Modelo teórico da atenção à saúde sexual e reprodutiva: subsídios para pesquisas avaliativas

Objetivo: Construir um Modelo Teórico da atenção à saúde sexual e reprodutiva ofertada na Atenção Primária à Saúde.Métodos: Pesquisa documental, com abordagem qualitativa. Documentos governamentais e estudos avaliativos constituíram as fontes de dados, coletadas entre agosto de 2018 e junho de 2019 e analisadas com base na literatura de avaliação em saúde.Resultados: A Promoção da Saúde Sexual e Reprodutiva e a Assistência Clínica foram os dois componentes estruturantes do modelo teórico da atenção à saúde sexual e reprodutiva na Atenção Primária. O modelo contempla atividades de prevenção de doenças, promoção da saúde, tratamentos e diagnósticos relacionados à saúde sexual e reprodutiva.Conclusão: O modelo teórico elaborado apresenta a teoria que subsidia a operacionalização da atenção à saúde sexual e reprodutiva na atenção primária, segundo as normativas governamentais no cenário brasileiro, e poderá ser útil em pesquisas avaliativas futuras sobre o tema. Palavras-chave: Saúde sexual e reprodutiva. Modelos teóricos. Estudos de avaliação como assunto. Atenção primária à saúde. Enfermagem em saúde pública

Eosinophilic esophagitis-endoscopic distinguishing findings

Eosinophilic esophagitis (EE) is the most frequent condition found in a group of gastrointestinal disorders called eosinophilic gastrointestinal diseases. The hypothetical pathophysiological mechanism is related to a hypersensitivity reaction. Gastroesophageal reflux disease- like complaints not ameliorated by acid blockade or occasional symptoms of dysphagia or food impaction are likely presentations of EE. Due to its unclear pathogenesis and unspecific symptoms, it is difficult to diagnose EE without a strong suspicion. Although histological criteria are necessary to diagnosis EE, there are some characteristic endoscopic features. We present the case of a healthy 55-year-old woman with dysphagia and several episodes of esophageal food impaction over the last six months. This case report stresses the most distinguishing endoscopic findings-mucosa rings, white exudative plaques and linear furrows-that can help in the prompt recognition of this condition

Cytotoxicity of contaminated protection devices used in waste sorting industry

Introduction - Waste sorting is one of the most critical working environments since waste is frequently contaminated by organic matter that functions as a nutrient substrate to microorganisms. In many occupational environments of the waste industry, workers are exposed during long periods to high concentrations of microbial contamination. Several studies have lately stressed health risks related to those environments. Microbial exposures are the leading inducers of several respiratory health symptoms, such as asthma, a decline in lung function, bronchial hyper-responsiveness, chronic bronchitis, wheeze, and cough. Due to the recognized increased risk of microbiologic agents’ exposure and the need of the employer to protect workers from the exposure risks, the use of Filtering Respiratory Protective Devices (FRPD) is mandatory in the Portuguese waste industry. Some hygienic measures taken by workers (such as where the FRPD is kept when not in use) or even the FRPD frequency replacement can impact the FRPD microbial contamination. Bioaerosols in the waste sorting industry consist of complex mixtures of organic and inorganic dust suspended in the air, including bacteria and endotoxins, fungi and mycotoxins, as well as particles of plant and animal origin. Aim of the study - To our knowledge, this is the FIRST study that will allow characterizing the risk resulting from the FRPD conditions of use and identifying the most suitable risk management measures.info:eu-repo/semantics/publishedVersio

Aspergillus spp. and azole-resistance characterization on mechanic protection gloves from waste sorting industry

Project "Waste Workers’ Exposure to Bioburden through Filtering Respiratory Protective Devices” (IPL/2018/WasteFRPD_ESTeSL).Aspergillus spp. species are filamentous fungi commonly found in different environmental compartments, where they thrive as saprophytes. Some species among the Aspergillus genera can be occasionally harmful to humans. Only a few species are considered as significant opportunistic pathogens in humans. Aspergillus section Fumigati is an opportunistic pathogen of immunocompromised hosts and one of several Aspergillus species that cause a wide range of respiratory disorders. Increased occurrence of opportunistic Aspergillus infections in immunocompromised patients, and the emergence of antifungal resistance, either in the clinical or in the environment had been reported.info:eu-repo/semantics/publishedVersio

Digital rectal examination and balloon expulsion test in the study of defecatory disorders: are they suitable as screening or excluding tests?

Background. Rome III criteria add physiological criteria to symptom-based criteria of chronic constipation (CC) for the diagnosis of defecatory disorders (DD). However, a gold-standard test is still lacking and physiological examination is expensive and timeconsuming. Aim. Evaluate the usefulness of two low-cost tests-digital rectal examination (DRE) and balloon expulsion test (BET)-as screening or excluding tests ofDD. Methods. Weperformeda systematic search inPUBMEDandMEDLINE. We selected studies where constipated patients were evaluated by DRE or BET. Heterogeneity was assessed and random effect models were used to calculate the sensitivity, specificity, and negative predictive value (NPV) of the DRE and the BET. Results. Thirteen studies evaluating BET and four studies evaluating DRE (2329 patients) were selected. High heterogeneity (.. 2 > 80%) among studies was demonstrated. The studies evaluating the BET showed a sensitivity and specificity of 67% and 80%, respectively. Regarding the DRE, a sensitivity of 80% and specificity of 84% were calculated. NPV of 72% for the BET and NPV of 64% for the DRE were estimated. The sensitivity and specificity were similar when we restrict the analysis to studies using Rome criteria to define CC. The BET seems to performbetter when a cut-off time of 2minutes is used and when it is compared with a combination of physiological tests. Considering the DRE, strict criteria seem to improve the sensitivity but not the specificity of the test. Conclusion. Neither of the low-cost tests seems suitable for screening or excluding DD.info:eu-repo/semantics/publishedVersio

Acidificação do condensado de uma indústria de pasta para papel

Mestrado em Engenharia do AmbienteCom este trabalho pretendeu-se avaliar a aplicabilidade do processo de acidificação anaeróbia como técnica de pré-tratamento do melaço actualmente existente numa indústria nacional de pasta para papel, com vista à sua junção futura com a corrente de condensado também existente na unidade fabril para valorização deste efluente. Este pré-tratamento teve como objectivo a optimização do processo em termos da produção de ácidos voláteis como matéria prima para a produção de biopolímeros. Neste sentido foi montada uma instalação experimental constituída por dois reactores anaeróbios contínuos do tipo “moving bed biofilm reactor” (MBBR) que operaram à temperatura mesofílica (37ºC). Os reactores foram submetidos a cargas orgânicas crescentes (1 a 70g CQO.(L.d)-1) e a dois tempos de retenção hidráulicos (6 e 12 horas), o que permitiu estudar a influência destes parâmetros no processo de acidificação anaeróbia do efluente em estudo. Para as condições testadas, verificou-se que o reactor que tinha sido inoculado com biomassa acidogénica (reactor R1) apresentou maior grau de acidificação quando comparado com o reactor inoculado com biomassa metanogénica (reactor R2). O grau de acidificação do reactor R1 atingiu valores de 30% enquanto no reactor R2 o grau de acidificação só foi superior a 10% quando a carga orgânica atingiu valores iguais ou superiores a 52 gCQO.(L.d)-1. A eficiência de remoção de CQO nos dois reactores só foi inferior a 30% (sinónimo da inibição da fase metanogénica), quando o TRH foi baixo (6 horas) e a carga orgânica foi igual ou superior a 52 gCQO.(L.d)-1. Relativamente à concentração total de AOV’s, esta foi aumentando à medida que a carga orgânica aplicada aos reactores aumentou e o TRH diminuiu. Comparando o comportamento dos dois reactores observa-se também que o reactor R1 apresentou sempre maior quantidade de AOVs produzidos do que o reactor R2. O aumento de carga orgânica para valores iguais ou superiores a 52g CQO.(L.d)-1 favorece o aparecimento do ácido n-butírico, em detrimento dos ácidos acético e propiónico. Os resultados obtidos neste estudo são indicadores de que a utilização do processo de pré-acidificação anaeróbia do melaço para obtenção de ácidos orgânicos voláteis para a valorização da corrente do condensado de uma fábrica de pasta para papel tem potencial. No entanto, deve haver uma optimização deste processo de modo a maximizar o tipo e a quantidade dos ácidos voláteis produzidos e que sejam ideais para a produção de biopolímeros. ABSTRACT: With this work, we intended to evaluate the applicability of the anaerobic acidification process as a technique for the pre-treatment of molasses, currently used in a national pulp industry, tin order to mix it with condensate which is produced in this industry for future valorization. The aim of this pre-treatment is the optimization of this process in terms of volatile acid production as raw material for the production of biopolymers. In this sense, an experimental set up was assembled with two anaerobic continuous reactors (“moving bed biofilm reactors (MBBR)) operated at mesofilic temperatures (37 ºC). The reactors were submitted to increasing organic loading rates (1 to 70 gCOD.(L.d)-1) and two hydraulic retention times (6 and 12 hours), which allowed to study the influence of these parameters in the anaerobic acidification of the effluent under study. For the tested conditions, it was noted that the reactor which had been inoculated with acidogenic biomass (reactor R1) showed a greater degree of acidification when compared to the reactor inoculated with metanogenic biomass (reactor R2). The acidification degree of reactor R1 reached values of 30% while in reactor R2 the degree of acidification was only greater than 10% when the organic load reached values equal or greater than 52 gCOD.(L.d)-1. The COD removal efficiency in the two reactors was only less than 30%, when the HRT was low (6 hours) and the organic load was equal or greater than 52 gCOD.(L.d)-1. Regarding the total concentration of volatile fatty acids, this was increasing as organic load applied to the reactors increased and HRT decreased. Comparing the behaviour of the two reactors it is observed that the reactor R1 has always VFA’s produced in a greater quantity than the reactor R2. The increase of the organic load to values equal or greater than 52 gCOD.(L.d)-1 promotes the appearance of n-butyric acid in detriment of acetic and propionic acids. The results obtained in this study indicate that the use of the anaerobic preacidification process of molasses to obtain different fatty acids for the improvement the valorization process of condensate has potential. However, there should be an optimisation of this process in order to maximize the type and quantity of volatile fatty acids produced which are ideal for the production of biopolymers

A Nova Gestão Pública e a Sustentabilidade no Sector Público Autárquico na óptica das Cidades Inteligentes e Sustentáveis. Estudo de caso da Câmara Municipal de Loures.

A conjuntura económica, social e a necessidade de desenvolvimento e inovação, encaminha a gestão das autarquias locais a adoptarem estratégias integradas que possibilitem suportar a sustentabilidade, o controlo de gestão, a eficácia e eficiência, como factores processuais de sucesso exigidos pela população. Na qual as premissas de conversão de gestão privada à gestão pública devidamente ajustadas da Nova Gestão Pública são mais adequadas e pertinentes à aplicabilidade na administração local, visto ser a gestão mais próxima do cidadão, interferindo directamente na sua qualidade de vida, tornando-se cidades com gestão equiparada com os devidos ajustes à privada, que lhes permite obter a designação de Cidades Sustentáveis e Cidades Inteligentes. No âmbito do estudo de caso da Câmara Municipal de Loures elaborou-se modelo teórico de interconecção dos itens inerentes às dimensões das três temáticas para os quais se realizou classificação dicotómica e respectiva valoração. A validação do modelo teórico demonstra que das cinco dimensões das três temáticas existe maior entrosamento nas dimensões da governança e sustentabilidade, que possui uma aplicação parcial ficando aquém da satisfação, apesar dos pressupostos de Cidades Inteligentes quase atingirem a satisfação de aplicação, nos das Cidades Sustentáveis essa satisfação já é mais notória, no entanto a aplicação dos princípios da Nova Gestão Pública na organização é largamente cumprida. Concluiu-se que é necessário desenvolver a interactividade da informação na autarquia, a sustentabilidade territorial e a gestão considerar a dependência simbiótica das três temáticas

Sustainability literacy in older age groups: on the way to sustainable development

Conferência internacional realizada em Bogotá, Colombia, de 14-16 de junho de 2017The world is facing sustainability challenges for which actions and results are needed in a 10 to 15 years time frame. Sustainability Literacy or Education has a crucial role for the Sustainable Development and is a set of different forms of education aiming to create economic, social, cultural and environmental conditions for sustainable development. This study looks at Sustainability Literacy or Education for Sustainable Development as a potential tool to empower individuals and communities to make more informed decisions that are aligned with long-term sustainability goals and can produce the short-term results needed. Any Education for Sustainable Development initiative relies and can greatly benefit from a bottom-up approach in local communities. An active participation of individuals in the community initiatives generates more opportunities for formal and non-formal lifelong learning and creates relevance that is engaging for other community members. The traditional approach of investment in Sustainability Literacy focuses on youth. However, while this approach is important in the long run, it may not yield results for current sustainability challenges. Older age groups (i.e. 50 or older), usually overlooked because they are perceived as not being motivated by sustainability or as being too late in their life span to have a significant impact, may play a crucial role in promoting sustainability within communities. Our study addresses the importance of improved sustainability literacy in older age groups (i.e. 50 or older) as a driver for sustainability. Endorsing a new role for senior citizens, by leveraging their last active years for short term sustainability efforts, we also empower them with the knowledge and tools to raise the sustainability literacy in younger generations. This work is being carried out in a Lisbon suburban community of around 12000 people, half of which are over 50 years old, and analyses some reflections on the importance of sustainability literacy within this age group and its effects on other age groups. It should be stressed that this population of 50+ years of age is actively engaged with the local University of the 3rd Age (U3A), where topics are presented and discussed in the classroom, using videos to generate a guided discussion toward the construction of the concepts by the students. The results from a group attending a life science literacy class show that the students experience increased personal satisfaction and wellbeing, are motivated towards learning and knowledge sharing within families and communities, including younger generations. These students also expressed greater understanding of messages from the media, health professionals and care takers, as well as a more positive health self-assessment and a greater treatment adherence. These results, aligned with the targets for good health and well-being sustainable development goal (SDG) suggest that initiatives to increase literacy lead to immediate behavior changes and knowledge dissemination. Further studies are ongoing regarding other SDGs, such as climate action, responsible consumption and production or affordable and clean energy.FCT - Fundação para a Ciência e Tecnologia, Ministério da Ciência, Tecnologia e Ensino SuperiorN/

Motor cortex stimulation for refractory demyelinating disease-associated trigeminal neuralgia

Patients with demyelinating diseases (DDs) such as multiple sclerosis have a 20-fold higher risk of developing trigeminal neuralgia (TN). DD-related TN is more frequently refractory to the usual medical and surgical treatment. We report the case of a 57-year-old man presenting to our neurology outpatient clinic with a 12-year history of medical and surgical refractory TN associated with demyelinating lesions on magnetic resonance imaging. After a new failure of pharmacological treatment with oxcarbazepine, pregabalin, baclofen, and duloxetine, motor cortex stimulation (MCS) was performed, and the patient remained mostly pain-free, without any pharmacological treatment during the 3.5 years of follow-up. MCS may be a useful approach for DD-related refractory TN, and further studies can clarify its role in TN management.publishersversionpublishe