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PurposeThis study aims to explore patterns of Emergency Medical Services (EMS) personnel's mental health, regarding their levels of anxiety, depression, stress, COVID-19 anxiety, obsessive-compulsive symptoms and well-being; and to explore variables that contribute to these patterns, among sociodemographic/professional and COVID-19 experience variables.Design/methodology/approachParticipants were 214 EMS personnel, who answered the Patient-Health Questionnaire, Perceived Stress Scale, COVID-19 Anxiety Scale, Obsessive-Compulsive Inventory, Well-Being Questionnaire and COVID-19 related questions.FindingsEMS personnel showed an adequate psychological adjustment during COVID-19. Two clusters/patterns were found: the poorly (34%) and the well (66%) psychologically-adjusted. Personnel's age, COVID-19 fear and workplace security measures' adequacy contributed to which pattern they were more likely to belong to.Research limitations/implicationsDespite being cross-sectional and not controlling for pre-COVID-19 data, this study adds to the COVID-19 literature. Findings call for the need to explore: other COVID-19 fears; how personnel perceive workplace security measures; COVID-19 valid instruments; pre-COVID-19 data; and mental health patterns with different rescuers.Practical implicationsFindings explored EMS personnel's patterns of mental health during the COVID-19, as well as its covariates. Results allow to better prepare emergency management, which can develop prevention strategies focused on older professionals, COVID-19 related fears and how personnel assess security measures.Originality/valueThis study contributes to the scarce literature focused on COVID-19 mental health patterns instead of focussing on isolated mental health variables, as well as what contributes to these patterns. Moreover, it is one of the few studies that focused on EMS personnel rather than hospital staff.

The COVID-19 pandemic places unique challenges to medical rescuers’ occupational health. Thus, it is crucial to assess its direct and indirect impacts on key psychological outcomes and adaptation strategies. This study aims to analyse the impact of this pandemic on medical rescuers’ coping and emotion regulation strategies, and their levels of work-related psychological outcomes, such as burnout, trauma and post-traumatic growth. Additionally, it aims to analyse the contribution of coping and emotion regulation strategies, employed to manage the COVID-19 pandemic, on burnout, trauma and post-traumatic growth. A sample of 111 medical rescuers answered the Brief Cope, Emotion Regulation Questionnaire, Oldenburg Burnout Inventory, Impact of Event Scale-Revised and Post-Traumatic Growth Inventory. Medical rescuers resorted moderately to coping and emotion regulation strategies, since the beginning of COVID-19. They presented moderate burnout and post-traumatic growth and low trauma. Coping presented a higher weight on burnout, trauma and post-traumatic growth, than emotion regulation. Expressive suppression and dysfunctional coping predicted burnout and trauma, and problem and emotion-focused coping predicted post-traumatic growth. Dysfunctional coping mediated and, thus, exacerbated the effect of expressive suppression on burnout and on trauma. Practitioners should pay closer attention to professionals with higher burnout and trauma. Occupational practices should focus on reducing dysfunctional coping and expressive suppression and promoting problem-focused coping.

Cities are complex systems with a key role in economic development and in improving the environmental sustainability of nations. Therefore, a comprehensive understanding of urban systems is fundamental to designing relevant policies and initiatives. Urban metabolism characterization may provide a holistic framework for analyzing urban systems in the context of the broader national metabolism. This paper provides a methodology to characterize the metabolism of an urban area, such as the Lisbon metropolitan area, taking as a source of data the socioeconomic metabolism of the country. The national metabolism is established by computing physical input-output tables. The downscaling to the urban level is accomplished with a variety of sector-specific parameters, from which an urban mass balance is established for a set of economic activities. The results obtained for the case study of Portugal and the city of Lisbon suggest that the share of services and the type of manufacturing industries in the economic structure of Lisbon, together with the higher resource productivity in the most representative economic sectors, are key aspects of the metabolism that contribute to Lisbon having higher overall resource productivity. The representation of the metabolism flows revealed key differences between the supply chains of Lisbon and the national flows, as well as a strong dependence of the Lisbon economy on material flows from other regions.

Nas suas atividades profissionais, polícias, bombeiros e técnicos de emergência pré-hospitalar enfrentam múltiplas fontes de stress. Apresenta-se uma revisão da literatura sobre estratégias de coping em profissionais que atuam em situações de risco (30 estudos empíricos), identificando ainda 13 programas de gestão do stress nestes profissionais. Predomina o coping focado no problema, e o coping disfuncional associa-se a stress, PTSD e problemas de saúde mental. Os programas são de gestão do stress e promoção do coping adaptativo, existindo preocupação crescente com a saúde mental destes grupos.

Background Emergency Medical Technicians (EMTs) are at high risk for traumatic disorders, and these disorders are more likely if they resort to dysfunctional coping. However, few studies have examined how dysfunctional coping can be decreased, specifically by comparing the impact of personal characteristics, such as resilience, and of occupational factors, such as stress. This study examines the contribution of resilience and perceived stress on EMTs’ dysfunctional coping. Methods A total of 502 EMTs (66% men), with a job experience of approximately 8 years (SD = 3.84), answered the Resilience Scale (Self and Life Acceptance; Personal Competence; Total score), Brief Cope, and Anxiety Depression Stress Scales. Results EMTs reported high resilience, low stress and dysfunctional coping. Resilience dimensions, specifically self and life acceptance, and stress contributed to dysfunctional coping. Stress displayed the highest regression coefficient. The effect of self and life acceptance on dysfunctional coping was no longer significant when accounting for stress, revealing a full mediation effect. Conclusions How EMTs perceive stress can mitigate the protective role of acceptance on the use of dysfunctional coping. These findings suggest EMTs’ occupational training may benefit from focusing on how to manage stressful and critical incidents, as well as on how to cope with stress.

O coping disfuncional desempenha um papel importante para o desenvolvimento do trauma, prejudicando os profissionais de socorro. É então relevante aprofundar o papel que este tipo de coping poderá assumir na relação entre o stress percecionado em incidentes críticos e o desenvolvimento de sintomatologia traumática. Pretendem-se analisar os efeitos diretos e indiretos do coping disfuncional na relação stress percebido / trauma, em técnicos de emergência médica pré-hospitalar (TEPH), bem como a sua variação em função de características socioprofissionais. Método: Aplicou-se o Inventário de Coping, a Escala do Impacto do Acontecimento (Revista) e a Escala de Ansiedade, Depressão e Stress, a 503 TEPH (66% homens), com idade média de 34,87 anos (DP=5,36) e 7,65 anos de experiência profissional (DP=3,84). Resultados: Encontraram-se níveis elevados de stress em profissionais do sexo feminino e com mais experiência profissional. Os profissionais do sexo feminino mobilizavam mais coping disfuncional e os profissionais com mais experiência apresentavam mais trauma. O coping disfuncional mediou parcialmente a relação entre stress percebido e trauma. Discussão: Estes dados permitem compreender o contributo do coping disfuncional para a evolução do stress experienciado nas ocorrências e da sintomatologia traumática, sendo importante desenvolver programas de intervenção dirigidos especificamente para a redução destas estratégias de coping. Dysfunctional coping plays an important role for the development of trauma symptoms, which as a significant impact on rescuers’ psychological health. Thus, research needs to deepen the knowledge about the role played by dysfunctional coping within the relationship between perceived stress and trauma. This study aims to analyze direct and indirect effects of dysfunctional coping in the relation perceived stress/trauma in emergency medical technicians (EMTs), as well as their variation according to socio-professional characteristics. Method: Brief Cope, Impact of Event-Scale Revised and Anxiety Depression and Stress Scale were applied to 503 EMTs (66% men). They had an average of 34.87 years (SD = 5.36) and 7.65 years of professional experience (SD = 3.84). Results: High levels of stress were found in women and in EMTs with more professional experience. Women also displayed more dysfunctional coping and professionals with more experience presented more trauma. Dysfunctional coping partially mediated the relationship between perceived stress and trauma. Discussion: Data allowed to understand the contribution of dysfunctional coping on the evolution of stress in trauma. Therefore, it is important to develop programs and interventions aimed at reducing dysfunctional coping strategies.

Introdução:O envelhecimento da população é uma realidade incontornável. Dados estatísticos recentemente publicados mostram que a população com 100 ou mais anos tem apresentado um franco crescimento em Portugal. No entanto, existem poucos estudos que caracterizem esta população tão idosa, mas que quase inevitavelmente é admitida no hospital em algum momento. Métodos:Estudo retrospetivo dos doentes com 100 ou mais anos internados num Serviço de Medicina Interna de 01/01/2006 a 31/12/2016. Resultados: No período em análise ocorreram 172 admissões (< 0,4% do total), correspondendo a 130 doentes. A idade média foi de 101,1 anos, sendo 74,4% dos doentes do género feminino. Dos doentes, 51,7% provinham do domicílio, sendo o grau de dependência para as atividades de vida diárias avaliado em “totalmente dependente” em 60,5% dos casos. A análise dos antecedentes pessoais revelou que 46,7% dos doentes tinham 2 ou 3 comorbilidades, sendo a hipertensão arterial, insuficiência cardíaca e síndrome demencial as mais prevalentes. A polifarmácia esteve presente em 41,8% dos doentes. A patologia infeciosa do sistema respiratório assumiu um lugar de destaque como motivo de internamento (57,6%) e como causa direta do óbito (52,1%). Constatou-se uma taxa de mortalidade de 41,3%. Conclusão: As admissões hospitalares de doentes centenários têm apresentado um aumento crescente ao longo dos anos, sendo que estas se associam geralmente a um agravamento do grau de dependência funcional e, consequentemente, a maiores custos a nível socioeconómico. Este trabalho permitiu caracterizar melhor esta população por forma a adotar uma conduta mais apropriada aquando do seu internamento hospitalar. Introduction: The aging of the population is an inescapable reality. Recently published statistical data shows that the population aged 100 years or over has shown a strong increase in Portugal. However, there are few studies characterizing such an elderly population which almost invariably is admitted to hospital at some point. Methods: A retrospective study of patients aged 100 years or over hospitalized in the department of Internal Medicine from 01/01/2006 to 31/12/2016. Results: In the period under analysis, there were 172 admissions (< 0.4% of the total) corresponding to 130 patients. The average age was 101.1 years, with 74.4% of the patients being female. A percentage of 51.7% of the patients came from their domiciles, and the degree of dependence for daily life activities evaluated as being “totally dependent” in 60.5% of cases. Analysis of the personal histories revealed that 46.7% of patients had 2 or 3 comorbidities, with arterial hypertension, heart failure and dementia being the most prevalent. Polypharmacy was present in 41.8% of patients. Infectious pathology of the respiratory system stood out as the reason for hospitalization (57.6%) and as the direct cause of death (52.1%). A mortality rate of 41.3% was found. Conclusion: Hospital admissions for centenarian patients have been steadily increasing over the years, and these are generally associated with a worsening degree of functional dependency and, consequently, higher socioeconomic costs. This study made it possible to better characterize this population in order to adopt more appropriate responses to these hospitalizations.

A obesidade mórbida (OM) é uma versão patológica de obesidade considerada um grave problema de saúde para os indivíduos que dela sofrem. O seu tratamento deve ser baseado numa abordagem biopsicossocial do indivíduo e do seu processo de doença que assegure o êxito do tratamento, a curto e longo prazo. A abordagem psicológica de cariz cognitivocomportamental estrutura-se ao longo das 3 principais fases do processo de tratamento: (1) pré-cirurgia, (2) internamento e (3) pós-cirurgia e follow-up. A primeira fase desta abordagem corresponde à avaliação psicológica dos doentes candidatos a cirurgia. Neste estudo apresenta-se a caracterização psicológica da população com OM, avaliada entre Fevereiro de 2002 e Maio de 2004, duma consulta de especialidade hospitalar. A metodologia desenvolvida inclui uma entrevista clínica semi-estruturada e questionários de auto- -avaliação das dimensões de personalidade (MCMI- -II), ansiedade e depressão (HADS), qualidade de vida (MOS-SF/20) e auto-conceito (ICAC). Foram avaliados 212 pacientes com uma média de idades de 41,1 anos e um IMC de 46,6Kg/m2. Apresentam-se os resultados obtidos e o protocolo de avaliação psicológica desenvolvido. Salienta-se a importância da avaliação psicológica para parecer técnico e os seus dados qualitativos para delineamento dos objectivos psicoterapêuticos e psico-educativos, como modo imprescindível ao sucesso deste processo de tratamento. Morbid obesity (MO) is a pathological type of obesity considered a serious health problem to the individuals who have it. Its treatment should be based on a biopsychosocial model of the individual and his/ her illness process for assuring short and long term treatment success. The psychological approach, cognitive- behaviour based, is structured along the 3 main phases of the treatment process: (1) pre-surgery; (2) inpatient; (3) post-surgery and follow-up. The first phase of this approach corresponds to the psychological assessment of the patients that are candidates to surgery. This study presents the psychological characterization of the MO population, assessed between February 2002 and May 2004, of a hospital specialized consultation. The developed methodology includes a semi-structured interview and self-assessment questionnaires of personality (MCMI-II), anxiety and depression (HADS), quality of life (MOS-SF/20) and self-concept (ICAC). 212 patients were assessed with a mean age of 41.1 years old, and a BMI of 46.6Kg/m2. We present the data and the protocol we developed for psychological assessment. We emphasize the importance of the psychological assessment for technical advice before surgery and its qualitative data for designing the psycho-educational and psychotherapeutic objectives, as fundamental to the success of the treatment process. info:eu-repo/semantics/publishedVersion

To study the dynamics and organization of the DNA within isolated Escherichia coli nucleoids, we track the movement of a specific DNA region. Labeling of such a region is achieved using the Lac-O/Lac-I system. The Lac repressor-GFP fusion protein binds to the DNA section where tandem repeats of the Lac operator are inserted, which allows us to monitor the motion of the DNA. The movement of such a GFP spot is followed at 48 ms temporal resolution during 12s. The spots are found to diffuse within a confined space, so that the nucleoid appears to behave like a viscoelastic network. The distribution of the "particle" position in time can be fitted to a Gaussian function indicating that the motion of the particle is Brownian. An average self-diffusion constant Ds=0.12 microm(2) s-1 is derived via the time auto-correlation functions of the displacement and is compatible with the collective diffusion coefficient measured previously by dynamic light scattering. Restriction of a DNA sequence to a small region of the nucleoid is tentatively related to the existence of so-called supercoiling domains.

Nucleoids of Escherichia coli were isolated by osmotic shock under conditions of low salt in the absence of added polyamines or Mg(2+). As determined by fluorescence microscopy, the isolated nucleoids in 0.2 M NaCl are expanded structures with an estimated volume of about 27 microm(3) according to a procedure based on a 50% threshold for the fluorescence intensity. The nucleoid volume is measured as a function of the concentration of added polyethylene glycol. The collapse is a continuous process, so that a coil-globule transition is not witnessed. The Helmholtz free energy of the nucleoids is determined via the depletion interaction between the DNA helix and the polyethylene glycol chains. The resulting compaction relation is discussed in terms of the current theory of branched DNA supercoils and it is concluded that the in vitro nucleoid is crosslinked in a physical sense. Despite the congested and crosslinked state of the nucleoid, the relaxation rate of its superhelical segments, as monitored by dynamic light scattering, turns out to be purely diffusional. At small scales, the nucleoid behaves as a fluid.

Numerous protocols for the isolation of bacterial nucleoids have been described based on treatment of cells with sucrose-lysozyme-EDTA and subsequent lysis with detergents in the presence of counterions (e.g., NaCl, spermidine). Depending on the lysis conditions both envelope-free and envelope-bound nucleoids could be obtained, often in the same lysate. To investigate the mechanism(s) involved in compacting bacterial DNA in the living cell, we wished to isolate intact nucleoids in the absence of detergents and high concentrations of counterions. Here, we compare the general lysis method using detergents with a procedure involving osmotic shock of Escherichia coli spheroplasts that resulted in nucleoids free of envelope fragments. After staining the DNA with DAPI (4ˈ,6-diamidino-2-phenylindole) and cell lysis by either isolation procedure, free-floating nucleoids could be readily visualized in fluorescence microscope preparations. The detergent-salt and the osmotic-shock nucleoids appeared as relatively compact structures under the applied ionic conditions of 1 M and 10 mM, respectively. RNase treatment caused no dramatic changes in the size of either nucleoid.