Experiências de uma equipa multiprofissional no atendimento pré-hospitalar em suporte avançado de vida a vítimas politraumatizadas

Dissertação de Mestrado em Enfermagem Médico-Cirúrgica apresentada na Escola Superior de Saúde do Instituto Politécnico de Viana do CasteloEm Portugal o trauma tem uma prevalência importante, sobressaindo provavelmente a todos os países da Europa Comunitária, salientando-se como fatores etiológicos os acidentes de trabalho e os acidentes de viação. O trauma continua a ser uma das principais causas de morte nas primeiras quatro décadas de vida, sendo a primeira causa de morte no grupo etário pediátrico. É também um fator de morbilidade elevada, provocando, muitas vezes, incapacidade definitiva, custos familiares, sociais e financeiros elevadíssimos. Reconhecendo que, em grande parte, a melhoria da resposta ao trauma se relaciona com a organização dos meios de socorro pré-hospitalar e assistência, pretende-se compreender as “Experiencias de uma Equipa Multiprofissional no Atendimento Pré-Hospitalar em Suporte Avançado de Vida a Vítimas Politraumatizadas”. Este estudo assenta em uma investigação qualitativa, de caracter exploratório e do tipo descritivo simples. Para a recolha de dados foi utilizada uma entrevista semiestruturada, que compreendeu questões sobre o perfil sociodemográfico, profissional e questões norteadoras sobre o tema. Participaram no estudo 10 profissionais de saúde (enfermeiros e médicos) que tripulam a Viatura Médica de Emergência e Reanimação de um Centro Hospitalar e Universitário da Região Norte do País. Os dados foram organizados através da técnica de análise de conteúdo segundo Bardin (2011), identificando-se 6 áreas temáticas: significado atribuído à experiência em Viatura Médica de Emergência e Reanimação; sentimentos/emoções vivenciadas pela equipa multiprofissional; fatores facilitadores do atendimento pré-hospitalar; fatores dificultadores do atendimento préhospitalar; implicações para a vida pessoal e profissional; sugestões para um melhor atendimento pré-hospitalar. Da análise de conteúdo dos discursos dos participantes conclui-se que a experiência em Viatura Médica de Emergência e Reanimação é desafiante, pela vivência de situações inesperadas, desconhecidas e angustiantes, pelo que desempenhar funções neste meio de emergência, confere satisfação pessoal e profissional e corresponde a um contributo para um melhor atendimento do paciente, antes da abordagem hospitalar. A equipa multiprofissional descreve sentimentos/emoções positivas; como o prazer de ajudar e a motivação; e sentimentos negativos como o stress/ansiedade, desconforto, insegurança, angústia, receio e responsabilidade. Foram relatados como fatores facilitadores do atendimento pré-hospitalar a vítimas de trauma a experiência profissional, fatores relacionados com a equipa nomeadamente o conhecimento dos elementos da equipa e a comunicação; existência de recursos humanos e materiais, existência de condições de segurança e existência de algoritmos de atuação. Os fatores dificultadores descritos são a inexperiência profissional, falta de liderança, falta de recursos humanos e materiais, falta de condições ambientais tais como a luminosidade, ruido, condições climatéricas; presença de populares, relação na equipa, incumprimento das medidas de segurança, riscos associados à viatura/condução, sobrecarga de trabalho, condições do trânsito, e por fim, o método de triagem nos Centro de Orientação de Doentes Urgentes. Refletindo sobre as vivências em SAV nas vítimas de trauma e as suas repercussões para a vida pessoal e profissional da equipa, os entrevistados referem que a nível profissional alcançam mais conhecimento teórico e capacitação técnica e a nível pessoal, há a possibilidade de envolvimento emocional, alteração do sono e também cansaço. Para um melhor atendimento pré-hospitalar, a equipa sugere formação continua; realização de debriefing; acompanhamento psicológico; equipas exclusivas VMER e aquisição de material.In Portugal, trauma has an important prevalence, probably surpassing all the countries of the Community, being highlighted as etiological factors the accidents at work and road accidents. Trauma continues to be one of the main causes of death in the first four decades of life, being the first cause of death in the pediatric age group. It is also a high morbidity factor, often causing permanent disability, very high family, social and financial costs. Recognizing that, in large part, the improvement in the response to trauma is related to the organization of pre-hospital means of relief and assistance, it is intended to understand the "Experiences of a Multiprofessional Team in Pre-Hospital Care in Advanced Life Support for Politraumatized Victims. This study is based on a qualitative, exploratory and simple descriptive research. For the data collection, a semi-structured interview was used, which included questions about the socio-demographic, professional profile and guiding questions on the subject. Ten health professionals (nurses and doctors) that crew the Emergency and Resuscitation Medical Vehicle of the Hospital and University Center of Porto participated in the study. The data were organized through the technique of content analysis according to Bardin (2011), identifying 6 thematic areas: significance attributed to the experience in Emergency and Resuscitation Medical Vehicles; feelings / emotions experienced by the multiprofessional team; factors facilitating the pre-hospital care; factors hindering the pre-hospital care; implications for personal and professional life; suggestions for better pre-hospital care. From the analysis of the content of the speeches of the participants it can be concluded that the experience in Emergency and Resuscitation Medical Vehicles is challenging, due to the experience of unexpected, unknown and distressing situations, so performing functions in this emergency environment, gives personal and professional satisfaction and corresponds to a contribution to a better patient care, before the hospital approach. The multiprofessional team describes positive feelings/emotions, such as the pleasure of helping and motivation; and negative feelings such as stress/anxiety, discomfort, insecurity, anguish, fear and responsibility. Professional experience, factors related to the team namely the knowledge of team members and communication; existence of human and material resources, existence of safety conditions and existence of performance algorithms were reported as facilitators of pre-hospital care for trauma victims. The difficult factors described are professional inexperience, lack of leadership, lack of human and material resources, lack of environmental conditions such as luminosity, noise, weather conditions; presence of popular, relationship in the team, non-compliance with safety measures, risks associated with the car/driving, work overload, traffic conditions, and finally, the method of screening in the Center for Guidance of Urgent Patients. Reflecting on the experiences in VSS in the victims of trauma and their repercussions on the personal and professional life of the team, the interviewees reported that at the professional level they achieve more theoretical knowledge and technical and personal training, there is the possibility of emotional involvement, sleep alterations and also tiredness. For a better pre-hospital care, the team suggests continuous training; debriefing; psychological follow-up; exclusive VMER teams and material acquisition

Yellow fever virus maintained by Sabethes mosquitoes during the dry season in Cerrado, a Semiarid Region of Brazil, in 2021

In recent decades, waves of yellow fever virus (YFV) from the Amazon Rainforest have spread and caused outbreaks in other regions of Brazil, including the Cerrado, a savannah-like biome through which YFV usually moves before arriving at the Atlantic Forest. To identify the vectors involved in the maintenance of the virus in semiarid environments, an entomological survey was conducted after confirmation of yellow fever (YF) epizootics at the peak of the dry season in the Cerrado areas of the state of Minas Gerais. In total, 917 mosquitoes from 13 taxa were collected and tested for the presence of YFV. Interestingly, mosquitoes of the Sabethes genus represented 95% of the diurnal captured specimens, displaying a peak of biting activity never previously recorded, between 4:30 and 5:30 p.m. Molecular analysis identified three YFV-positive pools, two from Sabethes chloropterus—from which near-complete genomes were generated—and one from Sa. albiprivus, whose low viral load prevented sequencing. Sa. chloropterus was considered the primary vector due to the high number of copies of YFV RNA and the high relative abundance detected. Its bionomic characteristics allow its survival in dry places and dry time periods. For the first time in Brazil, Sa. albiprivus was found to be naturally infected with YFV and may have played a role as a secondary vector. Despite its high relative abundance, fewer copies of viral RNA were found, as well as a lower Minimum Infection Rate (MIR). Genomic and phylogeographic analysis showed that the virus clustered in the sub-lineage YFVPA-MG, which circulated in Pará in 2017 and then spread into other regions of the country. The results reported here contribute to the understanding of the epidemiology and mechanisms of YFV dispersion and maintenance, especially in adverse weather conditions. The intense viral circulation, even outside the seasonal period, increases the importance of surveillance and YFV vaccination to protect human populations in affected areas

Serological evidence of orthopoxvirus infection in neotropical primates in Brazil

The genus Orthopoxvirus (OPXV) of the family Poxviridae comprises several viruses that are capable of infecting a wide range of hosts. One of the most widespread OPXVs is the Vaccinia virus (VACV), which circulates in zoonotic cycles in South America, especially in Brazil, infecting domestic and wild animals and humans and causing economic losses as well as impacting public health. Despite this, little is known about the presence and/or exposure of neotropical primates to orthopoxviruses in the country. In this study, we report the results of a search for evidence of OPVX infections in neotropical free-living primates in the state of Minas Gerais, southeast Brazil. The sera or liver tissues of 63 neotropical primates were examined through plaque reduction neutralization tests (PRNT) and real-time PCR. OPXV-specific neutralizing antibodies were detected in two sera (4.5%) from Callithrix penicillata, showing 55% and 85% reduction in plaque counts, evidencing their previous exposure to the virus. Both individuals were collected in urban areas. All real-time PCR assays were negative. This is the first time that evidence of OPXV exposure has been detected in C. penicillata, a species that usually lives at the interface between cities and forests, increasing risks of zoonotic transmissions through spillover/spillback events. In this way, studies on the circulation of OPXV in neotropical free-living primates are necessary, especially now, with the monkeypox virus being detected in new regions of the planet

Solid-state fermentation of plant feedstuff mixture affected the physiological responses of European seabass (Dicentrarchus labrax) reared at different temperatures and subjected to salinity oscillation

This study aimed to evaluate the effects of dietary inclusion of plant feedstuff mixture (PFM) pre-treated by solid-state fermentation (SSF) on the physiological responses of European seabass. For that purpose, two diets were formulated to contain: 20% inclusion level of non-fermented plant ingredients mixture (20Mix) and 20Mix fermented by A. niger in SSF conditions (20Mix-SSF). Seabass juveniles (initial body weight: 20.9 ± 3.3 g) were fed the experimental diets, reared at two different temperatures (21 and 26 °C) and subjected to weekly salinity oscillations for six weeks. Growth performance, digestive enzyme activities, humoral immune parameters, and oxidative stress indicators were evaluated. A reduction in weight gain, feed intake, and thermal growth coefficient was observed in fish fed the fermented diet (20Mix-SSF). Salinity oscillation led to an increase in weight gain, feed efficiency, daily growth index, and thermal growth coefficient, regardless of dietary treatment. Higher rearing temperatures also increased daily growth index. No dietary effect was observed on digestive enzymes activities, whereas rearing temperature and salinity oscillation modulated digestive enzyme activities. Oxidative stress responses were significantly affected by experimental diets, temperature, and salinity conditions. Catalase and glutathione peroxidase activities showed an interactive effect. Fish reared at 21 °C showed higher enzymatic activity when fed the 20Mix-SSF. Conversely, fish reared at 26 °C showed higher GPx activity when fed the 20Mix diet. Fish reared at 26 °C showed reduced peroxidase and lysozyme activities, while salinity fluctuation led to increased lysozyme activity and decreased ACH50 activity. ACH50 activity increased in fish fed the 20Mix-SSF. Overall, the dietary inclusion of PFM fermented by A. niger was unable to mitigate the impact of environmental stress on physiological performance in European seabass. In fact, fermented feed caused an inhibition of growth performances and an alteration of some physiological stress indicators.This work was funded by the Ocean3R project (NORT-01-0145-FEDER-000064), supported by the North Portugal Regional Operational Program (NORT2020), under the PORTUGAL 2020 Partnership Agreement and through the European Regional Development Fund (ERDF). This research was partially supported by national funds through FCT—Foundation for Science and Technology within the scope of UIDB/04423/2020 and UIDP/04423/2020.info:eu-repo/semantics/publishedVersio

Identification of aluminum resistant genotypes among Madeiran regional wheats

Forty-eight genotypes representing wheat diversity from the Island of Madeira were screened for resistance to aluminum (Al) in nutrient solution. Seeds of wheat used in the experiments were obtained from local farmers. The soil pH and content of ionic Al of plots cultivated with wheat were analyzed. The pH of topsoils varied between 3.83 and 6.59. The amount of ionic Al in soil samples varied between 0.38 and 1.36 cmol Al3 + per kg of soil and was positively correlated with the altitude of a plot. Eriochrome cyanine staining was used to evaluate the effect of Al ions on the root elongation. Seventy-two hour exposure of 3-day-old seedlings to 100 and 200 mM Al in nutrient solution revealed a high number of Al resistant genotypes among wheat germplasm. After withdrawal of Al stress, survival and root regrowth was observed in 28 and 23 genotypes screened at 100 and 200 mM Al in nutrient solution, respectively. Enhanced resistance to Al among Madeiran genotypes was associated with the amount of ionic Al in the soils. Complexity and various patterns of responses of tested cultivars to Al stress may suggest that Madeiran germplasm could be a valuable source of genes controlling Al resistance for conventional breeding programs and for studies of molecular bases of mechanisms of Al resistance.Portuguese Foundation for the Science and Technology (FCT, Fundac¸o para a Cieˆncia e Tecnologia) has sponsored this work, through the Centre of Biological and Geological Sciences (C.C.B.G.) and the project POCTI/no. 33005/AGR/1999. The authors are also grateful to the Madeiran Centre of Science and Technology (CITMA) for financial support. Acknowledgements are due to Mr. Roge´rio Correia and Juan Silva for the technical assistance in conducting the laboratory and fieldwork and to Dr. Andrzej Aniol for valuable advice during preparation of this manuscript.info:eu-repo/semantics/publishedVersio

Corrigendum to ‘a horizon scan exercise for aquatic invasive alien species in Iberian inland waters’

info:eu-repo/semantics/publishedVersio

A horizon scan exercise for aquatic invasive alien species in Iberian inland waters

As the number of introduced species keeps increasing unabatedly, identifying and prioritising current and potential Invasive Alien Species (IAS) has become essential to manage them. Horizon Scanning (HS), defined as an exploration of potential threats, is considered a fundamental component of IAS management. By combining scientific knowledge on taxa with expert opinion, we identified the most relevant aquatic IAS in the Iberian Peninsula, i.e., those with the greatest geographic extent (or probability of introduction), severe ecological, economic and human health impacts, greatest difficulty and acceptability of management. We highlighted the 126 most relevant IAS already present in Iberian inland waters (i.e., Concern list) and 89 with a high probability of being introduced in the near future (i.e., Alert list), of which 24 and 10 IAS, respectively, were considered as a management priority after receiving the highest scores in the expert assessment (i.e., top-ranked IAS). In both lists, aquatic IAS belonging to the four thematic groups (plants, freshwater invertebrates, estuarine invertebrates, and vertebrates) were identified as having been introduced through various pathways from different regions of the world and classified according to their main functional feeding groups. Also, the latest update of the list of IAS of Union concern pursuant to Regulation (EU) No 1143/2014 includes only 12 top-ranked IAS identified for the Iberian Peninsula, while the national lists incorporate the vast majority of them. This fact underlines the great importance of taxa prioritisation exercises at biogeographical scales as a step prior to risk analyses and their inclusion in national lists. This HS provides a robust assessment and a cost-effective strategy for decision-makers and stakeholders to prioritise the use of limited resources for IAS prevention and management. Although applied at a transnational level in a European biodiversity hotspot, this approach is designed for potential application at any geographical or administrative scale, including the continental one

Partial asynchrony of coniferous forest carbon sources and sinks at the intra-annual time scale.

As major terrestrial carbon sinks, forests play an important role in mitigating climate change. The relationship between the seasonal uptake of carbon and its allocation to woody biomass remains poorly understood, leaving a significant gap in our capacity to predict carbon sequestration by forests. Here, we compare the intra-annual dynamics of carbon fluxes and wood formation across the Northern hemisphere, from carbon assimilation and the formation of non-structural carbon compounds to their incorporation in woody tissues. We show temporally coupled seasonal peaks of carbon assimilation (GPP) and wood cell differentiation, while the two processes are substantially decoupled during off-peak periods. Peaks of cambial activity occur substantially earlier compared to GPP, suggesting the buffer role of non-structural carbohydrates between the processes of carbon assimilation and allocation to wood. Our findings suggest that high-resolution seasonal data of ecosystem carbon fluxes, wood formation and the associated physiological processes may reduce uncertainties in carbon source-sink relationships at different spatial scales, from stand to ecosystem levels

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Práticas artísticas no ensino básico e secundário

A mediação entre os conteúdos culturais e a Educação Artística formal tem emergido como uma distinta área de inovação e de intervenção, como o mostram os 18 artigos selecionados nesta nona edição da revista Matéria-Prima.Entre a identidade, fundada nos focos de conhecimento local, e uma inserção integrada nos problemas e conteúdos globais joga-se a problematização da Educação Artística. As propostas articulam quer discursos curatoriais (museu, bienal, exposição), como ações de mediação visando uma expansão das atividades, a que se juntam as reflexões sobre a realidade da formação de professores, nas suas diversas modalidades, em diversas realidades sociais.Propiciam-se oportunidades de ações de intervenção, concertadas ou não, entre os agentes artísticos e os educadores. O resultado pode ser potenciado se se conseguir uma perspetiva informada e integrada das realidades artísticas: pede-se a todos os intervenientes mais integração e disponibilidade para um conhecimento mútuo consequente.info:eu-repo/semantics/publishedVersio