Desafios na referenciação para intervenção psicológica em doentes em cuidados paliativos na perspetiva dos médicos

Objetivo: O presente estudo teve como objetivo conhecer quais os principais desafios no cuidado aos doentes com doença avançada progressiva e seus familiares, valorizados pelos médicos da equipa de Cuidados Paliativos e que aspetos estão a privilegiar quando tomam a decisão de fazer o encaminhamento para intervenção psicológica. Método: Foram realizadas entrevistas semiestruturadas a cinco médicos que constituem uma equipa de cuidados paliativos. A análise de conteúdo foi orientada pelos princípios da Grounded Theory e recorreu ao Software Nvivo11. Resultados: Os participantes identificaram a dependência e a perda do sentido da vida como os principais desafios no cuidado ao doente. Relativamente, aos desafios da família, foi reconhecida a conspiração do silêncio. O tempo disponível para acompanhar o doente e a dificuldade em colaborar com outros profissionais de saúde de outras especialidades foram privilegiados como os principais desafios dos médicos. Quanto aos recursos específicos da equipa para dar resposta a estes desafios, os médicos valorizaram o trabalho em equipa, a comunicação e o facto de a equipa ser interdisciplinar.Objective: This study was aimed to know which were the main challenges in the care of patients with advanced progressive disease and their relatives, valued by doctors of the palliative care team and which aspects they are taking more into consideration when the decision to refer the patient to psychological intervention is made. Method: Various semi-structured interviews were made to five doctors from a palliative care team. The content analysis was guided by the principles of Grounded Theory and the Nvivo11 was the software chosen. Results: The participants, named the dependency and the loss of the meaning of life as the main challenges to the patient. Familywise, it was acknowledged the conspiracy of silence. The short amount of time to accompany the patient and the difficulty to collaborate with other health professionals from different specialities, were the focus of challenge for the doctors. As for the specific resources available for the team to answer those problems, the doctors valued teamwork, communication and the fact that they are an interdisciplinary team. All the participants had difficulties in pointing out specific roles for the individuals within the team

Intervenções e práticas multiprofi ssionais na atenção à saúde de adolescentes: uma revisão integrativa

The various transformations in the contexts social, political and cultural issues affecting the epidemiological profi leof the population has increased and generated changes in health models, which requires professionals involved in the process of making health, a change in clinical practice. Mainly on aspects that concern the attention to adolescents, to make it possible lead them into adulthood with integrity, as subject transforming your reality. The objective in this study, was to analyze multidisciplinary experience in the integral attention to adolescent health, as well as providing some thoughts to proposition other studies. For this purpose, we used the methodological contributions of the integrative review, seeking to answer the following research question: What intervention strategies have been used by multidisciplinary teams in health care for adolescents? We analyzed two articles that met the criteria established by the study. We identifi ed a scarcity of publications, inferring that this theme is emerging recently in relation to multidisciplinary practices, while they are grounded in the perspectives of health education. It is understood that discussions and presentations on these actions are relevant when considering the novelty of thesubject adolescent today, and the publication of these experiences of healthcare practice.As diversas transformações nos contextos sociais, políticos e culturais que impactam no perfi l epidemiológico da população têm aumentado e produzido mudanças nos modelos de saúde, exigindo dos profi ssionais envolvidos no processo do fazer saúde modifi cações na prática assistencial. Principalmente nos aspectos que tangem a atenção ao adolescente, para que seja possível conduzi-los para fase adulta com integridade, enquanto sujeito transformador de sua realidade. Neste estudo objetivou-se, analisar experiências multiprofi ssionais na atenção integral à saúde do adolescente, bem como oferecer refl exões para proposição de outros estudos. Para tanto, utilizou-se os aportes metodológicos da revisão integrativa, buscando responder a seguinte questão de investigação: Quais estratégias de intervenção têm sido utilizadas por equipes multiprofi ssionais na atenção à saúde de adolescentes? Foram analisados dois artigos que atenderam aos critérios estabelecidos pelo estudo. Identifi cou-se uma escassez de publicações, inferindo que essa temática é emergente e recente no que se refere às práticas multiprofi ssionais, ao mesmo tempo em que estão alicerçadas nas perspectivas da educação em saúde. Entende-se que debates e exposições sobre essas ações são relevantes ao se considerar a novidade do assunto adolescência na atualidade, assim como a publicação de experiências desse tipo de prática em saúde

Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal

Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.info:eu-repo/semantics/publishedVersio

Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal

Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.info:eu-repo/semantics/publishedVersio

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

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Intervention and practices multidisciplinary in the attention to adolescent health: the integrative review

As diversas transformações nos contextos sociais, políticos e culturais que impactam no perfi l epidemiológico da população têm aumentado e produzido mudanças nos modelos de saúde, exigindo dos profi ssionais envolvidos no processo do fazer saúde modifi cações na prática assistencial. Principalmente nos aspectos que tangem a atenção ao adolescente, para que seja possível conduzi-los para fase adulta com integridade, enquanto sujeito transformador de sua realidade. Neste estudo objetivou-se, analisar experiências multiprofi ssionais na atenção integral à saúde do adolescente, bem como oferecer refl exões para proposição de outros estudos. Para tanto, utilizou-se os aportes metodológicos da revisão integrativa, buscando responder a seguinte questão de investigação: Quais estratégias de intervenção têm sido utilizadas por equipes multiprofi ssionais na atenção à saúde de adolescentes? Foram analisados dois artigos que atenderam aos critérios estabelecidos pelo estudo. Identifi cou-se uma escassez de publicações, inferindo que essa temática é emergente e recente no que se refere às práticas multiprofi ssionais, ao mesmo tempo em que estão alicerçadas nas perspectivas da educação em saúde. Entende-se que debates e exposições sobre essas ações são relevantes ao se considerar a novidade do assunto adolescência na atualidade, assim como a publicação de experiências desse tipo de prática em saúde.The various transformations in the contexts social, political and cultural issues affecting the epidemiological profi leof the population has increased and generated changes in health models, which requires professionals involved in the process of making health, a change in clinical practice. Mainly on aspects that concern the attention to adolescents, to make it possible lead them into adulthood with integrity, as subject transforming your reality. The objective in this study, was to analyze multidisciplinary experience in the integral attention to adolescent health, as well as providing some thoughts to proposition other studies. For this purpose, we used the methodological contributions of the integrative review, seeking to answer the following research question: What intervention strategies have been used by multidisciplinary teams in health care for adolescents? We analyzed two articles that met the criteria established by the study. We identifi ed a scarcity of publications, inferring that this theme is emerging recently in relation to multidisciplinary practices, while they are grounded in the perspectives of health education. It is understood that discussions and presentations on these actions are relevant when considering the novelty of thesubject adolescent today, and the publication of these experiences of healthcare practice

Retinopathy in patients with hypertension and / or diabetes in a family health unit

Purpose: To identify the prevalence of abnormal ophthalmoscopy in patients with systemic hypertension (SH) and / or diabetes mellitus (DM) in a Family Health Unit (FHU). Method: was performed a individual study, observational, primarily descriptive and crosssectional of a sample of a cohort of 50 patients with hypertension and / or diabetic enrolled in the program HIPERDIA in a FHU of the city of Ananindeua – Para, between the months of september and november 2009. Results: ophthalmoscopy was performed in 46 patients and 27 (58.7%) had some alteration. When performing a specific analysis (excluding the findings of arteriolar narrowing and venous engorgement) were changes in 18 (39.1%), 45.5% with DM and SH, 40% with DM and 36% with SH. Conclusion: The high prevalence of the changes in ophthalmoscopy found in this study demonstrates that effectiveness as a screening method in the context of primary health care, justifying that use. corroborates also the importance of primary care in the prevention of diabetic and hypertensive retinopathy, through periodic control of patients at high vascular risk as the population studied.Objetivo: Identificar a prevalência de alterações à oftalmoscopia direta em pacientes com diagnóstico de hipertensão e/ou diabetes mellitus em uma Unidade de Saúde da Família (USF). Método: Estudo individual, observacional, prioritariamente descritivo, do tipo transversal, com amostra composta por coorte de 50 pacientes hipertensos e/ou diabéticos matriculados no programa HIPERDIA de uma Unidade de Saúde Familiar (USF) do município de Ananindeua – Pará, entre os meses de setembro e novembro de 2009. Resultados: Foi realizada oftalmoscopia em 46 pacientes. Observou-se alteração à oftalmoscopia em 27 (58,7%). Ao realizar a análise específica (excluindo-se os achados de estreitamento arteriolar e ingurgitamento venoso) houve alterações em 18 (39,1%), sendo 45,5% com DM e HAS, quarenta por cento com DM e 36% com HAS. Conclusão: A elevada prevalência de alterações à oftalmoscopia encontradas no presente estudo demonstra sua eficácia como método de rastreio no contexto da atenção primária a saúde, justificando seu uso. Corrobora, ainda, a importância da atenção primária à saúde na prevenção da retinopatia hipertensiva e diabética, através do controle periódico de pacientes de alto risco vascular como a população estudada. Descritores: Prevenção; Retinopatia diabética; Retinopatia hipertensiva; Diabetes mellitus; Hipertensão