Prevention, protocols, and lab capacity: lessons from a norovirus outbreak in the Algarve.

This brief report presents the findings of an epidemiological investigation into a large-scale outbreak of norovirus gastroenteritis that occurred in a hotel in Algarve, Portugal, in August 2022. A total of 244 cases were reported, primarily affecting Portuguese families, with the parents aged 40-50 years and the children aged 0-19 years. Reported symptoms included vomiting, nausea, abdominal pain, and diarrhoea. Norovirus genotype GI.3 [P3] was detected in stool samples from eight probable cases, while food samples tested negative for norovirus and common pathogenic bacteria. The investigation data collected suggest that the source of the outbreak was likely in the hotel's common areas, with subsequent person-to-person transmission in other areas. The final report emphasizes the importance of improving outbreak prevention and control measures, including the development of a foodborne outbreak investigation protocol, the establishment of an outbreak response team, and the enhancement of regional laboratory capacity.

Contrasts in short- and long-term responses of Mediterranean reptile species to fire and habitat structure.

Changes in habitat structure constitute a major factor explaining responses of reptiles to fire. However, few studies have examined habitat factors that covary with fire-history variables to explain reptile responses. We hypothesise that more complex habitats should support richer reptile communities, and that species-specific relative abundance should be related to particular habitat features. From spring 2012-2014, twenty-five transects were surveyed in the Albera Region (north-east Iberia). The vegetation structure was measured and the extent of habitat types in a 1000-m buffer around each transect calculated. Reptile-community metrics (species richness and reptile abundance) were related to fire history, vegetation structure, and habitat types, using generalized additive models. These metrics correlated with habitat-structure variables but not with fire history. The number of species increased with more complex habitats but decreased with pine-plantation abundance in the 1000-m buffer. We found contrasting responses among reptiles in terms of time since fire and those responses differed according to vegetation variables and habitat types. An unplanned fire in August 2012 provided the opportunity to compare reptile abundance values between pre-fire and the short term (1-2 years) after the fire. Most species exhibited a negative short-term response to the 2012 fire except Tarentola mauritanica, a gecko that inhabits large rocks, as opposed to other ground-dwelling species. In the reptiles studied, contrasting responses to time since fire are consistent with the habitat-accommodation model of succession. These differences are linked to specific microhabitat preferences and suggest that functional traits can be used to predict species-specific responses to fire.

Implementing supportive supervision in acute humanitarian emergencies: Lessons learned from Afghanistan and Ukraine.

Mental Health and Psychosocial Support (MHPSS) practitioners working in humanitarian contexts are at significant risk of mental health conditions, ultimately hindering the quality and sustainability of their work. Supportive supervision has shown to be effective in improving the wellbeing of MHPSS staff and volunteers and enhancing the effectiveness of MHPSS service delivery. Despite these proven benefits, there is a lack of standardised guidelines to inform supportive supervision within humanitarian contexts. To address this gap, the Trinity Centre for Global Health and the International Federation of the Red Cross Red Crescent Societies' Reference Centre for Psychocosial Support co-developed the 'Integrated Model for Supervision' (IMS) Handbook and supporting tools and led IMS trainings with four humanitarian organisations in Ukraine, Afghanistan, Jordan, and Nigeria from June-August 2021. The subsequent acute humanitarian emergencies that occurred in Afghanistan and Ukraine provided the opportunity to (i) examine the implementation of the IMS in the acute stages of two humanitarian crises and (ii) identify the challenges and lessons learned from this process. This study employed a case study design using semi-structured qualitative interviews with five MHPSS personnel (female: 4; male: 1) who had received training in the IMS and were directly involved in the implementation of supportive supervision using IMS guidelines in either Ukraine or Afghanistan. Results showed that participants identified the key steps needed for the implementation of supportive supervision and reported two significant barriers to implementation including the stress of a humanitarian crisis leading to competing responsibilities and priorities, staff shortages and time constraints as well as the challenge of creating a new supervision structure when none had existed previously. Overall, participants felt that the IMS resulted in improved knowledge, confidence, perceived support, team cohesion, staff wellbeing and was a helpful blueprint to guide the implementation of supportive supervision in humanitarian contexts.

Facilitating permeability of landscapes impacted by roads for protected amphibians: patterns of movement for the great crested newt.

Amphibian populations are highly vulnerable to road mortality and habitat fragmentation caused by road networks. Wildlife road tunnels are considered the most promising road mitigation measure for amphibians yet generally remain inadequately monitored, resulting in mixed success rates in the short-term and uncertain conservation benefits in the long-term. We monitored a complex multi-tunnel and fence system over five years and investigated the impact of the scheme on movement patterns of two newt species, including the largest known UK population of the great crested newt (Triturus cristatus), a European Protected Species. We used a stage descriptive approach based on capture positions to quantify newt movement patterns. Newt species successfully used the mitigation but the system constituted a bottleneck to movements from the fences to the tunnels. Crossing rates varied widely among years and were skewed towards autumn dispersal rather than spring breeding migration. There was a substantial negative bias against adult male great crested newts using the system. This study indicates that road tunnels could partially mitigate wider connectivity loss and fragmentation at the landscape scale for newt species. However, the observed bottleneck effects and seasonal bias could have population-level effects which must be better understood, especially for small populations, so that improvements can be made. Current requirements for monitoring mitigation schemes post-implementation are probably too short to assess their effectiveness in maintaining connectivity and to adequately understand their population-level impacts.

Glucomannan- and glucomannan plus spirulina-enriched pork affect liver fatty acid profile, LDL receptor expression and antioxidant status in Zucker fa/fa rats fed atherogenic diets.

We evaluated the effects of glucomannan or glucomannan plus spirulina-restructured pork (RP) on liver fatty acid profile, desaturase/elongase enzyme activities and oxidative status of Zucker fa/fa rats for seven weeks. Control (C), glucomannan (G) and glucomannan/spirulina (GS)-RP; HC (cholesterol-enriched control), HG and HGS (cholesterol-enriched glucomannan and glucomannan/spirulina-RP) experimental diets were tested. Increased metabolic syndrome markers were found in C, G and GS rats. Cholesterol feeding increased liver size, fat, and cholesterol and reduced antioxidant enzyme levels and expressions. Cholesterolemia was lower in HG and HGS than in HC. GS vs. G showed higher stearic but lower oleic levels. SFA and PUFA decreased while MUFA increased by cholesterol feeding. The arachidonic/linoleic and docosahexaenoic/alpha-linolenic ratios were lower in HC, HG, and HGS vs. C, G, and GS, respectively, suggesting a delta-6-elongase-desaturase system inhibition. Moreover, cholesterol feeding, mainly in HGS, decreased low-density-lipoprotein receptor expression and the delta-5-desaturase activity and increased the delta-9-desaturase activity. In conclusion, the liver production of highly unsaturated fatty acids was limited to decrease their oxidation in presence of hypercholesterolaemia. Glucomannan or glucomannan/spirulina-RP has added new attributes to their functional properties in meat, partially arresting the negative effects induced by high-fat-high-cholesterol feeding on the liver fatty acid and antioxidant statuses.

Foreign Body Aspiration in the Elderly.

Foreign body aspiration is common in children and in the elderly, who may present with subtle symptoms. Clinical suspicion is crucial and bronchoscopy is the main diagnostic and therapeutic procedure available. This is the case of a man, 78 years old, with a history of chronic obstructive pulmonary disease, who presented with respiratory distress following oral intake of tablets. History taking and physical examination raised suspicion. The diagnosis was confirmed with flexible bronchoscopy and rigid bronchoscopy was carried out for treatment. The patient's condition is stable and he is under investigations for dysphagia.

A aspiração de corpo estranho é mais frequente em crianças e idosos, podendo ter uma apresentação subtil neste último grupo. A suspeição clínica é crucial, sendo a broncoscopia o principal meio de diagnóstico e tratamento disponível. Descreve-se o caso de um doente do sexo masculino, 78 anos, antecedentes de doença pulmonar obstrutiva crónica, com quadro de dificuldade respiratória após toma de comprimido, tendo sido levantada a suspeita de aspiração de corpo estranho através da anamnese e achados ao exame objectivo. O diagnóstico foi confirmado através de broncofibroscopia flexível e o tratamento através de broncoscopia rígida. Actualmente, encontra-se estável e com disfagia em estudo.

[High blood pressure prevalence in Oporto sedentary and regular exercise practicing people]. / Prevalência do diagnóstico de hipertensão arterial em pessoas sedentárias e em praticantes de exercício físico, na cidade do Porto.

INTRODUCTION: The association between the lack of exercise and prevalence of high blood pressure (HBP) is a well known fact. The non-pharmacological treatment for HBP includes regular aerobic exercise practicing. METHODS: A total of 900 individuals, aged above 40, resident in Oporto, representing the 15 parishes of the city, were approached to answer a questionnaire about exercise habits and diagnosis of HBP. The exercise practitioner was defined as the one who practices aerobic exercise for a minimal period of 30 minutes at least 3 times a week. For data analysis non-parametric tests (Pearson's Chi-Square) were used through the Statistical Package for the Social Sciences (SPSS) software. RESULTS: The HBP prevalence in the sample was 39.67% (Confidence Interval (IC) 95%, 36,46% to 42,87%). The HBP prevalence in the exercise practitioners was inferior to the one of the non-practitioners (13,78% vs 25,89%, p < 0,001). This result is valid to the male 33,5% vs 51,6%, p < 0,001) and female population (27,1% vs 51,9%, p < 0,001), as well as to the population without the most frequent HBP-related comorbidities (21,8% vs 44,6%, p < 0,001). CONCLUSIONS: The HBP prevalence in the population resident in Oporto city is higher in the non-practitioners of regular exercise. The HBP prevalence, in both sexes, is higher in the non-practitioners of exercise. Finally, we can also conclude that the studied comorbidities don't bias the obtained results because the group of individuals who don't have them the HBP prevalence is still higher in the group of sedentary.