The influence of job rotation in the job satisfaction of nurses in a surgical service =

Theoretical framework: Job satisfaction is associated with better performance, leading to an optimisation of healthcare. Objectives: To understand the influence of job rotation between units of the same service in the nurses’ job satisfaction. Methodology: Observational, analytic, cross-sectional and quantitative study using a questionnaire and subsequent bivariate descriptive statistical analysis. Results: Statistically significant results were found in the variables related to the nurse’s service, satisfaction with the number of shifts, pace of work, and technicality. The nurses who were very dissatisfied with the job rotation were professionally satisfied. On the other hand, the nurses who were very satisfied with the job rotation were somewhat professionally satisfied. Although no association was found between satisfaction and rotation, nurses informally expressed their dissatisfaction. Thus, a qualitative or mixed study should have been developed. Conclusion: The engagement of nurses in the decision-making process, particularly regarding the rotation system, should be continuously valued as it allows nurses to expand their field of action and achieve better results. Enquadramento: A satisfação profissional está associada a melhores resultados no trabalho permitindo uma otimização dos cuidados de saúde. Objectivos: Compreender a influência da rotação no trabalho, entre secções do mesmo serviço, na satisfação profissional dos enfermeiros. Metodologia: Estudo quantitativo, observacional, analítico e transversal, com recurso a 1 questionário e posterior análise estatística descritiva e bivariada dos dados. Resultados: Resultados referentes à proveniência do enfermeiro, satisfação com o número de turnos, ritmo de trabalho e tecnicidade, foram estatisticamente significativos. Os enfermeiros muito insatisfeitos com a rotação estavam profissionalmente satisfeitos. Por outro lado, os enfermeiros muito satisfeitos com a rotação estavam profissionalmente bastante satisfeitos. Não se verificou associação entre satisfação e rotação, mas denotou-se uma verbalização informal de insatisfação por parte dos enfermeiros, tornando-se ideal a realização de um estudo qualitativo ou misto. Conclusão: A participação dos enfermeiros no processo de tomada de decisão, nomeadamente quanto ao sistema de rotação, deve ser continuamente valorizada, uma vez que permite ao trabalhador expandir o seu campo de ação e atingir melhores resultados.publishersversionpublishe

Mathematical model for the assessment of fracture risk associated with osteoporosis

Osteoporosis is a skeletal disease characterized by low bone mass. It is considered a worldwide public health problem that affects a large number of people, in particularly for women with more than 50 years old. The occurrence pattern of osteoporosis in a population may be related to several factors, including socio-economic factors such as income, educational attainment, and factors related to lifestyle such as diet and physical activity. These and other aspects have increasingly been identified as determining the occurrence of various diseases, including osteoporosis. This work proposes a mathematical model that provides the level of osteoporosis in the patient. Preliminary numerical results are presented.The authors would like to thank the financial support from FEDER COMPETE and FCT Project FCOMP-01-0124-FEDER-022674

Metabolic factors in obesity

Obesity has a rising prevalence in children and adolescents, affecting 30% of the paediatric population in Portugal. Leptin is an important hormone involved in the pathogenesis of obesity and has been under investigation as a risk marker for future complications. AIMS: 1. To evaluate the relation between serum leptin levels and body mass index (BMI) and height. 2. To compare leptin levels in obese and non-obese children. 3. To evaluate the relation between leptin levels and insulin resistance index. METHODS: Cross-sectional study, using a sample of 70 obese children and a control group of 53 non-obese children. Obesity was defined as BMI standard deviation > 2 for age and sex. In the obese group we assessed sex, age, BMI SDS and height SDS for age and sex, and serum levels of glucose, insulin and leptin. In the control group were obtained BMI SDS and height SDS for age and sex and leptin levels. Data were analysed using SPSS 12. RESULTS: The mean age of obese and non-obese children was 10.3 +/- 2.9 versus 10.9 +/- 3.5 years. In the obese group, 32 (45.7%) were boys versus 18 (31.0%) in the non-obese group. BMI SDS in the obese group was 3.12 +/- 0.60 versus 0.20 +/- 0.99 in the non-obese group (p < 0.001). Leptin levels showed a positive correlation with BMI SDS (r = 0.69; p < 0.001) and height SDS (r = 0.31; p < 0.001). When comparing leptin levels between obese and non-obese groups, we found a significant difference in boys (50.7 +/- 27.3 versus 7.0 +/- 6.8 ng/ml; p < 0.001) and in girls (57.6 +/- 25.5 versus 16.5 +/- 10.3 ng/ml; p < 0.001). In the nonobese group, leptin levels were lower in boys. This difference was not seen in the obese group. Leptin showed a positive correlation with insulin resistance index in boys (r = 0.45, p = 0.05), but not in girls. CONCLUSIONS: This study has confirmed a positive correlation between leptin levels and BMI SDS. In obese children elevated leptin is associated with central resistance to its action. The positive correlation of leptin with insulin resistance index may suggest a major role of leptin in insulin resistance.info:eu-repo/semantics/publishedVersio

A rare cause of neonatal persistent jaundice

info:eu-repo/semantics/publishedVersio

Insect and spider rarity in an oceanic island (Terceira, Azores): true rare and pseudo-rare species

Until now the mechanisms of how recent historical land-use (hereafter called "habitat") changes in island ecosystems shape the distribution of individual insect species have been poorly understood in the field of conservation biology. In the present study we concentrate on the delicate equilibrium of the contribution of habitat island composition (i.e. habitat resource availability) with respect to island insect distribution patterns. In this context we study in detail the distribution patterns of four functional groups (herbivorous sucking insects, herbivorous chewing insects, spiders and other arthropod predators) of endemic, native and exotic arthropod species in a well-studied island of the Azores archipelago (Terceira). Within the bigger context of a standardized sampling program both for epigean and canopy insects and spiders we want to find out which species are truly rare and which are pseudo-rare species in each target habitat. Two dimensions of rarity were measured: abundance and habitat specialization. Two domains of rarity were identified: "among habitats" and "geographic". Some interesting patterns emerged. The high dispersal abilities of many insect and spider species together with the fact that many species from islands tend to be generalists imply that many species tend to be vagrants in several habitats and consequently are locally habitat pseudo-rarities. Two types of local pseudorare species were identified: "habitat (or land-use)" and "host plant" pseudorarities. Some species are rare in one habitat type whilst they are more common in another, often related habitat, or they are relatively rare in many habitats. This is a consequence of a "mass effect", with many species demonstrating a "source-sink" dynamics. Truly regionally rare species are those that are habitat specialists and many of them are threatened endemic species or recently introduced exotic species. We suggest several hypotheses for the patterns found, based on the former larger distribution and disturbance regimes of the native Laurel forest. Insufficient spatial replication in sampling can lead to the conclusion that numerous species appear to be rare because they were sampled in marginal sites or in the edge of their distribution. Since habitat occurrence is a less reliable predictor of the rarity status, more attention should be given to the standardized sampling of many habitats before extracting conclusions about the threatened status of a particular insect or spider species. Our results provide clear evidence that without adequate spatial data on abundance and habitat requirements, rarity status for insects and spiders on islands and elsewhere cannot be appropriately assessed

Hiperplasia Mesonéfrica pode Causar Alterações na Citologia Cervical: Descrição de um Caso cCínico

Mesonephric hyperplasia (MH) is a very rare condition. There are few cases in the literature. Mesonephric remnants (MR) or MH can be a rare source of abnormal Papanicolaou smears. The most common, often difficult, in the differential diagnosis of MH is mesonephric carcinoma that has a poor prognosis. We report a case of a 29-years-old with a routine Papanicolaou smear reported as atypical glandular cells. The patient underwent to a loop electrosurgical excision procedure and because it is a benign condition and a strong desire to preserve fertility, we opted for clinical surveillance.info:eu-repo/semantics/publishedVersio

Management of Locally Advanced Esthesioneuroblastoma in a Pregnant Woman

Esthesioneuroblastoma (ENB) is a rare malignant tumor that commonly develops in the upper nasal cavity. Standard treatment is not established, especially in locally advanced disease which portends the worse prognosis. Hereby, we report a case of a 27-year-old, 23-week pregnant woman, with a 2-month history of progressively growing right cervical lymphadenopathy, nasal obstruction, anosmia, frequent episodes of epistaxis, and right frontal headache. Imagiological evaluation revealed a lesion with 7×5,2×3,2 cm in the nasal fossae with extension to the ethmoidal complex and right olfactive fend and invasion of the endocranial compartment associated with lymphadenopathy. The biopsy revealed a high-grade EBN. Neoadjuvant chemotherapy with cisplatin and etoposide was administrated during pregnancy and continued after delivery up to 6 cycles of treatment with partial response. Radiotherapy followed, with complete response. This case report is intended to highlight that a high grade of suspicion should be kept in the presence of nonspecific symptoms of nasal obstruction, anosmia, facial pain, and/or headache and focus that chemotherapy is an important component of a combined-treatment modality for locally advanced ENB that can be used during pregnancy in a lifesaving situation.info:eu-repo/semantics/publishedVersio

3D echoendoscopy and miniprobes for rectal cancer staging

Background: rectal cancer staging using rigid probes or echoendoscopes has some limitations. The aim of the study was to compare rectal cancer preoperative staging using conventional endoluminal ultrasonography with three-dimensional endoscopic ultrasonography and miniprobes. Materials and methods: sixty patients were included and evaluated with: a) a conventional echoendoscope (7.5 and 12 MHz); b) miniprobes (12 MHz); and c) the Easy 3D Freescan software for three-dimensional endoscopic ultrasonography. The reference or gold standard was conventional endoluminal ultrasonography in all cases and pathological assessment for those without preoperative therapy. The differences in T and N staging accuracy in both longitudinal and circumferential extension were evaluated. Results: with regard to T staging, conventional endoluminal ultrasonography had an accuracy of 85% (compared to pathological analysis), and the agreement between miniprobes vs conventional endoluminal ultrasonography (kappa = 0.81) and three-dimensional endoscopic ultrasonography vs conventional endoluminal ultrasonography (k = 0.87) was significant. In addition, miniprobes had an accuracy of 82% and three-dimensional endoscopic ultrasonography had a higher accuracy (96%). With regard to N staging, conventional endoluminal ultrasonography had an accuracy of 91% with a sensitivity of 78%. However, the agreement between miniprobes and conventional endoluminal ultrasonography and three-dimensional endoscopic ultrasonography and conventional endoluminal ultrasonography (k = 0.70) was lower. Interestingly, miniprobes had a lower accuracy of 81% whereas three-dimensional endoscopic ultrasonography had an accuracy of 100% without any false negative. No false positives were observed in any of the techniques. Accuracy for T and N staging was not influenced by longitudinal or circumferential extensions of the tumor in all types of endoscopic ultrasonography analyzed. Conclusions: miniprobes and especially three-dimensional endoscopic ultrasonography may be relevant during rectal cancer staging.info:eu-repo/semantics/publishedVersio