Cocaine-induced stroke in a young patient / Acidente vascular cerebral induzido por cocaína em paciente jovem

The case report presented here addresses the relationship between cocaine use and stroke. A young adult patient arrived at a specialized unit with neurological deficits and a history of acute and long-term illicit drug use and presented no other comorbidities. In addition, he presented laboratory and serological tests without alterations. The only risk factor identified for stroke was, therefore, cocaine use. Thus, this work points to an eventual relationship between cocaine use and the case in question (AU).

O relato de caso apresentado neste trabalho, aborda a relação do uso da cocaína e o acidente vascular cerebral após um paciente adulto jovem chegar a uma unidade especializada com déficits neurológicos e histórico de uso de drogas ilícitas de forma aguda e de longa data, sem outras comorbidades constatadas. Além disso, apresentou exames laboratoriais e sorológicos sem alterações significativas. O único fator de risco identificado no caso em tela para o acidente vascular foi, portanto, o uso de cocaína. Assim, neste trabalho, enfatiza-se eventual relação entre o uso da cocaína com o caso em tela (AU).

Wavelet gated multiformer for groundwater time series forecasting.

Developing accurate models for groundwater control is paramount for planning and managing life-sustaining resources (water) from aquifer reservoirs. Significant progress has been made toward designing and employing deep-forecasting models to tackle the challenge of multivariate time-series forecasting. However, most models were initially taught only to optimize natural language processing and computer vision tasks. We propose the Wavelet Gated Multiformer, which combines the strength of a vanilla Transformer with the Wavelet Crossformer that employs inner wavelet cross-correlation blocks. The self-attention mechanism (Transformer) computes the relationship between inner time-series points, while the cross-correlation finds trending periodicity patterns. The multi-headed encoder is channeled through a mixing gate (linear combination) of sub-encoders (Transformer and Wavelet Crossformer) that output trending signatures to the decoder. This process improved the model's predictive capabilities, reducing Mean Absolute Error by 31.26 % compared to the second-best performing transformer-like models evaluated. We have also used the Multifractal Detrended Cross-Correlation Heatmaps (MF-DCCHM) to extract cyclical trends from pairs of stations across multifractal regimes by denoising the pair of signals with Daubechies wavelets. Our dataset was obtained from a network of eight wells for groundwater monitoring in Brazilian aquifers, six rainfall stations, eleven river flow stations, and three weather stations with atmospheric pressure, temperature, and humidity sensors.

Is the clinical performance of internal conical connection better than internal non-conical connection for implant-supported restorations? A systematic review with meta-analysis of randomized controlled trials.

PURPOSE: To evaluate bone loss, prosthodontics and biological complications, and implant survival rates of internal conical connections (ICC) compared with internal non-conical connection (INCC) implants. METHODS: The systematic review was registered on PROSPERO (CRD42021237170). Meta-analysis was performed using standardized mean difference (SMD) for bone loss and risk ratio (RR) for implant survival and complication rates. Risk of bias analysis was evaluated using RoB 2.0, whereas the GRADE tool was used to evaluate the certainty of evidence. A systematic search of the PubMed, Web of Science, Embase, Cochrane, and ProQuest databases was performed independently by two reviewers for articles published up to March 2022. The search criteria had no language or publication date restrictions. Handsearching analysis was performed in the reference list of potential articles. RESULTS: Twelve randomized clinical trials, including 678 patients and 1006 implants (ICC [n = 476]; INCC [n = 530]), were included. Meta-analysis revealed that ICC demonstrated a lower risk for marginal bone loss (SMD: -0.80 mm; p = 0.004) and prosthodontics complications (RR: 0.16; p = 0.01) than INCC. However, both internal connections demonstrated no significant difference in implant survival rates (RR: 0.54; p = 0.10) and biological complications (RR: 0.90; p = 0.82). The overall risk of bias revealed some concerns and a low risk of bias for most of the included studies. However, the certainty of evidence of outcomes was considered low to moderate. CONCLUSION: ICC may be considered a more favorable treatment option than INCC owing to greater preservation of peri-implant bone tissue and a lower probability of prosthodontics complications. However, well-conducted studies with long-term follow-up are warranted.

Sentimentos de estudantes de mestrado diante a morte da pessoa em situação crítica / Feelings of students in a master's in nursing program facing the death of patients in a critical situation

A morte faz parte do quotidiano da vida dos enfermeiros, principalmente quando lidam com pacientes em situação crítica. A forma como percecionam a morte pode ser relevante para uma prestação de cuidados humanizados. Objetivo: identificar quais os sentimentos de estudantes de um programa de mestrado perante a morte e a sua influência na prestação de cuidados a pacientes críticos. Método: Trata-se de uma pesquisa de abordagem qualitativa, aprovada pela comissão de ética da Universidade (Doc11/CE/2018 de 09/04/2018). Realizaram-se entrevistas a 11 estudantes, processadas por análise de conteúdo. Resultados: os principais sentimentos associados à morte dos pacientes foram: impotência, frustração/revolta, tristeza/angústia, aceitação, alívio e distanciamento. Conclusão: os estudantes criam barreiras emocionais para gerir o sofrimento dos pacientes com que lidam, sendo importante que estas não comprometam a qualidade dos cuidados. Os sentimentos dos estudantes perante a morte influenciam positivamente o cuidado ao paciente crítico, pois as vivências e experiência de vida permitem-lhes prestá-los com mais serenidade

Death is part of nurses' daily lives, especially when they deal with patients in critical situations. The way they perceive death may be relevant for providing humanized care. Objective: to identify the feelings of students of a master's program towards death and its influence on care provided to critical patients. Method: This is a study with a qualitative approach, approved by the ethics committee of the University (Doc11/CE/2018 of 09/04/2018). Interviews were carried out with 11 students, processed by content analysis. Results: the main feelings associated with the death of patients were: impotence, frustration/revolt, sadness/anguish, acceptance, relief, and distancing. Conclusion: students create emotional barriers to manage the suffering of the patients they deal with, and it is important that these do not compromise the quality of care. Students' feelings towards death positively influence critical patient care, as their experiences and life experience allow them to provide care more calmly.

Multi-fractal detrended cross-correlation heatmaps for time series analysis.

Complex systems in biology, climatology, medicine, and economy hold emergent properties such as non-linearity, adaptation, and self-organization. These emergent attributes can derive from large-scale relationships, connections, and interactive behavior despite not being apparent from their isolated components. It is possible to better comprehend complex systems by analyzing cross-correlations between time series. However, the accumulation of non-linear processes induces multiscale structures, therefore, a spectrum of power-law exponents (the fractal dimension) and distinct cyclical patterns. We propose the Multifractal detrended cross-correlation heatmaps (MF-DCCHM) based on the DCCA cross-correlation coefficients with sliding boxes, a systematic approach capable of mapping the relationships between fluctuations of signals on different scales and regimes. The MF-DCCHM uses the integrated series of magnitudes, sliding boxes with sizes of up to 5% of the entire series, and an average of DCCA coefficients on top of the heatmaps for the local analysis. The heatmaps have shown the same cyclical frequencies from the spectral analysis across different multifractal regimes. Our dataset is composed of sales and inventory from the Brazilian automotive sector and macroeconomic descriptors, namely the Gross Domestic Product (GDP) per capita, Nominal Exchange Rate (NER), and the Nominal Interest Rate (NIR) from the Central Bank of Brazil. Our results indicate cross-correlated patterns that can be directly compared with the power-law spectra for multiple regimes. We have also identified cyclical patterns of high intensities that coincide with the Brazilian presidential elections. The MF-DCCHM uncovers non-explicit cyclic patterns, quantifies the relations of two non-stationary signals (noise effect removed), and has outstanding potential for mapping cross-regime patterns in multiple domains.

Molybdenum Foliar Fertilization Improves Photosynthetic Metabolism and Grain Yields of Field-Grown Soybean and Maize.

Foliar fertilization has been used as a supplemental strategy to plant nutrition especially in crops with high yield potential. Applying nutrients in small doses stimulates photosynthesis and increases yield performance. The aim of this study was to evaluate the efficiency of foliar application of molybdenum (Mo) to soybean and maize. The treatments consisted of the presence (+Mo) and absence (-Mo) of supplementation. Plant nutritional status, nitrate reductase (NR) activity, gas exchange parameters, photosynthetic enzyme activity (Rubisco in soybean and maize and PEPcase in maize), total soluble sugar concentration, leaf protein content, shoot dry matter, shoot nitrogen accumulated, number of grains per plant, mass of 100 grains, and grain yield were evaluated. For soybean and maize, application of Mo increased leaf NR activity, nitrogen and protein content, Rubisco activity, net photosynthesis, and grain yield. These results indicate that foliar fertilization with Mo can efficiently enhance nitrogen metabolism and the plant's response to carbon fixation, resulting in improved crop yields.

Variability in nearshore fish biodiversity indicators after a mining disaster in eastern Brazil.

The rupture of the Fundão mining dam (Doce river basin, Brazil) caused a wide range of negative impacts. Yet, assemblage-level implications to estuarine and coastal fishes remain unclear, partly due to the lack of pre-disaster information. Based on monthly otter trawl surveys, we analyzed spatial and seasonal variability in univariate (total biomass, biomass of species vulnerable to exploitation, rarefied richness and evenness) and multivariate (species composition and trophic composition) indicators of fish biodiversity in the Doce river delta, eastern Brazil. We determined the independent and interactive effects of environmental, seasonal and spatial variables on species composition to test whether environmental alterations provoked by mine tailings could affect assemblage's organization. Most indicators present idiosyncratic spatiotemporal patterns, suggesting they have complementary roles in revealing changes in fish biodiversity. Environmental variables, including those affected by the Fundão dam collapse such as turbidity, dissolved oxygen and pH, were much more important than seasonal and spatial predictors in explaining the variation in fish species composition. These findings highlight the potential from mine tailings to disrupt local ichthyofauna and indicate a preponderant role of environmental conditions in assemblage structuring. Given the lack of data prior to rupture, our results may be used as a baseline against which to assess temporal trends in fish biodiversity relative to changes detected in less disturbed estuarine and coastal assemblages.

Fish biodiversity of a tropical estuary under severe anthropic pressure (Doce River, Brazil)

The Doce River has undergone severe changes over the last centuries (e.g., flow regulation, pollution, habitat and species loss). Here, we present the first comprehensive fish biodiversity assessment of the Doce River estuary and a summary of the main impacts and their drivers for the whole river since the early 18th century. Carangiformes, Siluriformes and Eupercaria incertae sedis were the most representative orders for the 115 species recorded. Most species are native (87.8%), euryhaline/peripheral (80%) and zoobenthivorous (33.9%). Threatened (Paragenidens grandoculis, Genidens barbus, and Lutjanus cyanopterus) and near threatened (Cynoscion acoupa, Dormitator maculatus, Lutjanus jocu, Lutjanus synagris, and Mugil liza) species are peripheral. Thirteen species are exotic at the country (Butis koilomatodon, Coptodon rendalli, and Oreochromis niloticus) or the basin level (e.g., Pygocentrus nattereri and Salminus brasiliensis). The catfish Cathorops cf. arenatus is reported for the first time on the eastern coast of Brazil and Paragenidens grandoculis, considered extinct in the Doce River, was discovered in the estuary.

O rio Doce tem passado por mudanças drásticas ao longo dos últimos séculos (e.g., alterações na vazão, poluição, perda de espécies e habitats). Neste trabalho, apresentamos a primeira avaliação abrangente da biodiversidade de peixes no estuário do rio Doce além de um resumo dos principais impactos e suas forçantes em toda a extensão do rio desde o início do século vinte. Carangiformes, Siluriformes e Eupercaria incertae sedis foram as ordens mais representativas considerando as 115 espécies registradas. A maioria das espécies são nativas (87,8%), eurialinas/periféricas (80%) e zoobentívoras (33,9%). As espécies ameaçadas (Paragenidens grandoculis, Genidens barbus e Lutjanus cyanopterus) e quase ameaçadas (Cynoscion acoupa, Dormitator maculatus, Lutjanus jocu, Lutjanus synagris e Mugil liza) são periféricas. Treze espécies são exóticas a nivel de país (Butis koilomatodon, Coptodon rendalli e Oreochromis niloticus) ou bacia (e.g., Pygocentrus nattereri e Salminus brasiliensis). O bagre Cathorops cf. arenatus é reportado pela primeira vez na costa leste do Brasil e Paragenidens grandoculis, considerado extinto no rio Doce, foi descoberto no estuário.

Occupational nursing in portugal: context and perspectives / Enfermería del trabajo en portugal: contexto y perspectivas / Enfermagem do trabalho em portugal: contexto e perspetivas

Objective: to know the perception of nurses at work regarding the areas of knowledge and intervention. Method: quantitative, descriptive and cross-sectional study. It involved a sample of 472 occupational nurses. A questionnaire was used as a data collection instrument, which took place between May and September 2017, based on the core areas of knowledge and competencies of the occupational nurse and on the scale of perception of the areas of knowledge and intervention of the occupational nurse. Results: Occupational Nursing was understood by the majority as a transitory professional activity, because it was exercised as a financial complement to the main activity or because they could not be placed in the area of professional practice of their preference. Conclusion: the professional practice in the areas of knowledge and intervention was devalued or not recognized and seen by the majority of nurses as transitory, because almost half aspire to work in the future in this area, but only on a part-time basis.

Objetivo: conocer la percepción de las enfermeras en el trabajo con respecto a las áreas de conocimiento e intervención. Método: estudio cuantitativo, descriptivo y transversal. Involucró una muestra de 472 enfermeras de trabajo. Se utilizó un cuestionario como instrumento de recolección de datos, que tuvo lugar entre mayo y septiembre de 2017, basado en las áreas nucleares de conocimiento y competencias de la enfermera de trabajo y en la escala de percepción de las áreas de conocimiento e intervención de la enfermera de trabajo. Resultados: la Enfermería Ocupacional fue entendida por la mayoría como una actividad profesional transitoria, porque se ejercía como complemento económico de la actividad principal o porque no podían ubicarse en el área de práctica profesional de su preferencia. Conclusión: la práctica profesional en las áreas de conocimiento e intervención fue devaluada o no reconocida y vista por la mayoría de las enfermeras como transitoria, porque casi la mitad aspira a trabajar en el futuro en esta área, pero solo a tiempo parcial.

Objetivo: conhecer a perceção dos enfermeiros do trabalho no que respeita às áreas de conhecimento e intervenção. Método: estudo quantitativo, descritivo e transversal. Envolveu amostra de 472 enfermeiros do trabalho. Utilizou-se como instrumento de recolha de dados, que decorreu entre maio e setembro de 2017, questionário, alicerçado nas áreas nucleares de conhecimentos e competências do enfermeiro do trabalho e na escala de perceção das áreas de conhecimento e intervenção do enfermeiro do trabalho. Resultados: a Enfermagem do Trabalho foi entendida pela maioria como atividade profissional transitória, pelo facto de ser exercida como complemento financeiro à atividade principal ou porque não conseguiram colocação na área de exercício profissional da sua preferência. Conclusão: o exercício profissional nas áreas de conhecimento e intervenção foi desvalorizado ou não reconhecido e encarado pela maioria dos enfermeiros como transitório, pelo facto de quase metade ambicionar trabalhar no futuro nessa área, mas apenas em regime de tempo parcial.

Effects of seasonal contaminant remobilization on the community trophic dynamics in a Brazilian tropical estuary.

In tropical estuaries, wet seasons are responsible for the downstream transport of allochthonous material from the upper basin and flooded plains. Although allochthonous matter is commonly associated to nutrient and detritus input, pollutants are also transported throughout the basin or suspended from the river bottom via strong streamflow remobilization and rainfall dynamics. We assessed community and population trophic niche-based patterns using organisms' stable isotopes signatures in the wet and the dry seasons to test if estuarine trophic diversity is affected by remobilization of metal-contaminated material from a mining dam collapse that occurred in the Doce river basin, Brazil. Trophic depletion was detected community-wide and in a key consumer group (bottom-dwelling fishes) at the end of the wet season in the impacted Doce river estuary (DRE). Conversely, higher trophic diversity values were recorded in a well-preserved estuary used as control site. Stable isotopes mixing models indicated in the DRE that G. genidens, a predator fish species, presented poor-quality diet based on pollutant-tolerant tiny organisms, a finding that strongly contrasts from diet described in other, little-impacted Brazilian estuaries. Although wet seasons are expected to increase trophic, functional and taxonomic diversity in tropical estuaries, in the DRE the rainfall-driven dynamics poses a threat to the community due to the presence of ore tailings.

Long-Term Lime and Phosphogypsum Amended-Soils Alleviates the Field Drought Effects on Carbon and Antioxidative Metabolism of Maize by Improving Soil Fertility and Root Growth.

Long-term surface application of lime (L) and/or phosphogypsum (PG) in no-till (NT) systems can improve plant growth and physiological and biochemical processes. Although numerous studies have examined the effects of L on biomass and plant growth, comprehensive evaluations of the effects of this practice on net CO2 assimilation, antioxidant enzyme activities and sucrose synthesis are lacking. Accordingly, this study examined the effects of long-term surface applications of L and PG on soil fertility and the resulting impacts on root growth, plant nutrition, photosynthesis, carbon and antioxidant metabolism, and grain yield (GY) of maize established in a dry winter region. At the study site, the last soil amendment occurred in 2016, with the following four treatments: control (no soil amendments), L (13 Mg ha-1), PG (10 Mg ha-1), and L and PG combined (LPG). The long-term effects of surface liming included reduced soil acidity and increased the availability of P, Ca2+, and Mg2+ throughout the soil profile. Combining L with PG strengthened these effects and also increased SO4 2--S. Amendment with LPG increased root development at greater depths and improved maize plant nutrition. These combined effects increased the concentrations of photosynthetic pigments and gas exchange even under low water availability. Furthermore, the activities of Rubisco, sucrose synthase and antioxidative enzymes were improved, thereby reducing oxidative stress. These improvements in the physiological performance of maize plants led to higher GY. Overall, the findings support combining soil amendments as an important strategy to increase soil fertility and ensure crop yield in regions where periods of drought occur during the cultivation cycle.

Influence of the COVID-19 Pandemic in Higher Education Courses in the Health Field

It is a fact that no one expected what took place in the world as of the end of 2019. And yes, I am talking about the ill-fated, damned and inconvenient COVID-19, which quickly spread around the globe, having been declared a pandemic by the World Health Organization in March 2020.(1) In the face of such a threat, not virtual, but very real, the need existed to undertake various measures that could interrupt the transmission of the infection by implementing, for example, restrictions on the movement of people, social distancing, use of personal protective equipment, measures of respiratory protocol, social confinement, among others.(2) Education, namely, higher education, also suffered immensely the consequences of COVID-19, right from the start, because there was a cessation of all classroom teaching activity, practically all over the world, which caused major modifications/alterations in the teaching-learning process.(3) From the outset, closing of Higher Education Institutions, globally, caused severe changes in teaching-learning processes because measures of social distancing and circulation restrictions were imposed.(4,5)

Magnesium Foliar Supplementation Increases Grain Yield of Soybean and Maize by Improving Photosynthetic Carbon Metabolism and Antioxidant Metabolism.

(1) Background: The aim of this study was to explore whether supplementary magnesium (Mg) foliar fertilization to soybean and maize crops established in a soil without Mg limitation can improve the gas exchange and Rubisco activity, as well as improve antioxidant metabolism, converting higher plant metabolism into grain yield. (2) Methods: Here, we tested foliar Mg supplementation in soybean followed by maize. Nutritional status of plants, photosynthesis, PEPcase and Rubisco activity, sugar concentration on leaves, oxidative stress, antioxidant metabolism, and finally the crops grain yields were determined. (3) Results: Our results demonstrated that foliar Mg supplementation increased the net photosynthetic rate and stomatal conductance, and reduced the sub-stomatal CO2 concentration and leaf transpiration by measuring in light-saturated conditions. The improvement in photosynthesis (gas exchange and Rubisco activity) lead to an increase in the concentration of sugar in the leaves before grain filling. In addition, we also confirmed that foliar Mg fertilization can improve anti-oxidant metabolism, thereby reducing the environmental stress that plants face during their crop cycle in tropical field conditions. (4) Conclusions: Our research brings the new glimpse of foliar Mg fertilization as a strategy to increase the metabolism of crops, resulting in increased grain yields. This type of biological strategy could be encouraged for wide utilization in cropping systems.

A utilização da acupuntura no controlo da dor crónica em usuários com síndrome vertebral com irradiação / The use of acupuncture to control chronic pain in users with irradiated vertebral syndrome

Objetivos: a acupuntura é, cada vez mais, uma técnica utilizada, em usuários portadores de várias patologias, e, em especial, aquelas que são acompanhadas de dor crónica. Esta pesquisa teve como objetivo geral analisar o efeito da terapêutica não farmacológica de acupuntura e eletroacupuntura para o controle da dor crónica, em usuários com diagnóstico médico de síndrome vertebral com irradiação. Métodos: foi realizada uma pesquisa com dois momentos de avaliação ­ antes e após sessões de terapêutica não farmacológica de acupuntura e eletroacupuntura. Utilizou-se um questionário com variáveis de caracterização sociodemográfica e clínica, o Brief Pain Inventory (BPI)e Short Form 6 Dimensions (SF-6D). Resultados: participaram no estudo 43 usuários, tendo sido encontradas diferenças estaticamente significativas, do momento 1 para o momento 2 de avaliação, quer no domínio da severidade da dor (p<0,01), quer no domínio interferência da dor no funcionamento diário (p<0,01), assim como nas diferentes dimensões do SF-6D foram encontradas diferenças estatisticamente significativas. Conclusões: salienta-se que a terapêutica não farmacológica de acupuntura e eletroacupuntura em usuários com diagnóstico de síndrome vertebral com irradiação e dor crónica contribuiu para a diminuição da severidade da dor, da interferência da dor no funcionamento diário e melhoria da qualidade de vida relacionada com a saúde.

Aims: acupuncture is increasingly a technique used in users with various pathologies, and especially those who are accompanied by chronic pain. This research aimed to analyze the effect of non-pharmacological acupuncture and electroacupuncture therapy for the control of chronic pain in users with medical diagnosis of irradiation vertebral syndrome. Methods: a research was conducted with two evaluation moments: before and after non-pharmacological acupuncture and electroacupuncture therapy sessions. A questionnaire with variables of sociodemographic and clinical characterization, the Brief Pain Inventory and Short Form 6 Dimensions (SF-6D) was used. Results: forty-three users participated in the study, and statistically significant differences were found from moment 1 to moment 2 of evaluation, either in the pain severity domain (p<0.01) or in the pain interference domain in daily functioning (p <0.01), as well as in the different dimensions of SF-6D, statistically significant differences were found. Conclusions: non-pharmacological acupuncture and electroacupuncture therapy in users diagnosed with irradiation and chronic pain have contributed to decrease pain severity, pain interference in daily functioning and improvement of health-related quality of life.

Foreign Body Granuloma in the Tongue by a Pequi Spine.

Substances considered foreign to the human organism can penetrate it due to local trauma, initially causing an acute inflammatory response against these substances, involving a neutrophilic infiltrate that, when it fails to deal with these foreign bodies, ends up generating a granulomatous inflammatory response. Granuloma formation has been associated with a variety of conditions. The correct clinical and imaging diagnoses are extremely important for the dentist to choose an appropriate therapeutic approach, aiming at the best possible treatment. This work is aimed at describing a case report of a foreign body granuloma, formed on the tongue, from the penetration of a pequi spine, in a 76-year-old patient, in whom, after an imaging diagnosis with ultrasound, surgical removal of the lesion was performed, and the piece was sent for histopathological examination, which confirmed the initial diagnostic hypothesis of a foreign body granuloma. The initial diagnosis of foreign body granulomas is challenging. For this reason, more sophisticated means of diagnosis such as tomography and magnetic resonance become important in the diagnosis, as they can show with greater clarity and reliability the nature of the lesion and its relationship with adjacent anatomical structures. In the case in question, an ultrasound examination was chosen, which was extremely important as an aid to diagnosis, considerably improving surgical planning. In addition, after surgical removal, the result of the histopathological analysis is essential to determine the definitive diagnosis, as it determines the granulomatous characteristic of the lesion.

Early evidences of niche shifts in estuarine fishes following one of the world's largest mining dam disasters.

The Fundão dam collapse occurred on November 2015 in Mariana city (Brazil), provoking a series of ecological impacts over the Doce river basin and its nearshore environment. However many impacts over fishery target fauna (fish and shrimp) are still unknown or underestimated due to the lack of baseline data in the region. In the present study we assessed the isotopic niches modeled from δ13C and δ15N signatures of six estuarine fish species before and after the impact to assign potential shifts at the population- and community-level. We showed isotopic niche has altered in all studied species irrespective of its trophic group and habitat use. Niche community metrics indicated a depletion of trophic diversity and basal resources of the whole community after the impact. Food web changes as we reported here can impair the energy transfer through the food chain and put at risk the sustainability of small fisheries that rely upon local resources.

A (des)educação contraceptiva dos jovens universitários / La (des)educación contraceptiva de jóvenes universitarios / Contraceptive (mis)education among young adults in Higher Education

Resumo Objetivo: Investigar o impacto que o mais recente enquadramento legal da educação sexual teve na vivência da sexualidade de jovens universitários segundo comportamentos protetores, profiláticos e de vigilância em saúde sexual e reprodutiva. Métodos: Trata-se de um estudo de natureza quantitativa, transversal e descritivo, com uma amostra não probabilística de conveniência, constituída por 365 universitários do norte de Portugal. Foi critério de inclusão os estudantes frequentarem o 1° ano de licenciatura, procurando recrutar estudantes mais jovens, que já foram abrangidos em todo o Ensino Secundário pela Lei 60/2009 de 06 de agosto, relativa à educação sexual em meio escolar. Utilizámos um questionário na coleta de dados, que analisámos recorrendo à estatística descritiva e inferencial com um nível de confiança de 95%. Resultados: A procura pelos serviços de saúde, no âmbito da saúde sexual e reprodutiva é baixa, apenas 28,7% frequenta as consultas de planejamento familiar, sendo o sexo feminino quem mais reporta este fato (Χ2 = 41,085 e p<0,000); o recurso aos serviços de saúde da universidade é ainda menor (13,7%), também a procura é maior pelo sexo feminino em relação masculino (11,2% versus 2,5%). Dos estudantes sexualmente ativos, 29,6% não faz uma utilização sistemática de métodos contraceptivos, estando este comportamento mais presente no sexo masculino (Χ2 = 9,950 e p=0,002). Conclusão: Comportamentos protetores no âmbito da sexualidade estão pouco presentes, devendo a intervenção junto dos jovens ultrapassar a genitalidade para uma visão holística e integradora da sexualidade.

Resumen Objetivo: Investigar el impacto del más reciente marco legal de la educación sexual en la vivencia de la sexualidad de jóvenes universitarios según comportamientos de protección, de profilaxis y de control de la salud sexual y reproductiva. Métodos: Se trata de un estudio de naturaleza cuantitativa, transversal y descriptiva, con muestreo no probabilístico por conveniencia, constituido por 365 universitarios del norte de Portugal. Fue un criterio de inclusión que los estudiantes estuvieran cursando 1° año de licenciatura, para reclutar estudiantes más jóvenes que hayan pasado toda la enseñanza secundaria regidos por la Ley 60/2009 del 06 de agosto, relacionada con la educación sexual en medio escolar. En la recolección de datos utilizamos un cuestionario que analizamos a través de la estadística descriptiva e inferencial, con un nivel de confianza del 95%. Resultados: En el ámbito de la salud sexual y reproductiva, la demanda de servicios de salud es baja, solo el 28,7% asiste a consultas de planificación familiar, y quien más reporta este hecho es el sexo femenino (Χ2 = 41,085 y p<0,000). Este porcentaje es aún menor en quienes recurren a los servicios de salud de la universidad (13,7%), la demanda también es mayor en el sexo femenino con relación al masculino (11,2% versus 2,5%). De los estudiantes sexualmente activos, el 29,6% no utiliza métodos contraceptivos de forma sistemática, y este comportamiento está más presente en el sexo masculino (Χ2 = 9,950 y p=0,002). Conclusión: Los comportamientos de protección en el ámbito de la sexualidad están poco presentes, y la intervención con los jóvenes debe ir más allá de la genitalidad, hacia una visión holística e integradora de la sexualidad.

Abstract Objective: To investigate how the current law on sex education has affected the sex life of young adults in Higher Education on the basis of protective, prophylactic, and sexual and reproductive health surveillance behaviors. Method: This was a quantitative cross-sectional descriptive study with a non-probability sample of convenience consisting of 365 Higher Education students from Northern Portugal. We included students attending the first year of Teaching Degree programs, therefore, younger students who would have had their Secondary Education under Law no. 60/2009 (August 6) would be included (this Law currently regulates sex education in schools). Data were collected using a questionnaire, which was submitted to descriptive and inferential statistical analysis with a confidence level of 95%. Results: For sexual and reproductive health, health services are rarely sought: only 28.7% of respondents have participate in family planning appointments, and women reported seek it more often (Χ2= 41.085 and p<0.000) than men. The university's health services are even more rarely sought (13.7%), and women also seek it more often than men (11.2% versus 2.5%). Of participants, 29.6% of sexually active students do not systematically use contraceptive methods, and this behavior is more prevalent among men (Χ2= 9.950 e p=0.002). Conclusion: Protective sexual behaviors are rarely present. The study recommends any interventions targeting young adults that should go beyond genital anatomy and need to introduce a holistic and integrating viewing of sexuality.

Scale of adverse events associated to nursing practices: a psychometric study in Portuguese hospital context.

OBJECTIVE: to contribute to the validation study of the Scale of Adverse Events associated with Nursing Practices in the hospital context. METHOD: cross-sectional study, in public hospital units, in the central and northern regions of Portugal. The exploratory factor analysis of the Scale of Adverse Events associated to Nursing Practices was conducted with a sample of 165 nurses and the confirmatory factorial analysis was made with a sample of 685 nurses. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples to confirm the stability of the factorial solution. RESULTS: the global sample consisted of 850 nurses aged between 22 and 59, mostly licensed professionals. The model had a good overall fit in the subscales (Nursing Practices: χ2/df = 2.88, CFI = 0.90, GFI = 0.86, RMSEA = 0.05, MECVI = 3.30; Adverse Events: χ2/df = 4.62, CFI = 0.93, GFI = 0.95, RMSEA = 0.07, MECVI = 0.39). There was a stable factor structure, indicating strong invariance in the subscale Nursing Practices and structural invariance in the subscale Adverse Events. CONCLUSION: the refined model of the Scale of Adverse Events associated with Nursing Practices revealed good fit and stability of the factorial solution. The instrument was adjusted to evaluate the perception of nurses about adverse events associated with health care, precisely nursing care, in the hospital setting.

The relationship between human vulnerability and health care: a study with professionals and students in the health area / A relação entre a vulnerabilidade humana e o cuidar em saúde: um estudo com profissionais e estudantes da área da saúde

There are, currently, many appeals for the adoption of more humane health care and are, thus, based on the "Caring" paradigm. One of the ways pointed out is the appreciation of the understanding of human vulnerability, especially when it is associated with the disease. Therefore, this study consists of understanding how the representation of human vulnerability of health care providers influences their practice of caring. The Human Vulnerability Representation Scale (HVRS) and the adapted Caring Attributes Scale (CAS) were applied to a sample of 1213 in health caregivers (doctors, nurses, medical students, and nursing students). Descriptive statistics (frequencies, measures of central tendency) and inferential analysis were performed (non-parametric tests, Spearman correlation coefficient). The results confirm a positive relationship between the two variables in the study because the caregivers with higher averages in the human vulnerability representation scale have higher averages in the scale of the caring attributes. That is, the greater the representation of human vulnerability, the greater the value of caring. This reality holds true for all dimensions of the scales. The experience of vulnerability allows the professional to better understand the patient, facilitates the development of empathy, and rouses caregivers to the need of improving the quality of care. It was concluded that the representation of human vulnerability may be the instrument for adopting the "Caring" paradigm. Thus, it would be important, in the near future, to develop interventions related to vulnerability capable of transforming future caregivers into humanization vehicles

Existem, na atualidade, muitos apelos para a adoção de cuidados de saúde mais humanos e, por isso, assentes no paradigma do "Cuidar". Um dos caminhos apontados passa pela valorização da compreensão da vulnerabilidade humana sobretudo quando ela surge associada à doença. Assim, este estudo consiste em perceber de que modo a representação da vulnerabilidade humana dos cuidadores de saúde influencia a sua prática do cuidar. Aplicou-se a Escala de Representação da Vulnerabilidade Humana em cuidadores de saúde (ERVH) e a Escala dos Atributos do Cuidar adaptada (CAQ) a uma amostra composta por 1213 cuidadores (médicos, enfermeiros, estudantes de medicina e estudantes de enfermagem). Foi realizada análise estatística descritiva (frequências, medidas de tendência central) e inferencial (testes não paramétricos, coeficiente de correlação Spearman). Os resultados confirmam uma relação positivas entre as duas variáveis em estudo pois os cuidadores com médias mais elevadas na escala da representação da vulnerabilidade humana têm médias mais elevadas na escala dos atributos do cuidar. Ou seja, quanto maior a representação da vulnerabilidade humana, maior a valorização do cuidar. Esta realidade é válida para todas as dimensões das escalas. A experiência da vulnerabilidade permite ao profissional uma melhor compreensão do doente, facilita o desenvolvimento da empatia e desperta os cuidadores para a necessidade da melhoraria da qualidade dos cuidados. Concluiu-se que a representação da vulnerabilidade humana pode ser o motor para a adoção de um paradigma baseado no "Cuidar", pelo que, seria importante, no futuro próximo, desenvolver intervenções relacionadas com a vulnerabilidade capaz de transformar os futuros cuidadores em veículos humanização