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Ensuring Access to Safe and Nutritious Food for All Through the Transformation of Food Systems
Anuário científico da Escola Superior de Tecnologia da Saúde de Lisboa - 2021
É com grande prazer que apresentamos a mais recente edição (a 11.ª) do Anuário Científico da Escola Superior de Tecnologia da Saúde de Lisboa. Como instituição de ensino superior, temos o compromisso de promover e incentivar a pesquisa científica em todas as áreas do conhecimento que contemplam a nossa missão. Esta publicação tem como objetivo divulgar toda a produção científica desenvolvida pelos Professores, Investigadores, Estudantes e Pessoal não Docente da ESTeSL durante 2021. Este Anuário é, assim, o reflexo do trabalho árduo e dedicado da nossa comunidade, que se empenhou na produção de conteúdo científico de elevada qualidade e partilhada com a Sociedade na forma de livros, capítulos de livros, artigos publicados em revistas nacionais e internacionais, resumos de comunicações orais e pósteres, bem como resultado dos trabalhos de 1º e 2º ciclo. Com isto, o conteúdo desta publicação abrange uma ampla variedade de tópicos, desde temas mais fundamentais até estudos de aplicação prática em contextos específicos de Saúde, refletindo desta forma a pluralidade e diversidade de áreas que definem, e tornam única, a ESTeSL. Acreditamos que a investigação e pesquisa científica é um eixo fundamental para o desenvolvimento da sociedade e é por isso que incentivamos os nossos estudantes a envolverem-se em atividades de pesquisa e prática baseada na evidência desde o início dos seus estudos na ESTeSL. Esta publicação é um exemplo do sucesso desses esforços, sendo a maior de sempre, o que faz com que estejamos muito orgulhosos em partilhar os resultados e descobertas dos nossos investigadores com a comunidade científica e o público em geral. Esperamos que este Anuário inspire e motive outros estudantes, profissionais de saúde, professores e outros colaboradores a continuarem a explorar novas ideias e contribuir para o avanço da ciência e da tecnologia no corpo de conhecimento próprio das áreas que compõe a ESTeSL. Agradecemos a todos os envolvidos na produção deste anuário e desejamos uma leitura inspiradora e agradável.info:eu-repo/semantics/publishedVersio
Neuroanatomical and gene expression features of the rabbit accessory olfactory system. Implications of pheromone communication in reproductive behaviour and animal physiology
Mainly driven by the vomeronasal system (VNS), pheromone
communication is involved in many species-specific fundamental innate socio-sexual behaviors such as mating and
fighting, which are essential for animal reproduction and survival. Rabbits are a unique model for studying
chemocommunication due to the discovery of the rabbit mammary pheromone, but paradoxically there has been a
lack of knowledge regarding its VNS pathway. In this work, we aim at filling this gap by approaching the system
from an integrative point of view, providing extensive anatomical and genomic data of the rabbit VNS, as well as
pheromone-mediated reproductive and behavioural studies. Our results build strong foundation for further
translational studies which aim at implementing the use of pheromones to improve animal production and welfare
EVALUACIÓN ANALGÉSICA PERIOPERATORIA DEL ACETAMINOFÉN EN PERRAS SOMETIDAS A OVARIOHISTERECTOMÍA ELECTIVA
Tesis de doctorado que evalúa el efecto analgésico del acetaminofén en perras ovarihisterectomizadas.La administración de analgésicos antiinflamatorios no esteroidales (AINES) para el control del
dolor post-quirúrgico en perros es una práctica común, debido a sus efectos analgésicos,
antiinflamatorios y antipiréticos. En el presente trabajo se realizaron dos estudios. En el
experimento 1, el objetivo fue evaluar la analgesia post-operatoria del acetaminofén
(paracetamol) a través de la utilización de las escalas de reconocimiento clínico del dolor
DIVAS (Escala Dinámica e Interactiva Analógica Visual) y UMPS (Escala de la Universidad
de Melbourne), en perras sometidas a ovariohisterectomía electiva. Además de valorar la
seguridad y eficacia clínica del uso del acetaminofén en perros mediante pruebas de
funcionamiento hepático y renal en el post-operatorio inmediato. Para ello, se utilizaron 30
perras de diferentes razas que fueron asignadas aleatoriamente a uno de los tres grupos de
tratamiento: acetaminofén [GACET; n=10, 15 mg kg-1 intravenoso (IV)], carprofeno (GCARP;
n=10, 4 mg kg-1 IV) y meloxicam (GMELOX; n=10, 0.2 mg kg-1 IV). Todos los tratamientos se
administraron 30 minutos antes de la cirugía y posterior a esta durante 48 horas. En este período
el acetaminofén se administró por vía oral cada 8 horas (15 mg kg-1); el carprofeno (4 mg kg-1)
y el meloxicam (0.1 mg kg-1) se administraron por vía IV cada 24 horas. Durante el
postoperatorio, los sistemas de puntuación del dolor DIVAS y UMPS fueron medidos a las 1,
2, 4, 6, 8, 12, 16, 20, 24, 36 y 48 horas post-cirugía. Para evaluar la seguridad clínica de los
tratamientos, se recolectaron muestras de sangre de la vena yugular para realizar la medición de
enzimas ALT, AST, ALP, y los metabolitos bilirrubina directa, bilirrubina indirecta, bilirrubina
total, creatinina, urea, albúmina y glucosa. Esto fue realizado en T0 (pre-anestesia; TBASAL), 48
y 96 horas después de la cirugía (T48, T96). Los resultados indican que en la evaluación clínica
del dolor de todos los grupos de estudio, hubo una reducción gradual en la percepción del mismo
durante el postoperatorio en ambos sistemas de puntuación; no obstante, también fue observado
que ninguna escala difirió significativamente entre los tres grupos de tratamiento (P>0.05) en
cada momento de evaluación durante las 48 horas post-cirugía. En cuanto a los parámetros
bioquímico séricos, sólo la ALT aumentó significativamente en T96 en el GACET y GCARP con
respecto a los valores basales (P<0.01). El resto de los analitos séricos evaluados se mantuvo
en rangos normales. En el experimento 2 bajo el mismo diseño experimental de tratamientos
administrados, el objetivo fue evaluar el efecto analgésico perioperatorio del acetaminofén
2
administrado pre y post-quirúrgicamente en perras sometidas a ovariohisterectomía electiva a
través de la medición del índice de la actividad del tono parasimpático (PTA). Este parámetro
hemodinámico fue medido 60 minutos antes de la cirugía (TBASAL) y durante el transquirúrgico
en la aplicación de estímulos nociceptivos: colocación de las pinzas de campo backhouse
(TPINZ), incisión de piel y abordaje quirúrgico primario (TINC), ligadura y extracción de pedículo
ovárico izquierdo (TOVI) y derecho (TOVD), ligadura y transfixión del cuello uterino (TLIGUT),
sección quirúrgica del cuello uterino (TCUT), reconstrucción de peritoneo y planos anatómicos
musculares (TMUSC) y sutura de piel (TSUT). Durante el postoperatorio, el índice PTA fue
valorado a las 1, 2, 4, 6, 8, 12, 16, 20, 24, 36 y 48 horas, en los mismos tiempos en que fueron
evaluadas las escalas de reconocimiento de dolor DIVAS y UMPS. Los resultados obtenidos en
la medición del índice PTA basal para GACET fue 65 ± 8, para GCARP 65 ± 7 y para GMELOX 62 ±
5. Durante los diferentes tiempos transquirúrgicos, los valores promedio de índice PTA indican
que GACET (76 ± 14) y GMELOX (72 ± 18) muestran tendencia a manifestar mayores niveles en
comparación con GCARP (62 ± 13) desde el inicio del procedimiento quirúrgico sin que esto
pudiera comprobarse estadísticamente, ya que no hubo diferencias significativas entre grupos
de tratamiento ni entre los tiempos quirúrgicos evaluados (P>0.05). En el postoperatorio, el
índice PTA fue de 65 ± 9 en el GACET, 63 ± 8 en el GCARP y 65 ± 8 en el GMELOX. Los resultados
tampoco mostraron diferencias estadísticamente significativas con los valores basales o entre
los tratamientos (P>0.05). El índice PTA postoperatorio mostró una sensibilidad del 40%,
especificidad del 98.46% y valor predictivo negativo del 99.07% con respecto a la escala
validada de UMPS. En conclusión, el acetaminofén puede considerarse una herramienta para el
tratamiento efectivo del dolor perioperatorio agudo en perros, ya que mostró la misma eficacia
clínica que el meloxicam y el carprofeno para la analgesia postquirúrgica en perras sometidas a
ovariohisterectomía electiva. Además, la evidencia del uso de este medicamento no condujo a
reacciones adversas o cambios en los parámetros evaluados, lo que indica su seguridad clínica.
Finalmente, destacar que el índice PTA representa una medición objetiva del comfort y
analgesia postoperatoria, por lo que es una herramienta que podría ayudar a predecir las
respuestas hemodinámicas asociadas con el dolor
Visualisation of Fundamental Movement Skills (FMS): An Iterative Process Using an Overarm Throw
Fundamental Movement Skills (FMS) are precursor gross motor skills to more complex or specialised skills and are recognised as important indicators of physical competence, a key component of physical literacy. FMS are predominantly assessed using pre-defined manual methodologies, most commonly the various iterations of the Test of Gross Motor Development. However, such assessments are time-consuming and often require a minimum basic level of training to conduct. Therefore, the overall aim of this thesis was to utilise accelerometry to develop a visualisation concept as part of a feasibility study to support the learning and assessment of FMS, by reducing subjectivity and the overall time taken to conduct a gross motor skill assessment. The overarm throw, an important fundamental movement skill, was specifically selected for the visualisation development as it is an acyclic movement with a distinct initiation and conclusion. Thirteen children (14.8 ± 0.3 years; 9 boys) wore an ActiGraph GT9X Link Inertial Measurement Unit device on the dominant wrist whilst performing a series of overarm throws. This thesis illustrates how the visualisation concept was developed using raw accelerometer data, which was processed and manipulated using MATLAB 2019b software to obtain and depict key throw performance data, including the trajectory and velocity of the wrist during the throw. Overall, this thesis found that the developed visualisation concept can provide strong indicators of throw competency based on the shape of the throw trajectory. Future research should seek to utilise a larger, more diverse, population, and incorporate machine learning. Finally, further work is required to translate this concept to other gross motor skills
The Professional Identity of Doctors who Provide Abortions: A Sociological Investigation
Abortion is a medicalised problem in England and Wales, where the law places doctors at the centre of legal provision and puts doctors in control of who has an abortion. However, the sex-selection abortion scandal of 2012 presented a very real threat to 'abortion doctors', when the medical profession's values and practices were questioned in the media, society and by Members of Parliament. Doctors found themselves at the centre of a series of claims that stated doctors were acting both illegally and unethically, driven by profit rather than patient needs. Yet, the perspectives of those doctors who provide abortions has been under-researched; this thesis aims to fill that gap by examining the beliefs and values of this group of doctors. Early chapters highlight the ambiguous position of the abortion provider in Britain, where doctors are seen as a collective group of professionals motivated by medical dominance and medical autonomy. They outline how this position is then questioned and contested, with doctors being presented as unethical. By studying abortion at the macro-, meso- and micro-levels, this thesis seeks to better understand the values of the 'abortion doctor', and how these levels shape the work and experiences of abortion providers in England and Wales. This thesis thus addresses the question: 'What do abortion doctors' accounts of their professional work suggest about the contemporary dynamics of the medicalisation of abortion in Britain?'. It investigates the research question using a qualitative methodological approach: face-to-face and telephone interviews were conducted with 47 doctors who provide abortions in England and Wales. The findings from this empirical study show how doctors' values are linked to how they view the 'normalisation of abortion'. At the macro-level doctors, openly resisted the medicalisation of abortion through the position ascribed to them by the legal framework, yet at the meso-level doctors construct an identity where normalising abortion is based on further medicalising services. Finally, at the micro-level, the ambiguous position of the abortion provider is further identified in terms of being both a proud provider and a stigmatised individual. This thesis shows that while the existing medicalisation literature has some utility, it has limited explanatory power when investigating the problem of abortion. The thesis thus provides some innovative insights into the relevance and value of medicalisation through a comprehensive study on doctors' values, beliefs and practices
An investigation of the relationship between perioperative characteristics and perioperative anaesthesia on the postoperative systemic inflammatory response and clinical outcome in patients undergoing surgery for colorectal cancer
In UK, colorectal cancer (CRC) is the fourth most common cancer and the second most common cause of cancer death. Until now, surgical resection remains the cornerstone for the management of CRC in all stages, however, stress response elicit from surgery may cause different changes through multiple systems in human body including neural, endocrine, metabolic, inflammatory, and immunological changes. In addition, other perioperative factors such as volatile anaesthetic and opioids may induce the immunosuppression. There is a proportional correlation between the stress response and the magnitude of the inflammatory immune response, invasiveness, and duration of surgery. The pre-operative and post-operative status of patients are important when considering the prognosis. The systemic inflammatory response (SIR) has been recognised to correlate with tumour progression and the prognosis of CRC. An exaggerated postoperative SIR is associated with postoperative infective complications and poor survival. Several predictive markers of the SIR have been used, such as the neutrophil to lymphocyte ratio (NLR), serum C-reactive protein (CRP) level, and Glasgow prognostic score (GPS). Some evidence reported that general anaesthesia (GA) combined with regional anaesthesia (RA) are better than the single use of general anaesthesia in reducing the post-operative immuno-suppression in some degrees. Furthermore, the peri-operative inflammatory process may be affected by the choice of anaesthetic technique, with propofol reported to have anti-inflammatory effect by targeting neutrophil activity. Up to now, there is insufficient evidence to recommend any specific anaesthetic or analgesic technique for patients undergoing surgery for tumour resection based on inflammatory response, recurrence, and metastasis. The work presented in this thesis further examines the relationship between the perioperative characteristics, perioperative anaesthesia, and the postoperative systemic inflammatory response following surgery for colorectal cancer. Several preoperative medications along with anaesthesia might influence the postoperative systemic inflammatory response but the question is whether the post-operative systemic inflammatory response affected by the administration of different types of anaesthesia or not following surgery for colorectal cancer. Chapter 1 discusses the epidemiology, aetiology, carcinogenesis, risk factors of colorectal cancer, pro-carcinogenic factors, anti-carcinogenic agents, inflammation and cancer, the post-operative systemic inflammatory response, tumour staging, screening, and diagnosis of colorectal cancer. Chapter 2 discusses the treatment of colorectal cancer. Chapter 3 discusses different anaesthetic techniques and agents. Chapter 4 provides summary and aims of the thesis. Chapter 5 represents findings from a systematic review and meta-analysis about the effect of anaesthesia on the postoperative systemic inflammatory response in patients undergoing surgery. The results conclude that there was some evidence that anaesthetic regimens may reduce the magnitude of the post-operative SIR. However, the studies identified in this systematic review were heterogeneous and generally of low quality. Chapter 6 represents a retrospective cohort study about the relationship between anaesthetic technique, clinicopathological characteristics and the magnitude of the postoperative systemic inflammatory response in patients undergoing elective surgery for colon cancer. The results show that the type of anaesthesia varied over time and appears to influence the magnitude of the postoperative SIR on post-operative day 2 for those patients who underwent for open surgery but not laparoscopic surgery. Chapter 7 represents a prospective cohort study about the effect of anaesthesia on the magnitude of the postoperative systemic inflammatory response in patients undergoing elective surgery for colorectal cancer in the context of an enhanced recovery pathway. The results show that there was a modest but an independent association between regional anaesthesia (RA) and a lower magnitude of the postoperative SIR. Chapter 8 represents the relationship between pre-operative medications, the type of anaesthesia and post-operative sequelae in patients undergoing surgery for colorectal cancer. The results show that there was no association between the preoperative administration of aspirin, statins and ACE inhibitors and anaesthesia. Chapter 9 represents the relationship between nutritional status, anaesthetic approach, and peri-operative characteristics of patients undergoing surgery for colorectal cancer. The results show that there was no significant association between measures of nutritional status and anaesthetic approach. Chapter 10 represents the relationship between opioid administration, type of anaesthesia and clinicopathological characteristics in patients undergoing surgery for colorectal cancer. The results show that opioid administration was independently associated with both anaesthetic and operative factors. Chapter 11 represents the main findings of the thesis and some recommendation for a future work
The potential of shade trees to improve microclimate in coffee production systems and contribute to the protection of coffee yield and quality in a changing climate
Climate change is a major challenge to which global coffee production must adapt.
With Coffea arabica being especially sensitive to rising temperatures, shade trees
present a promising adaptation strategy, as there is some evidence that they can
modify microclimate. Employing an interdisciplinary approach, combining biophysical
and sociological research, this study investigated the effect of shade on coffee
production on the southern slope of Mt. Kilimanjaro with the aim of finding suitable
strategies to optimise coffee production systems and ensure optimal yield and quality,
thus assuring farmers’ livelihoods into the future, in the face of climate change.
Precipitation records from coffee plantations were analysed for changes in weather
patterns in the last two decades. The influence of shade on microclimate, leaf
temperature, coffee yield and physical quality aspects was assessed in coffee
plantations and smallholder systems. Additionally, focus group discussions and
interviews with small-scale farmers were conducted to explore farmers’ knowledge on
the impacts of weather extremes on coffee production and the ecosystem services
different tree species provide. This research shows that climate change at
Mt. Kilimanjaro manifests as droughts and shorter wet seasons with less frequent but
heavier rainfall events, challenges to which coffee farmers will have to adapt. Shade
trees show potential in adaptation of coffee production systems to climate change, as
they reduce maximum air temperatures and can reduce leaf temperature extremes
during hot periods, without having negative effects on nocturnal temperatures, which
are beneficial for coffee production. In coffee plantations, no effect of shade on yields
was observed while a slight reduction was observed for smallholder systems. Coffee
quality benefits from shade, as different shade components are associated with an
increase in bean size and weight. Farmers identified Albizia schimperiana as an
important tree species, providing regulatory ecosystem services to improve coffee
production. Recommendations need to take farmers’ priorities into account, including
their willingness to trade some reduction in coffee production for other services, such
as food, fodder or firewood, which were identified as the most important ecosystem
services for farmers at Mt. Kilimanjaro
A Scoping Review and Appraisal of AAC Research in Inclusive School Settings
The aim of this scoping review was to explore the extent to which AAC studies have occurred in inclusive versus segregated settings, the role of AAC in inclusive setting studies, and the evidence for AAC supporting inclusive education of students with complex communication needs. A scoping review of studies published from 2000 to 2020 that involved students who used or could benefit from AAC or their peers conducted within schools yielded 167 studies. Relatively few studies (n=28, 17%) were conducted in inclusive settings. Data from these 28 studies were extracted and appraised for quality. AAC was integrated into intervention in 57% of these studies and in 61% improved use of AAC was an outcome variable, but in only six was this the main aim. Eighty-two students who used or could benefit from AAC were participants across studies. Classroom peers participated across 11 studies, including those in which qualitative designs were employed. The strength of evidence for the role of AAC could not be determined because only 12 studies were experimental and addressed varied aims. Nonetheless, these and seven qualitative studies were appraised as being of high quality. Implications of findings are discussed in terms of extending the evidence to demonstrate the role of AAC, and its potential to support academic and social school inclusion of students with complex communication needs, which may not rely on proficient use of AAC
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