Cost-effective energy and carbon emissions optimization in building renovation (annex 56): executive summary for policy makers

This guidebook was compiled to raise awareness among the players that can influence policies and standard definition and to engage them in the subjects of energy efficiency and renewable energy sources in the context of building renovation. Existing buildings present a tremendous potential, not only to reduce energy use and emissions, but also on other areas of the political agenda. It is the objective of this guidebook to highlight how energy related building renovation is a policy tool to achieve broad benefits to societyinfo:eu-repo/semantics/publishedVersio

Molecular survey of carbapenem resistant Enterobacteriaceae isolates from Portuguese Hospitals: co-production of carbapenemase KPC-3 and the efflux pump OqxAB

Objectives: Although there are important studies regarding the different carbapenemase (CARB)-producing Gram-negative bacteria, little is known concerning their molecular epidemiology in Portugal. The main aim of this study was to characterize, by phenotype and molecular typing methods, CARB-producing Enterobacteriaceae isolates recovered from Portuguese health care institutions, and evaluate its impact on treatment strategy. Methods: This study included 2105 clinical isolates, collected between April/2006 and February/2013, in different Portuguese healthcare institutions. Screening of antimicrobial susceptibility was performed by disc diffusion method. Clinical isolates with resistance or with decreased susceptibility to ertapenem were considered presumptively CARB-producers; in these isolates, PCR and sequencing were applied to detect and identify CARB-encoding genes, as well as other bla and plasmid-mediated quinolone resistance (PMQRs) genes. MICs of CARB-producing isolates were tested by microdilution (EUCAST breakpoints). The plasmids obtained from clinical isolates were characterized by PCR-based replicon typing (PBRT). Clonal relatedness of K. pneumoniae isolates was investigated by multilocus sequence typing (MLST), using the protocol developed by the Institute Pasteur (www.pasteur.fr/mlst/Kpneumoniae.html). Results: Among the 2105 isolates tested, 165 (7.8%) were putative CARB-producers and were selected for further analysis. Thirty-five (21.2%) of the 165 positive isolates were confirmed to be CARB-producers, of which the majority were collected from the urine (54.3%) of elderly (≥65 years old) male patients (54.3%), and admitted at the emergency room/ambulatory (22.9%) or internal medicine (17.1%) wards. All were multidrug-resistant, with nonsusceptibility to at least one carbapenem, and with consistent susceptibility only to colistin. In those isolates was detected the following beta-lactamases: 30 KPC-3 (22 K. pneumoniae, 3 Escherichia coli, 2 Enterobacter aerogenes and 3 Enterobacter clocae), 4 GES-5 (K. pneumoniae) and one VIM-2 (Klebsiella oxytoca). CARB-encoding genes were present alone or in combination with other bla genes, such as blaSHV-12, blaSHV-14, blaSHV-26, blaSHV-36, blaCTX-M-15, and the blaSHV-164. PMQR-encoding genes were also detected, namely qnrA, qnrB, aac(6’)-Ib-cr and the recently identified oqxAB. All blaKPC-3 genes were located on a Tn3-based transposon, Tn4401, while blaGES-5 and blaVIM-2 genes were associated with class 3 and 1 integrons, respectively. In our study, the majority of the blaCARB-harbouring plasmids were nonconjugative, having been typed as IncFrepB by PBRT. Clonal relatedness of the 26 K. pneumoniae isolates, obtained by MLST, showed that they were from distinct STs, namely ST14, ST15, ST34, ST59, ST147, ST416, ST698, and from the two novels ST: ST960 and, among all, the predominant ST1138 (corresponding to KPC-3 plus SHV-36 producers). Conclusion: In conclusion, this study provides new data regarding the molecular epidemiology of CARB-producing Enterobacteriaceae, which appears to be widespread in Portugal. Dissemination of blaCARB seems to be due to carriage of similar CARB-harbouring plasmids within genetically diverse clinical strains. Overall, our results emphasize the need of a concerted action to manage carbapenem use

Stent for Life in Portugal: This initiative is here to stay

AIMS: Portugal has one of the lowest rates of primary percutaneous coronary intervention (p-PCI) in Western Europe. This study assessed the progress of Portuguese p-PCI performance indicators one year after Portugal joined the Stent for Life (SFL) initiative. METHODS AND RESULTS: Two national surveys were carried out, each covering a period of one month: the first when Portugal joined the SFL in 2011 (Moment Zero), and the second one year later (Moment One). A total of 397 consecutive patients with probable ST-segment elevation myocardial infarction were enrolled (201 at Moment Zero and 196 at Moment One) from 15 centers. During this period, the number of patients who arrived at a local hospital without p-PCI decreased (62-47%; p=0.004) and transportation to a p-PCI hospital by the National Institute for Medical Emergencies (INEM) increased significantly (13-37%; p<0.001). Shorter times to revascularization were observed, due to shorter patient delay (118-102 min; p=0.008). Door-to-balloon delay and system delay remained unchanged. CONCLUSIONS: Improvements in performance indicators for p-PCI demonstrate the success of the first year of the local SFL plan, which was mainly focused on raising public awareness of the need to use the INEM emergency services, which has reduced patient delay, and on improving secondary transportation

Cost-effective energy and carbon emissions optimization in building renovation (annex 56): guidebook for professional home owners

This guidebook is particularly intended for professional home-owners, i.e. individuals or companies that own and manage residential buildings. It is assumed that these owners are responsible for ensuring maintenance, repair and general servicing tasks and lead the decisions on the improvements to be made regarding comfort, safety, saving energy or just uplifting the buildings to contemporary needs or style. The main goal is to help in the decision-making process towards the optimized renovation of the residential building stock. More specifically, the guidebook provides a framework for the understanding of the relationships between cost-effective building renovation, energy savings and the use of renewable energy sources, highlighting the total added value achieved with the interventions.info:eu-repo/semantics/publishedVersio

Test development and use in five Iberian Latin American countries

The abundance of scholarship on test development and use generally is higher in English-speaking than in Iberian Latin American countries. The purpose of this article is to help overcome this imbalance by describing and identifying similarities and differences in test development and use in two Iberian (Portugal and Spain) and three of the largest Latin American (Argentina, Brazil, and Venezuela) countries. The stages of test development in each country, roles of professional associations, presence of standards for test use, professionals’ educational training, commonly used tests, together with prominent challenges to continued progress are discussed. Test development and use in these five countries are transitioning from a dependence on the use of translated tests to greater reliance on adapted and finally nationally constructed tests. Continued growth requires adherence to international standards guiding test development and use. Stronger alliance among professional associations in the Iberian Latin American countries could serve as a catalyst to promote test development in these regions.A abundância de estudos sobre o desenvolvimento do teste e usar geralmente é maior em Inglês de língua do que nos países latino-americanos ibéricos. O objetivo deste artigo é ajudar a superar este desequilíbrio, descrever e identificar semelhanças e diferenças no desenvolvimento de testes e uso em dois Ibérica (Portugal e Espanha) e três dos maiores países da América Latina (Argentina, Brasil e Venezuela). Os estágios de desenvolvimento do teste em cada país, os papéis das associações profissionais, presença de padrões para uso de teste, a formação dos profissionais da educação, os testes comumente utilizados, juntamente com desafios importantes ao progresso continuado são discutidos. Desenvolvimento de testes e uso nestes cinco países estão em transição de uma dependência do uso de testes traduzidos para uma maior dependência de testes adaptados e finalmente construídos nacionalmente. O crescimento contínuo exige a adesão a padrões internacionais orientadores desenvolvimento de testes e uso. Aliança mais forte entre as associações profissionais dos países latino-americanos ibéricos poderia servir como um catalisador para promover o desenvolvimento do teste nessas regiões

USO DA BIODIVERSIDADE EM QUINTAIS DE COMUNIDADES TRADICIONAIS DA BAÍA DE CHACORORE, BARÃO DE MELGAÇO, MATO GROSSO, BRASIL

O objetivo do estudo é caracterizar os quintais das Comunidades tradicionais de pescadores localizados na bacia do Alto Paraguai nas redondezas da baia de Chacororé: Cuiabá Mirim e Porto Brandão, levantando dados referentes à: estrutura e composição vegetal, as diferentes etnocategorias de uso das plantas pelos moradores locais e a abordagem socioeconômica e cultural das comunidades em destaque. A fase de coleta de dados no campo ocorreu durante abril e maio de 2011 nas Comunidades pertencentes ao município de Barão de Melgaço/MT. Nos quintais estudados catalogaram-se plantas pertencentes a 82 espécies distribuídas em 46 famílias botânicas em Cuiabá Mirim e 96 espécies distribuídas em 48 famílias botânicas em Porto Brandão. A família Fabaceae foi a mais expressiva em Porto Brandão, entretanto em Cuiabá Mirim, Anacardiaceae foi a mais relatada pelos moradores. O número de espécies encontradas por propriedade variou de 9 a 38 espécies com média de 18 espécies em Cuiabá Mirim e 7 a 33 espécies, com média de aproximadamente 19 espécies em Porto Brandão. Com relação às categorias de uso, a população das Comunidades de Cuiabá Mirim e Porto Brandão a maioria das plantas mantidas e cultivadas nos quintais é direcionada à complementação alimentar dos moradores da comunidade

How Chaotic is the Stadium Billiard? A Semiclassical Analysis

The impression gained from the literature published to date is that the spectrum of the stadium billiard can be adequately described, semiclassically, by the Gutzwiller periodic orbit trace formula together with a modified treatment of the marginally stable family of bouncing ball orbits. I show that this belief is erroneous. The Gutzwiller trace formula is not applicable for the phase space dynamics near the bouncing ball orbits. Unstable periodic orbits close to the marginally stable family in phase space cannot be treated as isolated stationary phase points when approximating the trace of the Green function. Semiclassical contributions to the trace show an $\hbar$ - dependent transition from hard chaos to integrable behavior for trajectories approaching the bouncing ball orbits. A whole region in phase space surrounding the marginal stable family acts, semiclassically, like a stable island with boundaries being explicitly $\hbar$-dependent. The localized bouncing ball states found in the billiard derive from this semiclassically stable island. The bouncing ball orbits themselves, however, do not contribute to individual eigenvalues in the spectrum. An EBK-like quantization of the regular bouncing ball eigenstates in the stadium can be derived. The stadium billiard is thus an ideal model for studying the influence of almost regular dynamics near marginally stable boundaries on quantum mechanics.Comment: 27 pages, 6 figures, submitted to J. Phys.

Análise do conhecimento dos alunos de graduação, pós-graduação e estagiários da Faculdade de Odontologia de São José dos Campos – Unesp sobre Ética em Pesquisa Odontológica

The knowledge of the ethics and bioética and its applications are fundamental and wanted in the society. The study analyzed the students’ of the graduation and masters degree of the School of Dentistry of São José of Campos - UNESP knowledge on ethics in odontology research and its committee. The analysis was made through the application of a questionnaire on ethics research knowledge. The Resolution CNS 196/1996 was followed, applying the term of free and explainded consent, guaranteeing the confidential, the no badlly and the interviewees’ charity, it was wanted to know if the students that do or dont do research scientific had knowledge on those norms of the ethics in research. It was observed that, among the answers, 59,31% of the graduation students know what it is ethics in research, justified by the fact that 43,63% received some orientation on the theme. In spite of that small index, 88,73% know that they need to order projects for the Committee of Ethics in Research to accomplish a research. Among the trainees and students of the masters degree 100% know what is ethical in research and that it is necessary to send a project for the Committee of Ethics before accomplishing a research, in spite of 60% that have just received some orientation on the subject. It was concluded that the students have knowledge on ethics in research and the majority of than had already received orientations on how to proceed in relation to the Committee of Ethics.O conhecimento da ética e bioética e suas aplicações são fundamentais e desejados na sociedade. O estudo analisou o conhecimento dos alunos da graduação e pós graduação da Faculdade de Odontologia de São José dos Campos - UNESP sobre ética em pesquisa odontológica e seu comitê. A análise foi feita através da aplicação de um questionário sobre conhecimento de ética em pesquisa. Seguiu-se a Resolução CNS 196/1996, aplicando o termo de consentimento livre e esclarecido, garantindo a confidencialidade, a não maleficência e a beneficência dos entrevistados, e quis saber se os alunos que fazem ou não pesquisa científica tinham conhecimentos sobre essas normas da ética em pesquisa. Observou-se que, dentre as respostas, 59,31% dos alunos de graduação sabem o que é ética em pesquisa, justificada pelo fato de que 43,63% receberam alguma orientação sobre o tema. Apesar desse pequeno índice, 88,73% sabem que precisam mandar projetos para o Comitê de Ética em Pesquisa para realizar uma pesquisa. Dentre os estagiários e alunos da pós-graduação 100% sabe o que é ética em pesquisa e que é necessário enviar um projeto para o Comitê de Ética antes de realizar uma pesquisa, apesar de apenas 60% terem recebido alguma orientação sobre o assunto. Conclui-se que os alunos têm conhecimento sobre ética em pesquisa e a maioria já recebeu orientações sobre como proceder em relação ao Comitê de Ética. Essas informações são dadas aos alunos tanto na graduação quanto na pós graduação, mostrando que os alunos estão aptos a realizarem pesquisas cientificas

Listeriosis in Portugal: an existing but under reported infection

BACKGROUND: Listeriosis is a rare disease caused by the bacterium Listeria monocytogenes, the normal vehicle of which is food. The disease, which is largely confined to its risk groups of pregnant women, the elderly and immunocompromised individuals, has increased in incidence in recent years. In Portugal, listeriosis is not a notifiable infection and available data are scarce. The objective of this work was to collate the available information concerning listeriosis in Portugal by compiling a retrospective study of cases recorded over a decade. METHODS: Requests for case data on clinically confirmed listeriosis, recorded over the previous decade, were replied to by 23 hospitals and a National Institute of Health delegation. RESULTS: 35 cases of listeriosis were identified for the period between 1994 and 2003 inclusive, the mortality rate being greater than 17%. According to the data collected in this study for the year 2003, the incidence of this disease in Portugal was at least 1.4 cases per million inhabitants in that year. CONCLUSION: The study demonstrates, for the first time in the widely available literature, that despite their being no cases of listeriosis in Portugal recorded in official reports, the threat of L. monocytogenes to public health is of a similar dimension to that in other countries