Ticks and Tick-Borne Pathogens Circulating in Peri-Domestic Areas in Mainland Portugal.

Over the years, tick-borne pathogens (TBPs) have garnered significant interest due to their medical, veterinary and economic importance. Additionally, TBPs have drawn attention to how these microorganisms interact with their own vectors, increasing the risk to human and animal infection of emerging and reemerging zoonoses. In this sense, ticks, which are obligate hematophagous ectoparasites, have a key role in maintaining and transmitting TBPs among humans and animals. The aim of this study was to assess the prevalence of neglected TBPs in mainland Portugal, namely Anaplasma spp., Babesia spp., Ehrlichia spp. and Neoehrlichia mikurensis. DNA fragments were detected in questing ticks collected from five different ecological areas under investigation. To the best of the authors' knowledge, this study reports new worldwide findings, including B. bigemina infecting Ixodes frontalis, Ixodes ricinus and Rhipicephalus sanguineus sensu lato. Additionally, it presents new findings in Portugal of N. mikurensis infecting I. ricinus and of presumably Wolbachia endosymbionts being detected in I. ricinus. Overall, there were 208 tick samples that were negative for all screened TBPs. The results herein obtained raise concerns about the circulation of neglected TBPs in mainland Portugal, especially in anthropophilic ticks, highlighting the importance of adopting a One Health perspective.

Inducing perceived group variability triggers the incorporation of counter-stereotypic information into a generalized stereotype change.

Perceived variability is the extent to which individuals perceive group members as being similar to one another. Previous research has focused on how: group variability is perceived (and measured); information indicative of group heterogeneity can lead to reductions in stereotypicality; or how stereotype-inconsistent information can result into increased perceived variability. The present combines the three lines of research into a single research venue. In previous studies the stereotypicality of a group representation was influenced by priming stereotype-unrelated traits in an unrelated-context, prior to stereotype measurement; but priming counter-stereotypic traits had no effect on stereotypicality, although it boosted perceptions of group's variability. The present study examines whether highlighting dissimilarities among members of the same professional groups results in subsequent changes in the reported stereotype for a, not yet mentioned, group. The more the dissimilarity among group members, the more likely individuals were to incorporate counter-stereotypic information into the targeted-group, described as less stereotypic, even in central tendency measures. Importantly, the generating mechanism may involve a modification of participants' overall perception of variability. When members within professional groups are perceived as dissimilar, the well-known resistance of stereotypes to counter-stereotypic information is lessened making the group representations more flexible and less biased.

Efficacy of the Vaccine Candidate Based on the P0 Peptide against Dermacentor nitens and Ixodes ricinus Ticks.

The control of ticks through vaccination offers a sustainable alternative to the use of chemicals that cause contamination and the selection of resistant tick strains. However, only a limited number of anti-tick vaccines have reached commercial realization. In this sense, an antigen effective against different tick species is a desirable target for developing such vaccines. A peptide derived from the tick P0 protein (pP0) conjugated to a carrier protein has been demonstrated to be effective against the Rhipicephalus microplus, Rhipicephalus sanguineus, and Amblyomma mixtum tick species. The aim of this work was to assess the efficacy of this peptide when conjugated to the Bm86 protein against Dermacentor nitens and Ixodes ricinus ticks. An RNAi experiment using P0 dsRNA from I. ricinus showed a dramatic reduction in the feeding of injected female ticks on guinea pigs. In the follow-up vaccination experiments, rabbits were immunized with the pP0-Bm86 conjugate and challenged simultaneously with larvae, nymphs, and the adults of I. ricinus ticks. In the same way, horses were immunized with the pP0-Bm86 conjugate and challenged with D. nitens larva. The pP0-Bm86 conjugate showed efficacies of 63% and 55% against I. ricinus and D. nitens ticks, respectively. These results, combined with previous reports of efficacy for this conjugate, show the promising potential for its development as a broad-spectrum anti-tick vaccine.

A terapia da dignidade: uma intervenção especializada no conforto da pessoa em situação paliativa / Dignity therapy: a specialised intervention to comfort people in a palliative situation

Ao longo dos últimos anos, temos assistido a um aumento da esperança média de vida e o consequente envelhecimento populacional, aliados ao aumento da prevalência de doenças crónicas. Isto leva-nos a refletir sobre o fim de vida, e sobre a necessidade de conforto e qualidade de vida até ao último momento. Portanto, emerge a necessidade de Cuidados Paliativos (CP), que têm o objetivo o alívio do sofrimento físico, psicológico, social e espiritual, com base na identificação precoce e no tratamento rigoroso da dor e outros sintomas físicos, mas também psicossociais e espirituais, das pessoas que são portadoras de uma doença incurável e/ou grave, progressiva e avançada assim como as suas famílias ou pessoas significativas. Neste sentido, dando continuidade ao processo de aprendizagem, optou-se por realizar o estágio num serviço de cuidados paliativos de um hospital central com o objetivo de desenvolver competências comuns e específicas de enfermeiro especialista na área da enfermagem à pessoa em situação paliativa. O presente relatório do Estágio de Natureza Profissional contempla a descrição e análise critico-reflexiva das atividades realizadas e as competências adquiridas ao longo do mesmo. Para dar resposta aos objetivos propostos, das atividades desenvolvidas destacam-se o estudo de investigação, que se debruçou sobre a dimensão espiritual, ­concretamente sobre a Terapia da Dignidade (TD) no doente em cuidados paliativos. Neste sentido realizou-se uma scoping review, com o objetivo de mapear os efeitos da terapia da dignidade em doentes em cuidados paliativos. Os principais resultados mostram que esta terapia produz efeitos benéficos a nível espiritual, psi-emocional, físico, social e da própria qualidade de vida. Com este estudo percebeu-se que a TD tem efeitos bastante positivos no alívio do sofrimento do doente em situação de fim de vida pelo que pode ser considerada uma estratégia útil no âmbito dos cuidados paliativos tornando-os em cuidados cada vez mais dignos, humanizados e com um olhar holístico sobre o doente e a família. A nível do desenvolvimento de competências comuns, nomeadamente nas competências de gestão e formação, destacam-se nas atividades realizadas a elaboração de uma "Proposta de Protocolo de Apoio no Luto", e ainda à realização de duas formações "Dignidade em Fim de Vida" e "Apoio no Luto" dando resposta as necessidades da equipa e do serviço onde foi realizado o estágio. A nível do desenvolvimento de competências específicas, as atividades assentaram nas dimensões essenciais dos CP, nomeadamente: gestão de sintomas; comunicação; trabalho em equipa, apoio à família e apoio no luto, respeitando os princípios éticos, deontológicos e legais. Concluindo, verifica-se a necessidade de continuar a concetualizar e desenvolver cuidados paliativos especializados, nomeadamente pelo enfermeiro especialista em enfermagem à pessoa em situação paliativa, através da inclusão de estratégias sustentadas na melhor evidência, tais como a terapia da dignidade, e assim, proporcionar cuidados mais dignos ao doente e família, com o propósito de os ajudar a um melhor entendimento das formas de alívio de sofrimento na sua fase final de vida.

Over the last few years, we have witnessed an increase in life expectancy and the subsequent aging of the population, along with the rise in the prevalence of chronic diseases. This leads us to reflect on the end of life and the need for comfort and quality of life until the last moment. Thus, the need for palliative care arises. Palliative care's goal is the relief of physical pain, psychological, social and spiritual suffering for people diagnosed with an incurable and/or severe, progressive and advanced disease and their families or close friends. To achieve this, it uses early identification and rigorous treatment of pain and other physical, psychosocial and spiritual symptoms. In this sense, continuing the learning process, it was chosen to carry out the internship in a palliative care service at a central hospital aiming to develop common and specific specialist nurse skills in the field of nursing for individuals in palliative situations. This Professional Nature Internship report includes the description and critical-reflexive analysis of the activities carried out and the competencies acquired throughout the internship. To address the proposed objectives, among the activities carried out, the research study is highlighted, which focused on the spiritual dimension - specifically on Dignity Therapy (DT) in palliative care patients. In this regard, a scoping review was conducted aiming to map the effects of Dignity Therapy (DT) on patients in palliative care. The main findings show that this therapy has beneficial effects on the spiritual, psychosocial, physical, social, and overall quality of life aspects. Through this study, it was understood that DT has highly positive effects in relieving the suffering of patients in end-of-life situations, making it a valuable strategy within palliative care, which contributes to providing increasingly dignified, humanized care, with a holistic approach to the patient and their family. Regarding the development of common competencies, namely in management and training skills, the activities undertaken included the creation of a "Proposal for a Bereavement Support Protocol." Additionally, two training sessions were conducted on "Dignity at the End of Life" and "Bereavement Support," addressing the needs of the team and the service where the internship took place. Regarding the development of specific competencies, the activities focused on the essential dimensions of palliative care, including symptom management, communication, teamwork, family support, and bereavement support, adhering to ethical, deontological, and legal principles. In conclusion, there is a need to continue conceptualizing and developing specialized palliative care, particularly by the nurses specialized in nursing for individuals in palliative situations, through the incorporation of evidence-based strategies, such as dignity therapy, to provide more dignified care for patients and their families, aiming to help them better understand ways to alleviate suffering in their end-of-life phase.

Combined Use of a Bacterial Consortium and Early-Colonizing Plants as a Treatment for Soil Recovery after Fire: A Model Based on Los Guájares (Granada, Spain) Wildfire.

During 2022, intense heat waves, together with particularly extreme dry conditions, created a propitious scenario for wildfires, resulting in the area of vegetation consumed in Europe doubling. Mediterranean countries have been particularly affected, reaching 293,155 hectares in Spain, the worst data in the last 15 years. The effects on the vegetation and the soil are devastating, so knowing the recovery factors is essential for after-fire management. Resilient microorganisms play a fundamental role in rapid nutrient recycling, soil structure, and plant colonization in fire-affected soils. In this present work, we have studied emergent microbial communities in the case of the Los Guájares (Granada, Spain) fire, one of the most extensive of the year, to evaluate their role in the recovery of soil and vegetation cover. We aim to discern which are the main actors in order to formulate a new treatment that helps in the ecosystem recovery. Thus, we have found the relevant loss in phosphorous and potassium solubilizers, as well as siderophores or biofilm producers. Here, we decided to use the strains Pseudomonas koreensis AC, Peribacillus frigoritolerans CB, Pseudomonas fluorescens DC, Paenibacillus lautus C, Bacillus toyonensis CD, and Paenarthrobacter nitroguajacolicus AI as a consortium, as they showed most of the capacities required in a regenerative treatment. On the other hand, the microcosm test showed an enhanced pattern of germination of the emerging model plant, Bituminaria bituminosa, as well as a more aggregated structure for soil. This new approach can create a relevant approach in order to recover fire-affected soils in the future.

Adenitis as Initial Mycobacterium marinum Presentation.

Mycobacterium marinum is a ubiquitous and opportunist agent that may cause infections related to water activities in humans. It causes mainly skin and soft tissue infections, and other forms of presentation are uncommon. A 27-year-old man presented to the Emergency Department of a tertiary hospital due to a cervical foreign-body sensation that evolved into right cervical swelling and consumption symptoms. He was a waiter on a cruise in the Douro river. Weeks after the initial presentation, the diagnosis of Mycobacterium marinum infection was made by positive nucleic acid amplification tests (NAAT) in tissues obtained by excisional biopsy of cervical adenopathy. Treatment with rifampicin and clarithromycin was started. The symptoms improved, and there was a decrease in the adenopathy number and size. Although Mycobacterium marinum adenitis as initial presentation of the disease is rare, the identification of the agent by NAAT and favorable response to treatment supported the diagnosis.

Espiritualidade em cuidados paliativos: um imperativo no cuidar em enfermagem / Spirituality in palliative care: an imperative in nursing care

O aumento da esperança média de vida leva a que haja uma maior prevalência das doenças crónicas e degenerativas, tornando-se premente a mudança do paradigma do cuidar. Assumindo a inevitabilidade do fim de vida, é essencial que passemos a olhar para a multidimensionalidade da pessoa que é portadora de uma doença incurável e/ou grave, progressiva e avançada, focando-nos naquilo que é a promoção do conforto, do bem-estar e da qualidade de vida. É neste contexto que emergem os Cuidados Paliativos (CP) que têm o objetivo de melhorar a qualidade de vida das pessoas em situação paliativa e suas famílias, considerando-a como um ser biopsicossocial e espiritual. Quando a pessoa se depara com um diagnóstico sem perspetiva de cura, pode emergir o sofrimento espiritual, pela perda de sentido da vida, pelo que a abordagem da espiritualidade em CP é de grande relevo. Porém, a intervenção na dimensão da espiritualidade por parte dos profissionais de saúde, nomeadamente pelos enfermeiros em CP está, ainda, muito aquém daquilo que seria desejado. Neste sentido, optou-se por realizar o estágio num serviço de cuidados paliativos de um hospital central com o objetivo de desenvolver competências comuns e específicas de enfermeiro especialista na área da enfermagem à pessoa em situação paliativa. O presente relatório contempla a descrição e análise critico-reflexiva das atividades realizadas e as competências adquiridas ao longo do Estágio de Natureza Profissional relativas à avaliação e intervenção dos enfermeiros à pessoa em situação paliativa, dando ênfase especial à dimensão da espiritualidade. Das atividades e competências desenvolvidas destacam-se a realização de formação em contexto de trabalho subordinada ao tema "Espiritualidade em Cuidados Paliativos"; na área da gestão de cuidados destaca-se a realização de um projeto de intervenção designado por "Proposta de Parametrização em SClinico: A dimensão espiritual". Face à não satisfação das necessidades espirituais das pessoas em situação paliativa e famílias, realizou-se uma scoping review relativa às dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa. No domínio do cuidar da pessoa em situação paliativa e família, sustentadas nas múltiplas atividades realizadas e experiências vividas, desenvolveram-se competências especializadas técnico-científicas, éticas e humanas atendendo às dimensões: comunicação, trabalho em equipa, gestão de sintomas e apoio familiar. Este relatório transparece a necessidade premente de se investir na formação base dos enfermeiros em cuidado espiritual, assim como as instituições de saúde necessitam de estar mais sensibilizadas para a importância da abordagem da dimensão espiritual das pessoas em situação paliativa e família.

The increase in average life expectancy leads to a higher prevalence of chronic and degenerative diseases, making it urgent to change the paradigm of care. Assuming the inevitability of the end of life, it is essential that we start looking at the multidimensionality of the person who has an incurable and/or serious, progressive and advanced disease, focusing on the promotion of comfort, well-being and the quality of life. It is in this context that Palliative Care (PC) emerges, which aims to improve the quality of life of people in a palliative situation and their families, considering them as a biopsychosocial and spiritual being. When the person faces a diagnosis with no prospect of cure, spiritual suffering can emerge, due to the loss of meaning in life, which is why the approach to spirituality in PC is of great importance. However, intervention in the dimension of spirituality by health professionals, more precisely by Palliative Care nurses, is still far below what would be desired. In this sense, it was decided to carry out the internship in a palliative care service of a central hospital with the objective of developing common and specific competences of a specialist nurse in the area of nursing for the person in a palliative situation. This report includes the description and critical-reflective analysis of the activities carried out and the skills acquired during the Professional Internship related to the assessment and intervention of nurses in palliative care, with special emphasis on the dimension of spirituality. Of the activities and competences developed, emphasis should be given to the work-related training on the theme "Spirituality in Palliative Care"; in the area of care management an intervention project called "Proposal for Parameterization in SClinico: The spiritual dimension" stands out. In view of the non-satisfaction of the spiritual needs of people in a palliative situation and their families, a scoping review was carried out regarding the nurses' difficulties in providing spiritual care for people in a palliative situation. In the field of caring for people in critical situations and their families, supported by the multiple activities carried out and lived experiences, specialized technical-scientific, ethical and human skills were developed, taking into account the dimensions: communication, teamwork, symptom management and family support. This report shows the urgent need to invest in the basic training of nurses in spiritual care, as well as health institutions need to be more aware of the importance of approaching the spiritual dimension, especially in sick people and families in Palliative Care.

Dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa: uma scoping review / Difficulties Of Nurses In The SpiritualCare Of The Palliative Person: A Scoping Review

Objetivo: Mapear a evidência científica relativa às dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa. Método: Estudo do tipo Scoping Review, com base nas recomendações PRISMA-ScR e do protocolo definido pelo Joanna Briggs Institute. Pesquisa em 4 bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), National Library of Medicine (PUBMED), Cummulative Index to Nursing and Allied Heath Literature (CINAHL) e Web of Science e considerados estudos dos últimos 5 anos. Resultado: Amostra final de 10 estudos. Foram identificadas várias dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa, dos quais destacamos: falta de formação; falta de tempo; falta de reconhecimento; falta de confiança; evitamento; referenciação tardia; espiritualidade dos enfermeiros pouco desenvolvida; crenças diferentes. Conclusão: Foram identificadas múltiplas dificuldades sentidas pelos enfermeiros no cuidar espiritual, as quais passam quer por défices na formação, quer por défices organizacionais, quer por défices pessoais. (AU)

Objective: To map the scientific evidence concerning the difficulties faced by nurses in the spiritual care of palliative care patients. Method: Scoping Review, based on PRISMA-ScR recommendations and the protocol defined by the Joanna Briggs Institute. Search in 4 databases: Latin American and Caribbean Literature on Health Sciences (LILACS), National Library of Medicine (PUBMED), Cumulative Index to Nursing and Allied Heath Literature (CINAHL) and Web of Science and considered studies from the last 5 years. Result: Final sample of 10 studies. Several difficulties were identified among the nurses in the spiritual care of palliative patients, namely: lack of training; lack of time; lack of recognition; lack of trust; avoidance; late referral; nurses' spirituality underdeveloped; different beliefs. Conclusion: We identified multiple difficulties experienced by nurses in spiritual care, either due to deficits in training, organizational deficits, or personal deficits.(AU)

Mapear la evidencia científica sobre las dificultades experimentadas por las enfermeras en la atención espiritual de pacientes en cuidados paliativos. Método: Scoping Review, basado en las recomendaciones PRISMA-ScR y en el protocolo definido por el Instituto Joanna Briggs. Búsqueda en 4 bases de datos: Latin American and Caribbean Literature on Health Sciences (LILACS), National Library of Medicine (PUBMED), Cumulative Index to Nursing and Allied Heath Literature (CINAHL) y Web of Science. Resultado: Muestra final de 10 estudios. Se identificaron varias dificultades entre las enfermeras en la atención espiritual de los pacientes paliativos, a saber: falta de formación; falta de tiempo; falta de reconocimiento; falta de confianza; evitación; derivación tardía; espiritualidad de las enfermeras poco desarrollada; creencias diferentes. Conclusión: Se identificaron múltiples dificultades experimentadas por las enfermeras en la atención espiritual, que pueden explicarse por déficits formativos, organizativos y personales.(AU)

Digital Methods in the Promotion of Well-Being in Immigrants: A Systematic Review : Author Note.

Migration is a disruptive experience that undermines immigrants' well-being. This systematic review explores the diversity of digital methods available to promote their well-being. The review includes 13 studies (6 were RCTs), comprising 8181 participants, collected through EBSCOhost web, b-ON, Scopus, SciELO and ProQuest, with no time restriction (to access all available literature). Primary outcomes were well-being (mental health; quality of life), and the secondary were stigma, integration and connection. Study quality was assessed by the QuADS tool. Digital methods are a valuable tool for improving immigrants' well-being. M-integration methods tend to focus on promoting mental health in immigrants, developing individual resilience while participatory methods address the quality of life in refugees, contributing to social resilience. Digital methods must not only be part of the guidelines of interventions for immigrants and refugees but also be a foundation upon which those guidelines are outlined.

Geographically Disperse, Culturable Seed-Associated Microbiota in Forage Plants of Alfalfa (Medicago sativa L.) and Pitch Clover (Bituminaria bituminosa L.): Characterization of Beneficial Inherited Strains as Plant Stress-Tolerance Enhancers.

Agricultural production is being affected by increasingly harsh conditions caused by climate change. The vast majority of crops suffer growth and yield declines due to a lack of water or intense heat. Hence, commercial legume crops suffer intense losses of production (20-80%). This situation is even more noticeable in plants used as fodder for animals, such as alfalfa and pitch trefoil, since their productivity is linked not only to the number of seeds produced, but also to the vegetative growth of the plant itself. Thus, we decided to study the microbiota associated with their seeds in different locations on the Iberian Peninsula, with the aim of identifying culturable bacteria strains that have adapted to harsh environments and that can be used as biotreatments to improve plant growth and resistance to stress. As potentially inherited microbiota, they may also represent a treatment with medium- and long-term adaptative effects. Hence, isolated strains showed no clear relationship with their geographical sampling location, but had about 50% internal similarity with their model plants. Moreover, out of the 51 strains isolated, about 80% were capable of producing biofilms; around 50% produced mid/high concentrations of auxins and grew notably in ACC medium; only 15% were characterized as xerotolerant, while more than 75% were able to sporulate; and finally, 65% produced siderophores and more than 40% produced compounds to solubilize phosphates. Thus, Paenibacillus amylolyticus BB B2-A, Paenibacillus xylanexedens MS M1-C, Paenibacillus pabuli BB Oeiras A, Stenotrophomonas maltophilia MS M1-B and Enterobacter hormaechei BB B2-C strains were tested as plant bioinoculants in lentil plants (Lens culinaris Medik.), showing promising results as future treatments to improve plant growth under stressful conditions.

Discerning Transcriptomic and Biochemical Responses of Arabidopsis thaliana Treated with the Biofertilizer Strain Priestia megaterium YC4-R4: Boosting Plant Central and Secondary Metabolism.

As a response to the current challenges in agriculture, the application of alternatives to a more sustainable management is required. Thus, biofertilizers begin to emerge as a reliable alternative to improve crop development and resistance to stresses. Among other effects on the plant, the use of beneficial strains may cause changes in their metabolic regulation, as in cell wall biogenesis and in nutrient/ion transportation, improving their growth process. Previous works showed that inoculation with the strain Priestia megaterium YC4-R4 effectively promoted vegetative growth of Arabidopsis thaliana Col-0 plants. Hence, the present work recorded a strain-mediated induction of several pathways of the central and secondary metabolism of the plant, as the induction of lipid, cellulose, phenol, and flavonoid biosynthesis, by using transcriptomic and biochemical analyses.

ANIPHI: An innovative pedagogical platform based on the Delphi method to support animal welfare teaching.

As a teaching subject, animal welfare is challenging for educators and learners, as was recently shown in a recent survey on the evolution of animal welfare teaching in Europe. Among several suggestions to overcome the current resistance to implementing animal welfare education, we highlight two. The first is that animal welfare education should be based on learner-centred approaches; the second is that it should encompass both animal welfare science and ethics and law. To the best of our knowledge, there are no learner-centred pedagogical approaches that can simultaneously explore scientific and ethical concepts. Furthermore, when exploring ethical concepts within the educational context, there is the additional challenge of being able to depart from discussion and debate to a systematic organization of knowledge. Our work simultaneously addresses these two challenges, presenting the design and implementation of a novel web-based learner-centred pedagogical platform for farm animal welfare teaching. The platform, named ANIPHI, uses the Delphi method's iterative nature as a learning process to generate both reflection and (online) debate among learners. ANIPHI can be used by educators in an online environment, in a classroom environment, or in a combination of the two environments. ANIPHI was developed within the ERASMUS+ ANICARE project and is an open web-based platform for all educators interested in teaching farm animal welfare. Given ANIPHI's flexible and user-friendly nature, the platform simultaneously exposes learners to ethical and scientific concepts in different educational realities, according to the educator's objectives. Furthermore, videos depicting different husbandry practices across different types of animal production and countries are embedded in the platform. These videos are commented on by the farmer himself and by animal scientists, which enriches the learner's experience. Educators across the ANICARE consortium have already successfully tested the ANIPHI platform for different farm animal welfare topics. We conclude this article by presenting one example of using ANIPHI in a real-life educational context, where we discuss some aspects of the design and use of our pedagogical platform.

O papel do enfermeiro de reabilitação na capacitação do cuidador informal do idoso dependente por AVC no domicilio / The role of the rehabilitation nurse in empowering the informal caregiver of stroke-dependent elderly at home

O atual envelhecimento e aumento populacional, associado ao progresso científico e tecnológico, proporcionou a existência de maior cronicidade e incapacidade na saúde. Os cuidados de saúde primários são, neste âmbito, um dos contextos privilegiados de intervenção. O Acidente Vascular Cerebral (AVC) é uma das maiores causas de incapacidade crónica dos idosos, e o cuidador informal (CI) é um dos pilares da assistência necessária, podendo o seu papel influenciar várias dimensões da saúde. A literatura releva que os CI se deparam com dificuldades no regresso ao domicílio, com necessidade de mais e melhor informação e suporte na aquisição de competências que os capacitem para o seu desempenho. A intervenção na área da capacitação do CI no autocuidado do idoso dependente por AVC no domicílio, espera-se enriquecedora para os cuidados de saúde. O Enfermeiro Especialista em Reabilitação (EEER) tem um papel fundamental na construção de respostas dos sistemas de saúde aos desafios societais. No desenvolvimento profissional especializado é fundamental uma prática sustentada pela evidência, adequada às necessidades da população e orientada para resultados sensíveis aos cuidados de enfermagem de reabilitação. Nesta ótica, foi realizado um Estágio de Natureza Profissional com o objetivo geral de desenvolver competências no âmbito da Enfermagem de Reabilitação na Comunidade. O Relatório Final apresentado constitui um relato fundamentado e reflexivo das atividades realizadas, que permitiram o desenvolvimento de competências profissionais específicas do EEER, junto com o perfil das competências comuns. No nortear deste percurso foram tidos como modelos teóricos estruturantes as Teoria do Défice de Autocuidado de Orem e Teoria das Transições de Meleis. A componente de investigação desenvolvida baseou-se numa metodologia quantitativa (estudo pré-experimental de grupo único), com os objetivos de: identificar caraterísticas sociodemográficas e clínicas dos CI de idosos dependentes por AVC no domicílio, e conhecer os efeitos de um programa de enfermagem de reabilitação na capacitação destes CI para o autocuidado: cuidar da higiene pessoal, transferir, posicionar, providenciar ajudas técnicas, usar o sanitário, alimentar/hidratar e vestir/despir. Foram utilizados como instrumentos de recolha de dados: Formulário de Caraterização do CI e Escala de Capacidades do Prestador Informal de Cuidados a Idosos Dependentes por AVC (Araújo [et al.], 2016). A amostra foi constituída por 15 CI de uma Unidade de Cuidados na Comunidade da região Norte de Portugal, cujo programa de intervenção, baseado no ensino e treino de capacidades, contemplou seis contactos: cinco presenciais e um telefónico, com sessões individuais no domicílio e uma em grupo. Os resultados do estudo permitiram concluir que o programa de enfermagem de reabilitação influenciou favoravelmente a capacitação do CI para o autocuidado do idoso dependente por AVC no domicílio, comprovando-se as hipóteses estatísticas relativas às áreas do autocuidado referidas, corroborando a importância da intervenção nesta área. A compreensão e análise desta problemática ajudará os profissionais, como o EEER, a melhor apoiar esta população. O presente e futuro patenteiam novos desafios e oportunidades para tornar mais forte o corpo de conhecimentos da enfermagem na área da reabilitação.

The current aging and population increase, associated with scientific and technological progress, has provided the existence of a bigger chronicity and disability on health. Primary health care is, in this area, one of the privileged contexts of intervention. Stroke is one of the major causes of chronic disability in the elderly, and the informal caregivers are one of the pillars of their assistance, whose role can influence several dimensions of health. The literature reveals that informal caregivers faces difficulties on returning home, needing more and better information and support in acquiring skills that enable them to perform their role. The intervention in the area of informal caregiver empowerment with regard to self-care of the elderly dependent for stroke, at home, is expected to be enriching for health care. The rehabilitation specialist nurse has a role key in building health systems responses to societal challenges. In a specialized professional development, the practice supported by evidence is essential, also adequate to the needs of the population and oriented towards sensitive results to rehabilitation nursing care. A Professional Internship was carried out with the general objective of developing competences of rehabilitation nursing in the community. The Final Report presented constitutes a reasoned and reflective account of the performed activities, which allowed the development of specific professional competences of the rehabilitation specialist nurse, together with the common competences. In order to guide this path, Orem's Self-Care Deficit Theory and Meleis's Transition Theory were taken as structuring theoretical models. The developed study was based on a quantitative methodology (pre-experimental study with a single group). The objectives were: identifying sociodemographic and clinical characteristics of informal caregivers of elderly people dependent for stroke, at home, and knowing the effects of a nursing rehabilitation training program on the empowerment of this informal caregivers, with regard to self-care in the areas of: personal hygiene, transferring, positioning, providing technical assistance, using the toilet, feeding/hydrating and dressing/undressing. The data collection tools used were: The Informal Caregiver Characterization Form and The Skills Scale of Informal Caregivers of Dependent Older People Post-Stroke (Araújo [et al.], 2016). The participants were 15 informal caregivers from a Community Care Unit in the North region of Portugal, whose intervention program, based on teaching and training skills, included six contacts: five in person and one by telephone, with individual sessions at home and one in a group. The results of the study allowed us to conclude that the nursing rehabilitation training program favorably influenced the empowerment of informal caregiver with regard to self-care of the elderly dependent for stroke, at home, proving the statistical hypotheses related to the aforementioned areas of self-care, corroborating the importance of intervention in this area. The understanding and analysis of this matter will help health professionals, such as the rehabilitation specialist nurse, to better support this population. The present and the future reveals new challenges that will constitute opportunities to strengthen the nursing body of knowledge, in the area of rehabilitation.

Seed-Encapsulation of Desiccation-Tolerant Microorganisms for the Protection of Maize from Drought: Phenotyping Effects of a New Dry Bioformulation.

Droughts and high temperatures deeply affect crop production. The use of desiccation-tolerant (or xerotolerant) microorganisms able to protect plants from droughts represents a promising alternative. These xerotolerant microorganisms have previously been used to modulate plant responses and improve their tolerance to drought. In addition, these microorganisms could be stored and used in dry formats, which would improve their viability and resilience at a much lower cost than current market alternatives. In the present study we analyze the possibility of using strains of xerotolerant Actinobacteria in encapsulated format on seeds. Under this formulation, we carried out greenhouse with farming soil with maize plants. Under greenhouse conditions, the plants showed greater resistance to drought, as well as increased growth and production yield, but not as well in field trials. This alternative could represent a useful tool to improve water efficiency in crops for drought-affected areas or affected by water scarcity.

SARS-CoV-2-related Multisystem Inflammatory Syndrome in Adults.

Adults infected with SARS-CoV-2 may develop a multisystem inflammatory syndrome (MIS-A) characterized by elevated inflammatory markers and multisystem organ involvement. We report the case of a patient who presented with fever and vomiting at hospital admission. He tested positive for SARS-CoV-2 infection and blood tests showed elevated inflammatory markers. The patient developed acute cardiac dysfunction and shock in less than 24 hours and the echocardiogram revealed an LVEF of 30%. He was discharged 3 weeks later fully recovered. MIS-A should be considered if a compatible syndrome is observed in patients with evidence of SARS-CoV-2 infection by PCR test or serology. LEARNING POINTS: Multisystem inflammatory syndrome should be considered in young adults presenting with shock and elevated inflammatory markers.Multisystem inflammatory syndrome may be highly responsive to parenteral steroids.

Combined lung-kidney transplantation: First case in Portugal.

A significant dysfunction of another organ is usually considered an absolute contraindication for lung transplantation, unless multiorgan transplantation is indicated and practical, as is the case of combined lung-kidney transplantation. Few cases of combined lung-kidney transplantation have been described in the literature; however, it is known that, in certain cases, it is the only way to offer an opportunity to selected patients with renal and lung dysfunction. The authors are not aware of any previously published case of a patient receiving both extracorporeal membrane oxygenation and continuous venovenous hemodiafiltration as a bridge for combined kidney-lung transplantation. The authors present the first case of combined lung-kidney transplantation performed in Portugal.

Validation of the Personal Social Capital Scale-16 in Portugal: preliminary data on Portuguese and immigrants.

OBJECTIVES: The Personal Social Capital Scale 16 (PSCS-16) is a self-report measure used to assess social capital, as a social determinant of health. To guarantee validated measures of this construct, the psychometric properties of the Portuguese version of the PSCS-16 were studied. METHODS: The PSCS-16 comprises 16 items, organized in two scales: bonding and bridging social capital. A convenience sample of 280 participants was collected through an online survey. For construct validity, we used confirmatory factor analysis, and convergent and discriminant validity through the average variance extracted (AVE) and correlations. For reliability, we used: The Spearman-Brown split-half and the omega hierarchical coefficient. Correlations were made between the PSCS-16 and socio-demographic variables. RESULTS: A first-order model depicting two oblique factors was supported, suggesting the use of the two scales. Evidence of convergent validity was achieved: acceptable AVE and associations between social capital and emotional self-disclosure. For discriminant validity, the AVE values surpassed the squared correlation between bonding and bridging, and associations with sexual health were found to be absent. Reliability was good. Additional correlations: A positive association between the education level and bridging social capital and participants with an immigrant status having more bridging social capital. CONCLUSIONS: Preliminary findings support the Portuguese version of PSCS-16 as suitable to evaluate social capital. Contributions are highlighted: the need to study correlates of social capital, particularly crossing migrations, social capital and mental health; and confirming the structure found by measuring its invariance.

Evaluation of dental trauma in inmates of the most highly populated Brazilian prison complex.

BACKGROUND/AIM: Due to the increase in incarceration rates, the prison community has attracted much concern in the recent past. Although people in prison are often socially disadvantaged and vulnerable to a range of health problems, there is a lack of information on the oral health conditions of prisoners. Thus, the aim of this study was to survey the oral problems of a sample of the male incarcerated population of Brazil, focusing on dental trauma. MATERIAL AND METHODS: The research was undertaken over a three-month period in 2017. It was a cross-sectional study of 756 prisoners of the Curado Prison Complex, located in Recife, PE. Using a previously calibrated examiner, dental trauma was measured with the Andreasen index. Etiology of dental trauma and socio-demographic data were collected with questions developed for this survey. Standard descriptive statistics were used to report frequency estimates. The chi-square test, Fisher's exact test, and Mann-Whitney U-test were used to compare groups. In addition, a binary logistic regression was performed to identify whether the studied variables could predict the occurrence of dental trauma. RESULTS: The prevalence of dental trauma in the sample was 10.8% and most of the cases (42.7%) occurred due to violent events. A higher frequency of violent etiology was observed in cases that occurred during imprisonment (p = 0.037). Individuals that suffered dental trauma during incarceration were more likely to have been incarcerated for longer periods of time (p = 0.043). The main type of injury found was enamel and dentin fracture without pulp exposure (68%). The most affected tooth was the upper right central incisor (40%). CONCLUSION: These results underline the high prevalence of dental trauma experienced by men in prison.

Descriptive Acute Respiratory Distress Syndrome (ARDS) in adults with imported severe Plasmodium falciparum malaria: A 10 year-study in a Portuguese tertiary care hospital.

BACKGROUND: Acute respiratory distress syndrome (ARDS) is a severe complication of malaria that remains largely unstudied. We aim to describe the development of ARDS associated with severe P. falciparum malaria, its management and impact on clinical outcome. METHODS: Retrospective observational study of adult patients admitted with severe P. falciparum malaria in an Intensive Care Unit (ICU) of a tertiary care hospital from Portugal from 2008 to 2018. A multivariate logistic regression analysis was used to identify factors associated with the development of ARDS, defined according to Berlin Criteria. Prognosis was assessed by case-fatality ratio, nosocomial infection and length of stay. RESULTS: 98 patients were enrolled, of which 32 (33%) developed ARDS, a median of 2 days after starting antimalarial medication (IQR 0-4, range 0-6). Length of stay in ICU and in hospital were significantly longer in patients who developed ARDS: 13 days (IQR 10-18) vs 3 days (IQR 2-5) and 21 days (IQR 15-30.5) vs 7 days (IQR 6-10), respectively. Overall case-fatality ratio in ICU was 4.1% and did not differ between groups. The risk of ARDS development is difficult to establish. CONCLUSION: ARDS is a hard to predict late complication of severe malaria. A low threshold for ICU admission and monitoring should be used. Ideally patients should be managed in a centre with experience and access to advanced techniques.

How Your Power Affects My Impression of You.

In the present article, we investigate how a person's power affects the way we infer traits from their behavior. In Experiment 1, our results suggest that, when faced with behavioral descriptions about others, participants infer both positive and negative traits about powerless actors, whereas for powerful and control (power irrelevant) actors, only positive but no negative traits are inferred, an effect we call the benevolence bias. In the second experiment, (a) we replicate this effect, (b) we show that it does not depend on the specific traits used in Experiment 1, and (c) we show that it is also detected when an implicit measure of inferences is used. Experiment 3 further shows that this effect generalizes to a more generic power manipulation. Theoretical explanations for these findings are discussed.