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Introducción: Considerado un problema impredecible y recurrente, el Intestino Neurogénico no se resuelve por sí solo con el tiempo y se vuelve progresivamente más pronunciado, traduciéndose en un desafío físico y psicológico, reduciendo significativamente la Calidad de Vida. Objetivo: Construir y validar el rostro y el contenido de una tecnología educativa para uso del enfermero en la rehabilitación del Intestino Neurogénico en personas con Lesión Médular. Materiales y Métodos: Estudio metodológico, cuantitativo, desarrollado en dos etapas: construcción de una tecnología educativa en la plataforma Canvas a partir de una revisión de literatura basada en la Teoría de las Necesidades Humanas de Wanda Horta y validación por jueces expertos. Para la validación se incluyeron enfermeros con experiencia en Intestino Neurogénico en la docencia, investigación o asistencia. El criterio de validación fue la concordancia mayor al 80%, analizado mediante el Índice de Validación de Contenido y prueba binomial con intervalos de confianza al 95,00% (p

ABSTRACT Objective: To explore how the development of research skills through postgraduate training is transferred to the use of research in clinical nursing practice. Method: This was a qualitative, exploratory, descriptive study developed based on a focus group in October 2021, using an intentional sample of eight postgraduate nurses from a healthcare institution in the region of Baixo Alentejo, Portugal. Bardin's content analysis was performed to analyze data. The participants and two reviewers legitimized the findings. In addition, the consolidated criteria for reporting qualitative research checklist were applied to this study to ensure the quality of the research report. Results: From the data analysis, three categories emerged: 1) transfer of research skills to clinical practice, 2) constraints to the development of research, and 3) expectations concerning the development of nursing research. Conclusion: Appreciation of research skills in contexts of practice, team involvement, improvement of nursing care outcomes, greater understanding of the research process, communication of results, and transferring knowledge to the clinic are contributions of research skills acquired in postgraduation training. The findings from this study can contribute to the development of health and nursing education policies.

Abstract Background The literature review notes that people in need of care from Rehabilitation Programs do not always see their continuity ensured. Objective This study aim to analyze the perspective of Specialists Nurse in Rehabilitation Nursing in relation to the organization and specialized intervention of transitional care for older people in need of rehabilitation programs. Methods This is a qualitative study within the interpretivist paradigm. A focus group with 8 nurses and 13 interviews with Portuguese nurses were carried out between April 2022 and February 2023. Content analysis was carried out. Results The triangulation of the data made it possible to identify 3 categories: Coordination of a transitional care program; Empowering the person to self-manage the transitional care process and Empowering the Informal Caregiver. Conclusions It is imperative to promote the coordination of transitional care, increase the functional capacity of the person and empower the informal caregiver.

One of the significant challenges facing modern medicine is the rising rate of antibiotic resistance, which impacts public health, animal health, and environmental preservation. Evaluating antibiotic resistance in wildlife and their environments is crucial, as it offers essential insights into the dynamics of resistance patterns and promotes strategies for monitoring, prevention, and intervention. Klebsiella and Raoultella genera isolates were recovered from fecal samples of wild animals and environmental samples using media without antibiotic supplementation. Antibiograms were performed for 15 antibiotics to determine the phenotypic resistance profile in these isolates. Extended-spectrum β-lactamase (ESBL) production was tested by the double-disc synergy test, and one ESBL-producing K. pneumoniae isolate was screened by PCR and whole-genome sequencing. Biofilm production was analyzed using the microtiter plate method. A total of 23 Klebsiella spp. and 3 Raoultella spp. isolates were obtained from 312 fecal samples from wild animals, 9 Klebsiella spp. and 4 Raoultella spp. isolates were obtained from 18 river and stream water samples, and 4 Klebsiella spp. and 3 Raoultella spp. isolates from 48 soil samples. Regarding antibiotic resistance, only one isolate of K. pneumoniae from soil samples was an ESBL-producer and showed resistance to six antibiotics. This isolate harbored multiple β-lactams genes (blaCTX-M-15, blaTEM-1, blaSHV-28, and blaOXA-1), as well as genes of resistance to quinolones, sulfonamides, tetracycline, aminoglycosides, and chloramphenicol, and belonged to the lineage ST307. Most of the Klebsiella spp. and Raoultella spp. isolates were biofilm producers (except for one Klebsiella isolate), and 45.6% were weak biofilm producers, with the remaining being moderate to strong biofilm producers. We can conclude that antibiotic resistance is not widespread in these environment-associated isolates, which is a positive epidemiological outcome. However, identifying a single ESBL-K. pneumoniae isolate should serve as a warning of potential hotspots of resistance emergence.

Background: Personal emotions and affects have been identified and studied in the context of pandemics, as well as coping strategies centered on emotional regulation or the balance between positive and negative emotions. Objectives: The objectives of this paper are to identify an emotion and affect structure in our sample and analyze the relationship of these dimensions with resilient coping in the context of the COVID-19 pandemic. Method: This study employed a cross-sectional design that involved a non-probabilistic sample with 598 participants over the age of 18, with 51.1% being female, and an average age of 40.73 years. First, the emotional structure was identified through principal component analysis (PCA). Secondly, a linear regression analysis was performed to investigate emotional dimensions as predictors of coping. Results: A valid and reliable emotional structure with four dimensions was identified. The regression model revealed that coping is positively associated with the active and positive dimension and negatively correlated with the negative and moral dimensions. Conclusions: Emotional dimensions are predictors of coping, with moral and negative dimensions having a negative effect, while active and positive dimensions have a positive effect. When designing interventions for coping strategies, multiple dimensions of emotions and affective states in people who are in vulnerable situations must be considered.

Antimicrobial resistance (AMR) surveillance in fecal Escherichia coli isolates from wildlife is crucial for monitoring the spread of this microorganism in the environment and for developing effective AMR control strategies. Wildlife can act as carriers of AMR bacteria and spread them to other wildlife, domestic animals, and humans; thus, they have public health implications. A total of 128 Escherichia coli isolates were obtained from 66 of 217 fecal samples obtained from different wild animals using media without antibiotic supplementation. Antibiograms were performed for 17 antibiotics to determine the phenotypic resistance profile in these isolates. Extended-spectrum β-lactamase (ESBL) production was tested using the double-disc synergy test, and 29 E. coli strains were selected for whole genome sequencing. In total, 22.1% of the wild animals tested carried multidrug-resistant E. coli isolates, and 0.93% (2/217) of these wild animals carried E. coli isolates with ESBL-encoding genes (blaCTX-M-65, blaCTX-M-55, and blaEC-1982). The E. coli isolates showed the highest resistance rates to ampicillin and were fully susceptible to amikacin, meropenem, ertapenem, and imipenem. Multiple resistance and virulence genes were detected, as well as different plasmids. The relatively high frequency of multidrug-resistant E. coli isolates in wildlife, with some of them being ESBL producers, raises some concern regarding the potential transmission of antibiotic-resistant bacteria among these animals. Gaining insights into antibiotic resistance patterns in wildlife can be vital in shaping conservation initiatives and developing effective strategies for responsible antibiotic use.

Suicidal behavior is considered a worldwide social phenomenon and a serious public health problem. In this regard, people with traumatic spinal cord injury may be associated with low mood, depression, suicidal ideation, and behavior. To evaluate the factors associated with suicidal ideation in people with SCI, this is quantitative, cross-sectional, descriptive study was carried out in a virtual environment. In total, 200 people aged 18 or over with TSCI living in Brazil took part in the study. Data were collected using the Beck Scale for Suicidal Ideation, answered online by participants using SurveyMonkey®. The sample consisted of 200 participants, most of whom were male, from southeast Brazil, with a mean age of 36.22 years, a duration of injury of 134.4 months, and a 32.5% frequency of suicidal ideation, as suicidal ideation was also verified in relation to the variables of schooling, rehabilitation, and consequence of injury. A statistically significant relationship was found between the duration of injury and suicidal ideation. According to the results, a considerable percentage of these individuals still think about suicide. On the other hand, the duration of the injury showed a significant difference in relation to suicidal ideation, and it was observed that the shorter the duration of spinal cord injury, the greater the likelihood of suicidal ideation.

The challenges experienced in the context of the pandemic have required a significant reconciliation between work and family domains due to confinement and the need to spend more time at home, which may have increased the levels of stress, anxiety, and depression, making it necessary to use resilient coping strategies to overcome the difficulties felt. This study examined the effect of resilient coping on the relationship between work-family conflict and stress, anxiety, and depression in this context. Data were collected using a self-report protocol from a sample of Portuguese workers (N = 476). The results indicated that work-family conflict was positively associated with stress, anxiety, and depression. Resilient coping established a negative relationship with stress, anxiety, and depression. The moderation effect was not corroborated; it was found that in the presence of the moderating variable (resilient coping), the relationship between the variables of work-family conflict and stress, anxiety, and depression was strengthened. This study reinforces the importance of appropriate interventions in resilient coping in the work-family context, which helps control stress, anxiety, and resilience levels.

Background: Addressing informal caregivers’ needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities. Methods: Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers’ needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis. Results: The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive–behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers’ psychological outcomes were scarce. Conclusions: This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers’ needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers’ educational support and the implementation of cognitive–behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers’ physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.

Aim: This study aims to describe rehabilitation nurses' perspectives on the complexity of and intention to use an innovative device for post-infarction patients. Design: The research employed a qualitative method, with a video demonstration, and analysis provided by the participants. To guide the study, the Technology Acceptance Model was used in order to measure perceived usefulness and perceived ease of use. Methods: Focus Groups were used to collect nurses' perspectives on the developed device. Recruitment followed a snowball sampling method. Eligible participants received an email with an informed consent form. Privacy and confidentiality were maintained throughout. Content analysis was performed using ATLAS.ti v7, with Bardin's technique, i.e., an a posteriori categorical organization. Results: Three categories were identified as relevant to the study objectives: "Therapeutic adherence and motivation"; "Home and autonomy of the patient and caregiver"; and "Factors that facilitate the practice of the rehabilitation nurse". Participants felt that the innovation and technological complexity of the device might help to increase patient motivation and adherence, which would be of great use to rehabilitation nurses, allowing better intervention development. Conclusion: Participants perceived the device as useful to practice, and beneficial to post-infarction patients. Interestingly, the complexity inherent to the device is regarded as a factor that may increase motivation and adherence.

Introdução: A revisão da literatura permite observar que o cuidado transicional, numa modalidade de e-health, promove a continuidade dos cuidados e o contacto de proximidade entre profissionais de saúde, clientes e famílias, bem como entre o hospital e os cuidados de saúde primários, garantindo assim a continuidade do programa de reabilitação da pessoa após infeção pelo SARS-CoV-2, a capacitação da pessoa e família para a gestão da sintomatologia, a detecção atempada de complicações, diminuindo as preocupações/medos associadas com a alta e o decurso da doença, controlando medos/receios, infundados, nomeadamente de contagio à família e suporta a transição para o papel de cuidador informal. Objetivo: Desenhar a intervenção de telereabilitação para a continuidade de cuidados de reabilitação na pessoa com Long COVID-19 após internamento. Método: Para responder à questão de investigação ‘Quais as intervenções de telereabilitação que garantem a continuidade de cuidados de reabilitação na pessoa com Long COVID-19 após internamento?’ optou - se por um Focus Group (FG)1, realizado on-line, a 28 de abril de 2022, na plataforma Colibri®. Os participantes foram 8 Enfermeiros Especialistas em Enfermagem de Reabilitação do contexto hospitalar e da comunidade, com experiência clínica na transição de cuidados, telereabilitação no processo de transição e/ou telemonitorização do programa de reabilitação após infeção pelo SARS-Cov-2. O FG foi gravado e transcrito. A análise qualitativa dos achados foi efetuada, por dois investigadores independentemente, de acordo com a técnica de análise de conteúdo2. Este estudo foi autorizado pela Comissão de Ética do Centro Hospitalar Universitário de Lisboa Central (Parecer n.º 1209/2022 de 18/03/2022). Resultados e discussão: Na análise de conteúdo emergiram cinco categorias: Coordenação entre níveis de Cuidados; Intervenção de telereabilitação de cuidado transicional; Vantagens da telereabilitação; Oportunidades e respetivas subcategorias. É consensual que a coordenação entre níveis de cuidados deve ser multidisciplinar com a definição de um programa de cuidado transicional que garanta a continuidade das intervenções iniciadas no hospital. Emergem como elementos centrais a comunicação e a articulação pré-alta com a família e os cuidados de saúde primários, que quando assegurados contribuíram para prevenir a desfragmentação da continuidade de cuidados e manter o programa de reabilitação iniciado no hospital, e nas situações em que não foram garantidos são apontados como a grande falha em alguns contextos para assegurar um cuidado centrado nas necessidades destes cidadãos. Conclusões e implicações para o desenvolvimento de conhecimento: Os participantes observam que a emergência de uma pandemia nova sobre a qual não há conhecimento, fez com que a aprendizagem do cuidado fosse feita em simultâneo com a construção do conhecimento sobre a doença, sua evolução, prognóstico e reabilitação. A telereabilitação foi uma estratégia importante para garantir a continuidade de cuidados aos doentes com internamentos, em unidades de cuidados intensivos e em serviços de COVID, e que após um período de internamento, mais ou menos longo, ficaram com sequelas que não permitiam ou dificultavam a execução das atividades de vida diária, no regresso a casa; custo efetiva e que possibilitou a própria gestão dos recursos humanos no período de pandemia.

In the face of an increasingly aging population, nurses have to design and implement programs aimed at the elderly in order to keep them healthy and maintain their quality of life. Structured physical exercise and overall physical activity play a major role in maintaining an active lifestyle, improving health, preventing disease, and helping to maintain older people’s quality of life. To investigate the importance of implementing physical exercise programs for the older person in the community, taking into account the perspective of the rehabilitation nurse specialist, this is a qualitative, exploratory, and descriptive study with nine rehabilitation nurses from various regions of Portugal who have experience of implementing physical exercise programs with the elderly. This study used semi-structured interviews, one of the most common data collection procedures in social and health research. Content analysis was used to analyze the data. The study received a positive opinion from the Ethics Committee. The participants’ perspectives focused on the following subjects: “Physical exercise program for the elderly in the community”, “Importance of physical exercise in the rehabilitation of the elderly in the community”, “People’s adherence to the programs”, “Gains in health resulting from the implementation of these strategies” and “Gains from group activities”. A set of indicators emerged from the analysis. Nurses recognize the importance of using structured physical exercise programs adjusted to the rehabilitation of the older person, with gains in promoting active and healthy aging.

Enquadramento: Os programas de reabilitação cardíaca são fundamentais para a recuperação e manutenção da capacidade funcional em pessoas vítimas de enfarte agudo do miocárdio. Os programas atuais evidenciam taxas de abandono elevadas e requerem mais elementos geradores de motivação nos utilizadores. Objetivos: Avaliar e comparar a usabilidade de dois protótipos de um dispositivo de reabilitação inovador para doentes pós enfarte agudo do miocárdio. Metodologia: Estudo observacional quantitativo, utilizando uma escala do tipo Likert de 5 pontos numa amostra de 16 enfermeiros especialistas em reabilitação, selecionados através da técnica de amostragem “bola de neve”. Resultados: A análise quantitativa revelou uma avaliação tridimensional dos protótipos com uma pontuação média de 4 valores, indicando usabilidade e intenção de uso. Ambos os protótipos foram considerados úteis, funcionais e fáceis de aprender e utilizar, observando-se poucas diferenças nas três dimensões. A facilidade de aprendizagem revelou-se mais consensual no protótipo Alfa. Conclusão: Os dois protótipos desenvolvidos alcançaram pontuações de usabilidade elevadas e são muito semelhantes, apresentando um forte potencial de eficácia no contexto desejado.

Introduction: people with COVID-19 will mostly present mild to moderate forms of the disease and will remain at home under telephone monitoring. The person must maintain specialized monitoring leading to the optimization of their healing process, without associated complications, responsible for readmissions. Objective: describe the gains in knowledge and skills learning with the implementation of a telerehabilitation program in a person with dyspnea, anxiety and changes in expiratory flow in the context of COVID 19. Method: quantitative and qualitative approach study, case study. Refers to a case of a 53-year-old person with COVID 19 hospitalized followed by discharge with home isolation. An intervention was made using tele-rehabilitation, through 4 videos. Ethical research principles were followed. Results: there were evidences of gains in the person's training in the control of dyspnea, in the reduction of anxiety and depression and in the air flow. Conclusion: the use of telerehabilitation in the context of COVID 19 can bring benefits to the training of the person in the control of symptoms, allow the recovery of the person at home and avoid hospitalization.

Introduction: The new coronavirus infection appeared in China in December 2019, it spread rapidly throughout the world, and was considered a pandemic by the World Health Organization in March 2020. This infection can cause pneumonia requiring hospitalization in intensive care units. The prone position is one of the interventions that can help in the treatment of acute respiratory distress syndrome in these people. Objective: to identify the effects of the prone position in the treatment of patients with acute respiratory distress syndrome caused by the corona virus. Method: integrative literature review conducted in May 2020. The following databases were used for data collection: SCOPUS, MEDLINE, and Google Scholar. Inclusion and exclusion criteria were applied. Results: Of the 241 articles identified, 13 articles were selected, all published in 2020. The data was synthesized in 3 main subjects, indications, frequency of position changing and duration, and lastly, the effects of the prone position. Conclusions: The prone position in this context, helps improve ventilatory and blood gas parameters, dyspnea symptoms, facilitates recovery, and consequently, early discharge, reduces hospitalization days and reduces mortality at 28 and 90 days.

Objective: to design a proposal for nursing care aimed at activity intolerance, in an individual with Stage 5 Chronic Kidney Disease undergoing hemodialysis. Methods: a case study and descriptive study, referring to a 76-year-old male undergoing hemodialysis. The Roper, Logan and Tierney Life Activities Model was used for data collection and NANDA-I, NIC and NOC taxonomy to support the care plan. Results: in the initial assessment, 6 autonomous nursing diagnoses were raised, of which one was highlighted as a priority: Activity intolerance (00092) and interventions that promote physical activity and physical exercise. Conclusion: nursing intervention has a fundamental role for the assessment and intervention in the scope of physical activity and physical exercise in people undergoing hemodialysis, which can reduce intolerance to activity and subsequently improve their quality of life.

Portugal is the habitat of three species of vultures. According to the IUCN Red List of Threatened Species, Neophron percnopterus is an Endangered species, Aegypius monachus is nearly Threatened, and Gyps fulvus is of Least Concern. This study aims to investigate the admission causes, morbidity, and outcomes of vultures admitted to a wildlife rehabilitation centre and necropsy service in Northern Portugal. Over 17 years (2005–2022), 84 animals were admitted: 10 A. monachus, 69 G. fulvus, and 5 N. percnopterus. The main causes of admission to the centre were 80% (n = 63) unknown cause, 13% (n = 10) found debilitated, 6 % (n = 5) vehicle collision, 4% (n = 3) captivity, 1% (n = 1) gunshot, and 1% (n = 1) electrocution. Most animals were admitted during the summer (45.2%) and autumn (36.9%). Analysis of outcome data showed that 73% (n = 58) of the animals that arrived alive at the centre could be rehabilitated and released back into the wild. Thirteen animals died during treatment and five were found dead. This is the first time that such a lengthy study of results and mortality has been carried out for these species in Portugal. Although the data are limited, they can already provide some information about these populations, particularly for the endangered species that are so rare to observe.

Objetivo: analisar o pensamento crítico desenvolvido pelos estudantes participantes de um componente curricular do curso de graduação em enfermagem. Método: estudo de natureza qualitativa, observacional e comparativa, antes e após a intervenção. Foi aplicado questionário sociodemográfico e texto-estímulo em dois momentos. A amostra foi constituída por 48 estudantes que frequentaram a unidade curricular de Pensamento Crítico em Enfermagem. Resultados: no primeiro momento, os estudantes reconheceram o pensamento crítico como importante na tomada de decisão e no desenvolvimento de competências, educar para pensar. No segundo momento, os comentários indicaram um papel ativo da escola, e a informação e o conhecimento do estudante são acurados no contexto formativo. Considerações finais: no pensamento crítico desenvolvido pelos estudantes participantes do componente curricular do curso de enfermagem constatou-se alteração significativa no léxico dos dois momentos, houve desenvolvimento de habilidades de pensamento crítico, das quais destacamos a interpretação, a argumentação, a análise e avaliação. Descritores: Pensamento. Conhecimento. Tomada de Decisão Clínica. Educação em Enfermagem. Estudantes de Enfermagem.

Alpha-synuclein (aSyn) plays a central role in Parkinson’s disease (PD) and has been extensively studied in the brain. This protein is part of the synuclein family, which is also composed of beta-synuclein (bSyn) and gamma-synuclein (gSyn). In addition to its neurotoxic role, synucleins have important functions in the nervous system, modulating synaptic transmission. Synucleins are expressed in the retina, but they have been poorly characterized. However, there is evidence that they are important for visual function and that they can play a role in retinal degeneration. This study aimed to profile synucleins in the retina of naturally aged mice and to correlate their patterns with specific retinal cells. With aging, we observed a decrease in the thickness of specific retinal layers, accompanied by an increase in glial reactivity. Moreover, the aSyn levels decreased, whereas bSyn increased with aging. The colocalization of both proteins was decreased in the inner plexiform layer (IPL) of the aged retina. gSyn presented an age-related decrease at the inner nuclear layer but was not significantly changed in the ganglion cell layer. The synaptic marker synaptophysin was shown to be preferentially colocalized with aSyn in the IPL with aging. At the same time, aSyn was found to exist at the presynaptic endings of bipolar cells and was affected by aging. Overall, this study suggests that physiological aging can be responsible for changes in the retinal tissue, implicating functional alterations that could affect synuclein family function.

Background: The autumn and winter months are associated with an increase in the seasonal epidemic flu responsible for 3 to 5 million cases of serious illness. Secondary bacterial infection is the most frequent complication, with high hospitalization rates. The rehabilitation nurse is recognized for being specialist in therapeutic interventions to provide the recovery of the person with respiratory pathology. Objective: To identify health outcomes from rehabilitation nursing care associated with the optimization of the respiratory function in a person diagnosed with streptococcus pneumonia community-acquired pneumonia secondary to Influenza A infection. Method: Qualitative case study research type. The study highlights the nursing care using the Padrão Documental dos Cuidados da Especialidade de Enfermagem de Reabilitação in an elderly person with altered respiratory function is presented, necessitating oxygen therapy and with its ability to expectorate compromised. The ethical principles in research have been fulfilled. Results: The implementation of the intervention plan constituted by four days revealed a reduction in the sensation of dyspnea; reduction of oxygen therapy; reduction of secretions; improvement in pulmonary auscultation of the vesicular murmur. Conclusions: It is verified that the implementation of an individualized rehabilitation nursing care plan can contribute significantly to promote the recovery of the person with restrictive respiratory pathology.

Background: Diabetes mellitus is characterized as group of metabolic alterations manifested by chronic hyperglycemia. Physical exercise emerges in this context as a positive strategy in the diabetes therapeutic process. Objective: Access physical exercise effects on people with diabetes. Methods: Systematic Review of Literature through the PICO method with the following research question: Which are the benefits of physical exercise in a diabetic person? The research was carried out using the electronic database platforms: EBSCOhost, Medline and BVS, having identified, selected, evaluated the methodological quality and included the articles that take into account the PRISMA recommendations. Results: 9 studies were included that fulfilled the eligibility and methodological quality criteria. Conclusion: The physical exercise prescription in people with diabetes can be an adjuvant in the treatment of that condition with metabolic control benefits and increase of life quality.

Background: Depressive disorder is one of the most common forms of mental disorder and one of the greatest causes of health problems nowadays. There has been a need to combine the pharmacological approach with adjuvant treatment such as psychoterapy and physical exercise in the treatment of this disorder. Objective: To identify the benefits of physical exercise in the person with depressive disorder. Method: Systematic Review of Literature that was based on the recommendations of the Joanna Briggs Institute on PICO strategy and based on PRISMA, the research question raised was “What are the benefits of physical exercise in people with Depressive Disorder?”. The research was carried out using the electronic database platforms: EBSCOHost and B-on. Results: A sample of nine studies were included that fulfilled the eligibility and methodological quality criteria, where the type, volume, frequency and duration of the physical exercise practiced in each of the studies were described and analyzed. Conclusions: The results obtained allow us to conclude that regardless of the frequency, duration and intensity of physical exercise in depressive disorder, this decreases the depressive symptoms, improving also the physical fitness, the cognitive function and the well-being of the person with this disorder.

Background: Dementia is characterized by a set of disorders that involving a progressive loss of cognitive functions as well as affecting the skill necessary for the normal development of activities of daily living. Objective: Identify the benefits of physical exercise at the cognitive, sensory and motor level in the person with dementia. Method: Systematic Review of literature, started with the question: "What are the benefits of physical exercise in people with dementia?". The research was carried out using the electronic database platforms: EBSCOHost and BVS, having been identified, selected, evaluated in a methodological quality and included articles that take into account the PRISMA recommendations. Results: There were included seven studies meeting the inclusion criteria, that is, primary experimental studies, addressing the practice of physical exercise in people with dementia and Alzheimer Disease, published in the last 5 years (2014-2018), in Portuguese, English and Spanish, were included, with full text of free access. Conclusions: This Systematic Review reveals evidence of the beneficial effects of physical exercise on cognition and motor ability in people with dementia.

Domestic refrigeration and freezing appliances can be used for electrical load shifting from peak to off-peak demand periods, thus allowing greater penetration of renewable energy sources (RES) and significantly contributing to the reduction of CO2 emissions. The full realization of this potential can be achieved with the synergistic combination of smart grid (SG) technologies and the application of phase-change materials (PCMs). Being permanently online, these ubiquitous appliances are available for the most advanced strategies of demand-side load management (DSLM), including real-time demand response (DR) and direct load control (DLC). PCMs are a very cost-effective means of significantly augmenting their cold storage capacity and, hence, their load-shifting capabilities. Yet, currently, refrigerators and freezers equipped with PCMs for DSLM are still absent in the market and research works focusing on the synergy of these technologies are still scarce. Intended for a multidisciplinary audience, this broad-scoped review surveys the literature to evaluate the technological feasibility, economic viability and global impact of this combination. The state-of-the-art of SG-enabling technologies is investigated—e.g., smart meters, Internet-of-Things (IoT)—as well as current and future standards and norms. The literature on the use of PCMs for latent heat/cold storage (LHCS) is also reviewed.

A 3-to-4-year-old roe deer (Capreolus capreolus L.) was admitted to the Veterinary Hospital. Although it showed well-developed antlers with retained velvet, an external female appearance and genitalia were evident. External biometrical measurements were taken for the antlers, and a computed tomography was performed. Molecular studies targeting the SRY gene were performed, and a PIS (polled intersex syndrome) mutation diagnosis was implemented. The gonads consisted of a right testicle paired with a left ovotestis. Histologically, the ovary-like structures in the ovotestis were functional, but the testis, as the testis-like structure in the ovotestis, did not show active spermatogenesis. No evidence of SRY gene was detected by PCR, suggesting an XX-chromosome constitution. Additionally, polled intersex syndrome (PIS) deletion was not detected in the case under study. The clinical and histopathological findings confirmed the DSD with the presence of a testicle and a contralateral ovotestis.

The objective of this study was to understand the contribution of postgraduate training to the development of research skills, aiming at their application in clinical practice. Method: This was a qualitative, exploratory, and descriptive study conducted with eight nurses in the Local Health Unit of Baixo Alentejo, in Portugal, who had postgraduate training. The researchers conducted a group interview, or discussion group, using a semi-structured interview, which was assessed by two reviewers. The data were submitted to content analysis, and the results underwent a validation process with the participants and two reviewers. This study was approved by the institution’s ethics committee. Result: In terms of the research skills developed in nursing postgraduate education, the following indicators emerged from the participants’ discourse: understanding the research process, searching databases, developing literature reviews, assessing the quality of articles, developing research projects, communicating about science, and translating knowledge into clinical practice. Conclusion: The participants developed research skills in their nursing postgraduate training and reported developing these skills in their clinical practice.

Ti-based materials are widely used for dental and orthopaedic implant applications due to their adequate mechanical properties, corrosion behaviour and biocompatibility. However, these materials are biologically inert and display poor wear resistance. In one of the most studied processes that aims to overcome these drawbacks, Ti surfaces are often covered by anodic oxide films with the incorporation of bioactive agents such as Ca and P. Although there are several works on the tribocorrosion behaviour of MAO-treated Ti surfaces, the influence of electrolyte composition on the corrosion kinetics under sliding is yet to be fully understood. In the present work, anodic oxide films were produced on cp-Ti surfaces with different calcium acetate concentrations in the electrolyte. Tribocorrosion behaviour was investigated by reciprocating sliding tests performed in 8 g/L NaCl solution at body temperature, under potentiostatic conditions. The results showed that higher concentrations of calcium acetate had a detrimental effect on tribocorrosion kinetics, however, they resulted in less mechanical damage due to alterations in the topography and structure of the MAO layer.

N/a.

This paper presents a methodology for the appropriate treatment of variability in the process of building vulnerability assessment. Material, geometric and mechanical properties of the assessed building typologies are simulated through a Monte-Carlo sampling procedure in which the statistical distribution of the latter parameters are taken into account. Record selection is performed in accordance with conditional hazard-consistent distributions of a comprehensive set of intensity measures, and matters of sufficiency, efficiency, predictability and scaling robustness are envisaged in the presented framework. Several intensity measures (IMs) are conjugated in the evaluation of building fragility and vulnerability, whereby fragility functions are established as the multivariate distribution of joint probability of being in a sequential set of damage states. Vulnerability Functions consequently determined provide not only a mean Damage Ratio per level of seismic intensity, but rather probabilistic distributions of Damage Ratio that reflect the ground motion variability expected as the interested site; as determined by the hazard-consistent conditional distribution of a set of sufficient intensity measures.

Carbon formation on steel has recently become an active research area with several important applications, using either carbon nanotubes (CNTs) or graphene structures. The production of vertically aligned CNT (VACNT) forests with combined metals has been explored with important results. Detailed kinetics is the best approach to understand a mechanism. The growth behavior seems complex but can be simplified through the knowledge of the three more common alternative reaction mechanisms/routes. The time required to optimize the production and properties might be reduced. The mechanistic proposal reported in 1971 was better explained recently. The volcano shape Arrhenius plot reported is observed only when Fe, Co, and Ni are used as reaction catalysts. Other metals are catalytically active at higher temperatures, following a different route, which does not require surface catalysis decomposition of the reactive gas. C2H2 and low olefins react well, but CH4 is not reactive via this surface catalysis route. Optimizing production of CNTs, research work is usually based on previous experience, but solid-state science-based studies are available.

Background: Facial paralysis remains as one of the major morbidities of surgery of cerebellopontine angle tumors. The preoperative standard Magnetic Resonance Image does not identify, with precision, the path of the facial nerve. Case description: The authors describe a case of a 56 years-old female with a cerebellopontine angle meningioma, submitted to preoperative Diffusion Tensor Tractography to identification of the course of the facial nerve, and correlate its position with the intraoperative findings. There was an accurate correlation between the path of the facial nerve revealed by preoperative DTT and the route of the nerve identified during surgery. Conclusion: The preoperative identification of the facial nerve seems to be possible by tractography in meningiomas of the cerebellopontine angle. It is possible that this technique may have utility in larger tumors, where the intraoperative identification of the facial path can be more difficult. Keywords: Cerebellopontine angle meningioma, Diffusion tensor tractography, Facial nerve, Vestibular schwannoma

Thermodynamics must be favorable for the growth of carbon nanotubes (CNTs) and graphene to take place, but a kinetic study is required to find the operating mechanism. In fact, thermodynamics indicates whether a reaction is possible; however, the route prevailing is not necessarily the most thermodynamically favorable, but the fastest one. Detailed kinetic studies state that there are three alternative routes operating under different temperature and pressure rates. The modes and rates of diffusion of carbon (C) atoms and noble metals have been known since the 1930s, but proof of C bulk diffusion operating in CNT growth came from detailed kinetic studies performed in the early 1970s, when reversible versus irreversible C formation was discussed with examples. The reason for interstitial C bulk diffusion in transition metals is evidenced based on the values of covalent radius. The reason for operating under steady-state conditions (linearity of the weight versus time) when searching for the operating mechanism is discussed herein. The steady-state C formation process operates sometimes with two different solid phases at each side of the catalyst particle (e.g., Ni and Ni3C), with thicknesses proportional to 1/D of the respective C bulk diffusivities when the carbon bulk diffusion step is the rate-determining one.

This study aimed to analyze the admission causes, outcomes, primary causes of death, and main lesions observed in the post mortem examinations of Western European hedgehogs, Erinaceus europaeus (Linnaeus, 1758), in the north of Portugal. The data were obtained by consulting the records from the two main wildlife rehabilitation centers located in the north of Portugal (Wildlife Rehabilitation Centre of Parque Biologico de Gaia and the Wildlife Rehabilitation Centre of the University of Trás-os-Montes and Alto Douro). Over 17 years (2002–2019) a total of 740 animals were admitted. Most of the animals were juveniles, with the highest number of admissions occurring during summer (36.8%) and spring (33.2%). The main reasons for admission were debilitation (30.7%) and random finds (28.4%). Of the total number of individuals admitted to these centers, 66.6% were successfully released back into the wild. The most relevant causes of death were trauma of unknown origin (32.7%), nontrauma causes of unknown origin (26.6%), and nutritional disorders (20.2%). The main lesions observed were related to trauma, including skeletal and skin lesions (fractures, hemorrhages, wounds) and organ damage, particularly to the lungs and liver. The hedgehog is a highly resilient and adaptable animal. The urban environment has many benefits for hedgehogs, yet the presence of humans can be harmful. In the future, the public needs to become even more involved in the activities of the wildlife centres, which will make a positive difference for these populations.

The mechanism of bamboo-like growth behavior of carbon fibers is discussed. We propose that there is a requirement to have this type of growth: operation above the Tammann temperature of the catalyst (defined as half of the melting point). The metal nanoparticle shape can then change during reaction (sintering-like behavior) facilitating carbon nanotube (CNT) growth, adjusting geometry. Using metal nanoparticles with a diameter below 20 nm, some reduction of the melting point (mp) and Tammann temperature (TTa) is observed. Fick’s laws still apply at nano scale. In that range, distances are short and so bulk diffusion of carbon (C) atoms through metal nanoparticles is quick. Growth occurs under catalytic and hybrid carbon formation routes. Better knowledge of the mechanism is an important basis to optimize growth rates and the shape of bamboo-like C fibers. Bamboo-like growth, occurring under pyrolytic carbon formation, is excluded: the nano-catalyst surface in contact with the gas gets quickly “poisoned”, covered by graphene layers. The bamboo-like growth of boron nitride (BN) nanotubes is also briefly discussed.

Mitral valve aneurysms are rare and occur most commonly in association with aortic valve endocarditis. Transesophageal echocardiography is the most sensitive imaging modality for the diagnosis of this entity and its potential complications, such as leaflet rupture and mitral regurgitation, which mandate prompt surgical intervention.We present the case of a 70-year-old male patient with aortic valve endocarditis complicated with a ruptured aneurysm of the anterior mitral valve leaflet and associated severe mitral regurgitation, diagnosed by transesophageal echocardiography, with impressive images. We hypothesized that the aneurysm developed through direct extension of infection from the aortic valve or from a prolapsing aortic vegetation, with abscess formation and subsequent rupture and drainage. This case highlights the importance of appropriate imaging for early detection and timely surgical intervention (repair or replacement) to prevent fatal outcomes. Resumo: Os aneurismas da válvula mitral são raros e, habitualmente, encontram-se associados a endocardite da válvula aórtica. O ecocardiograma transesofágico é a modalidade imagiológica mais sensível para o diagnóstico desta entidade e das suas potenciais complicações, tais como perfuração e regurgitação mitral, que exigem intervenção cirúrgica urgente.Apresentamos o caso clínico de um doente de 70 anos, do sexo masculino, com endocardite da válvula aórtica complicada por aneurisma perfurado do folheto anterior da válvula mitral e regurgitação mitral grave associada, diagnosticada por ecocardiograma transesofágico com imagens muito ilustrativas. Admitimos como hipótese, mais provável, que o aneurisma se desenvolveu por extensão direta da infeção a partir da válvula aórtica ou do prolapso de uma vegetação aórtica, com formação de abcesso e subsequente rotura e drenagem. Este caso realça a importância das modalidades imagiológicas adequadas no diagnóstico precoce do aneurisma da válvula mitral e da intervenção cirúrgica atempada (plastia ou substituição) na prevenção de eventos fatais. Keywords: Mitral valve, Aneurysm, Aortic valve, Endocarditis, Echocardiography, Palavras-chave: Válvula mitral, Aneurisma, Válvula aórtica, Endocardite, Ecocardiografia

Real-driving emissions (RDE) testing with portable emissions measurement systems (PEMS) during the type approval and in-service conformity of light-duty vehicles was recently introduced in the European Union legislation. In this paper, three PEMS were compared with laboratory analyzers connected to the tailpipe and the dilution tunnel. The tests were conducted with two Euro 6 vehicles (one gasoline and one diesel) performing the World harmonized Light vehicles Test Cycle (WLTC) and a pre-recorded RDE cycle on a chassis dynamometer. The results showed that the differences of the PEMS gas analyzers compared to the laboratory references were typically within 2% for CO2 and 5% for NOx. The CO2 and NOx mass emissions were within 10% and 15%, respectively, with only a few exceptions. The exhaust flow rate measurements were within 10% at low speeds (urban conditions), and 5% at higher speeds. These results confirm the legislated permitted tolerances and the 2017 PEMS uncertainty estimates.

Objetivo: Rever a evidência sobre a eficácia da terapêutica tripla (TT) e da terapêutica sequencial (TS) na erradicação da infeção por Helicobacter pylori (H. pylori). Fontes de Dados: MEDLINE e sítios de medicina baseada na evidência. Métodos: Pesquisa de normas de orientação clínica (NOC), revisões sistemáticas (RS), meta-análises (MA) e ensaios clínicos aleatorizados e controlados (EAC), publicados entre junho/2004 e junho/2014, utilizando os termos MeSH Helicobacter pylori, Drug therapy e Disease eradication. Para atribuição do nível de evidência (NE) e da força de recomendação (FR) foi utilizada a Strenght of Recomendation Taxonomy (SORT). Resultados: Foram selecionados 15 de entre 227 artigos encontrados: três NOC, oito MA, duas RS e dois ECA. As NOC recomendam a TT como principal tratamento a ser utilizado. As oito MA e as duas RS evidenciaram superioridade da TS na erradicação do H. pylori (variando entre 81-95,6%) comparativamente à TT (principalmente de 7-10 dias, consistentemente

Introdução: O herpes zoster (HZ) surge esporadicamente por reativação do vírus Varicella Zoster (VVZ), latente na raiz dorsal dos gânglios sensoriais ou dos pares cranianos, após a infeção primária que se manifesta clinicamente como varicela. A sua incidência aumenta com a idade, sendo rara na infância. Descrição do caso: É descrito o caso de uma criança de nove anos, do sexo masculino, previamente saudável, trazida à consulta por dor e exantema vesicular localizado no dermátomo T1, clinicamente compatível com HZ. Foi medicada com aciclovir, com boa evolução clínica e desaparecimento das lesões cutâneas após três semanas. Comentário: Em crianças imunocompetentes, a aquisição precoce de HZ é rara. O principal fator de risco é a ocorrência de varicela durante a gestação ou no primeiro ano de vida. Numa criança pequena, previamente saudável, a exclusão de imuno-deficiência subjacente não é mandatória, exceto em casos de recorrência. Pelas suas características, o HZ infantil pode suscitar dúvidas no momento do diagnóstico e na orientação terapêutica.

Dyspnea and hypoxemia are among the most common symptoms and signs that need to be assessed in clinical practice.This case illustrates how simple steps in history taking and physical examination can be crucial for diagnosis.We present a patient with intermittent hypoxemia, initially attributed to a pulmonary infection. However, the hypoxemia persisted even after successful treatment of the infection. Computed tomography angiography of the chest and ventilation/perfusion lung scan excluded pulmonary embolism.We then observed that the hypoxemia and dyspnea were triggered by orthostatism. An echocardiogram with a bubble test showed a patent foramen ovale, with a right-to-left shunt, without pulmonary hypertension. After percutaneous closure of the foramen ovale, the symptoms completely resolved.This is a case of platypnea-orthodeoxia syndrome, which is usually associated with patent foramen ovale or atrial septal defect and is typically observed in the elderly. The features and causes of this curious syndrome are discussed. Resumo: A dispneia e hipoxemia são dos sintomas e sinais mais comuns que avaliamos diariamente na prática clínica.Este caso ilustra como uma avaliação simples da anamnese e exame físico podem ser cruciais para o diagnóstico.Apresentamos um doente com hipoxemia intermitente, inicialmente atribuída a uma infeção respiratória. Contudo, a hipoxemia manteve-se apesar de tratamento eficaz da infeção. A angiotomografia computorizada do tórax e cintigrafia de ventilação-perfusão excluíram tromboembolismo pulmonar. Verificámos posteriormente que a hipoxemia e dispneia eram despoletadas pelo ortostatismo. Um ecocardiograma com administração de soro agitado revelou a presença de foramen ovale patente, com fluxo espontâneo direito-esquerdo, sem hipertensão pulmonar. Após encerramento do forâmen ovale patente, os sintomas desapareceram.Este é um caso de síndrome de platipneia-ortodeoxia, que geralmente se associa a foramen ovale patente ou comunicação interauricular, e é especialmente frequente em idosos. Discutimos as características e causas desta interessante síndrome. Keywords: Platypnea, Orthodeoxia, Patent foramen ovale, Atrial septal defect, Palavras-chave: Platipneia, Ortodeoxia, Foramen ovale patente, Comunicação interauricular