Fundamentos Da Fisica 3 Ramalho Games

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1CUF Hospitals, Lisbon, Portugal; 2Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal The advancement of technology in diagnostic equipment was the major driving force in the advancement of medical knowledge. In few decades, imaging methods went from two planes conventional radiology to computed tomography in volumetric acquisition and multiplanar reconstruction, with morphological analysis and quantification of densities. With magnetic resonance we are able to perform the analysis of tissue composition and to identify it´s changes in context with each disease. Nowadays, molecular imaging methods enable the correlation of metabolism and diseases. The research and knowledge acquired about the genome and the development of genomics has given to the medical community the opportunity to study genetic alterations linked to a large number of diseases. New technology allows physicians a better diagnosis of a significant number of syndromes and diseases, has seen in chronic degenerative diseases and in oncological diseases.

This big technological progress is responsible for the advancement of personalized medicine and new treatments, taking into account the biological and genetic characteristics of each individual diseases. All the progress made in screening methods has also lead the medical community to a more efficient study of diseases with high prevalence in the general population. The link between technological advancement seen today and the early diagnosis of a large number of oncological diseases as well as the development of a personalized medicine contributes not only to the well-being of each patient but also to the practice of sustainable medicine. 1Swiss Centre for Medical Simulation & Swiss Association of Simulation in Healthcare, 4031 Basel, Switzerland; 2Basel University Hospital, 4056 Basel, Switzerland Dr.

Stefan Gisin is staff anaesthesiologist at the University Hospital in Basel/Switzerland, deployed in various specialties of anaesthesia (including cardiac, thoracic, neuro, obstetric), he has a special interest in pre-hospital emergency medicine and is flying doctor for the Swiss Helicopter Rescue Service (Rega) and passionate ATLS Course Director. Stefan Gisin is head of the Swiss Center for Medical Simulation in Basel and implemented a multitude course concepts for pre- and postgraduate simulation-based education, focussing on interdisciplinary and multiprofessional team training. In collaboration with the Swiss Department for Development and Collaboration (DEZA) he is a consultant in several healthcare education projects in Eastern European countries. He serves as faculty for international simulation instructor courses (EuSim, PAEDSIM, InFact) and is on the advisory board of PAEDSIM eV.

Stefan Gisin is currently President of SASH (Swiss Association of Simulation in Healthcare) and Vice-President of SESAM (Society in Europe for Simulation applied to Medicine). Centro Superior de Estudios Universitarios La Salle, Madrid, Spain Experience economy is the last segment in the evolution of the market, and it is characterized by the fact that consumers do not acquire goods, products or services, but experiences that they integrate in their biography, and consequently in their identity. Customer Experience, possibly the latest revolution in business thinking along with the digital transformation, seeks the design and management of truly customer-centric experiences. This revolution is spreading across different sectors, among which the health sector should necessarily be considered.

External leads to finding the root cause of the problem can include: Customer complaints/suggestions; customer rejections; non-conformities raised in customer/third-party audits; recommendations by auditors. Iso 9001 corrective action examples. The problem or a non-conformance can be identified internally through staff suggestions, management reviews, document reviews or internal audits. A root cause is the identification of the source of the problem where the person(s), system, process, or external factor is identified as the cause of the non conformity. Implementation of corrective and preventive actions is the path towards improvement and effectiveness of Quality Management Systems. Corrective actions is nothing but the action/actions based on the problem identification.

This talk covers the fundamental ideas within the concept of customer experience, as well as it provides information and suggestions about how to design and deliver an optimal patient experience. Keywords: Experience economy, customer experience, patient experience, health care, customer centric culture. Correspondence: Helena G.

Jardim (hjardim@uma.pt) – Universidade da Madeira, 9000-082 Funchal, Portugal Disasters affect emergency teams to varying degrees, causing trauma. The risk factors for mental health can be determined according to the experience of professionals in coping with these situations. The gravity of the situation, as well as the behaviour and response of those present will be different, depending on the extent of the catastrophe, such as the number of deaths, destruction, duration and degree of rapidity of the phenomenon. The purpose of the study was to assess the psychological impact on emergency crews after the natural disaster of February 20 2010, in the isle of Madeira, Portugal. The professional group was comprised of 405 individuals: firemen (41.7%), military (32.8%), police (17.3%) and health professionals (8.1%). The assessment tools used were: the list of life events and the peri-traumatic experiences questionnaire, adult version. Ethical issues were considered as well as informed consent.

The average age was 34.5 years, mostly male, married and in residence at the time of the event. The data show that there were significant differences between the profession and the response to the event, as well as in relation to Post Traumatic Stress Disorder (PTSD), this being most evident in the group of firemen and military (p.

Correspondence: Cristina L. Baixinho (crbaixinho@esel.pt) – Escola Superior de Enfermagem de Lisboa, 1700-063 Lisboa, Portugal Background The prevalence of musculoskeletal disorders related to work (MDRW) is high in midwives. The risk factors are associated with the physical environment, the nature of the occupation, the parturient, the type of delivery and the new-born. Objective: Identifying the safety practices adopted by the midwives to prevent the MDRW.

Methods Qualitative exploratory study. The inclusion criteria for the 12 participants were, the professional title of the midwives, if they work in childbirth blocks. For results analysis, Bardin’s propose of content analysis was used. The anonymity and confidentiality of the results was guaranteed. Results Concerns about equipment and materials manipulation as to prevent low back overload in the initial positioning of the parturient and the mobilization of the new-born stood out. Speech analysis revealed difficulty in adopting preventive measures for the expulsive period, because the movement of pronation supination of the upper limbs needed to facilitate the birth is done by increasing muscular tension, making it difficult to maintain alignment and body balance.

Conclusions Participants report difficulties in maintaining the principles of biomechanics especially in the expulsive period caused by the complications in controlling the parturient behaviour. Keywords Musculoskeletal disorders, midwives, biomechanics. Correspondence: Marina Cunha (marinacunha@ismt.pt) – Instituto Superior Miguel Torga, Coimbra, 3000-132 Coimbra, Portugal Background Adverse childhood experiences are not only linked to mental health difficulties but also to the inability to generate positive and affiliative emotions. Individuals from these adverse backgrounds may also fear and avoid compassionate feelings from others and being compassionate for others and for themselves. Objective: This study aims to test whether the impact of early negative memories in childhood on psychological difficulties is mediated by fears of compassion (for others, from others and for self). Methods The sample consists of 178 adolescents with ages between 12 and 18 years old (M = 15.53, SD = 1.96) from middle and secondary schools in the central region of Portugal.

Participants answered the following self-report questionnaires: The Early Life Experiences Scale; the Fears of Compassion Scales; and the Strengths and Difficulties Questionnaire. Results Results from Path Analysis showed that the full model accounted for 36% of the psychological difficulties among adolescents. The recall of threatening, subordination and devaluation experiences in childhood with parents had a direct impact on psychological difficulties. These early adverse experiences also had an indirect effect in psychological difficulties through both fears of compassion from others and for self. A multi-group analysis for gender was tested and the meditational model was equivalent for both genders. Conclusions These findings suggest that addressing adverse emotional memories in childhood and fears of compassion (in others and self-to-self relationships) may be a valuable approach for preventive and intervention actions in order to promote psychological adjustment in youths. Keywords Adolescence, psychological difficulties, negative emotional memories, fear of compassion, Path analysis.

Correspondence: Andrea Ribeiro (andrear@ufp.edu.pt) – Universidade Fernando Pessoa, Porto, 4249-004, Portugal Background Quantify the prevalence of musculoskeletal disorders (MSDs) in musicians due by posture. The goal was also to measure the intensity of pain in different body parts and the influence of playing a certain musical instrument has on pain. Methods The sample used in this study consisted of all musicians of the Philharmonic Society of Crestuma and the Musical Band of Avintes, each constituted by fifty (50) musicians. All elements completed an individual questionnaire about individual and work factors and then the Nordic Musculoskeletal Questionnaire (NMQ).

Results Neck, shoulders, wrists/hands, lumbar spine were main areas where the musicians complained about pain. Drummers were the ones who reported more intense pain in shoulders, wrists/hands and lumbar spine.

It was also observed that women had higher pain intensities while compared to men. The pain seems to decrease with years of practice, except in what concerns the lower back. Conclusions This study concluded that there is a high prevalence of musculoskeletal disorders (MSDs) in musicians and the lumbar and cervical spine, shoulders and wrists/hands were the most affected areas. Keywords Prevalence, musculoskeletal disorders, pain, musicians. Correspondence: Daniel Seabra (danielseabra@hotmail.com) – Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, 3001-802 Coimbra, Portugal Background Social Anxiety Disorder (SAD) is characterized by a marked fear or anxiety in situations where the individual might be exposed to the possible scrutiny by others.

Post-Event Processing (PEP), which refers to a post-mortem rumination wherein the subject reviews critically and with detail what went wrong in the social event, is considered an important maintenance factor of SAD. Clinical practice seems to indicate that rumination in patients with SAD, is mainly a self-critical process frequently resulting in feelings of shame. Aims: This study aimed to bridge the gap between cognitive variables (PEP) and evolutionary variables (Self-Criticism and Internal/External Shame) in understanding Social Anxiety (SA), exploring the mediator role of these evolutionary variables in the relationship between PEP and SA in a clinical sample of patients with SAD. Methods The sample was constituted by 32 subjects with SAD – 25 females (78.10%) and 7 males (21.90%) – with an average age of 26.78 (SD = 9.22), that filled several self-report instruments and answered a diagnostic interview. Results Self-Criticism and Internal Shame fully mediated the relationship between PEP and SA. However, Sobel test only supported the full mediation of Internal Shame.

Fundamentos Da Fisica 3 Ramalho Games Download

Conclusions These results suggest that SA does not directly depend on PEP levels but from Internal Shame levels. In other words, Internal Shame is the mechanism through which PEP impacts on SA. Therefore, Internal Shame seems to be an important health indicator to consider in the intervention with this population.

Limitations and clinical implications will be discussed. Keywords Social Anxiety Disorder, Post-Event Processing, Shame, Self-Criticism, Mediation. Correspondence: Joana Santos (joanacarvalhosantos@ua.pt) – School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal Background Falls have high incidence in elderly and are major responsible for accidental deaths. People with high depression and anxiety symptoms have impaired balance and this is more problematic in the elderly population. However, it is unknown how anxiety and depression symptoms affect the different systems responsible for balance and balance confidence. Objective: Explore balance systems and balance confidence differences between elderly with presence/absence of anxiety and depression symptoms.

Methods A quantitative cross-sectional study was conducted. Socio-demographic, anthropometric and general clinical data were collected with a structured questionnaire. Balance confidence was evaluated with Activities-specific Balance Confidence (ABC) and balance with Balance Evaluation System Test (BESTest) and Berg Balance Scale (BBS). The level of significance was set at p 0.046)) but not the balance confidence (anxiety: p = 0.516; depression: p = 0.274). Conclusions The presence of anxiety and of depression symptoms significantly decrease balance performance and balance confidence in the elderly.

The severity of symptoms significantly decreases balance performance but does not seem to significantly impact on balance confidence. Keywords Balance, old age people, anxiety, depression. Correspondence: Clarinda Festas (clarinda@ufp.edu.pt) – Universidade Fernando Pessoa, 4249-004 Porto, Portugal Background Postural changes acquired during childhood and adolescence are a risk factor for disorders of the spine in adulthood and may become irreversible if not treated in time. The purpose of this study was to evaluate the postural changes among students of basic schools in the district of Porto. Methods Weight and height were measured.

The 'body chart' and visual analogue scale for pain and static postural form for evaluation of postural changes, backpack characteristics and additional physical activity questionnaire were used. Results This study included 285 students, aged 11.46 years ± 1.32 years, and weighing 43.36 kg ± 10.49 kg and with a height of 1.48 m ± 0.95 m. Use of backpack: 97.5% of the participants, 83.0% use it in both shoulders and 17.0% only on one shoulder. In relationship to physical activity 58.0% do it after regular school time, the most prevalent physical activity was swimming with 21.3% and 23.1% for football.

Pain lifetime prevalence was 43.0%. With regard to postural changes, elevation of the shoulders was the most prevalent (78.0%), changes in iliocostalis angle (52.5%) and flat feet (47.2%), calcaneus valgus (37.7%) and scoliosis (25.5%), anterior head projection (63.0%), anterior shoulder (45.2%), pelvic anteversion (37.7%), lumbar hyperlordosis (56.9%) and knee recurvatum (24.2%). Conclusions We conclude that postural changes found are according the postural characteristics for this age group and identification of changes allowed earlier clinical referral and propose school postural education prevention programmes. Keywords Postural changes, school children and adolescents, school health, backpack, pain. Correspondence: Gilberta Sousa (gfranca@uma.pt) – Universidade da Madeira, 9000-082 Funchal, Portugal Background Adherence to medication regimens is an indicator of health service efficiency (WHO, 2003).

It promotes improvements in clinical status, safety and quality of life of individuals and leads to better financial results, reflected by reduced use of health services and decreases the risk of aggravation of disease and acute crises caused by inadequate drug management. Objective: Describe the level and factors associated with the adherence to medication regimens in the elderly. Methods From a research-action perspective, we developed a descriptive, quantitative and transversal study (2014), with random and accidental sample in a Madeira Island parish (n = 493) using the questionnaire “Measure Adherence to Treatment- MAT” validated for the Portuguese population (α = 0.74). Results Mean age 70 years (σ ± 7.1); 68% female; 70% have 4 years of education; 40% consume 5 or more different drugs/day; with a mean of adherence of 5.4(6). The main factors that influence adherence are the problems of memory (40%); In the MAT subscales 23.5% non-adherence was found; 13.5% non-adherence by excess; 18.0%-non-adherence by deficit and 14.1% other causes.

In the subscale of non-adherence, the values observed were: 33.0% failure to take the medication; 30.5% the neglect in the time of taking; 16.8% abandonment because they feel better and 15.8% because they feel worse. Conclusions The results corroborate the findings of other studies and express the priorities for action in this context. In partnership, specific objectives were outlined and nursing interventions designed to enhance patient adherence to medication prescriptions. Acknowledgements Authors wish to acknowledge the helpful collaboration given to this study by the Nursing students. Keywords Adherence to medication regimen, elderly, nursing intervention. Correspondence: Roger S. Rosa (roger.rosa@ufrgs.br) – Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, 90050-170, Brasil Background Cervical cancer is caused by persistent infection due to certain oncogenic types of human papillomavirus (HPV).

These changes of the cells are easily discovered on the Pap test and are curable in almost all cases. Objective: To describe the characteristics of hospitalizations for cervical cancer in the public health system by residents of the Greater Porto Alegre (GPA), in southern Brazil, 2012 to 2014. Methods Analysis of hospitalizations with a primary diagnosis ICD-10 C53 from the Hospital Information System (HIS)/SUS publicly available. Calculation of indicators by age, stay, mortality and hospitalization for spending. Results There were 2,143 hospitalizations (714.3/year) in the public health system for cervical cancer of the GPA residents (3.4/10,000 inhabitants/year). Hospitalizations and deaths of patients up to 44 years represented 41.0% and 27.9% respectively. The average length of stay was 7.4 days.

Thirty-two (1.5%) patients needed to use Intensive Care Unit (ICU). The mortality rate reached 8.5% with 183 deceased patients (61/year). The average annual expenditure was $ 657,0 thousand PPP (Purchasing Power Parity) and the average value per hospitalization $ 919,78 PPP. Conclusions Hospitalization for and death from cervical cancer have occurred in young women in GPA and it could be prevented if more emphasis was given to preventive tests. Keywords Women, cervical cancer, hospitalization, primary care sensitive conditions, public health system. Correspondence: Alice Morgado (alicemmorgado@gmail.com) – Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, 3000-115 Coimbra, Portugal The adolescent antisocial phenomenon is an important matter for our society due to the increase in frequency and severity of deviant conducts during a developmental stage, when individuals face multiple changes. We present a study on antisocial manifestations and their relation with gender, age, socioeconomic status, personality, social skills, self-concept, and family environment in a sample of 489 adolescents, that filled self-report measures to assess behaviour, personality, self-concept, family environment and social skills.

Results show important gender differences that may explain why boys have higher antisocial tendencies. While, in boys, psychoticism and family environment contribute to determine which individuals are more likely to have higher antisocial scores; female antisocial tendency appears to be defined by individual dispositions and social skills. Significant correlations between antisocial behaviour, age, personality, social skills, self-concept and family environment in boys and girls reveal the importance of individual dispositions and of early prevention efforts focused on the individual and family. Conclusions focus on the importance of dimensions for the prevention of adolescent antisocial behaviour and reveal important gender differences and trends on the evolution of antisocial behaviour through adolescence. We demonstrate the importance of differences between boys and girls in adolescent antisocial behaviour and of the necessity to address this issue taking into account gender specificities and vulnerabilities. Keywords Antisocial behaviour, adolescence, gender differences. Escola Superior de Enfermagem, Universidade do Minho, Braga, 4710-057 Braga, Portugal Background Cultural differences in sexual symptoms exist, and should be measured in perimenopause, including the following symptoms: loss of interest in sex, vaginal dryness, satisfaction and pain during intercourse.

The measurement of these symptoms provides a comparison between studies. Methods A cross-sectional study, correlational; with a non-probabilistic convenience sample (n = 600 Portuguese women perimenopause, 45 - 55 years) was performed. Protocol included: Menopause Rating Scale; attitudes and beliefs before menopause (built and validated by us); Social Support Satisfaction Scale, Scale, levels E2; FSH, sociodemographic; lifestyle and projects, perception of subjective well-being and stressful events. Results Regarding the influence of different factors included in the final model on the probability of a woman having reported uncomfortable sexual symptoms, logistic regression forward showed the conditions of socio-demographic/socio-economic factors: labour condition (bunemployed = 0.817; p = 0.001; OR = 2.264), household formation (balone, with children = - 0.993; p. Correspondence: Sandra Xavier (sandraalvesxavier@gmail.com) – Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal Background The 2015 update of the depression screening recommendations reflects the importance of screening during and after pregnancy. The perinatal depression screening and early detection should combine the evaluation of depressive symptoms and risk factors.

Objective: To analyse the predictive ability of the Perinatal Depression Screening and Prevention Tool (PDSP Tool) assessing both PD symptoms and risk factors identified by our team (lifetime history of depression/LtHD, prenatal insomnia, increased depressive symptoms and negative affect/NA at pregnancy) to identify postpartum major depression. Methods Nighty-two (92) pregnant women (mean age: 32.64 ± 4.59 years) in their second trimester (21.38 ± 2.41 weeks of gestation) completed the PDSP Tool. At six (6.34 ± 1.66) weeks postpartum they were interviewed with the Diagnostic Interview for Psychological Distress-Postpartum, to determine if they fulfilled the diagnostic criteria for major depression/DSM-5. Results 4.3% of the women showed major depression. The global correct classification rate of the PDSP Tool was 53.3%. False-negatives 1.1%, false-positives 44.6%, true-negatives 55.2% and true-positives 3.3%. Considering the PDSP Tool components, high NA showed the highest predictive ability: 100% of women with high NA at pregnancy (X 2 = 11.21, OR = 2.190, p =.005) had major depression in the postpartum.

Conclusions Considering that false-negatives are worse than false-positives, the finding that the PDS Tool identifies more than half of the women who will develop postpartum major depression encourages us to continue to develop efforts to succeed in this very difficult task of identifying pregnant women who will tend to have major depression in the postpartum. Keywords Perinatal Depression, early screening, assessment. Correspondence: Ana S. Maia (anamargarette@yahoo.com.br) – Faculdade Nobre, Feira de Santana, Bahia, 44001-008, Brasil In Brazil, there is a steady increase in life expectancy, due to the decline in mortality and fertility rates, thus increasing the number of elderly. With that index of Chronic Diseases has grown, with arterial hypertension as an example.

This research aimed to analyse accessibility of the elderly in the prevention of hypertension in a Family Health Unit. This is a descriptive and exploratory study, with qualitative approach, performed at a Family Health Unit in the municipality of Bahia, Brazil.

It was conducted with 16 elderly people, aged over 60 years, through a semi-structured interview. The interviews were submitted to thematic content analysis. The study was divided into the following categories: “ You have to be careful”, “ have to do your exams every month”, “ every year to stay healthy”, respondents show access to knowledge on how to prevent high blood pressure, citing changes in habits beyond just use of prescribed medication. Respondents indicated that access to knowledge and information in the prevention of hypertension happens through media, health professionals, consultations, lectures, television, and conversation groups. The orientation of the unit's health team contributes to changes in the lifestyle of the elderly. Therefore, it is concluded that access to health education and encouraging changes of habits in daily life are required for the acquisition of knowledge, assisting in self-care.

Keywords Access, arterial hypertension, elderly.