Contributos do relatório técnico para o desenvolvimento dos técnicos de radiologia do Centro Hospitalar do Médio Tejo, E.P.E.: O caso dos técnicos de radiologia da unidade de Torres Novas

A presente dissertação pretende contribuir para um aprofundamento do conhecimento do lugar e do papel do relatório técnico (RT) no contexto do desenvolvimento dos Técnicos de Radiologia (TR). Em termos estritos trata-se de um estudo sobre os conhecimentos dos TR sobre o relatório técnico, a autoavaliação das competências do TR nessa matéria, interrogando ainda as limitações e vantagens da introdução do relatório técnico nas atividades deste grupo profissional no Centro Hospitalar do Médio Tejo, na Unidade de Torres Novas. Para a pesquisa realizada e em relação as opões metodológicas, optei por um paradigma qualitativo, recorrendo como técnica privilegiada de recolha de dados a entrevista. De acordo com as entrevistas efetuadas, os Técnicos de Radiologia valorizam positivamente o desenvolvimento e a participação em projetos multidisciplinares de pesquisa e investigação, bem como a formação continua e o aperfeiçoamento profissional em áreas essenciais para efetuar o relatório técnico. A formação inicial e contínua nestes domínios do RT é entendida como um motor de desenvolvimento profissional do Técnico de Radiologia e do sector da Radiologia. Os resultados do estudo sugerem ainda que o desenvolvimento da profissão passa pelo reforço da cooperação entre as instituições de saúde e o próprio Sistema Nacional de Saúde (SNS), que em conjunto possam oferecer não só a melhoria das condições de trabalho dos Técnicos de Radiologia, mas também, novas oportunidades de colaboração com os Médicos e os restantes profissionais das equipas multidisciplinares, designadamente no diagnostico clinico e na promoção e valorização da qualidade na prestação cuidados e/ou de serviços técnicos de diagnostico para os utentes. /ABSTRACT - The present dissertation intends to be a contribution in the understanding about the influence of the technical report (TR) as a factor in radiographers’ (R) professional development. It’s a study which intends to evaluate radiographers’ knowledge about the report, enhancing self-evaluation, and questioning all the limitations and advantages of its implementation in radiographers’ daily activities in Centro Hospitalar do Médio Tejo, Torres Novas Unit. As for methodological options, the method chosen to the research was a qualitative paradigm using interview to collect data. According to the interviews made about the technical report, the Radiographers enhance the importance of developing and taking part in multidisciplinary research and development projects, as well as the need for continuous formation to achieve professional development in the area of TR. Continuous formation is the base in the development of radiologist’s skills in order to produce the technical report. This research results demonstrates that in order to this Project to take shape, it is fundamental to improve cooperation between health institutions and the National Health System itself, which together will allow the radiographers to take a step forward in role development, making a huge contribution to accurate clinical diagnoses and improving the quality of the service provided to all wealth care users

How Far Upstream: A Review of Estuary-Fresh Water Fish Movements in a Large Neotropical Basin

The present study comprises the first systematic analysis of the limits of upstream movement by some fish species that use the estuarine area of the Patos Lagoon basin in southern Brazil. The Sinos River sampling program included 86 sites, sampled from 1998 to 2014, covering lowland stretches and headwater streams. The Guaíba sampling program was conducted from February 2011 to March 2013 and comprised 59 independent samples. Six fish species using estuarine areas occur in the upper Patos basin, 250–500 km from the Patos Lagoon outlet to the Atlantic Ocean. Parapimelodus nigribarbis specimens ranged from 11.3 to 18.9 cm (median = 13.3 cm) in length, i.e., were adults (Sinos, n = 459; Guaíba, n = 149). The species was captured almost 500 km from the Patos outlet, as far as 180 km upstream in the Sinos main channel. In Guaíba Lake, the species was captured mainly in autumn, although it was more abundant in winter and spring in the Sinos River. Lycengraulis grossidens was captured in the Sinos Basin, restricted to the lower stretches in spring and summer months (n = 7). In Guaíba Lake (n = 134) the species occurred throughout the lake and year-round, and was ten times more abundant in spring. Most specimens were adult (8.2–26.9 cm, median = 20.0 cm). Most Micropogonias furnieri individuals (n = 63) were juveniles (10.7–33.4 cm, median = 14.2 cm). The species was not captured in the Sinos Basin. In Guaíba Lake M. furnieri occurred predominantly in the southernmost part (downstream) and was more abundant (>10×) in winter. Genidens genidens (n = 27) was captured only in summer in the southern part of Guaíba Lake (closest to the outlet). Most individuals were adults (24.5–34.0 cm, median = 27.8 cm). Genidens barbus (n = 7) was restricted to spring and summer months and was captured only in southern (near-outlet) parts of Guaíba Lake, comprising mainly large juveniles and adults (31.5–68.0 cm, median = 37.9). Mugil liza (n = 13) appeared in spring in relatively low abundances but was widespread throughout Guaíba Lake during the summer. The species was not captured in the Sinos sampling program. The size profile comprised specimens nearing maturity (34.3–45.5 cm, median = 38.9 cm). Finally, we suggest possible biological cycles for these species that combine these new distribution data with published information

Estudo biométrico do caranguejo-de-profundidade de Angola (Chaceon maritae) e determinação do tamanho de primeira maturação sexual

Dissertação de Mestrado, Biologia Marinha, Especialização em Pescas e Aquacultura, Faculdade de Ciências do Mar e do Ambiente, Universidade do Algarve, 2008O caranguejo-de-profundidade Chaceon maritae (Manning & Holthuis, 1981) constitui um dos importantes recursos de crustáceos de Angola, principalmente nas costas do Lobito e do Namibe, onde é capturado comercialmente desde os anos 80. Apesar disso, esta espécie encontra-se pouco estudada em Angola sendo, por isso, reduzida a informação publicada sobre a sua biologia e dinâmica populacional, nesta região. Neste estudo foram estimadas relações biométricas (comprimento-largura de carapaça e peso total-largura de carapaça) para machos e fêmeas de C. maritae com base em exemplares capturados ao largo do Lobito em dois períodos distintos: Janeiro a Julho de 1974 (informação não publicada da BIOPESCA) e Abril a Maio de 2007 (informação recolhida no presente estudo). Com dados de 2007 foram ainda estimadas relações morfométricas, usando como variável de estudo o comprimento do 5º segmento abdominal (CSA) para as fêmeas e o comprimento/largura das pinças (Cp e Lp, respectivamente) para os machos, de forma a estimar o tamanho ao qual ocorre a maturação sexual nesta espécie. Estas variáveis foram seleccionadas após realização de uma análise hierárquica de clusters para cada sexo. Todas as relações (CSA-LC e Cp/Lp-LC) apresentaram um crescimento alométrico negativo (p < 0,05; b < 1). Estas relações, juntamente com as análises de regressão de “eixo maior reduzido”, mostraram que as fêmeas e os machos maturam a tamanhos diferentes, atingindo os últimos a maturidade a tamanhos superiores. Com base na sua condição vulvar, estimou-se uma ogiva de maturação para as fêmeas e determinou-se o tamanho de primeira maturação sexual (LC50) em 7,51 cm de largura de carapaça (LC). Morfometricamente, obtiveram-se valores de LC50, entre 7,5 e 8,5 cm para as fêmeas e a partir de 9,4 cm os machos, estando estes valores de acordo com os obtidos nos estudos de maturidade realizados por vários autores para C. maritae e para outras espécies pertencentes ao mesmo género.The deep-sea red crab Chaceon maritae (Manning & Holthuis, 1981) constitutes one of the most important crustacean resources of Angola, commercially exploited since the eighties off Lobito and Namibe coasts. However, this species is poorly studied in Angola, therefore, published data on its biology and population dynamics is quite scarce. This study aimed to contribute to a better knowledge of C. maritae, by estimating some biometric relationships and biological traits of this species caught off Lobito coast. Two biometric relationships were estimated (carapace length-carapace width-CC/LC and total weight-carapace width-Pt/LC) for males and females of C. maritae, caught off Lobito from January to July of 1974 (unpublished data of BIOPESCA) and from April to May of 2007 (data collected during the present study). During the present study, additional relationships were estimated using the length of the fifth abdomen segment (CSA) against LC for females and the length (Cp) and width (Lp) of male claws against LC, to estimate the size at first maturity. These variables were used after analyzing the results obtained from Hierarchical Cluster Analyses. The CSA/LC, Cp/LC and Lp/LC showed allometric negative growth (p < 0.05; b < 1). The results obtained showed that males mature at larger size than females. The size at first maturity was also estimated by adjusting an ogive to the percentage of mature females by length (LC50= 7,51 cm). Maturity was assessed according vulvae condition. The size at first maturity obtained for this species caught off Lobito, were between 7,5 and 8,5 cm of LC for females and larger than 9,4 cm for males, which agrees with previous studies on this species carried out in different locations and for species of the same genus

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Delaying surgery for patients with a previous SARS-CoV-2 infection

Not availabl