficial and deep venous systems. This inefficient vascular architecture can be detected during surgery, and the venous outflow drainage can be improved through several techniques. We present two case reports of intraoperative venous congestion. In the first case, we performed an intra-flap rerouting, through a venous anastomosis between the superficial and the deep venous systems. In the second case, an extra-flap rerouting was executed, through a venous anastomosis between the superficial venous system and a recipient vein. We present the current institutional approach to DIEAP flap breast reconstruction, incorporating surgical insights for addressing intraoperative venous congestion.