Community Empowerment Assessment and Community Nursing Diagnosis for Climate Change Mitigation and Adaptation in the Northern Region of the Portuguese Atlantic Coast: A Mixed-Methods Study Using MAIEC Framework.

The Community Intervention and Empowerment Assessment Model (MAIEC) offers a framework for community empowerment in several fields such as Climate Change (CC), the largest health emergency crisis globally, through diagnosis and interventions in Community Health Nursing. This study aims to assess the level of community empowerment in climate change mitigation and adaptation, and to identify nursing diagnosis through the MAIEC clinical decision matrix, within a local intermunicipal association in the northern region of the Portuguese Atlantic Coast. A convergent mixed-methods design was used, applying a focus group technique to a purposive sampling of ten key stakeholders of this community. A Portuguese version of the Empowerment Assessment Rating Scale and a questionnaire were both applied to the same participants, and qualitative and quantitative data generated were analysed using a content analysis technique and an Excel database sheet created using Microsoft Office 365. The analysis of the Portuguese northern community exposed: a low level of community empowerment for mitigation and adaptation to climate change; a nursing diagnosis of community management impairments in several dimensions, such as community process, community participation and community leadership. However, the study confirmed that MAIEC contributed to future community-based solutions, responding to the challenges of climate change, and enabling the planning of interventions to address MAIEC diagnoses in the form of CC-specific training and recommendations for new cooperation approaches from all stakeholders. This study was not registered.

Isolation of saprophytic filamentous fungi from avian fecal samples and assessment of its predatory activity on coccidian oocysts.

Fungal strains used in the biocontrol of animal gastrointestinal parasites have been mainly isolated from pasture soil, decaying organic matter, and feces from herbivores and carnivores. However, their isolation from birds and assessment of predatory activity against avian GI parasites has been scarce thus far. This research aimed to isolate filamentous fungi from avian fecal samples and evaluate their predatory activity against coccidia. A pool of 58 fecal samples from chickens, laying hens, and peacocks, previously collected between July 2020-April 2021, were used for isolation of filamentous fungi and assessment of their in vitro predatory activity against coccidian oocysts, using Water-Agar medium and coprocultures. The Willis-flotation technique was also performed to obtain concentrated suspensions of oocysts. A total of seven Mucor isolates was obtained, being the only fungal taxa identified, and all presented lytic activity against coccidia. Isolates FR3, QP2 and SJ1 had significant coccidiostatic efficacies (inhibition of sporulation) higher than 70%, while isolates FR1, QP2 and QP1 had coccidicidal efficacies (destruction of the oocysts) of 22%, 14% and 8%, respectively, after 14 days of incubation, being a gradual and time-dependent process. To our knowledge, this is the first report regarding the isolation of native predatory fungi from avian feces and demonstration of their lytic activity against coccidia.

A re-analysis of 150 women's health trials to investigate how the Bayesian approach may offer a solution to the misinterpretation of statistical findings.

OBJECTIVE: To investigate whether a Bayesian interpretation might help prevent misinterpretation of statistical findings and support authors to differentiate evidence of no effect from statistical uncertainty. DESIGN: A Bayesian re-analysis to determine posterior probabilities of clinically important effects (e.g., a large effect is set at a 4 percentage point difference and a trivial effect to be within a 0.5 percentage point difference). Posterior probabilities greater than 95% are considered as strong statistical evidence, and less than 95% as inconclusive. SAMPLE: 150 major women's health trials with binary outcomes. MAIN OUTCOME MEASURES: Posterior probabilities of large, moderate, small and trivial effects. RESULTS: Under frequentist methods, 48 (32%) were statistically significant (p-value ≤ 0.05) and 102 (68%) statistically non-significant. The frequentist and Bayesian point estimates and confidence intervals showed strong concordance. Of the statistically non-significant trials (n = 102), the Bayesian approach classified the majority (94, 92%) as inconclusive, neither able to confirm or refute effectiveness. A small number of statistically non-significant findings (8, 8%) were classified as having strong statistical evidence of an effect. CONCLUSIONS: Whilst almost all trials report confidence intervals, in practice most statistical findings are interpreted on the basis of statistical significance, mostly concluding evidence of no effect. Findings here suggest the majority are likely uncertain. A Bayesian approach could help differentiate evidence of no effect from statistical uncertainty.

Validation of Angle Estimation Based on Body Tracking Data from RGB-D and RGB Cameras for Biomechanical Assessment.

Motion analysis is an area with several applications for health, sports, and entertainment. The high cost of state-of-the-art equipment in the health field makes it unfeasible to apply this technique in the clinics' routines. In this vein, RGB-D and RGB equipment, which have joint tracking tools, are tested with portable and low-cost solutions to enable computational motion analysis. The recent release of Google MediaPipe, a joint inference tracking technique that uses conventional RGB cameras, can be considered a milestone due to its ability to estimate depth coordinates in planar images. In light of this, this work aims to evaluate the measurement of angular variation from RGB-D and RGB sensor data against the Qualisys Tracking Manager gold standard. A total of 60 recordings were performed for each upper and lower limb movement in two different position configurations concerning the sensors. Google's MediaPipe usage obtained close results compared to Kinect V2 sensor in the inherent aspects of absolute error, RMS, and correlation to the gold standard, presenting lower dispersion values and error metrics, which is more positive. In the comparison with equipment commonly used in physical evaluations, MediaPipe had an error within the error range of short- and long-arm goniometers.

Morphological abnormalities in Acartia lilljeborgii Giesbrecht (1889) (Copepoda, Calanoida) in a tropical estuary under industrial development.

Morphological abnormalities in crustaceans have been registered and several are attributed to pollution and others anthropogenic activities. This study reports for the first time a temporal record of the amount and variety of morphological abnormalities in Acartia lilljeborgii, in an impacted neotropical estuary. The specimens were obtained from Suape port area, Northeast Brazil, between May 2009 and September 2010 using a 300 µm plankton net. Seven types of abnormalities were observed in one of the terminal spines of the prosome, but no temporal variation of abnormalities was found in our study. The deformities were registered in 85.7% of samples and they were found in up to 10% of the individuals (3.2 ± 2.9%). The proportion of females with abnormalities was greater than for males, in opposite to most previous reports. Due to its high distribution and abundance in part of the neotropical Atlantic coastal area, A. lilljeborgii has the potential to be used as a bioindicator of environmental conditions, although the reasons of the abnormality occurrences should be accurately investigated.

Nursing Epidemiological Approach of Hypertension Management in a Public Health Service from the Northern Region of Portugal.

BACKGROUND: Epidemiological surveillance of a nursing diagnosis is an approach anchored in a post-modern epidemiology focused on a person's health disease responses. Regarding public health priorities, the population where our study occurred had as a priority problem arterial hypertension. Related to this chronic disease, nursing diagnoses about health disease responses in primary healthcare has, as a major focus, Therapeutic Regimen Management. Our aim was to study the nursing diagnosis in this issue from an epidemiological approach. METHODS: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. RESULTS: We found 17.7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. CONCLUSIONS: Nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology for the future.

Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care.

Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.

A Synoptic Assessment of the Amazon River-Ocean Continuum during Boreal Autumn: From Physics to Plankton Communities and Carbon Flux.

The Amazon generates the world's largest offshore river plume, which covers extensive areas of the tropical Atlantic. The data and samples in this study were obtained during the oceanographic cruise Camadas Finas III in October 2012 along the Amazon River-Ocean Continuum (AROC). The cruise occurred during boreal autumn, when the river plume reaches its maximum eastward extent. In this study, we examine the links between physics, biogeochemistry and plankton community structure along the AROC. Hydrographic results showed very different conditions, ranging from shallow well-mixed coastal waters to offshore areas, where low salinity Amazonian waters mix with open ocean waters. Nutrients, mainly [Formula: see text] and [Formula: see text], were highly depleted in coastal regions, and the magnitude of primary production was greater than that of respiration (negative apparent oxygen utilization). In terms of phytoplankton groups, diatoms dominated the region from the river mouth to the edge of the area affected by the North Brazil Current (NBC) retroflection (with chlorophyll a concentrations ranging from 0.02 to 0.94 mg m-3). The North Equatorial Counter Current (NECC) region, east of retroflection, is fully oligotrophic and the most representative groups are Cyanobacteria and dinoflagellates. Additionally, in this region, blooms of cyanophyte species were associated with diatoms and Mesozooplankton (copepods). A total of 178 zooplankton taxa were observed in this area, with Copepoda being the most diverse and abundant group. Two different zooplankton communities were identified: a low-diversity, high-abundance coastal community and a high-diversity, low-abundance oceanic community offshore. The CO2 fugacity (fCO2sw), calculated from total alkalinity (1,450 < TA < 2,394 µmol kg-1) and dissolved inorganic carbon (1,303 < DIC < 2,062 µmol kg-1) measurements, confirms that the Amazon River plume is a sink of atmospheric CO2 in areas with salinities <35 psu, whereas, in regions with salinities >35 and higher-intensity winds, the CO2 flux is reversed. Lower fCO2sw values were observed in the NECC area. The ΔfCO2 in this region was less than 5 µatm (-0.3 mmol m-2 d-1), while the ΔfCO2 in the coastal region was approximately 50 µatm (+3.7 mmol m-2 d-1). During the cruise, heterotrophic and autotrophic processes were observed and are indicative of the influences of terrestrial material and biological activity, respectively.

Socioeconomic determinants of disability in Chile.

BACKGROUND: Disability is a worldwide public health priority. A shift from a biomedical perspective of dysfunction to a broader social understanding of disability has been proposed. Among many different social factors described in the past, socioeconomic position remains as a key multidimensional determinant of health. The study goal was to analyze the relationship between disability and different domains of socioeconomic position in Chile. METHODS: Cross-sectional analysis of an anonymized population-based survey conducted in Chile in 2006. Any disability (dichotomous variable) and 6 different types of disability were analyzed on the bases of their relationship with income quintiles, occupational status, educational level, and material living standards (quality of the housing, overcrowding rate and sanitary conditions). Confounding and interaction effects were explored using R statistical program. RESULTS: Income, education, occupation, and material measures of socioeconomic position, along with some sociodemographic characteristics of the population, were independently associated with the chance of being disabled in Chile. Interestingly, classic measures of socioeconomic position (income, education, and occupation) were consistently associated with any disability in Chile, whereas material living conditions were partially confounded by these classic measures. In addition to this, each type of disability showed a particular pattern of related social determinants, which also varied by age group. CONCLUSIONS: This study contributed to the understanding of disability in Chile and how different domains of socioeconomic position might be associated with this prevalent condition. Disability remains a complex multidimensional public health problem in Chile that requires the inclusion of a wide range of risk factors, of which socioeconomic position is particularly relevant.

Qualidade na prestação do serviço público / Curso de Capacitação a Distância

CD-ROM contém vídeo de apresentação do em formato de vídeo juntamente com vídeos aulas do curso de capacitação de curta duração em qualidade na prestação do serviço público. Contém o livro do curso e orientações aos estudantes em formato PDF e aplicativo da disciplina. Objetiva discutir a qualidade na prestação de serviço público, seus aspectos gerais, bem como os padrões de qualidade e eficiência

Técnica de oscilações forçadas na avaliação funcional de pacientes com fibrose cística com idade superior a 18 anos / Forced oscillation techinique for the functional evaluation of cystic fibrosis patients older 18 years

Objetivo: o objetivo deste estudo foi investigar as alterações nas propriedades resistivas e reativas do sistema respiratório de pacientes com fibrose cística. Metodologia: o estudo foi realizado em um grupo controle de 23 indivíduos saudáveis, e em um grupo de 27 pacientes com fibrose cística com idade maior que 18 anos que foram avaliados pela FOT e espirometria. Resultados: os pacientes com fibrose cística apresentaram aumento significativo (p<0,0001) na resistência total do sistema respiratório (R0), redução significativa do coeficiente angular da curva de resistência (S) (p<0,0006) e na complacência dinâmica (Cdin, sr) (p<0,0001) em comparação aos indivíduos saudáveis. Conclusão: os resultados do presente estudo são coerentes com a fisiopatologia da fibrose cística. A FOT descreveu adequadamente estas alterações, demonstrando elevado potencial na avaliação da mecânica pulmonar de pacientes com fibrose cística com idade superior a 18 anos.

Introduction: The aims of this study were (1) to investigate the changes in resistive and reactive properties of the respiratory system of cystic fibrosis patients older than 18 years and (2) assess the contribution of the forced oscillation technique (FOT) in the diagnosis of cystic fibrosis. Methodology: The study was conducted in a control group of 23 healthy individuals and a group of 27 cystic fibrosis patients older than 18 years who were assessed by the FOT and spirometry. Results: Cysticfibrosis patients presented increased total respiratory resistance (R0) (p <0.0001) and reduced slope of resistance curve (S) (p<0.0006) and dynamic compliance (Cdyn,rs) (p <0.0001) compared to healthy individuals. Conclusion: The results of thisstudy are consistent with the pathophysiology of cystic fibrosis. The FOT adequately described these changes, showing great potential in assessing pulmonary mechanics of patients with cystic fibrosis with age over 18 years.

Assessment of respiratory mechanics in patients with sarcoidosis using forced oscillation: correlations with spirometric and volumetric measurements and diagnostic accuracy.

BACKGROUND: The forced oscillation technique (FOT) is a promising method for providing a detailed analysis of respiratory mechanics during spontaneous breathing. There is limited data about the use of FOT in patients with sarcoidosis. OBJECTIVES: The aims of this study were to test the ability of FOT to describe the changes in respiratory mechanics in sarcoidosis and to evaluate the clinical potential of FOT. METHODS: Twenty healthy subjects and 31 patients were studied. All subjects performed spirometric exams, and pulmonary volumes were measured in patients. Resistive data were interpreted using the zero-intercept resistance (R0), the slope of the resistive component of the impedance (S), and the mean resistance (Rm). The analysis of reactance was used to measure the mean reactance (Xm) and the respiratory system dynamic compliance (C(dyn)). The total mechanical load was evaluated using the absolute value of the respiratory impedance (Z4Hz). RESULTS: In close agreement with pathophysiological fundamentals, significant (p < 0.001) increases in R0, Rm, and Z4Hz, and reductions in C(dyn) (p < 0.003) were observed. S and Xm presented smaller modifications (p < 0.02). All FOT parameters were significantly correlated with spirometric indices. Z4Hz was the most adequate parameter for clinical use (Se = 75%, Sp = 75%), followed by R0 and Rm. CONCLUSIONS: FOT parameters were consistent with the pathophysiology of sarcoidosis and were also able to detect the effects of this disease. Because the FOT is easy to perform, such a technique may represent an alternative and/or a complement to other conventional exams to help the clinical evaluations of sarcoidotic patients.

Técnica de oscilações forçadas na avaliação funcional de crianças asmáticas / Forced oscillation technique in the evaluation of asmathic children

Objetivo: Investigar as alterações nas propriedades resistivas e reativas do sistema respiratório de crianças asmáticas e avaliar a contribuição da técnica de oscilações forçadas (FOT) no diagnóstico da asma. Metodologia: O estudo foi realizado em um grupo controle de 20 crianças saudáveis, e em um grupo de 20 crianças asmáticas, que foram avaliadas pela FOT e espirometria. Resultados: Considerando os parâmetros resistivos da FOT, houve um aumento significativo na resistência total do sistema respiratório (R0) (p<0,02) e não significativo na resistência média (Rm), além de uma redução significativa da inclinação do componente resistivo da impedância (S) (p<0,002), no grupo de crianças asmáticas. Nos parâmetros reativos a complacência dinâmica (Cdin,sr) mostrou-se significativamente (p< 0,01) menor, sendo acompanhada pela redução da reatância média (Xm) (p<0,01) e pela elevação significativa da frequência de ressonância (fr) (p< 0,03) no grupo de crianças asmáticas. Conclusão: Os resultados do presente estudo são coerentes com a fisiopatologia da asma. A FOT escreveu adequadamente estas alterações, demonstrando elevado potencial na avaliação da mecânica pulmonar de crianças asmáticas.

Objective: To investigate the alterations on resistive and reactive proprieties of the respiratory system and evaluate the contribution of the forced oscillation technique (FOT) on the diagnosis of the asthma in children. Methodology: The study was performed in a control group formed by 20 healthy children and 20 asthmatic children, which were evaluated by FOT and spirometry. Results: Considering the resistive parameters of the FOT in the asthmatic children group, the total respiratorysystem resistance (R0) had significant increase (p<0,02) and a not significant increase in mean respiratory resistance (Rm), and a significant decreased of the resistance/frequency slope (S) p<0,02). The reactive parameters, the dynamic compliance (Cdin) and the mean respiratory reactance (Xm) presented significant (p<0,01) reduction, and significant increase resonance frequency (fr) (0,03). Conclusion: The results of the present study, demonstrate that the FOT is useful for detecting the respiratory mechanics modifications. This indicate that the FOT has a high potential in evaluating respiratory mechanics of asthmatics children.