Contributo da análise ergonómica do trabalho para o estudo de acidentes de trabalho em enfermeiros no serviço de urgência

Mestrado em Segurança e Higiene no Trabalho.O presente estudo pretende identificar os contributos da Análise Ergonómica Trabalho (AET) para a compreensão dos Acidentes de Trabalho (AT) com implicações a nível da coluna lombar em enfermeiros do serviço de urgência (SU). Na maioria dos casos, os resultados da análise dos AT (AAT) revelam-se insuficientes, quer na gestão do risco, quer na identificação dos motivos que impedem a aprendizagem com os AT. Metodologia: O estudo é de carácter exploratório/descritivo e transversal e integra todos os enfermeiros do SU de uma UH. A recolha de dados assenta na identificação dos últimos 10 AT no SU, recorrendo aos resultados da AAT e comparando-os com a aplicação da metodologia da AET (questionários, entrevistas, observação directa do local do AT, presencial, com registos em fotografia e/ou filme e confrontação dos acidentados). Resultados esperados: a AAT relaciona-se essencialmente com causas activas, o que é visível, atribuindo “culpas ao trabalhador” pelo acidente ocorrido. Em oposição, a AET identifica condições latentes da actividade de LMTD, designadamente a nível da concepção e organização do espaço de trabalho, da (in)adequação dos equipamentos, dos rácios doente/enfermeiro, da presença de stress, etc., que estão na origem da ocorrência de AT, frequentemente “ocultas ou diluídas” no contexto e, por isso, invisíveis, e associa-as às causas activas (ex. posições corporais, decisões e acções). Só através desta associação se consegue efectuar um diagnóstico das situações reais de trabalho. Espera-se um contributo para uma abordagem de gestão de risco mais assertiva e, sobretudo, com maior probabilidade de prevenção desses AT. ABSTRACT - This study aims to identify the contributions of Ergonomic Work Analysis (EWA) for the understanding of Occupational Accidents (OA) with implications for the lumbar spine in nurses at the emergency room department (ER). In most cases, the results of the Occupational Accidents Analysis (OAA) are insufficient, either in risk management, or in identifying the reasons which prevent the learning with the OA. Methodology: The study is an exploratory/descriptive and transversal that integrates all the nurses of the ER from one Hospital. The data collection is based on the identification from the last 10 OA occurred in the ER, using the results of the OAA comparing them with the EWA methodology (questionnaires, interviews, direct observation from the workplace where OA occurred, photography/movie records, and workers confrontation). Expected Results: The OAA is primarily related with active causes, what is visible, assigning "blame to worker" for the accident occurred. In opposition EWA identifies latent conditions of the manual patients handling (MPH) activity particularly, the design and layout from the workplace, the (in)adequacy of equipment, the ratios of patient/nurses, the presence of stress, etc., which are the source of OA, often "hidden or diluted" in the context and, therefore invisible, so those are associated with the active causes (eg, body positions, decisions and actions). Only through this association is possible to make a diagnosis of real work situations. It is expected to contribute to a more assertive risk management approach and, especially, to prevent OA related with manual patient handling

Essential oils encapsulated in zeolite structures as delivery systems (EODS): an overview

Essential oils (EO) obtained from plants have proven industrial applications in the manufacturing of perfumes and cosmetics, in the production and flavoring of foods and beverages, as therapeutic agents in aromatherapy, and as the active principles or excipients of medicines and pharmaceutics due to their olfactory, physical-chemical, and biological characteristics. On behalf of the new paradigm of a more natural and sustainable lifestyle, EO are rather appealing due to their physical, chemical, and physiological actions in human beings. However, EO are unstable and susceptible to degradation or loss. To tackle this aspect, the encapsulation of EO in microporous structures as zeolites is an attractive solution, since these host materials are cheap and non-toxic to biological environments. This overview provides basic information regarding essential oils, including their recognized benefits and functional properties. Current progress regarding EO encapsulation in zeolite structures is also discussed, highlighting some representative examples of essential oil delivery systems (EODS) based on zeolites for healthcare applications or aromatherapy.The authors are grateful for the national funds provided by the FCT (Foundation for Science and Technology, Portugal) under the projects UIDB/04050/2020 (CBMA) and PTDC/AAGTEC/5269/2014 (FEDER, European Fund for Regional Development)/COM PETE/POCI—Operational Competitiveness and Internationalization Programme under the project POCI-01-0145-FEDER-006958. They are grateful for the financial support provided by the Research Centers CQ/UM through UID/QUI/0686/2020 and Project BioTecNorte (operation NORTE-01-0145-FEDER-000004), supported by the Northern Portugal Regional Operational Programme (NORTE 2020) under the Portugal 2020 Partnership Agreement through the European Regional Development Fund.info:eu-repo/semantics/publishedVersio

Second Workshop on Atlantic chub mackerel (Scomber colias) (WKCOLIAS2)

The Atlantic chub mackerel Scomber colias has become an increasingly important commercial species in the European Atlantic waters in the last 10–15 years, probably through an expansion process from NW African waters and due to market needs. However, at present there are no assessment or advice requirements. In the WK framework, available information of the species in the West Atlantic waters has been compiled in order to evaluate possible geographical differences and trends, and the feasibility to describe its population structure. Though the Atlantic chub mackerel is not routinely included among the target species in the acoustic surveys performed in the Atlantic Iberian waters and the Mediterranean Sea, a synoptic overview of the species is possible over all its West Atlantic distribution. Moreover, the data available have indicated latitudinal trends, mainly in the landings’ length composition, L50 and the spawning periods. Nevertheless, even if some degree of connectivity likely exists and migrations are occurring between adjacent areas, some subunits could be considered for management purposes. From the assessment models’ trials carried out, the results or reference points obtained for the European fisheries cannot be retained at present. Therefore, continuing collating information from fisheries and biological sampling of the species, obtaining reliable biomass estimations from scientific surveys and identifying management units seem the main priorities to address in future research work and in case of assessment requirements

Multiple Myeloma Treatment Guidelines by the Portuguese Group of Multiple Myeloma

The treatment of multiple myeloma has profoundly changed with the introduction of several innovative therapies. The optimization of therapeutic sequencing through the combined use of the various drugs developed in recent years and the attention given to the characteristics of patients have allowed the reduction of toxicities and increased survival and quality of life of patients with multiple myeloma. These treatment recommendations from the Portuguese Multiple Myeloma Group offer guidance for first-line treatment and progression/relapse situations. These recommendations are given highlighting the data that justify each choice and referring to the respective levels of evidence that support these options. Whenever possible, the respective national regulatory framework is presented. These recommendations constitute an advance towards the best treatment of multiple myeloma in Portugal.publishersversionpublishe

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research