The ecological dichotomy of ammonia-oxidizing archaea and bacteria in the hyper-arid soils of the Antarctic Dry Valleys

The McMurdo Dry Valleys of Antarctica are considered to be one of the most physically and chemically extreme terrestrial environments on the Earth. However, little is known about the organisms involved in nitrogen transformations in these environments. In this study, we investigated the diversity and abundance of ammonia-oxidizing archaea (AOA) and bacteria (AOB) in four McMurdo Dry Valleys with highly variable soil geochemical properties and climatic conditions: Miers Valley, Upper Wright Valley, Beacon Valley and Battleship Promontory. The bacterial communities of these four Dry Valleys have been examined previously, and the results suggested that the extremely localized bacterial diversities are likely driven by the disparate physicochemical conditions associated with these locations. Here we showed that AOB and AOA amoA gene diversity was generally low; only four AOA and three AOB operational taxonomic units (OTUs) were identified from a total of 420 AOA and AOB amoA clones. Quantitative PCR analysis of amoA genes revealed clear differences in the relative abundances of AOA and AOB amoA genes among samples from the four dry valleys. Although AOB amoA gene dominated the ammonia-oxidizing community in soils from Miers Valley and Battleship Promontory, AOA amoA gene were more abundant in samples from Upper Wright and Beacon Valleys, where the environmental conditions are considerably harsher (e.g., extremely low soil C/N ratios and much higher soil electrical conductivity). Correlations between environmental variables and amoA genes copy numbers, as examined by redundancy analysis (RDA), revealed that higher AOA/AOB ratios were closely related to soils with high salts and Cu contents and low pH. Our findings hint at a dichotomized distribution of AOA and AOB within the Dry Valleys, potentially driven by environmental constraints

Resolução de problemas utilizando materiais de uso comum

Neste artigo apresenta-se uma experi^encia de consolidação de aprendizagens, realizada no âmbito da Unidade Curricular da Pr atica de Ensino Supervisionada, atrav es da resolução de problemas utilizando materiais de uso comum. Este estudo realizou-se numa turma do 2.º ano de escolaridade e teve como objetivo a resolução de problemas para rever alguns conceitos ligados ao dinheiro.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portugal, Fundos Nacionais através da FCT (Fundação para a Ciência e a Tecnologia) e cofinanciado pelo Fundo Europeu de Desenvolvimento Regional (FEDER) através do COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) com a referência POCI-01-0145-FEDER-007562info:eu-repo/semantics/publishedVersio

Modification of an OSCE format to enhance patient continuity in a high-stakes assessment of clinical performance

<p>Abstract</p> <p>Background</p> <p>Traditional Objective Structured Clinical Examinations (OSCEs) are psychometrically sound but have the limitation of fragmenting complex clinical cases into brief stations. We describe a pilot study of a modified OSCE that attempts to balance a typical OSCE format with a semblance of a continuous, complex, patient case.</p> <p>Methods</p> <p>Two OSCE scenarios were developed. Each scenario involved a single standardized patient and was subdivided into three sequential 10 minute sections that assessed separate content areas and competencies. Twenty Canadian PGY-4 internal medicine trainees were assessed by trained examiner pairs during each OSCE scenario. Paired examiners rated participant performance independent of each other, on each section of each scenario using a validated global rating scale. Inter-rater reliabilities and Pearson correlations between ratings of the 3 sections of each scenario were calculated. A generalizability study was conducted. Participant and examiner satisfaction was surveyed.</p> <p>Results</p> <p>There was no main effect of section or scenario. Inter-rater reliability was acceptable. The g-coefficient was 0.68; four scenarios would achieve 0.80. Moderate correlations between sections of a scenario suggest a possible halo effect. The majority of examiners and participants felt that the modified OSCE provided a sense of patient continuity.</p> <p>Conclusions</p> <p>The modified OSCE provides another approach to the assessment of clinical performance. It attempts to balance the advantages of a traditional OSCE with a sense of patient continuity.</p

Economic Evaluation of Multisystemic Therapy for Young People at Risk for Continuing Criminal Activity in the UK

Abstract Objective: To evaluate whether multisystemic therapy (MST) is more cost-effective than statutory interventions that are currently available for young offenders in England. Method: A cost-offset evaluation of MST based on data from a randomised controlled trial conducted in North London, England, comparing MST with usual services provided by two youth offending teams (YOT). Service costs were compared to cost savings in terms of rates of criminal re-offending. Results: 108 adolescents, aged 11–17 years, were randomly allocated to MST+YOT (n = 56) or YOT alone (n = 52). Reductions in offending were evident in both groups, but were higher in the MST+YOT group. At 18-month follow-up, the MST+YOT group cost less in terms of criminal activity (£9,425 versus £11,715, p = 0.456). The MST+YOT group were significantly cheaper in terms of YOT services than the YOT group (£3,402 versus £4,619, p = 0.006), but more expensive including the cost of MST, although not significantly so (£5,687 versus £4,619, p = 0.195). The net benefit per young person for the 18-month follow-up was estimated to be £1,222 (95% CI 2£5,838 to £8,283). Conclusions: The results reported in this study support the finding that MST+YOT has scope for cost-savings when compared to YOT alone. However, the limitations of the study in terms of method of economic evaluation, outcome measures used and data quality support the need for further research

Caracterização das crianças transplantadas renais com diabetes mellitus pós-transplante

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023O transplante renal (TR) é o tratamento de eleição para crianças com doença renal crónica estadio 5. Avanços na abordagem e na terapêutica imunossupressora determinaram melhor qualidade de vida e melhores taxas de sobrevivência dos enxertos e das crianças submetidas a TR. Embora seja uma complicação frequente no adulto, em pediatria a diabetes mellitus pós-transplante (PTDM) afeta 1-7% das crianças submetidas a TR. A PTDM associa-se a um aumento da morbilidade e a um aumento de incidência de doença cardiovascular e infeção, as quais são as principais causas de morte neste grupo de doentes. O objetivo deste estudo é caracterizar as crianças submetidas a TR que desenvolveram PTDM. Para tal, desenvolveu-se um estudo retrospetivo dos doentes submetidos a TR que desenvolveram PTDM, seguidos num Centro de Referência de Transplante Renal Pediátrico e procedeu-se à revisão de literatura. Resultados: 60% eram do género masculino, todos receberam enxerto de dador cadáver e a maioria tinha ≥ 4 incompatibilidades HLA. Verificou-se também que a maioria teve um aumento no percentil do IMC desde o TR até ao diagnóstico de PTDM e hipomagnesemia no mesmo período. A maioria dos doentes foi tratada com uma insulina de ação prolongada e metformina. A PTDM e a obesidade associam-se a múltiplas complicações, as mesmas dos adultos, com a diferença que surgem mais precocemente na vida e têm impacto na esperança de vida destes doentes, sendo por isso fundamental o diagnóstico precoce desta entidade e alteração do estilo de vida, sobretudo com intervenção nutricional.Kidney transplantation (KT) is the treatment of choice for children with stage 5 chronic kidney disease. Advances in the approach and in immunosuppressive therapy determined the improvement of quality of life and the survival rates of grafts and children undergoing KT. Although it is a frequent complication in adults, post-transplantation diabetes mellitus (PTDM) in pediatrics has a prevalence of 1-7%. PTDM is associated with increased morbidity and an increased incidence of cardiovascular diseases and infections, which are the main causes of death in this group of patients. The aim of this study is to characterize children who underwent KT, who developed PTDM. To this end, a retrospective consultation study was carried out of patients who underwent KT and who developed PTDM, followed at a Reference Center for Pediatric Renal Transplantation and a literature review was carried out. Results: 60% were male, all received deceased donor grafts, and most had ≥ 4 HLA mismatches. It was also found that the majority had an increase in the BMI percentile from the KT until the diagnosis of PTDM and hypomagnesemia in the same period. Most patients were treated with a long-acting insulin and metformin. PTDM and obesity are associated with multiple complications, same as in the adults, with the difference that they appear earlier in life and have an impact on the life expectancy of these patients. Therefore, it is essential to have an early diagnosis of this entity and to change patient’s lifestyle, especially with nutritional intervention

Voluntariado corporativo : expectativas e percepções : um estudo no setor das telecomunicações em Portugal

Mestrado em Ciências EmpresariaisA presente dissertação teve como propósito estudar o Voluntariado Corporativo no setor das telecomunicações em Portugal, nomeadamente a diferença existente entre as expectativas dos responsáveis pelo Voluntariado dentro de uma organização e as perceções dos respetivos voluntários. Paralelamente tentou-se também perceber quais as diferenças de motivação/perceção de um colaborador que adere ao Voluntariado e um que não adere/nunca aderiu. O estudo exploratório foi feito através de instrumentos quantitativos e qualitativos. Neste sentido, contou-se com a participação de três empresas de telecomunicações e com a entidade reguladora deste setor, onde foram realizadas entrevistas e inquéritos. Concluiu-se que, apesar de haver um grande acompanhamento e reconhecimento dos programas de Voluntariado dentro das organizações, existe espaço para melhoria, visto que alguns colaboradores estão descontentes, na medida em que afirmaram que, se tivessem a possibilidade, mudariam vários aspetos nos programas. Além disso, há ainda oportunidades para uma maior mobilização das ações de Voluntariado. Sugere-se que haja um contacto mais próximo entre os colaboradores e a gestão da organização, para que as ações de Voluntariado Corporativo possam cumprir as expectativas dos colaboradores.This work aimed to study the Corporate Volunteering in the telecommunications sector in Portugal, namely the difference between the expectations of those responsible for the Volunteering within an organization and the perceptions of the respective volunteers. At the same time it also tried to report the differences of motivation/perception of an employee who joins the Volunteering and one that does not adhere/never joined. The exploratory study was conducted through quantitative and qualitative instruments. Following the prior idea, it counted with the participation of three telecommunications´ companies and the regulator of this sector, where interviews and surveys were carried out. It was concluded that, although there is a large monitoring and recognition of the Volunteering programs within organizations, there is room for improvement because some employees are unhappy, as they said if given the chance, they would change several aspects in the programs. In addition, there are still opportunities for a greater mobilization of Voluntary actions. It is suggested a closer contact between employees and the organization´s managers, so that the Corporate Volunteering actions can meet the employees´ expectations

Faire face à la salinisation et à la contamination des aquifères côtiers dans le contexte des changements environnementaux planétaires et sociétaux : Approches géochimique et isotopique appliquées aux ressources en eau de Recife (Brésil)

National audienceEn raison d'une pression démographique croissante, la région métropolitaine de Recife a subi d'importants changements d'utilisation des terres et de l'eau au cours des dernières décennies. Ces évolutions ont notamment généré une baisse spectaculaire des niveaux piézométriques, la salinisation et la contamination des eaux souterraines. Cette dégradation des ressources naturelles est liée à l'augmentation de la demande en eau, ponctuellement amplifiée par des périodes de sécheresse qui ont conduit à la construction de milliers de puits privés. La région de Recife apparaît ainsi comme un "point chaud" typique illustrant les problèmes des pays émergents tels que l'urbanisation, la répartition inégale de la richesse, la faiblesse des structures décisionnelles, les rapides développements industriel et touristique, induisant des pressions fortes sur les ressources en eau (quantité et qualité) dans le contexte des changements globaux sociétaux et environnementaux. Le projet COQUEIRAL a pour objectif d'étudier l'impact des activités humaines sur les aquifères côtiers surexploités en (1) analysant les pressions sur les ressources en eau souterraine et leurs raisons sociales et structurelles,(2) identifiant les sources et les mécanismes de la dégradation des ressources en eau souterraine en termes de qualité et de quantité, en se concentrant sur les processus physiques et chimiques en tant que vecteurs de la réaction du système aux pressions extérieures et (3) évaluant les impacts des changements globaux sur les ressources en eau à l'échelle régionale

Costs and consequences of the Portuguese needle-exchange program in community pharmacies

© The Author(s) 2020. Article reuse guidelines: sagepub.com/journals-permissionsBackground: Needle-exchange programs (NEPs) reduce infections in people who inject drugs. This study assesses the impact community pharmacies have had in the Needle-Exchange Program in Portugal since 2015. Methods: Health gains were measured by the number of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections averted, which were estimated, in each scenario, based on a standard model in the literature, calibrated to national data. The costs per infection were taken from national literature; costs of manufacturing, logistics and incineration of injection materials were also considered. The results were presented as net costs (i.e., incremental costs of the program with community pharmacies less the costs of additional infections avoided). Results: Considering a 5-year horizon, the Needle Exchange Program with community pharmacies would account for a 6.8% (n = 25) and a 6.5% reduction (n = 22) of HCV and HIV infections, respectively. The present value of net savings generated by the participation of community pharmacies in the program was estimated at €2,073,347. The average discounted net benefit per syringe exchanged is €3.01, already taking into account a payment to community pharmacies per needle exchanged. Interpretation: We estimate that the participation of community pharmacies in the Needle Exchange Program will lead to a reduction of HIV and HCV infections and will generate over €2 million in savings for the health system. Conclusions: The intervention is estimated to generate better health outcomes at lower costs, contributing to improving the efficiency of the public health system in Portugal.info:eu-repo/semantics/publishedVersio

Effectiveness of needle and syringe Programmes in people who inject drugs : an overview of systematic reviews

Background: Needle and syringe programmes (NSP) are a critical component of harm reduction interventions among people who inject drugs (PWID). Our primary objective was to summarize the evidence on the effectiveness of NSP for PWID in reducing blood-borne infection transmission and injecting risk behaviours (IRB). Methods: We conducted an overview of systematic reviews that included PWID (excluding prisons and consumption rooms), addressed community-based NSP, and provided estimates of the effect regarding incidence/prevalence of Human Immunodeficiency Virus (HIV), Hepatitis C virus (HCV), Hepatitis B virus (HBV) and bacteremia/sepsis, and/or measures of IRB. Systematic literature searches were undertaken on relevant databases, including EMBASE, MEDLINE, and PsychINFO (up to May 2015). For each review we identified relevant studies and extracted data on methods, and findings, including risk of bias and quality of evidence assessed by review authors. We evaluated the risk of bias of each systematic review using the ROBIS tool. We categorized reviews by reported outcomes and use of meta-analysis; no additional statistical analysis was performed. Results: We included thirteen systematic reviews with 133 relevant unique studies published between 1989 and 2012. Reported outcomes related to HIV (n = 9), HCV (n = 8) and IRB (n = 6). Methods used varied at all levels of design and conduct, with four reviews performing meta-analysis. Only two reviews were considered to have low risk of bias using the ROBIS tool, and most included studies were evaluated as having low methodological quality by review authors. We found that NSP was effective in reducing HIV transmission and IRB among PWID, while there were mixed results regarding a reduction of HCV infection. Full harm reduction interventions provided at structural level and in multi-component programmes, as well as high level of coverage, were more beneficial. Conclusions: The heterogeneity and the overall low quality of evidence highlights the need for future community-level studies of adequate design to support these results.info:eu-repo/semantics/publishedVersio

Psychosocial Determinants of Presenteeism at the Workplace in the Pre - COVID-19 Era in A Southern European Country - The Mediating Role of Mental Health and Wellbeing

Introduction: The impact of organizational stressors on presenteeism at individual and organizational levels, mediated by workers Psychological Wellbeing (PWB) acting as a buffering effect, in the pre-COVID-19 era, is reported. We hypothesize that individual wellbeing is the pathway through which organizational stress affects presenteeism. Methods: A study was conducted between November 2012 and June 2013 and data correspond to a nonrandomised sample of 405 employees at a private financial institution in Lisbon area. The Portuguese version of ASSET (A Shortened Stress Evaluation Tool), a self- report instrument validated for the Portuguese population, measuring individual’s perceptions regarding stress, and Psychological Wellbeing (PWB) at work, was applied. ASSET’s Work Relationships (WR), Aspects of the Job (YJ), Overload (OL), Control (CL), Job Security (JS), Resources and Communication (RC) and Work-Life Balance (WLB) dimensions were used, and PWB of ASSET health scale was used as mediator. Presenteeism was obtained with an item measure from the World Health Organization’s Health and Work Performance Questionnaire. Mediation analysis was tested using Structural Equation Modelling with AMOS software.info:eu-repo/semantics/publishedVersio