Estágio realizado no Centro de Saúde de Paço de Arcos : programa comunitário PLE2NO : atividade física na osteoartrose

A Osteoartrose (OA) é uma doença reumática crónica com elevado impacto na sociedade afetando a saúde, interferindo na realização das atividades de vida diárias e na qualidade de vida da pessoa. O exercício e a educação do paciente destacam-se como medidas de controlo de sintomas. Os objetivos do estágio curricular foram: adquirir conhecimentos teórico-práticos relacionados com OA, desenvolver competências essenciais à ótima comunicação e liderança com as pessoas e instituições envolvidas e prescrever exercícios adaptados a indivíduos com OA no joelho. O estágio esteve relacionado com o desenvolvimento de uma intervenção: Programa Livre de Educação e Exercício Na Osteoartrose - PLE²NO (programa de três meses de educação e exercício), tendo como principal objetivo: cativar e motivar as pessoas para a prática de exercício; determinar a eficácia na gestão da patologia, e controlo dos sintomas, e verificar a sua efetividade na aptidão física e qualidade de vida de pessoas com OA no joelho. Em suma, esta intervenção mostrou-se uma mais-valia na aquisição de conhecimento e relação interpessoal com a população alvo deste programa.Osteoarthritis (OA) is a chronic rheumatic disease with a high impact on society, affecting health, interfering in the performance of daily life activities and in the person's quality of life. Exercise and patient education stand out as symptom control measures. The objectives of the curricular internship were: to acquire theoretical and practical knowledge related to OA, to develop essential skills for excellent communication and leadership with the people and institutions involved and to prescribe exercises adapted to individuals with OA in the knee. The internship was related to the development of an intervention: Free Education and Exercise Program in Osteoarthritis - PLE²NO (three-month education and exercise program), with the main objective: to captivate and motivate people to exercise; to determine the effectiveness in the management of the pathology, and control of the symptoms, and to verify its effectiveness in the physical fitness and quality of life of people with OA in the knee. In short, this intervention showed a capture of knowledge and interpersonal relationship with the target population of this program

Functional, nutritional and social factors associated with mobility limitations in the elderly: a systematic review

Objective. To systematically review the prevalence and in­cidence of mobility limitations in the elderly people and their associated factors. Materials and methods. Articles in the electronic literature were searched via PubMed, Scopus, Lilacs, SciELO, PAHO, MedCarib, Repidisca, Wholis, IBCES, PEDro, Medline and Bireme (2012-2016). The instrument STROBE was used to analyze the quality of the work and the PRISMA recommendation was used to structure the review. Results. Nine studies were included. The prevalence of mobility limitations ranged from 58.1 to 93.2% and the inci­dence ranged from 23 to 53.7%. Studies provided evidence of association of mobility limitations in the elderly popula­tion with high BMI, low 25-hydroxy vitamin D, sarcopenia, fragility, chronic pain, functional dependence, advanced age in women, low hip flexion, sedentary lifestyle, and social support difficulties. Conclusion. Mobility limitations in the elderly had high prevalence and incidence, and there was evidence of association with nutritional, functional and social factors

Discriminação Salarial por Gênero e Raça na Paraíba e em João Pessoa

Este artigo tem por objetivo analisar se houve discriminação salarial por gêne-ro e raça na Paraíba e em sua capital, João Pessoa, no ano de 2017. A estratégia empírica consiste no uso de equações mincerianas que buscarão captar os efeitos das características produtivas e do mercado de trabalho. Para atingir esse objeti-vo, empregam-se dois métodos. A primeira parte consiste em utilizar a decompo-sição de Oaxaca-Blinder (1973) para verificar, por meio das médias salariais das equações mincerianas, o diferencial bruto de salários, tendo como foco a parcela do diferencial salarial atribuído à parte explicada (características dos trabalhado-res) e à parte não explicada (“possível discriminação”). O segundo método aplica RIF-regressions para estimar as equações de rendimentos para três quantis: 25°, 50° e 75°. Os resultados sinalizam que os atributos produtivos ajudam no dife-rencial de salário entre homens e mulheres, e o componente não explicado indica que o efeito discriminatório tende a aumentar a diferença entre esses agentes. Por último, os resultados das RIF-regressions sugerem que há discriminação salarial entre todos os grupos estudados ao longo dos quantis da amostra. Observou-se também que o ensino superior contribuiu de maneira positiva em todas as amos-tras analisadas

PERFIL SOCIODEMOGRÁFICO E LABORATORIAL DOS PACIENTES SUBMETIDOS À HEMODIÁLISE EM UM CENTRO DE REFERÊNCIA DO ESTADO DO CEARÁ

A Doença Renal Crônica (DRC) é uma importante redução da função renal que causa alterações no metabolismo dos indivíduos. Para acompanhar a progressão da DRC e prevenir possíveis complicações, foi realizada uma pesquisa para avaliar o perfil sociodemográfico, bioquímico e hematológico de pacientes com Insuficiência Renal Crônica (IRC) submetidos a hemodiálise. Esta pesquisa foi quantitativa, descritiva e transversal de caráter retrospectivo, realizada por meio da análise de dados secundários contidos nos prontuários dos pacientes. A coleta de dados ocorreu no Centro de Hemodiálise da cidade de Russas, no Ceará. A amostra foi constituída por 161 pacientes com DRC, sendo 63,35% do sexo masculino e 85,71% pardos, com uma idade média de 54,39 anos. Desses, 63,97% tinham entre 2 e 10 anos de tratamento e 57,76% possuíam ensino fundamental incompleto. 19,25% residiam em Russas. Resultados: Após a hemodiálise, os resultados mostraram 44 mg/dL de Ureia, 48,44% dos pacientes com valores normais. A hemoglobina e hematócrito médios foram 11,8 g/dL e 33,7%, respectivamente, sendo que 63,35% tiveram valores reduzidos. 85,10% dos pacientes tiveram contagem de plaquetas normal, 72,04% níveis adequados de ferro e albumina, 52,79% tiveram níveis elevados de ferritina, 23,61% redução de transferrina e níveis lipídicos satisfatórios. 79,50% apresentaram níveis séricos de potássio dentro da normalidade, 12,42% de fósforo acima do normal, 85,09% de cálcio dentro dos valores normais, 39,13% de PTHi normais e 86,33% de glicose dentro dos valores considerados normais. Com base nos resultados, concluiu-se que todos os pacientes em tratamento hemodialítico apresentam diversas alterações em decorrência da DRC e do próprio processo de tratamento. Portanto, a realização de exames para avaliar ou monitorar possíveis complicações da IRC é essencial para criar estratégias e intervenções mais eficazes, que melhorem a assistência prestada a esses pacientes e, consequentemente, da qualidade e expectativa de vida dos mesmos

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Trichomes in the megadiverse genus Croton (Euphorbiaceae): a revised classification, identification parameters and standardized terminology

Trichomes are key functional traits that protect plants against abiotic stresses, herbivores and pathogens. In addition to their ecological roles, trichomes show high morphological variability in many lineages, providing useful characters for species characterization and taxon delimitation. Here, we focus on trichomes in Croton, a megadiverse genus (c. 1200 spp.) of Euphorbiaceae, in which these structures are ubiquitous and exhibit significant variation in form, location on the plant body, density and function. Owing to their functional and taxonomic relevance and the current need for further standardization of their terminology and classification, we revised previous trichome classifications used in the genus. We also provide new trichome data by expanding taxon sampling and using different methodological approaches in plant anatomy to improve understanding of the structural patterns of the trichome types present in the genus. On the basis of our results and literature review, we propose a new classification for trichomes in Croton based on well-defined parameters; this clarifies existing redundancies, is consistent with anatomical evidence and can be easily updated as new types are revealed in future surveys. This contribution will improve communication among taxonomists and promote more meaningful morphological comparability across systematics studies, including those focusing on morphological evolution and functional traits.NPPS thanks the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) – Finance Code 001. We are grateful to our colleagues Inês Cordeiro, Ricardo Souza Secco and Letícia Ribes de Lima for sending us plant material and verifying the identification of some specimens. RR was supported by project PID2019-108109GB-I00, funded by MCIN/AEI/10.13039/501100011033/ and FEDER ‘A way to make Europe’. We also acknowledge support from the CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI). We have no conflicts of interest to declare.Peer reviewe

Variation in stem mortality rates determines patterns of above-ground biomass in Amazonian forests: implications for dynamic global vegetation models

Understanding the processes that determine above-ground biomass (AGB) in Amazonian forests is important for predicting the sensitivity of these ecosystems to environmental change and for designing and evaluating dynamic global vegetation models (DGVMs). AGB is determined by inputs from woody productivity [woody net primary productivity (NPP)] and the rate at which carbon is lost through tree mortality. Here, we test whether two direct metrics of tree mortality (the absolute rate of woody biomass loss and the rate of stem mortality) and/or woody NPP, control variation in AGB among 167 plots in intact forest across Amazonia. We then compare these relationships and the observed variation in AGB and woody NPP with the predictions of four DGVMs. The observations show that stem mortality rates, rather than absolute rates of woody biomass loss, are the most important predictor of AGB, which is consistent with the importance of stand size structure for determining spatial variation in AGB. The relationship between stem mortality rates and AGB varies among different regions of Amazonia, indicating that variation in wood density and height/diameter relationships also influences AGB. In contrast to previous findings, we find that woody NPP is not correlated with stem mortality rates and is weakly positively correlated with AGB. Across the four models, basin-wide average AGB is similar to the mean of the observations. However, the models consistently overestimate woody NPP and poorly represent the spatial patterns of both AGB and woody NPP estimated using plot data. In marked contrast to the observations, DGVMs typically show strong positive relationships between woody NPP and AGB. Resolving these differences will require incorporating forest size structure, mechanistic models of stem mortality and variation in functional composition in DGVMs

Artistas sobre outras obras

Sobre arte e viagem pode-se estabelecer um paralelo continuado, irónico, expressivo. Entre as duas, a síntese do signo, a justaposição associativa. A viagem mostra o mundo, a viagem mostra quem somos. A caminho se desenha, se imagina, se fantasia, se mente. Neste ensejo, e neste mote da descoberta, se apreentam os 16 artigos que compõem o número 26 da revista Estúdio.info:eu-repo/semantics/publishedVersio

Variation in stem mortality rates determines patterns of above-ground biomass in Amazonian forests: implications for dynamic global vegetation models

This is the final version of the article. Available from Wiley via the DOI in this record.Understanding the processes that determine above-ground biomass (AGB) in Amazonian forests is important for predicting the sensitivity of these ecosystems to environmental change and for designing and evaluating dynamic global vegetation models (DGVMs). AGB is determined by inputs from woody productivity [woody net primary productivity (NPP)] and the rate at which carbon is lost through tree mortality. Here, we test whether two direct metrics of tree mortality (the absolute rate of woody biomass loss and the rate of stem mortality) and/or woody NPP, control variation in AGB among 167 plots in intact forest across Amazonia. We then compare these relationships and the observed variation in AGB and woody NPP with the predictions of four DGVMs. The observations show that stem mortality rates, rather than absolute rates of woody biomass loss, are the most important predictor of AGB, which is consistent with the importance of stand size structure for determining spatial variation in AGB. The relationship between stem mortality rates and AGB varies among different regions of Amazonia, indicating that variation in wood density and height/diameter relationships also influences AGB. In contrast to previous findings, we find that woody NPP is not correlated with stem mortality rates and is weakly positively correlated with AGB. Across the four models, basin-wide average AGB is similar to the mean of the observations. However, the models consistently overestimate woody NPP and poorly represent the spatial patterns of both AGB and woody NPP estimated using plot data. In marked contrast to the observations, DGVMs typically show strong positive relationships between woody NPP and AGB. Resolving these differences will require incorporating forest size structure, mechanistic models of stem mortality and variation in functional composition in DGVMs.This paper is a product of the European Union's Seventh Framework Programme AMAZALERT project (282664). The field data used in this study have been generated by the RAINFOR network, which has been supported by a Gordon and Betty Moore Foundation grant, the European Union's Seventh Framework Programme projects 283080, ‘GEOCARBON’; and 282664, ‘AMAZALERT’; ERC grant ‘Tropical Forests in the Changing Earth System’), and Natural Environment Research Council (NERC) Urgency, Consortium and Standard Grants ‘AMAZONICA’ (NE/F005806/1), ‘TROBIT’ (NE/D005590/1) and ‘Niche Evolution of South American Trees’ (NE/I028122/1). Additional data were included from the Tropical Ecology Assessment and Monitoring (TEAM) Network – a collaboration between Conservation International, the Missouri Botanical Garden, the Smithsonian Institution and the Wildlife Conservation Society, and partly funded by these institutions, the Gordon and Betty Moore Foundation, and other donors. Fieldwork was also partially supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico of Brazil (CNPq), project Programa de Pesquisas Ecológicas de Longa Duração (PELD-403725/2012-7). A.R. acknowledges funding from the Helmholtz Alliance ‘Remote Sensing and Earth System Dynamics’; L.P., M.P.C. E.A. and M.T. are partially funded by the EU FP7 project ‘ROBIN’ (283093), with co-funding for E.A. from the Dutch Ministry of Economic Affairs (KB-14-003-030); B.C. [was supported in part by the US DOE (BER) NGEE-Tropics project (subcontract to LANL). O.L.P. is supported by an ERC Advanced Grant and is a Royal Society-Wolfson Research Merit Award holder. P.M. acknowledges support from ARC grant FT110100457 and NERC grants NE/J011002/1, and T.R.B. acknowledges support from a Leverhulme Trust Research Fellowship

Local hydrological conditions influence tree diversity and composition across the Amazon basin

Tree diversity and composition in Amazonia are known to be strongly determined by the water supplied by precipitation. Nevertheless, within the same climatic regime, water availability is modulated by local topography and soil characteristics (hereafter referred to as local hydrological conditions), varying from saturated and poorly drained to well-drained and potentially dry areas. While these conditions may be expected to influence species distribution, the impacts of local hydrological conditions on tree diversity and composition remain poorly understood at the whole Amazon basin scale. Using a dataset of 443 1-ha non-flooded forest plots distributed across the basin, we investigate how local hydrological conditions influence 1) tree alpha diversity, 2) the community-weighted wood density mean (CWM-wd) – a proxy for hydraulic resistance and 3) tree species composition. We find that the effect of local hydrological conditions on tree diversity depends on climate, being more evident in wetter forests, where diversity increases towards locations with well-drained soils. CWM-wd increased towards better drained soils in Southern and Western Amazonia. Tree species composition changed along local soil hydrological gradients in Central-Eastern, Western and Southern Amazonia, and those changes were correlated with changes in the mean wood density of plots. Our results suggest that local hydrological gradients filter species, influencing the diversity and composition of Amazonian forests. Overall, this study shows that the effect of local hydrological conditions is pervasive, extending over wide Amazonian regions, and reinforces the importance of accounting for local topography and hydrology to better understand the likely response and resilience of forests to increased frequency of extreme climate events and rising temperatures