Stress e incidentes críticos em operacionais de emergência médica pré-hospitalar

Os operacionais de emergência médica pré-hospitalar, no exercício das suasfunções, estão diariamente expostos a cenários com reconhecido potencial traumático eimpacto negativo a nível laboral e pessoal, tendo um risco de desenvolver problemas desaúde mental superior ao da população em geral. Pela relevância destes profissionais nasociedade, existe interesse crescente no estudo das suas condições de trabalho, bem comodos fatores de risco e de proteção que poderão criar ambientes de trabalho saudáveis epromover o bem-estar psicológico.Pretende-se conhecer o impacto do stress associado a incidentes críticos emoperacionais de emergência médica pré-hospitalar, nomeadamente ao nível da ansiedade,depressão, trauma, resiliência e coping. Os dados foram recolhidos junto de 743profissionais do INEM (91% técnicos de emergência pré-hospitalar, 8% enfermeiros e 1%psicólogos), utilizando as versões portuguesas da Resilience Scale (Wagnild, & Young,1993), Depression Anxiety Stress Scales (Lovibond, & Lovibond, 1995), Brief ResilientCoping Scale (Sinclair, & Wallston, 2004), Impact of Event Scale (Weiss, & Marmar,1997) e Brief Cope (Carver, Scheier, & Weintraub, 1989).Os resultados revelaram níveis reduzidos de ansiedade, depressão, stress e trauma,moderados a elevados de resiliência, baixo a moderados de coping resiliente e elevados decoping funcional (focado no problema e na emoção), embora 19% dos profissionaisapresentassem trauma. Foram encontradas algumas diferenças em função das variáveissociodemográficas e profissionais, nomeadamente, sexo, estado civil, existência de filhos,anos de serviço e área de atividade, sendo que os anos de serviço, o exercício da profissãoem dois contextos distintos e a exposição indireta constituem fatores de risco. Osincidentes críticos com maior potencial traumático são imprevisíveis (acidentes, paragemcardiorrespiratória), resultam em consequências trágicas (morte) e envolvem crianças. Aresiliência parece ser desenvolvida em função das estratégias de coping utilizadas e domodo como os incidentes críticos são geridos. Sugere-se a realização de estudoslongitudinais e qualitativos que incluam outras variáveis psicológicas, como o sentido decoerência e a ideação suicida, bem como aprofundar a análise da capacidade preditiva daresiliência em relação ao trauma

European life project: a global strategy for the responsible use of a coastal lagoon: a case study from Portugal

Rin de Aveiro is a coastal lagoon located at the Central Region of Portugal subjected to the influence of the tides, resulting in a set of characteristic biotopes favouring anthropic and natural processes. Once managed and controlled correctly, each of these biotopes will allow simultaneously the biodiversity and integration in the making of the wetland landscape. In 1998, one of the final conclusions of the "MARIA" Demonstration Programme for the Integrated Management of Ria de Aveiro was that the poor current state of the environment area resulted from a set of interrelated factors. The Programme selected four (4) pilot-projects towards the integrated management of the lagoon biotopes as possible scenarios for an intervention. This selection was based in criteria related to environmental priorities and the maintenance of traditional economic activities in the region. The idea of choosing projects that would involve the whole geographic space of the Ria, without forgetting the other important themes interrelated with the Management Structure, emerged as a relevant aspect for their definition. Thus, and as a first test of this Management Structure functionality, the following task forces were put forward: Recovery and valorisation of the piers; Recovery of the former salt pans; Management of the agricultural fields of Baixo-Vouga; Implementation of measures for the classification of the Protected Landscape Area of the River Caster Mouth. This payer will report the main results of these pilot-projects attained during their first year period, especially the intervention strategies defined by the Partnership created for this aim

Subcutaneous Panniculitis-Like T-Cell Lymphoma (SPTL) in a Child with Spontaneous Resolution

Subcutaneous panniculitis-like T-cell lymphomas (SPTLs) α/β are rare in childhood. The present report refers to a case of a 7-year-old male child presenting an extensive skin lesion that began when he was 5 years of age. Two biopsies were evaluated using the CD3, CD4, CD8, CD56, βF1, and TIA markers. A dense infiltrate of CD3+, CD4−, CD8+, CD56−, βF1+, and TIA+ pleomorphic lymphocytes was found in the subcutis. The previous biopsy showed cytophagic histiocytic panniculitis with a small focus on CD8+ and βF1+ malignant cells. The lesion regressed spontaneously. This case shows that prognosis may be excellent in SPTL (α/β). On the other hand, it also serves as an alert that a biopsy performed in an area of cytophagic panniculitis may lead to misdiagnosis

Evaluation of the cross-cultural adaptation of Brazilian version of the Sense of Coherence Scale : a systematic review

Introdução: Há crescente número de publicações brasileiras envolvendo a escala de Senso de Coerência (SOC), mas o processo de adaptação transcultural ainda não pode ser considerado definitivo. Objetivo: Revisar sistematicamente estudos de adaptação transcultural da versão brasileira, sumarizando as propriedades psicométricas. Método: Foram pesquisadas sete bases de dados eletrônicas até janeiro de 2019: LILACS, BBO, BDENF-Nursing, Index Psychology, PubMed, EMBASE e Scopus, com restrição para o Brasil ou língua portuguesa. Resultados: Foram identificadas 78 referências das quais foram incluídos 15 artigos e duas teses. Versões com 13 e 29 itens foram encontradas, que deveriam possuir os seguintes domínios: compreensão, manejo e significado. Verificou-se que até o momento os estudos não consideraram todas as etapas específicas para adaptação transcultural brasileira, apesar de apresentarem etapas metodológicas para validade de conteúdo e confiabilidade. A consistência interna da escala inteira (α de Cronbach) de oito estudos para SOC-13 variou de 0,61 a 0,81, e em quatro estudos, para SOC-29 de 0,77 a 0,87. Um único estudo (SOC-29) mostrou cargas fatoriais baixas para cinco itens nas análises dos componentes principais. Conclusão: Há necessidade de aprofundar as pesquisas sobre adaptação da versão brasileira, em português, da escala de SOC.Background: Brazilian publications involving the Sense of Coherence (SOC) scale has increased, however the cross-cultural adaption process is not yet definite. Objective: This study aimed to review systematically the cross-cultural adaptation studies of the Brazilian version of the SOC scale, summarizing psychometric properties. Method: Seven electronic databases were searched until January 2019: LILACS, BBO, BDENF-Nursing, Index Psychology, PubMed, EMBASE and Scopus with restriction for Brazil or Portuguese Language. Results: It was identified 78 references, which15 papers and 2 thesis were included. Versions with 13 and 29 items were used and items should group in three domains: comprehensibility, manageability and meaningfulness. It was verified that the studies did not consider all specific stages of cross-cultural adaptation to the Brazilian culture, despite presenting methodological steps for content validity and reliability. The internal consistency for the whole scale (Cronbach α) in eight studies for SOC-13 ranged from 0.61 to 0.81 and 4 studies for SOC-29 from 0.77 to 0.87. A single study showed low factor loadings for some items in the main component analysis on SOC-29. Conclusion: It is possible to conclude that it is necessary to deepen the research on adaptation of the Brazilian version of the SOC scale

Inativação do vírus da doença-de-newcastle pela Beta-Propiolactona, Acetilenoimina e Etilenoimina Binária.

The inactivating action of BPL, AEI and BEl upon the infectivity and hemagglutinating activity of Newcastle Disease virus (Macapá strain), was studied. The inactivant was addcd to infected allantoic fluid, incubated at 37 ºC and samples collected at appropriate intervals to determine infectivity, hemagglutination titer and sterility. BPL at a final concentration of 1:4000 revealed higher inactivation at two hours incubation period and complete inactivation by six hours and 16 minutes. AEI, at a final concentration of 0,05%, showed more accentuated inactivation around six hours incubation períod and complete inactivation calculated to occur by 11 hours and 28 minutes. The 2% of BEl inactivating action was higher at four hours incubation with complete inactivation taking place at four hours and 18 minutes. All three chemical substances showed first order inactivating action, with linear infectivity decrease and no residual active virus particleEstudou-se a ação inativante da BPL da AEI e da EIB sobre a infecciosidade e capacidade hemoaglutinante do vírus da doença-de-newcastle (cepa macapá) contido em líquido alantóide virulento. O inativante era adicionado à suspensão de vírus, incubada à 37 ºC e uma amostra retirada a determinados intervalos para verificação da esterilidade e títulos infeccioso e hemoaglutinante. A BPL, na concentração de 1:4000, demonstrou poder inativante mais acentuado no período de duas horas de inativação, devendo a inativação ser completa às seis horas e 16 minutos. A ALI empregada na concentração de 0,05% revelou maior inativação por volta de seis horas de ação, indicando os dados experimentais tempo de onze horas e 28 minutos para a eliminação da infecciosidade. O poder inativante da EIB a 2% foi mais acentuado no período de quatro horas, devendo a inativação ter-se completado com quatro horas e 18 minutos. As três substâncias químicas experimentais mostraram uma ação inativante do tipo linear, completa, sobre a infecciosidade do vírus em estudo, sem afetar sua capacidade hemoaglutinant

Structural validity of the Brazilian version of the Sense of Coherence scale (SOC-13) in oral health research : exploratory and confrmatory factor analysis

Background: The Sense of Coherence (SOC) construct has been used worldwide in oral health research, but rigorous factor analyses of the scale are scarce. We aim to test the dimensional structure of the Brazilian short version of the SOC scale with 13 items. Methods: This study is a secondary analysis of four independent cross-sectional Brazilian studies on oral health, using the 13-items SOC scale. Sample 1 was conducted on 1760 mothers and 1771 adolescents. Sample 2 comprised 1100 adults. Sample 3 had 720 adults and older individuals. Sample 4 comprised 664 adolescent students. Confrmatory Factor Analysis (CFA) was conducted on sample 1 to compare two models: 3-factor versus 1-factor. Because they were refuted, Exploratory Factor Analysis was implemented in samples 2 and 3. Modifed models were tested in sample 4 using CFA. All analyses were conducted with MPlus version 7.11. Results: CFA of sample 1 resulted in an unacceptable ft (RMSEA=0.12;CFI=0.78; TLI=0.73; and WRMR=3.28) for 1-factor model and 3-factor (RMSEA=0.10; CFI=0.87; TLI=0.84; and WRMR=2.50). The EFA on samples 2 and 3 showed, respectively, two eigenvalues greater than 1 (4.11 and 1.56) and (4.32 and 1.42), but the scale items soc1, soc2 and soc3 formed an uninterpretable second factor. Another CFA, using sample 4, showed acceptable model ft after removing those three items and also soc11 (RMSEA=0.05; CFI=0.98; TLI=0.99; and WRMR=0.71). Conclusion: The results indicate that the SOC-13 scale needs further adjustments. The one-factor model with nine items showed a good statistical ft, but the implications of excluding items should be further investigated, considering the scale’s content validity, cross-cultural adaptation and theoretical background

Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features

Trends in Self‐Reported Oral Health of US Adults: National Health and Nutrition Examination Survey 1999‐2014

Objective Single‐item self‐reported oral health (SROH) is a convenient and reliable measure for the assessment of population‐based oral health. However, little is known about trends and its associations among US adults. This study investigated trends in SROH (aged 20+ years) and the associated factors among adults living in the United States. Methods Self‐reported oral health data for 41 621 adults aged 20+ years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2014 were analysed. Survey‐weighted descriptive statistics were computed to provide nationally representative estimates. Multivariable logistic regression was performed separately for each survey period with SROH as the primary outcome. Independent variables included were age, gender, race/ethnicity, education level and family poverty income ratio or PIR. Pooled survey‐weighted multivariable logistic regression was also performed to consider possible time‐changing effects. Results The survey‐weighted proportions of “excellent or very good” in SROH increased from 27% in 1999‐2000 (n = 4873) to 38% in 2013‐2014 (n = 5765). Separate multivariable logistic analyses for each survey period suggested that females, Whites (vs Mexican and Black Americans) as well as respondents from high family PIR had higher odds of reporting their oral health as “excellent or very good” (P \u3c .05). The pooled multivariable logistic model confirmed results in the separate logistic regression, and respondents in the more recent survey periods had higher probabilities of reporting “excellent or very good” oral health. Respondents aged 50‐59 years were found to have relatively lower probabilities of reporting “excellent or very good” oral health, while people aged 20‐29 years had higher probabilities than those aged 30‐39 years. Compared to respondents with lower education, those with higher education were more likely to report their oral health as excellent or very good. Conclusions Self‐reported oral health improved from 1999 to 2014. In general, respondents who were young, female, White, had higher education or higher income or were surveyed in more recent years reported excellent or very good oral health