Psychological distress, burnout and personality traits in Dutch anaesthesiologists

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Satisfaction of quality of care in a Pediatric Emergency Room

Objective: To evaluate the satisfaction index of pediatric patients' companions in relation to the quality of care provided in an emergency service. Methods: Cross-sectional and descriptive study conducted in a Pediatric Emergency Room of a teaching hospital with participation of 300 companions of pediatric patients. A validated instrument was offered to family members for their evaluation of the emergency service quality. Results: Pediatric patients' companions demonstrated satisfaction with the quality of care provided at the Pediatric Emergency Room. There was a significant statistical difference (p<0.05) in the satisfaction index of family members of children diagnosed with dermatological diseases and who received medications administered via rectal route, and those who sought the service because they considered it a reference or because they did not have health insurance. Conclusion: The family members surveyed are satisfied with the quality of care provided to their children in the emergency room service.Objetivo: Avaliar o índice de satisfação do acompanhante do paciente pediátrico com relação à qualidade do atendimento prestado em um serviço de emergência. Métodos: Pesquisa transversal e descritiva desenvolvida em um Pronto-Socorro Infantil de um hospital universitário, com a participação de 300 acompanhantes dos pacientes pediátricos. Utilizou-se um instrumento validado oferecido aos familiares para avaliar a qualidade do serviço de emergência. Resultados: Os acompanhantes dos pacientes pediátricos demonstraram satisfação com a qualidade de atendimento prestado pelo Pronto-Socorro Infantil. Registrou-se diferença estatística significativa (p<0,05) quanto ao índice de satisfação manifestado pelos familiares das crianças diagnosticadas com doenças dermatológicas, que receberam medicações administradas pela via retal e que procuraram o serviço por considerarem-no como referência ou por não possuírem plano de saúde. Conclusão: Os familiares pesquisados encontram-se satisfeitos no que se refere à qualidade de atendimento prestado às suas crianças no serviço de pronto-socorro.Univ Fed Sao Paulo, Escola Paulista Enfermagem, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Enfermagem, Sao Paulo, SP, BrazilWeb of Scienc

Stressors in anaesthesiology: development and validation of a new questionnaire: A cross-sectional study of Portuguese anaesthesiologists

BACKGROUND: Stress in anaesthesiologists is a common and multifactorial problem related to patients, colleagues and organisations. The consequences of stress include depression, work-home conflicts and burnout. Reduction in stress can be achieved by reducing the number and magnitude of stressors or by increasing resilience strategies. OBJECTIVES: We have created the self-reporting 'Stress Questionnaire in Anaesthesiologists' (SQA), to qualify the sources of stress in anaesthesiologists' professional lives, and measure the level of associated stress. Our study aimed to develop and validate the SQA using exploratory and confirmatory factor analyses. Construct validity was assessed through correlations between SQA and negative psychological outcomes as well as by comparing perception of stress among different known groups. DESIGN: A questionnaire-based cross-sectional, correlational, observational study. SETTINGS: The study was conducted between January 2014 and December 2014, throughout different anaesthesia departments in Portuguese hospitals. Data collection was from a representative subset at one specific time point. PARTICIPANTS: A sample of 710 anaesthesia specialists and residents from Portugal. MAIN OUTCOME MEASURES: The primary outcome measure was to identify specific stressors in anaesthesiologists. Secondary outcome was the association between stressors and burnout, depression symptoms, anxiety, stress, rumination, satisfaction with life and functional impairment. RESULTS: The exploratory analysis showed the SQA is a tri-dimensional instrument and confirmatory analysis showed the tri-dimensional structure presented good model fit. The three dimensions of SQA correlated positively with other stress measures and burnout, but negatively with satisfaction with life. CONCLUSION: SQA is a well adjusted measure for assessing stressors in anaesthesia physicians and includes clinical, organisational and team stress factors. Results showed that the SQA is a robust and reliable instrument.info:eu-repo/semantics/publishedVersio

Do sound waves transport the AGN energy in the Perseus cluster?

The level of random motions in the intracluster gas lying between 20 and 60 kpc radius in the core of the Perseus cluster has been measured by the Hitomi Soft X-ray Spectrometer (SXS) at 164 ± 10 km s$^{−1}$ . The maximum energy density in turbulent motions on that scale is therefore low. If dissipated as heat, the turbulent energy will be radiated away in less than 80 Myr and cannot spread across the core. A higher velocity is needed to prevent a cooling collapse. Gravity waves are shown to travel too slowly in a radial direction. Here we investigate propagation of energy by sound waves. The energy travels at ~1000 km s$^{−1}$ and can cross the core in a cooling time. We show that the displacement velocity amplitude of the gas required to carry the power is consistent with the Hitomi result and that the inferred density and temperature variations are consistent with $\textit{Chandra}$ observations.ACF, CP, CSR and HRR thank the Hitomi collaboration for the opportunity to participate in the analysis of the SXS data. ACF, CP, HRR and SAW acknowledge support from ERC Advanced Grant FEEDBACK, 340442

Impact of a simulation-based interprofessional workshop (LINKS) on Portuguese healthcare students’ perception of roles and competencies: a quasi-experimental pilot study

Introduction There is a scarcity of simulation-based interprofessional (IP) programs in Portugal, with a notorious absence in undergraduate education. This paper describes the first step towards the development of an interprofessional education (IPE) undergraduate program, namely the implementation and preliminary assessment of the workshop LINKS – Lifting INterprofessional Knowledge through Simulation. The aim of this pilot study was to assess the educational effect of LINKS, in medical and nursing undergraduate students’ attitudes towards IP teamwork and collaborative practices, and their perception of roles and competencies within an IP team. Methods A total of 23 final-year students participated in the workshop. Teams of three or four elements (medical and nursing students) were exposed to two critical patient management simulation scenarios. To assess the impact of the workshop on students’ perception of IP collaborative practice, two surveys (ATTITUDES and IPEC) were applied before and after the workshop. Additionally, students’ opinion/satisfaction towards the workshop and its curricular integration was explored. Results Students’ awareness of the relevancy of IP learning and self-competency in IP practice improved. For all subdomains and overall scores, statistically significant differences were found when comparing the pre- and post-scores, for both medical and nursing students, in both surveys. All students agreed that the workshop added educational value to their training, and recommended its integration in the formal curriculum, with a first round in the penultimate year and repeated in the last year. Discussion Considering the pre–post test results and anecdotal comments shared during the session, we may infer that this single IPE event contributed to a clearer understanding of the team dynamic and individual role definition, increased the motivation to engage in collaborative practice between physicians and nurses and potentially challenged pre-existent stereotypes of each professional group. These findings corroborate the need for sustainable simulation-based IP programs, integrated in the undergraduate curricula, promoting early clinical interactions of different professional groups. We envision that the results of this study can help to inform future curriculum planning and provide useful insights that can be used within and between Portuguese institutions to develop a common IP undergraduate program.info:eu-repo/semantics/publishedVersio

Increased Frequency of CD4 and CD8 Regulatory T Cells in Individuals under 15 Years with Multibacillary Leprosy

Background: Leprosy is a chronic disease, caused by Mycobacterium leprae, which poses a serious public health problem worldwide. Its high incidence in people under 15 years old in Ceara state, Brazil, reflects the difficulty of its control. the spectrum of clinical manifestations is associated with the immune response developed, with the Th1 and Th2 responses being related to the paucibacillary and multibacillary forms, respectively. Regulatory T cells (Treg), which can suppress Th1 and Th2 response, have received special attention in the literature and have been associated with development of chronic infections. However, their role in leprosy in individuals under 15 years old has not yet been elucidated. We evaluated the frequency of CD4(+)/CD8(+)CD25(high)FOXP3(+) and CD4(+)/CD8(+)CD25(high)FOXP3(high) cells in leprosy patients and household contacts, in both cases under 15 years old.Methodology/Principal Findings: PBMC from 12 patients and 17 contacts were cultured for 72 hours with anti-CD3 and anti-CD28 (activators) or with activators associated with total sonicated fraction of M. leprae. After culture, the frequency of CD4(+)/CD8(+) Treg was identified by flow cytometry. Cells stimulated by activators and antigen from multibacillary patients showed Treg frequencies almost two times that of the contacts: CD4(+)FOXP3(+) (21.93 +/- 8.43 vs. 13.79 +/- 8.19%, p = 0.0500), CD4(+)FOXP3(high) (10.33 +/- 5.69 vs. 5.57 +/- 4.03%, p = 0.0362), CD8(+)FOXP3(+) (13.88 +/- 9.19 vs. 6.18 +/- 5.56%, p = 0.0230) and CD8(+)FOXP3(high) (5.36 +/- 4.17 vs. 2.23 +/- 2.68%, p = 0.0461). Furthermore, the mean fluorescence intensity of FOXP3 in Treg was higher in multibacillary patients than in the contacts. Interestingly, there was a positive correlation of the bacillary index and number of lesions with the frequency of all Treg evaluated in patients.Conclusions/Significance: We have demonstrated for the first time that multibacillary leprosy patients under 15 years old have greater CD4(+) and CD8(+) Treg frequencies and these correlate with clinical and laboratorial aspects of disease. These findings suggest the involvement of these cells in the perpetuation of M. leprae infection.Fundacao Cearense de Apoio ao Desenvolvimento Cientifico e TecnologicoPost-Graduation Program in Medical MicrobiologyUniv Fed Ceara, Dept Pathol & Legal Med, Med Lab Immunol, Fortaleza, Ceara, BrazilDermatol Ctr Dona Libania, Fortaleza, Ceara, BrazilWalter Cantidio Univ Hosp, Fortaleza, Ceara, BrazilUniv Fortaleza, Fortaleza, Ceara, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilWeb of Scienc

Implementation of a PBL/CDIO methodology at ISEP-P.PORTO Systems Engineering Course

The earlier engineers start their creative process, the faster they can be useful to industry and economically compensated. The academy therefore has the duty to take the first step as an educational agent.info:eu-repo/semantics/publishedVersio

Effects of high temperature on survival, symbiotic performance and genomic modifications of bean nodulating Rhizobium strains.

High temperatures can affect the survival, establishment and symbiotic properties of Rhizobium strains. Bean nodulating Rhizobium strains are considered particularly sensitive because on this strains genetic recombinations and/or deletions occur frequently, thus compromising the use of these bacteria as inoculants. Rhizobium tropici and R. leguminosarum bv. phaseoli strains isolated from cerrado soils were exposed to thermal stress and the strains' growth, survival and symbiotic relationships as well as alterations in their genotypic and phenotypic characteristics were analysed. After successive thermal shocks at 45 degrees C for four hours, survival capacity appeared to be strain-specific, independent of thermo-tolerance and was more apparent in R. tropici strains. Certain R. leguminosarum bv. phaseoli strains had significant alterations in plant dry weight and DNA patterns obtained by AP-PCR method. Rhizobium tropici strains (with the exception of FJ2.21) were more stable than R. leguminosarum bv. phaseoli strains because no significant phenotypic alterations were observed following thermal treatments and they maintained their original genotypic pattern after inoculation in plants.

Semantic Web Services for Multi-Agent Systems Interoperability

Agent-based technologies are often used including existing web services. The outputs of some services are also frequently used as inputs for other services, including other MAS. However, while agent-based technologies can be used to provide services, these are not described using the same semantic web technologies web services use, which makes it difficult to discover, invoke and compose them with web services seamlessly. In this paper, we analyse different agent-based technologies and how these can be described using extensions to OWL-S. Additionally, we propose an architecture that facilitates these services’ usage, where services of any kind can be registered and executed (semi-)automatically.The present work has been developed under the PIANISM Project (ANI|P2020 40125) and has received funding from FEDER Funds through NORTE2020 program and from National Funds through Fundação para a Ciência e a Tecnologia (FCT) under the project UID/EEA/00760/2019. Gabriel Santos is supported by national funds through FCT PhD studentship with reference SFRH/BD/118487/2016.info:eu-repo/semantics/publishedVersio