Frailty in Portuguese Older Patients From Convalescence Units: A Cross-Sectional Study

Background: Frailty is a common geriatric syndrome, associated with adverse clinical outcomes. Nevertheless, studies about frailty in continuous care units are scarce. In this way, this study aimed to assess frailty in older patients admitted in convalescence units (CUs) and analyze its association with demographic, social and clinical characteristics. Methods: This cross-sectional study included older patients admitted in eight CUs of the Integrated Continued Care National Network in Northern Portugal. Exclusion criteria were: total ≤ 11 in Glasgow coma scale, < 10 in mini-mental state examination or being unable to communicate. A comprehensive protocol was administered to assess health-related and lifestyle characteristics, comorbidity, dependence on activities of daily living (ADL), depressive and anxiety symptoms, cognition, and socio-familial risk. Frailty was assessed by Tilburg frailty indicator (TFI). Results: A sample of 165 patients was included (median age = 77; 65% female), with 80% classified as frail, mostly women (P = 0.002), widowed (P = 0.016), shorter (P = 0.005), feeling more tired (P < 0.005) and with less energy (P < 0.005). Also, these patients reported more vision problems (P = 0.006), difficulties in walking (P = 0.022) and climbing stairs (P = 0.029), pain (P = 0.004), falls (P = 0.046), non-alcohol use (P = 0.043) and non-physical activity (P = 0.032). Frail patients had a higher number of previous hospitalizations (P = 0.018), comorbidity (P = 0.006), dependence on instrumental (P < 0.001) and basic (P = 0.006; P < 0.001) ADL, depressive (P < 0.001) and anxiety (P = 0.002) symptoms. After adjusting for covariates, frailty was associated with females (adjusted odds ratio (aOR) = 4.45, P = 0.011), vascular disease (aOR = 4.40, P = 0.040), vision problems (aOR = 10.85, P < 0.001), high dependency on instrumental ADL (aOR = 0.74, P = 0.002), and depressive symptoms (aOR = 1.37, P = 0.001). Conclusions: Frailty is high among older patients in CUs, particularly in females, with vascular disease, vision problems, instrumental ADL dependence and depressive symptoms. Thus, frailty should be screened, and preventive and therapeutic measures should be considered for those at high risk, in order to minimize possible negative consequences. © The authors | Journal compilation J Clin Med Res and Elmer Press Inc™ | www.jocmr.org This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cite

"O ponto é começo… o ponto é vida." : uma experiência de ensino integrado

O presente trabalho tem como principal objectivo partilhar experiências decorridas do desenvolvimento do Projecto "O ponto é começo… o ponto é vida.". Este foi desenvolvido com uma turma do 1.º ano do 1º Ciclo do Ensino Básico no Agrupamento Vertical de Escolas de Macedo de Cavaleiros (Norte de Portugal). Contou com a colaboração de vários docentes do Agrupamento e docentes da Escola Superior de Educação de Bragança. Salientamos que todas as etapas do projecto, ao surgir do interesse das crianças, foram desenvolvidas de acordo com uma pedagogia de participação e suportadas por uma metodologia de projecto. Esta experiência constituiu-se um exemplo de interdisciplinaridade, pois foram abordadas diferentes áreas curriculares, nomeadamente a Língua Portuguesa; a Exploração do Meio Físico (Ciências) e as Expressões, sempre de uma forma integrada e não compartimentada

“O ponto é começo… o ponto é vida.” : uma experiência de ensino integrado

O presente trabalho tem como principal objectivo partilhar experiências decorridas do desenvolvimento do Projecto “O ponto é começo… o ponto é vida. ”. Este foi desenvolvido com uma turma do 1. º ano do 1º Ciclo do Ensino Básico no Agrupamento Vertical de Escolas de Macedo de Cavaleiros (Norte de Portugal). Contou com a colaboração de vários docentes do Agrupamento e docentes da Escola Superior de Educação de Bragança. Salientamos que todas as etapas do projecto, ao surgir do interesse das crianças, foram desenvolvidas de acordo com uma pedagogia de participação e suportadas por uma metodologia de projecto. Esta experiência constituiu-se um exemplo de interdisciplinaridade, pois foram abordadas diferentes áreas curriculares, nomeadamente a Língua Portuguesa; a Exploração do Meio Físico (Ciências) e as Expressões, sempre de uma forma integrada e não compartimentada

Efeito do sal no desempenho de um reator batelada sequencial

Neste trabalho investigou-se o desempenho de um Reator Batelada Sequencial no tratamento de efluentes salinos (0,5 a 6,0%) utilizando uma estratégia de enchimento por pulsos simétricos. Verificou-se que com a estratégia adotada se obtiveram elevadas porcentagens de remoção de amónia (acima de 70%) evidenciando a elevada eficiência do reator batelada sequencial no processo de nitrificação. Contudo, para 0,5 e 1,0% de sal a remoção de amónia diminuiu indicando que a influência do choque de adição de sal é maior no início da etapa de aclimatação da biomassa. Apesar de ter sido observado um aumento da concentração de biomassa dentro do reator durante o período estudado, as porcentagens de remoção de DQO diminuíram com o aumento da concentração de sal no efluente, apontando um efeito inibitório do sal. A diminuição do IVL com o aumento da concentração de sal indica a sedimentação dos flocos menos compactos, enquanto que o aumento da turbidez demonstra uma maior quantidade de sólidos suspensos no efluente tratado.The work aims to evaluate a Sequencing Batch Reactor performance treating with saline wastewater (0,5 to 6,0%) employing a filling strategy with symmetric pulses. It was verified that the adopted operational strategy provides ammoniacal nitrogen removal rates over than 70%, demonstrating the high efficiency of this reactor in the nitrification process. Nevertheless, amonia removal rate lowered for 0,5 and 1,0% NaCl, indicating that the influence of salt addition is more significant in the early biomass acclimation stages. Although it was observed an increase in biomass concentration inside the reactor along the operation period, the removal indexes for COD diminishes with salt concentration increase, denoting somehow an inhibitory effect. Lower SVI were achieved with an increase in salt concentration leading to the settling of less compact sludge, while higher turbidity reveals na increase in the suspended solids in the treated effluent

New Insights about Pulmonary Epithelioid Hemangioendothelioma: Review of the Literature and Two Case Reports

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare neoplasm of vascular origin. There are three different major imaging patterns identified in thoracic manifestation of epithelioid hemangioendothelioma: (1) multiple pulmonary nodules; (2) multiple pulmonary reticulonodular opacities; and (3) diffuse infiltrative pleural thickening. Radiographically, presence of bilateral multiple nodules is the most common pattern of presentation. The diagnosis is made on the basis of histopathological findings and confirmed by positive immunohistochemistry staining. Although the prognostic factors for PEH have not yet been well established, a better prognosis is usually associated with the multinodular pattern. We report two different imagological presentations of this rare disease, based on two institutional experiences, along with a review of the relevant literature.info:eu-repo/semantics/publishedVersio

First Diabetic Retinopathy Prevalence Study in Portugal: RETINODIAB Study-Evaluation of the Screening Programme for Lisbon and Tagus Valley Region

BACKGROUND/AIMS: In Portugal, so far, there is no study or even accurate data on the prevalence of diabetic retinopathy (DR), based on a large representative sample and on a long-term follow-up. The objective of our study was to determine the prevalence of DR based on a national screening community-based programme. METHODS: A 5-year retrospective analysis of the RETINODIAB screening programme results was implemented in Lisbon and Tagus Valley area between July 2009 and October 2014. We estimated the prevalence of retinopathy for all patients with type 2 diabetes and studied the association between known risk factors and retinopathy emergence at their first screening. RESULTS: Throughout this period, from a total of 103 102 DR readable screening examinations, 52 739 corresponded to patients who attended RETINODIAB screening at entry. Globally, DR was detected in 8584 patients (16.3%). Of these, 5484 patients (10.4%) had mild non-proliferative (NP) DR, 1457 patients (2.8%) had moderate NPDR and 672 (1.3%) had severe NPDR. Finally, 971 patients (1.8%) had proliferative DR requiring urgent referral to an ophthalmologist. The presence of any DR, non-referable DR or referable DR was strongly associated with increasing duration of diabetes and earlier age at diagnosis. CONCLUSIONS: The prevalence rate of DR in our study (16.3%) was slightly lower than other published international data. The RETINODIAB network proved to be an effective screening programme as it improved DR screening in Lisbon and Tagus Valley surrounding are

Chemical composition and anthelmintic activity in vitro of the essential oil of Mentha piperita: preliminary data.

Abstract: Research towards plant compounds with activity against worm parasites has been carried out for a number of decades; however it is especially important now when drench resistance has compromised the effectiveness of present control methods. In this study we characterized the composition of Mentha piperita essential oil and evaluated its anthelmintic effect against developmental stages of trichostrongylids from naturally infected goats (95% Haemonchus contortus and 5% Trichostrogylus spp.) through the egg hatch and larval development assays. The major constituent of the tested substance quantified by gas chromatography was menthol (58.35%). The lowest concentration of essential oil with 100% efficacy in all in vitro tests against caprine trichostrongylids was 0.35%. However, the equivalent dose of menthol alone (0.4%) was not fully effective against nematode egg eclosion. The anthelmintic activity of the essential oil of M. piperita showed good effectiveness in previous studies but also showed the presence of toxic compounds such as pulegone which could be toxic to goats according to allometric extrapolation. Our results show that the major component in the essential oil is not the only one responsible for the antiparasitic effect of M. piperita. Also, our data support the idea there is a wide variation in the composition of essential oils obtained from different sources. Thus, it is important that in assessing anthelmintic activity of plant candidates, the chemical composition should be thoroughly investigated before proceeding to the in vivo step.In conjunction with 53rd MSPTM Annual Conference

What can be recommended to engineering teachers from the analysis of 16 European teaching and learning best practices?

European Higher Education institutions have been implementing active learning strategies in different contexts. In order to learn and disseminate these approaches, it is important to understand how these successful active learning strategies can be implemented in new contexts. The EXTEND ERASMUS+ project aims to develop Engineering Education Centres in Russia and Tajikistan in order to make a contribution for the development of these countries' schools of Engineering. One of the first steps in pursue of this objective is the study of European teaching and learning best practices and the definition of a set of useful recommendations for the teachers of Engineering schools. A question raised by this approach was what can be recommended to engineering teachers from the analysis of teaching and learning best practices? The objective of this paper is to develop a method for the analysis and recommendations and to present the results of the application of this method in 16 European teaching and learning best practices. The method was qualitative and developed by brainstorming between experts of the projects from different areas of knowledge. This method included the definition of a glossary, selection of best practices, collection of the information, analysis in relation to the best practices, analysis of maturity levels regarding the current level of partner countries and development of collaborative recommendations. The main recommendations for the Russia and Tajik contexts are to develop Project Based Learning approaches in interaction with industry, and additionally for Tajik partners to develop entrepreneurial and management competences in engineering students.This work is based on outcomes of the project EXTEND –“Excellence in Engineering Education through Teacher Training and New Pedagogic Approaches in Russia and Tajikistan” that has been funded with support from the European Commission (Project Number: 586060-EPP-1-2017-1-RO-EPPKA2-CBHE-JP). This publication reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein. The authors would like to thank to the members of the consortium and all that made possible to collect the data we used in this paper.This work has been supported by FCT –Fundação para aCiência e Tecnologia within the Project Scope UIDCEC003192019