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The olfactory system is a niche of continuous structural plasticity, holding postnatal proliferative neurogenesis in the olfactory bulbs and a population of immature neurons in the piriform cortex. These neurons in the piriform cortex are generated during embryonic development, retain the expression of immaturity markers such as doublecortin, and slowly mature and integrate into the olfactory circuit as the animal ages. To study how early life experiences affect this population of cortical immature neurons, we submitted mice of the C57/Bl6J strain to a protocol of maternal separation for 3 h per day from postnatal day 3 to postnatal day 21. Control mice were continuously with their mothers. After weaning, mice were undisturbed until 6 weeks of age, when they were weighted and tested in the elevated plus-maze, a standard test for anxiety-like behavior, to check for phenotypical effects. Mice were then perfused, and their brains processed for the immunofluorescent detection of doublecortin and the endogenous proliferation marker Ki67. We found that maternal separation induced a significant increase in the body weight of males, but not females. Further, maternally separated mice displayed increased exploratory-like behavior (i.e., head dipping, velocity and total distance traveled in the elevated plus maze), but no significant differences in anxiety-like behavior or corticosterone levels after behavioral testing. Finally, we observed a significant increase in the number of complex doublecortin neurons in the piriform cortex, but not in the olfactory bulbs, of mice submitted to maternal separation. Interestingly, most doublecortin neurons in the piriform cortex, but not the olfactory bulb, express the epigenetic reader MeCP2. In summary, mild early life stress results, during adolescence, in a male-specific increase in body weight, alteration of the exploratory behaviors, and an increase in doublecortin neurons in the piriform cortex, suggesting an alteration in their maturation process.

Fibromyalgia affects about 1.78% of the population worldwide and has been recognized and studied since the 16th century. Despite that, the etiopathogenesis of fibromyalgia is still unknown. Consequently, there is still an ongoing debate whether fibromyalgia should be considered within the category of somatization disorders, or as a central pain sensitization syndrome, or even as a peripheral nerve disease. We consider that this is a relevant issue, since it impacts the referral of these patients to the different healthcare professionals, the type of assessment that is provided and the therapeutic approaches that are proposed to them. Several aspects point to similarities between fibromyalgia and somatic symptom disorder: both diagnoses share high comorbidity with several psychiatric disorders, a history of childhood trauma, the presence of alexithymia and other personality traits, insecure attachment styles and comorbidity with the so-called chronic overlapping pain conditions. Therefore, we hypothesize that fibromyalgia can be conceptualized as a somatic symptom disorder. However, the debate continues, since there is still a lack of scientific evidence supporting either in favor or against this perspective. More studies are needed to unveil the etiopathogenesis behind these two diagnoses.

The prompt management of patients with massive burns is essential to maximize survival by preventing infection, hemorrhage, fluid and heat loss, and to optimally prepare the wound bed for the application of autografts or cultured tissue-engineered artificial autologous skin. Acute treatments are typically based on temporary bio-dressings, commonly cadaveric skin allografts, but supply challenges, high costs and increasingly stringent regulatory requirements preclude their widespread use. Nanostructured fibrin-agarose hydrogels (NFAH) have been proven to be safe and effective biomaterials in preclinical and clinical studies, and show good hemostatic and biomechanical properties. Here we generated and tested NFAH with embedded allogeneic dermal fibroblasts (NFAH-F) under Good Manufacturing Practice (GMP) conditions. Fibroblasts were first expanded and characterized to create a GMP bank and the NFAH-F was manufactured on demand. Three patients with major burns were treated with this product as a temporary bio-dressing under compassionate use. Our results suggest that NFAH-F product was a safe product and no adverse reactions were observed. In all cases, the patients survived until definitive treatment. Therefore, the application of NFAH-F might be a temporary bio-dressing for patients with massive burns when cadaveric skin allografts are not available.

Abstract Background There remains much interest in improving cryopreservation techniques for advanced therapy medicinal products (ATMPs). Recently, human platelet lysate (hPL) has emerged as a promising candidate to replace fetal bovine serum (FBS) as a xeno-free culture supplement for the expansion of human cell therapy products. Whether hPL can also substitute for FBS in cryopreservation procedures remains poorly studied. Here, we evaluated several cryoprotective formulations based on a proprietary hPL for the cryopreservation of bioengineered tissues and cell therapy products. Methods We tested different xenogeneic-free, pathogen-inactivated hPL (ihPL)- and non-inactivated-based formulations for cryopreserving bioengineered tissue (cellularized nanostructured fibrin agarose hydrogels (NFAHs)) and common cell therapy products including bone marrow-derived mesenchymal stromal cells (BM-MSCs), human dermal fibroblasts (FBs) and neural stem cells (NSCs). To assess the tissue and cellular properties post-thaw of NFAHs, we analyzed their cell viability, identity and structural and biomechanical properties. Also, we evaluated cell viability, recovery and identity post-thaw in cryopreserved cells. Further properties like immunomodulation, apoptosis and cell proliferation were assessed in certain cell types. Additionally, we examined the stability of the formulated solutions. The formulations are under a bidding process with MD Bioproducts (Zurich, Switzerland) and are proprietary. Results Amongst the tissue-specific solutions, Ti5 (low-DMSO and ihPL-based) preserved the viability and the phenotype of embedded cells in NFAHs and preserved the matrix integrity and biomechanical properties similar to those of the standard cryopreservation solution (70% DMEM + 20% FBS + 10% DMSO). All solutions were stable at − 20 °C for at least 3 months. Regarding cell-specific solutions, CeA maintained the viability of all cell types > 80%, preserved the immunomodulatory properties of BM-MSCs and promoted good recovery post-thaw. Besides, both tested solutions were stable at − 20 °C for 18 months. Finally, we established that there is a 3-h window in which thawed NFAHs and FBs maintain optimum viability immersed in the formulated solutions and at least 2 h for BM-MSCs. Conclusions Our results show that pathogen-inactivated solutions Ti5 allocated for bioengineered tissues and CeA allocated for cells are efficient and safe candidates to cryopreserve ATMPs and offer a xenogeneic-free and low-DMSO alternative to commercially available cryoprotective solutions.

Abstract Background Acromegaly diagnosis is established when plasma levels of IGF-1 are increased and the Oral Glucose Tolerance Test (OGTT) with 75gr of glucose can’t suppress Growth Hormone (GH) levels. These two parameters are also useful during follow-up, after surgical/radiologic therapy and/or during medical therapy. Case presentation A 29-year-old woman was diagnosed with acromegaly after a severe headache. Previous amenorrhea and facial and acral changes were noticed. A pituitary macroadenoma was found, biochemical evaluation was in agreement with the suspected acromegaly and a transsphenoidal adenectomy was performed. As the disease recurred, a surgical reintervention and radiosurgery (Gamma Knife, 22 Gy) were necessary. No normalization of IGF-1 was achieved during three years after radiosurgery. Surprisingly, then, and although clinical features seemed getting worse, IGF-1 levels became consistently controlled to 0.3–0.8 times the upper limit of the reference range. Questioned, the patient referred that she was following an intermittent fasting dietary plan. However, based on the dietary questionnaire, she was found to be under severe caloric restriction. First OGTT (under caloric restriction) showed absence of GH suppression and an IGF-1 value of 234 ng/dL (Reference Range 76–286 ng/mL). A second OGTT, one month after an eucaloric diet was instituted, showed an increased IGF-1 of 294 ng/dL, maintaining an unsuppressed, yet less elevated, GH. Conclusions GHRH/GH/IGF-1 axis controls somatic growth. Regulation is complex, and nutrition status and feeding pattern have a recognized role. Like systemic inflammation or chronic liver disease, fasting and malnutrition decrease the expression of hepatic GH receptors, with consequent reduction of IGF-1 levels, through resistance to GH. This clinical report shows that caloric restriction may represent a pitfall in acromegaly follow-up.

Objetivo: A transição de cuidados (TC) do hospital para o domicílio é um indicador potencial para a avaliação dos cuidados integrados e centrados nas pessoas. Este estudo qualitativo, exploratório e descritivo, teve como objetivo identificar os princípios das boas práticas da TC na alta hospitalar, através da análise de conteúdo de experiências compartilhadas por profissionais em saúde num workshop. Métodos: O workshop envolveu duas moderadoras, quatro oradoras e 24 profissionais em saúde divididos em três grupos. As oradoras apresentaram boas práticas da TC em saúde e os grupos propuseram estratégias de TC, com base nas apresentações das oradoras e nas suas experiências e conhecimentos na área da saúde. As propostas foram registadas em áudio e analisadas em termos de conteúdo. Resultados: Segundo os participantes, a criação e implementação de um projeto de TC implica contextualizar e definir: o problema/necessidade, objetivos, população-alvo, intervenientes e as suas funções, elos, parcerias de saúde-sociais-comunitárias, redes de comunicação e indicadores de avaliação de processo e resultados. Conclusão: A importância da TC na alta hospitalar foi destacada, fornecendo-se insights para a criação e implementação de um projeto de TC bem-sucedido.

The study of coordination practices in health policy is a central aspect. The need for further research has been recently highlighted because of COVID-19. In this sense, dialogic practices (DP) have been identified but not validated yet. The purpose of this study is to develop and validate a DP questionnaire for healthcare teams. Items were identified based on a literature review, and the content validation was carried out by means of a Delphi study. A total of 10 experts assessed the clarity and appropriateness of the items and their corresponding measurement scales. After two rounds, a high level of consensus was reached, with agreement of 90% or higher on all items, and a high degree of stability and concordance in the results. This study resulted in a questionnaire consisting of four items, one for each identified DP initially proposed to the experts, as no other practices were revealed. From a practical perspective, the validation of these items constitutes a methodological innovation that responds to the call in the literature to open new avenues for comparative studies, and the possibility of generalising the findings and bringing together different approaches to the problem of coordination, which is key in health policy where unforeseen situations emerge.

Recent years have witnessed the introduction of ex vivo expanded dermal fibroblasts for several cell therapy and tissue-engineering applications, including the treatment of facial scars and burns, representing a promising cell type for regenerative medicine. We tested different in-house produced human platelet lysate (HPL) solutions against fetal bovine serum as supplements for in vitro fibroblast expansion by comparing cell yield, molecular marker expression, extracellular matrix (ECM) generation, genomic stability and global gene expression. Our in-house produced HPL supported fibroblast growth at levels similar to those for FBS and commercial HPL products and was superior to AB human serum. Cells grown in HPL maintained a fibroblast phenotype (VIM+, CD44+, CD13+, CD90+), ECM generation capacity (FN+, COL1+) and a normal karyotype, although gene expression profiling revealed changes related to cell metabolism, adhesion and cellular senescence. The HPL manufacturing process was validated within a GMP compliant system and the solution was stable at −80ºC and −20ºC for 2 years. Dermal fibroblasts expanded in vitro with HPL maintain a normal karyotype and expression of fibroblast markers, with only minor changes in their global gene expression profile. Our in-house produced GMP-HPL is an efficient, safe and economical cell culture supplement that can help increase the healthcare activity of blood transfusion centers through the re-use of transfusional plasma and platelets approaching their expiration date. Currently, our HPL solution is approved by the Spanish Agency of Medicines and Medical Devices and is being used in the manufacture of cell therapy products.Abbreviations: AB plasma: plasma group AB; ABHS: AB Human Serum; ABHS+GF: AB Human Serum supplemented with growth factors; ANOVA: Analysis of variance; ATMPs: Advanced Therapies for Medicinal Products; CPE: cytopathic effect; DEGs: Differentially expressed genes; DMEM: Dulbecco’s modified Eagle’s Medium; ECM: Extracellular matrix; ELISA: enzyme-linked immunosorbent assay; FBS: Fetal bovine serum; FDR: False discovery rate; FGF: Fibroblast growth factor; GMP: Good manufacturing practice; HPL: Human platelet lysate; HPL-CM: commercial human platelet lysate; MSCs: mesenchymal stem cells; NEAA: non-essential amino acids; P/S: penicillin/streptomycin; PBS: phosphate buffered saline; PC: leukodepleted platelet concentrate; PCR: polymerase chain reaction; PDGF: Platelet-derived growth factor; PDGFRA: Platelet-derived growth factor receptor alpha; qPCR: quantitative polymerase chain reaction; RNA: Ribonucleic acid; RT: Room temperature; TAC: Transcriptome analysis console; TGF-β: Transforming growth factor beta

Abstract Background Early-life stress can leave persistent epigenetic marks that may modulate vulnerability to psychiatric conditions later in life, including anxiety, depression and stress-related disorders. These are complex disorders with both environmental and genetic influences contributing to their etiology. Methyl-CpG Binding Protein 2 (MeCP2) has been attributed a key role in the control of neuronal activity-dependent gene expression and is a master regulator of experience-dependent epigenetic programming. Moreover, mutations in the MECP2 gene are the primary cause of Rett syndrome and, to a lesser extent, of a range of other major neurodevelopmental disorders. Here, we aim to study the interaction of MeCP2 with early-life stress in variables known to be affected by this environmental manipulation, namely anxiety-like behavior and activity of the underlying neural circuits. Methods Using Mecp2 heterozygous and wild-type female mice we investigated the effects of the interaction of Mecp2 haplodeficiency with maternal separation later in life, by assessing anxiety-related behaviors and measuring concomitant c-FOS expression in stress- and anxiety-related brain regions of adolescent females. Moreover, arginine vasopressin and corticotropin-releasing hormone neurons of the paraventricular hypothalamic nucleus were analyzed for neuronal activation. Results In wild-type mice, maternal separation caused a reduction in anxiety-like behavior and in the activation of the hypothalamic paraventricular nucleus, specifically in corticotropin-releasing hormone-positive cells, after the elevated plus maze. This effect of maternal separation was not observed in Mecp2 heterozygous females that per se show decreased anxiety-like behavior and concomitant decreased paraventricular nuclei activation. Conclusions Our data supports that MeCP2 is an essential component of HPA axis reprogramming and underlies the differential response to anxiogenic situations later in life.

A number of conditions can mimic amyotrophic lateral sclerosis (ALS), which are in general excluded by neurophysiological and neuroimaging investigation. We present a novel mimicking disorder. A 58-year-old male, without relevant past medical history, presented with a 7-year history of progressive paraparesis. On examination, he had bilateral thigh atrophy, fasciculations, and asymmetric paraparesis (severe on the left side). Upper motor neuron signs were present in the lower limbs, with normal sensory examination. Needle EMG disclosed mild chronic neurogenic changes in the lower limbs. Brain and spinal cord neuroimaging was normal, namely, in the dorso-lumbar segment. Lumbar puncture showed mild hyperproteinorachia. Diagnosis of slowly progressive (possible) ALS was established. One year later, he required a bilateral support to walk, and neurological examination revealed weak tendon reflexes, abnormal pinprick, and proprioceptive sensation in the legs. Repeated lumbar MRI showed an extensive spinal cord oedema from T7 to the conus with multiple perimedullary vessel flow voids suggestive of a vascular malformation. Conventional angiography revealed a spinal dural arteriovenous fistula in L2–L3 with the left L4 lumbar branch as the afferent artery. Dural arteriovenous fistula is the most common vascular malformation of the spinal cord, despite being rare. It leads to arterialization of spinal veins, causing venous hypertension, spinal cord oedema, and ischaemia. The clinical picture includes a stepwise, sometimes fluctuant, myeloradiculopathy. In this case, EMG changes did not meet Awaji criteria. This case reinforces the need to critically follow atypical cases to ascertain clinical progression in patients with suspected ALS.

Fibrin is widely used for tissue engineering applications. The use of blood derivatives, however, carries a high risk of transmission of infectious agents, necessitating the application of pathogen reduction technology (PRT). The impact of this process on the structural and biomechanical properties of the final products is unknown. We used normal plasma (PLc) and plasma inactivated by riboflavin and ultraviolet light exposure (PLi) to manufacture nanostructured cellularized fibrin-agarose hydrogels (NFAHs), and then compared their structural and biomechanical properties. We also measured functional protein C, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and coagulation factors [fibrinogen, Factor (F) V, FVIII, FX, FXI, FXIII] in plasma samples before and after inactivation. The use of PLi to manufacture cellularized NFAHs increased the interfibrillar spacing and modified their biomechanical properties as compared with cellularized NFAH manufactured with PLc. PLi was also associated with a significant reduction in functional protein C, FV, FX, and FXI, and an increase in the international normalized ratio (derived from the PT), APTT, and TT. Our findings demonstrate that the use of PRT for fibrin-agarose bioartificial tissue manufacturing does not adequately preserve the structural and biomechanical properties of the product. Further investigations into PRT-induced changes are warranted to determine the applications of NFAH manufactured with inactivated plasma as a medicinal product.

The methyl-CpG binding protein 2 gene (MECP2) encodes an epigenetic transcriptional regulator implicated in neuronal plasticity. Loss-of-function mutations in this gene are the primary cause of Rett syndrome and, to a lesser degree, of other neurodevelopmental disorders. Recently, we demonstrated that both Mecp2 haploinsuficiency and mild early life stress decrease anxiety-like behaviours and neuronal activation in brain areas controlling these responses in adolescent female mice. Here, we extend this work to males by using Mecp2-null and wild type adolescent mice subjected to maternal separation and their non-stressed controls. We assessed their behavioural responses in a battery of anxiety-provoking tests. Upon exposure to an elevated plus maze in aversive conditions, we evaluated changes in c-FOS expression in stress- and anxiety-related brain regions. In addition, we assessed the impact of maternal separation in neuronal maturation using doublecortin and reelin as surrogate markers. Mutant males showed reduced motor abilities, increased activation of the olfactory bulbs, probably due to breathing abnormalities, and decreased activation of the paraventricular thalamic nucleus, when compared to wild type mice. In addition, maternal separation increased the number of immature doublecortin-like neurons found in Mecp2-null animals. Moreover, this work shows for the first time that reelin is decreased in the mutant animals at the olfactory tubercle, piriform cortex and hippocampal dentate gyrus, an effect also associated to maternal separation. Taken together, our results suggest that maternal separation exacerbates some phenotypical alterations associated with lack of MeCP2 in adolescent males.

abstract: Introduction: Diagnostic yield of brain biopsy in neoplastic brain disease is high and its clinical impact is well established. In nonneoplastic brain disease with negative conventional investigation, decision to undergo invasive procedures is difficult due to its inherent risk and known lower diagnostic yield. Research question: What is the clinical impact of brain biopsy results on management of nonneoplastic brain disease ? Material and methods: A multidisciplinary team retrospectively reviewed and included all nonneoplastic brain disease cases submitted to biopsy between 2009 and 2019, in a tertiary hospital in Lisbon. Baseline characteristics were registered, including immunosuppression status, diagnostic workup, and treatment prior to biopsy. Diagnostic yield, clinical impact and in-hospital complication rates were assessed. Results: Sixty-four patients were included, 20 (31.3%) of them immunosuppressed (15 HIV ​+ ​patients). Thirty-five (67.7%) were previously treated with steroids or antiinfectious agents, with higher percentage (93.3%) in the immunosuppressed group. Biopsy results were diagnostic in 46 (71.9%) cases. More frequent diagnosis was infectious in 20 (31.2%), neoplastic in 12 (18.8%) and inflammatory diseases in 8 (12.5%). Brain biopsy resulted on impact on patient's clinical management in 56 (87.5%), of which 37(57.8%) were submitted to treatment change. In-hospital complications were registered in 4 (6.6%) patients. Discussion and conclusion: Brain biopsy had clinical impact, including a change in treatment, in most patients studied, and may be considered a useful diagnostic option in nonneoplastic brain disease. However, associated complication rate is not negligible, and previous thorough workup, patient selection and risk-benefit assessment are important.

Kikuchi-Fujimoto disease (KFD) is a rare, benign and usually self-limiting disorder that more often affects young women, which is characterized by cervical lymphadenopathy and fever. Clinical presentation may be indistinguishable from other diseases, and its inclusion in the differential diagnosis of lymphoproliferative, infective and autoimmune diseases is essential. An association with systemic lupus erythematosus is acknowledged. We present 2 different cases of 2 young women with KFD; the first case highlights the classic diagnostic features of this rare entity, and the second, the findings when KFD occurs in association with systemic lupus erythematosus.

Presentación: La protesta social ha sido una herramienta de expresión de inconformidades y deseos reformistas a la cual acuden personas y colectivos en busca de un cambio político dentro de su sistema de gobierno. Si bien la protesta ha probado ser un medio eficaz en diferentes contextos y momentos históricos, surge en el presente la pregunta por su vigencia, es decir, si la protesta sigue siendo efectiva en un contexto social determinado o si es ya una herramienta obsoleta para la manifestación de inconformidades. En consonancia con lo anterior, el presente estudio provee un acercamiento a la visión que un grupo de jóvenes y adultos-jóvenes zacatecanos han desarrollado sobre las protestas sociales a partir de su experiencia o el contacto que han tenido con las mismas. Lo anterior a través de un análisis de sus representaciones sociales por Propósito: Esta investigación tiene por objetivo explorar las representaciones sociales que tienen jóvenes y adultos-jóvenes mexicanos zacatecanos acerca de la protesta social. Para ello, empleamos la técnica de grupos focales con un análisis de categorías a parir la teoría fundamentada. Dicha teoría nos permitió determinar los principales conceptos relacionados con las representaciones de la protesta, a saber: violencia; medios de comunicación; política como algo obsoleto para el cambio social; y creatividad en la protesta. En el análisis se consideran factores macroculturales con el fin de proponer una explicación al carácter individualista de las representaciones. Resultados: Los resultados ponen en evidencia una actitud negativa hacia la manifestación social a través de la protesta.

This article focuses on the Portuguese case to discuss the employment insertion of graduates. It starts by presenting a typology of professional situations with the purpose of analyzing graduate transition fromhigher education to the labor market. The heuristic potential of the typology is then described, showing its key role when analyzing two important topics in the study of the professional situation of graduates: i) the unequal distribution of individuals in the occupation structure and ii) the relationship between the graduates’ positions in the occupational structure and the work orientations. Two important conclusions are drawn: in Portugal higher education continues to be permeated by reproduction logics of inequalities that go beyond this; the importance of intrinsic and extrinsic values bears almost no relation to variations in levels of job security and material prosperity in this population, for whom intrinsic values are of great relevance.

The article seeks to understand the transition of Law graduates as a process that id shaped, firstly, by the expansion of Portuguese higher education and the persistence of social inequalities in its entrance and distribution by subsystems and faculties. And secondly, by the entrance mechanisms of regulated professions, in particular, lawyers. The study focuses on a sample of 565 graduates who completed the graduation between the school years 2002/2003 and 2006/2007, and whose academic qualification was obtained in one of the six public and private universities of North Portugal.

This study analyzed emotional self-regulation in relation to K-9 and K-10 school children’s emotional intelligence defined on three dimensions: Emotional attention, clarity of feelings, and emotional repair. The objective was to analyze the students’ perceptions of skills and capacities that promoted the awareness of emotions when performing introjective motor practices, i.e., motor skill exercises in which the inner logic provokes a process of sensorial self-awareness and psychosomatic balance. A total of 90 fourth-year primary school students from four different schools participated in the study and a reduced version of the Trait-Meta Mood Scale (TMMS) questionnaire was used to measure students’ individual self-regulation. First, pre- and post-test results showed significant differences with a 20.1% improvement in the three dimensions of intrapersonal emotional attention (emotional attention, clarity of feeling, and emotional repair) after having performed a set of in-class introjective practices. Second, while there were no significant differences between the boys and girls during the pre-test, significant changes—an 8.1% difference—were found in the post-test results for girls.

The lack of external regulation about the form and substance of the financial statements that railroad companies had to report during the implementation phase of the Spanish railway, meant that each company developed its own accounting model. In this study we have described, analysed and interpreted the more relevant changes in the accounting information in relation to the business result. Using the analysis of an historical case, we developed an ad-hoc research tool, for recording all the changes of the operating account. The results of the study prove that MZA’s operating account reflected the particularities of the railway business although subject to limitations, and the reported information improved during the study period in terms of relevance and reliability

This article is part of a specific axis of a research project on social entrepreneurship in Portugal, the axis of the Portuguese social entrepreneurship policy towards third sector organizations. In an exploratory way, we aim to identify, within the key stakeholders and third sector Portuguese organizations, the representations about the emergence (or not) of policies that enable the development of practices of social entrepreneurship. From here we are going to reflect about the articulation between the State and third sector entities in order to find out the main trends of this relationship and forms of action

A adequação entre o nível e tipo de formação académica e a situação profissional é um tema presente sempre que se aborda a temática da inserção profissional dos licenciados. Pretende-se, com este artigo, analisar as situações profissionais de diplomados portugueses do ensino superior cinco anos após a conclusão da licenciatura, à luz da problemática da inserção e transição profissional. Enquadra-se a relação entre sistema de ensino e mercado de trabalho comparando-se indicadores internacionais que contextualizam o caso português, de modo a discutir os resultados empíricos que caracterizam a situação profissional vivida em 2010 por uma amostra de 1.004 diplomados de duas universidades portuguesas. Definem-se cinco tipos de situações profissionais a partir de técnicas de análise multivariadas e reflete-se sobre os perfis encontrados. Conclui-se que a maioria dos licenciados exerce uma atividade profissional adequada ao seu nível de graduação, com rendimentos salariais, vínculos laborais e horários adequados ao grupo dos especialistas das actividades intelectuais e científicas. Porém, a análise mais fina revela-nos uma configuração hierárquica das situações profissionais num continuum que se organiza desde a inserção frágil à inserção qualificante associada às áreas de formação frequentadas. Os diplomados nas áreas de educação, artes e humanidades ocupam as situações profissionais mais precarizantes, contrastando com a sobrerrepresentação nos empregos mais favoráveis dos licenciados das áreas de saúde, economia, gestão e direito.

Thermal conditions in mainland Portugal were evaluated using a new hourly database over the recent period of 2000−2018 (19 years). The number of hours within each different temperature interval was calculated from the long-term means of the hourly temperatures of a network of 63 meteorological stations. A geostatistical approach, using elevation, distance to coastline and latitude, was subsequently applied to provide gridded patterns at a high spatial resolution (1 km grid spacing). Eight fruit species (almond tree, carob tree, chestnut tree, citrus fruits, cork oaks, holm oaks, olive trees, and grapevines) were selected to assess their hourly thermal growing conditions. The results highlight the strong spatial variability of temperature levels in mainland Portugal, providing new insights into their spatial distribution. The number of hours in the year with cool conditions (4−12 °C) is higher in the northern-central regions, mainly in mountainous areas. Additionally, the number of hours in the year with temperate conditions (12−20 °C) emphasizes the importance of the distance to the coastline (maritime influence). The warm conditions (20−28 °C) are most prevalent in the south of the country and in the Douro valley, whereas the very warm conditions (number of hours with temperature between 28−36 °C) are essentially restricted to inner-southern Portugal and to the upper Douro valley. This study also reveals, with high accuracy, the thermal growing conditions of main fruit species in mainland Portugal, giving particular emphasis to olive trees and grapevines. These findings may help decision support systems providing more reliable and accurate guidelines to stakeholders, decision-makers, and farmers. The main maps are available in a widely used file format (shapefile), thus allowing their application to a wide range of other areas of interest.

A lei portuguesa não define com rigor as habilitações do Enfermeiro de Saúde Ocupacional nem o seu papel na Equipa de Saúde Ocupacional. Pretende-se com esta revisão bibliográfica, que utiliza as palavras-chave: “Enfermagem do trabalho e Saúde do trabalhador”, nas bases de dados MedLine with Full Text, MedicLatina, Academic Search Complete, CINAHL Plus with full text, Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection, Health Technology Assess e NHS Economic Evaluation Database, perceber qual o lugar que a Enfermagem tem na equipa de Saúde Ocupacional, descrevendo como esta é executada em diferentes países, com variadas perspetivas e objetivos. A Saúde Ocupacional comporta hoje uma abordagem abrangente, onde se inserem aspetos não laborais que interferem com a saúde do trabalhador, podendo englobar a família e/ou comunidade. A nível internacional, as tarefas predominantemente curativas deram lugar a outras de prevenção e de gestão, sendo inúmeros os programas que o Enfermeiro de Saúde Ocupacional tem capacidade para orientar, assumindo um papel central, completo e integrativo dentro da equipa. Finalmente, é fundamental quantificar custos, pré- e pós-atuação, para valorizar o seu trabalho financeiramente, perante a gestão da entidade empregadora.La legislación portuguesa no define con rigor la cualificación de la enfermera de salud laboral ni tampoco su papel dentro del equipo de salud laboral. Se pretende con esta revisión de la literatura, utilizando las palabras clave: “el trabajo de enfermería” y “salud en el trabajo” MedLine with Full Text, MedicLatina, Academic Search Complete, CINAHL Plus with full text, Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection, Health Technology Assess e NHS Economic Evaluation Database, entender qué lugar ocupa la enfermería en el equipo de salud laboral y describir cómo esta se lleva a cabo en diferentes países con diversas perspectivas y objetivos. La salud laboral incluye actualmente un enfoque integral, que abarca aspectos no laborales que interfieren en la salud del trabajador y puede englobar a la familia y/o a la comunidad. A nivel internacional, las tareas predominantemente curativas han dado paso a otras de prevención y de gestión, con numerosos programas que la enfermera de salud laboral está capacitada para dirigir, asumiendo así un papel central, completo e integrativo dentro del equipo. Por último, es fundamental cuantificar los costes de las actividades previas y posteriores para valorizar su trabajo financieramente, atendiendo así a la gestión de la entidad empleadora.Portuguese law does not define the precise qualifications of occupational health nurses or their role in the occupational health team. A literature review was carried out using the keywords “nursing work and occupational health,” in the databases Medline with Full Text, MedicLatina, Academic Search, CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection, Health Technology Assess and NHS Economic Evaluation Database, The aim was to understand the place of nursing in occupational health, describing how this is implemented in different countries with different perspectives and goals. Occupational health now uses a comprehensive approach which includes non-work aspects that interfere with worker health and may include family and/or community. Internationally, predominantly curative tasks have given way to others centered on prevention and management, with numerous programs that the occupational health nurse is able to lead, assuming a central role, fully integrated within the team. Finally, it is crucial to quantify costs, before and after activities, to evaluate the work financially for the management of the employer.

O envelhecimento gradual da população e aumento da prevalência de patologias crónicas, conduzem ao aparecimento de guidelines que implicam polimedicação e recurso a fármacos considerados potencialmente inapropriados para os idosos (embora estando adequados às patologias diagnosticadas). Objectivo: Conhecer a melhor evidência sobre a polimedicação nos idosos. Metodologia: Revisão bibliográfica, utilizando as palavras/expressões-chave: polymedication, polypharmacy, medication, inappropriate, prescription, elderly e older, nas bases de dados “The Cochrane Library”, “Science Direct”, “CINAHL” e “Up to date”; tendo como critérios de selecção a pertinência, metodologia e data de publicação. Resultados: Verifica-se que os idosos, para além de terem alterações fisiológicas que potenciam a adversidade dos fármacos, são também os que mais consomem e que recorrem frequentemente a vários prescritores, factores que influenciam a adesão ao regime terapêutico. O risco de interacção aumenta exponencialmente com o número de fármacos prescrito, estando os idosos institucionalizados em maior risco. Por ano, estimam-se cerca de 140.000 mortes, sendo que, as interacções medicamentosas justificam 50% das urgências hospitalares. Conclusão: Os profissionais de saúde que se centram nos projectos individuais de saúde dos cidadãos estão em posição privilegiada para ponderar/sugerir que fármacos deverão estes iniciar, continuar e/ou interromper, proporcionando o máximo benefício, com menores riscos e custo.El envejecimiento progresivo de la población y el aumento de la prevalencia de enfermedades crónicas lleva a la aparición de pautas que requieren polifarmacia y el uso de medicamentos considerados potencialmente inapropiados para los ancianos (independientemente de adaptarse a las patologías diagnosticadas). Objetivo: Conocer la mejor evidencia sobre la polifarmacia en ancianos Metodología: Búsqueda bibliográfica, utilizando las palabras o expresiones clave: , polypharmacy, medication, inappropriate, prescription, elderly y older, en las bases de datos “The Cochrane Library”, “Science Direct”, “CINAHL” y “Up to date”; como la pertinencia cuenta de los criterios de selección, la metodología y fecha de publicación. Resultados: Parece que las personas mayores, además de tener los cambios fisiológicos que mejoran la adversidad de los medicamentos, son también los que consumen más y recurren a menudo a los médicos múltiples, los factores que influyen en la adherencia al tratamiento. El riesgo de interacción aumenta exponencialmente con el número de fármacos prescritos, siendo los ancianos institucionalizados en mayor riesgo. Por año se estima alrededor de 140.000 muertes, y las interacciones medicamentosas justifican el 50% de las urgencias hospitalarias. Conclusiones: Los profesionales de la salud que se centran en la salud individual de los ciudadanos están en condiciones de examinar/sugerir que estos medicamentos deben iniciar, continuar y/o dejar de proporcionar el máximo beneficio con menor riesgo y coste.The gradual aging of population and increased prevalence of chronic conditions lead to the emergence of guidelines that require polypharmacy and use of drugs deemed potentially inappropriate for older people (although appropriate for the pathologies diagnosed). Aim: To identify the best evidence about polypharmacy in older people Methodology: Literature review, using the key words/terms: polymedication, polypharmacy, medication, inappropriate, prescri-ption, elderly and older in the databases “The Cochrane Library”, “Science Direct”, “CINAHL” and “Up to date”, using the selection criteria of relevance, methodology and publication date. Findings: It appears that older people, in addition to having physiological changes that increase the negative effects of drugs, also use them more and often resort to multiple prescribers, factors influencing adherence to therapy. The risk of interaction increases exponentially with the number of drugs prescribed and institutionalized older people are at increased risk. It is estimated that each year about 140,000 deaths occur for these reasons, and drug interactions cause 50% of hospital emergencies. Conclusions: Healthcare professionals involved in individual citizens’ health projects are in position to consider/suggest which drugs these individuals should start, continue and/or discontinue taking, in order to provide the maximum benefit with less risk and cost.

A hipertensão arterial é um dos problemas de saúde pública mais importantes, sobretudo nos países desenvolvidos. É razoavelmente comum, facilmente diagnosticada e tem prognóstico reservado quando não tratada. Efectuou-se a pesquisa através das bases de dados EBSCO (Academic Search Premier, Sport diskus e a Medline), utilizando as palavras/ expressões- chave: “validation, accuracy, blood pressure measurement, reproducibility, sphygmomanometer, mercury, oscillometer e dinamap”. Os critérios de selecção basearam-se na pertinência, metodologia e data mais recente de elaboração. O instrumento considerado gold standart é o Esfigmomanómetro (EM); contudo, o mercúrio é tóxico para o ambiente, pelo que surgiu a necessidade da sua substituição por instrumentos com outra tecnologia. Além disso, acredita-se que 50% dos EM não estão em condições de serem utilizados. Braçadeiras menores que o desejável sobrestimam a Tensão Arterial (TA). Acredita-se também que 23% dos profissionais de saúde nunca tenham calibrado os seus instrumentos e que 40% não se recorde da data em que o fez; em 2/3 tal procedimento tinha ocorrido há mais de um ano, apesar de ser simples e pouco dispendioso. Recomenda-se uma calibração anual.La hipertensión es uno de los problemas de salud pública más importantes, sobre todo en los países desarrollados. Es bastante común, fácil de diagnosticar y tiene pronóstico reservado si no es tratada. Se llevó a cabo una investigación a través de las bases de datos EBSCO (Academic Search Premier, Sport diskus e a Medline), utilizando las palabras/expresiones clave: “validation, accuracy, blood pressure measurement, reproducibility, sphygmomanometer, mercury, oscillometer e dinamap”. Los criterios de selección se basaron en la pertinencia, la metodología y la fecha más reciente de elaboración. El instrumento considerado gold standart es el esfigmómetro (EM); sin embargo, el mercurio es tóxico para el medio ambiente, de ahí que surgiera la necesidad de su sustitución por instrumentos con otra tecnología. Además, se cree que el 50% de EM no está en condiciones de ser utilizado. Las abrazaderas menores de lo deseable sobrestiman la tensión arterial (TA). También se cree que el 23% de los profesionales de la salud nunca ha calibrado sus instrumentos y que el 40% no se acuerda de la fecha en la que lo ha hecho; 2/3 habían hecho esta prueba hace más de un año a pesar de ser simple y poco dispendiosa. Se recomienda una calibración anual.Arterial hypertension is one of the most important public health problems, especially in developed countries. It is reasonably common, easy to diagnose and has a limited prognosis when not treated. The research was done using the keywords: validation, accuracy, blood pressure measurement, reproducibility, sphygmomanometer, mercury, oscillometer e dinamap” in “Academic Search Premier, Sport diskus and Medline”; selecting the articles by methodology, relevance and publication date. The “gold standard” instrument is the sphygmomanometer; however, mercury is toxic, and so it must be substituted by other technology. In addition, 50% of sphygmomanometers are not in good condition for clinical use. Cuffs smaller than necessary over-estimate arterial blood pressure. It seems that 23% of health professionals have never calibrated the sphygmomanometer and 40% of the others did not remember when they did this; in 2/3 this situation has continued for longer than one year, despite being cheap and simple. Annual calibration is recommended.

Este trabajo tiene como objetivo describir, analizar e interpretar el reflejo del proceso de inversión en infraestructuras realizada por una de las principales Compañías ferroviarias españolas pioneras en el sector, a través del estudio del modelo contable desarrollado en la primera etapa de establecimiento y expansión del negocio. En concreto, la compañía ferroviaria analizada es el ferrocarril Madrid-Zaragoza-Alicante (MZA) durante el período 1856-1874.

Thresholds based on critical combinations of amount/duration of precipitation and flood events were estimated for the Corgo hydrographic basin, in northern Portugal. Thirty-one flood events in the Corgo basin were identified between 1865 and 2011 from a database of hydrometeorological disasters in Portugal. The minimum, maximum, and pre-warning thresholds that define the boundaries for flood occurrence were determined. The results show that the ratio between the total number of floods and precipitation events exceeding the minimum threshold denotes a relatively low probability of successful forecasting. This result may be due to the reduced number of flooding events in the floods database, which only include floods that caused damage as reported by the media. The estimated maximum threshold is not adequate for use in floods, since the majority of true positives are below this limit. However, and more interestingly, the retrospective verification of the estimated thresholds suggests that the minimum and pre-warning thresholds are well adjusted. Therefore, the application of these precipitation thresholds may contribute to minimize possible situations of pre-crisis or immediate crisis by reducing the flood consequences and the resources involved in emergency response to flood events.