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Abstract Objective Scientific scrutiny has proved the safety and benefits of caffeine to treat apnoea of prematurity (AOP). However, there is no consensus on the effects of this treatment on sleep, especially considering the key role of adenosine and early brain development for sleep maturation. We systematically reviewed studies with sleep as a primary and/or secondary outcome or any mention of sleep parameters in the context of caffeine treatment for AOP. Methods We performed a systematic search of PubMed, Web of Science and the Virtual Health Library from inception to 7 September 2022 to identify studies investigating the short- and long-term effects of caffeine to treat AOP on sleep parameters. We used the PIC strategy considering preterm infants as the Population, caffeine for apnoea as the Intervention and no or other intervention other than caffeine as the Comparison. We registered the protocol on PROSPERO (CRD42021282536). Results Of 4019 studies, we deemed 20, including randomised controlled trials and follow-up and observational studies, to be eligible for our systematic review. The analysed sleep parameters, the evaluation phase and the instruments for sleep assessment varied considerably among the studies. The main findings can be summarised as follows: (i) most of the eligible studies in this systematic review indicate that caffeine used to treat AOP seems to have no effect on key sleep parameters and (ii) the effects on sleep when caffeine is administered earlier, at higher doses or for longer periods than the most common protocol have not been investigated. There is a possible correlation between the caffeine concentration and period of exposure and negative sleep quality, but the sleep assessment protocols used in the included studies did not have high-quality standards and could not provide good evidence. Conclusions and implications Sleep quality is an important determinant of health, and better investments in research with adequate sleep assessment tools are necessary to guarantee the ideal management of children who were born preterm.

Veterinarians are commonly exposed to occupational stressors, including excessive workload and financial constraints. These stressors can lead to psychological distress, which typically results in mental health disorders such as depression, anxiety, and burnout and can even culminate in suicide attempts or suicide deaths. Risk factors associated with poor mental health and high rates of suicide in veterinary practitioners include continuous exposure to challenging scenarios, such as interpersonal conflicts, performing euthanasia, and easy access to lethal means of suicide, such as opioids and anesthetics. The previous studies highlight the urgent need for a better understanding of predisposing factors, mental health-related improvements in the professional environment, and the subsequent establishment of primary mental health-related care policies. Effective ways to promote mental health and prevent suicide may include social support, resilience, developing coping skills, promoting a healthy work environment, and discouraging perfectionist behaviors. This review aimed to summarize findings in studies that have investigated mental health and suicide in veterinarians and veterinary students and highlight measures that could be implemented as options for mental health promotion and suicide prevention.

In cheese-making, a starter culture composed of adequately chosen lactic acid bacteria (LAB) may be suitable to ensure the rapid acidification of milk, improve textural and sensorial characteristics, and avoid pathogen proliferation. In this work, 232 LAB isolates collected from artisanal goat’s raw milk cheeses produced in Portugal were evaluated for their antimicrobial capacity (at 10 and 37°C), as well as their acidifying and proteolytic properties. Among the 232 isolates, at least 98% of those isolated in De Man-Rogosa-Sharpe (MRS) agar presented antagonism against Listeria monocytogenes, Salmonella Typhimurium, or Staphylococcus aureus, whereas less than 28.1% of M17-isolated LAB showed antagonism against these pathogens. M17-isolated LAB displayed better results than MRS ones in terms of acidifying capacity. As for the proteolytic assay, only two MRS isolates showed casein hydrolysis capacity. Principal component analyses and molecular characterization of a subset of selected isolates were conducted to identify those with promising capacities and to correlate the identified LAB genera and species with their antimicrobial, acidifying, and/or proteolytic properties. Lactococcus strains were associated with the highest acidifying capacity, whereas Leuconostoc and Lacticaseibacillus strains were more related to antimicrobial capacities. Leuconostoc mesenteroides, Lactococcus lactis, and Lacticaseibacillus paracasei were the predominant organisms found. The results of this work highlight various strains with pathogen inhibition capacity and suitable technological properties to be included in a customized starter culture. As future work, it is necessary to appropriately define the starter culture and implement it in the cheese-making process to evaluate if the in-vitro capacities are observable in a real food system.

Abstract Background Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic. Methods A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge. Results There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth. Conclusions Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner. Trial registration number Clinical Trials NCT04847336.

Alheira is a naturally fermented meat sausage traditionally made in the Portuguese region of Trás-os-Montes. Lactic acid bacteria (LAB) are the dominant microorganisms in alheira and can endow it with various technological properties. This study aimed (1) to characterize technological features and in vitro antimicrobial activity of LAB isolated from alheira, and (2) to reveal associations between such phenotypic characteristics and the isolates species identified through amplification and sequencing of the 16S ribosomal gene. Sixty-two LAB isolates were identified and Enterococcus (E.) faecium corresponded to 32.3% of isolates, followed by Leuconostoc (L.) mesenteroides (19.4%) and Latilactobacillus (Lb.) sakei (17.7%), aligning with previous research on traditional Portuguese fermented meat sausages. The phenotypic analysis of LAB isolates indicated diverse acidification capacities, proteolytic activities, and inhibitory effects against foodborne pathogens Listeria (L.) monocytogenes, Salmonella (S.) Typhimurium and Staphylococcus (S.) aureus. Overall, lactobacilli displayed high inhibition activity against the pathogens S. aureus, L. monocytogenes, and S. Typhimurium. Although the mechanisms for the inhibition of pathogen growth need to be further elucidated, these findings enhance our understanding of LAB diversity and functionality in alheira sausages, contributing to product safety and quality.

Abstract The timely identification of cohort participants at higher risk for attrition is important to earlier interventions and efficient use of research resources. Machine learning may have advantages over the conventional approaches to improve discrimination by analysing complex interactions among predictors. We developed predictive models of attrition applying a conventional regression model and different machine learning methods. A total of 542 very preterm (

BackgroundPreterm birth is a global health concern. Its adverse consequences may persist throughout the life course, exerting a potentially heavy burden on families, health systems, and societies. In high-income countries, the first children who benefited from improved care are now adults entering middle age. However, there is a clear gap in the knowledge regarding the long-term outcomes of individuals born preterm. ObjectiveThis study aimed to assess the feasibility of recruiting and following up an e-cohort of adults born preterm worldwide and provide estimations of participation, characteristics of participants, the acceptability of questions, and the quality of data collected. MethodsWe implemented a prospective, open, observational, and international e-cohort pilot study (Health of Adult People Born Preterm—an e-Cohort Pilot Study [HAPP-e]). Inclusion criteria were being an adult (aged ≥18 years), born preterm (

Este estudo propõe-se investigar como a ideologia da democracia racial, na obra Casa-Grande & Senzala, foi construída pautada em categorias como hibridismo, integração, miscigenação, linguagem e formação social. Para isso, foi preciso recorrer a um referencial teórico-metodológico fundamentado, dentre outros, em Florestan Fernandes (2007),Caio Prado Júnior (2011),Carlos Guilherme Mota (1978), Carboni &Maestri (2003), Gramsci (1999) e Dumont (1974).Trata-se, portanto, de um estudo sustentado numa dialética que tenta investigar a centralidade do culturalismo regionalista freyriano e a sua sociologia da vida social; uma fenomenologia dos sentimentos cotidianos. Podemos concluir, parcialmente, que Freyre procura sustentar uma narrativa cujo foco é uma democracia racial calcada num jogo de equilíbrio entre sujeitos em situações opostas, −senhor e escravizado −, que reduz a “diversidade” étnico-racialà unidade, elaborando uma linguagem comum em que as diferenças são um estado subjetivo e objetivo aberto e conciliável.

Abstract In a cohort of children born very preterm (VPT), we investigated the association between breast milk feeding (BMF) initiation and its duration on cognitive development at 2 years of corrected age. Data were obtained from the Effective Perinatal Intensive Care in Europe population‐based prospective cohort of children born

Objectives Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers’ perspective.Design Mixed-methods study.Setting Six countries of the WHO European Region.Participants and methods The questionnaire is based on lessons learnt in previous studies, and was developed in three sequential phases: (1) WHO Quality Measures were prioritised and content, construct and face validity were assessed through a Delphi involving a multidisciplinary board of experts from 11 countries of the WHO European Region; (2) translation/back translation of the English version was conducted following The Professional Society for Health Economics and Outcomes Research guidelines; (3) internal consistency, intrarater reliability and acceptability were assessed among 600 health workers in six countries.Results The questionnaire included 40 items based on WHO Standards Quality Measures, equally divided into four domains: provision of care, experience of care, availability of human and physical resources, organisational changes due to COVID-19; and its organised in six sections. It was translated/back translated in 12 languages: Bosnian, Croatian, French, German, Italian, Norwegian, Portuguese, Romanian, Russian, Slovenian, Spanish and Swedish. The Cronbach’s alpha values were ≥0.70 for each questionnaire section where questions were hypothesised to be interrelated, indicating good internal consistence. Cohen K or Gwet’s AC1 values were ≥0.60, suggesting good intrarater reliability, except for one question. Acceptability was good with only 1.70% of health workers requesting minimal changes in question wording.Conclusions Findings suggest that the questionnaire has good content, construct, face validity, internal consistency, intrarater reliability and acceptability in six countries of the WHO European Region. Future studies may further explore the questionnaire’s use in other countries, and how to translate evidence generated by this tool into policies to improve the QMNC.Trail registration number NCT04847336

For prioritizing conservation actions, it is vital to understand how ecologically diverse species respond to environmental change caused by human activity. This is particularly necessary considering that chronic human disturbance is a threat to biodiversity worldwide. Depending on how species tolerate and adapt to such disturbance, ecological integrity and ecosystem services will be more or less affected. Bats are a species-rich and functionally diverse group, with important roles in ecosystems, and are therefore recognized as a good model group for assessing the impact of environmental change. Their populations have decreased in several regions, especially in the tropics, and are threatened by increasing human disturbance. Using passive acoustic monitoring, we assessed how the species-rich aerial insectivorous bats—essential for insect suppression services—respond to chronic human disturbance in the Caatinga dry forests of Brazil, an area potentially harboring ca. 100 bat species (nearly 50% are insectivorous), but with > 60% its area composed of anthropogenic ecosystems under chronic pressure. Acoustic data for bat activity was collected at research sites with varying amounts of chronic human disturbance (e.g., livestock grazing and firewood gathering). The intensity of the disturbance is indicated by the global multi-metric CAD index (GMDI). Using Animal Sound Identifier (ASI) software, we identified 18 different bat taxon units. Using Hierarchical Modeling of Species Communities (HMSC), we found trends in the association of the disturbance gradient with species richness and bat activity: species richness was higher at sites with higher human disturbance, whereas bat activity decreased with increasing human disturbance. Additionally, we observed taxon-specific responses to human disturbance. We conclude that the effects of chronic anthropogenic disturbance on the insectivorous bat fauna in the Caatinga are not homogeneous and a species-specific approach is necessary when assessing the responses of local bats to human disturbances in tropical dry forests, and in other biomes under human pressure.

Background: As childbearing is postponed in developed countries, maternal age (MA) has increased over decades with an increasing number of pregnancies between age 35–39 and beyond. The aim of the study was to determine the influence of advanced (AMA) and very advanced maternal age (vAMA) on morbidity and mortality of very preterm (VPT) infants.Methods: This was a population-based cohort study including infants from the “Effective Perinatal Intensive Care in Europe” (EPICE) cohort. The EPICE database contains data of 10329 VPT infants of 8,928 mothers, including stillbirths and terminations of pregnancy. Births occurred in 19 regions in 11 European countries. The study included 7,607 live born infants without severe congenital anomalies. The principal exposure variable was MA at delivery. Infants were divided into three groups [reference 18–34 years, AMA 35–39 years and very(v) AMA ≥40 years]. Infant mortality was defined as in-hospital death before discharge home or into long-term pediatric care. The secondary outcome included a composite of mortality and/or any one of the following major neonatal morbidities: (1) moderate-to-severe bronchopulmonary dysplasia; (2) severe brain injury defined as intraventricular hemorrhage and/or cystic periventricular leukomalacia; (3) severe retinopathy of prematurity; and (4) severe necrotizing enterocolitis.Results: There was no significant difference between MA groups regarding the use of surfactant therapy, postnatal corticosteroids, rate of neonatal sepsis or PDA that needed pharmacological or surgical intervention. Infants of AMA/vAMA mothers required significantly less mechanical ventilation during NICU stay than infants born to non-AMA mothers, but there was no significant difference in length of mechanical ventilation and after stratification by gestational age group. Adverse neonatal outcomes in VPT infants born to AMA/vAMA mothers did not differ from infants born to mothers below the age of 35. Maternal age showed no influence on mortality in live-born VPT infants.Conclusion: Although AMA/vAMA mothers encountered greater pregnancy risk, the mortality and morbidity of VPT infants was independent of maternal age.

Traditional Portuguese fermented meat products represent a valued economic and cultural heritage. The objective of this work was to screen the lactic acid bacteria (LAB) present in alheira sausages. Twenty-five LAB were identified by means of Sanger sequencing of the 16S ribosomal gene. Sequencing results were aligned with sequences from the NCBI database using the BLAST algorithm. Genetic analysis showed a diverse lactic-acid-producing microbiome, and LAB from the family Lactobacillaceae and Leuconostocaceae were dominant, found in 64% of samples, whereas other organisms of the family Streptococcaceae and Enterococcaceae were found in 36% of samples. This work enabled the identification of the LAB that are normally present in alheira, as well as the understanding of their association with the technological characteristics of this traditional fermented sausage.

Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19.Methods: Searches were conducted in PubMed®, Scopus®, Web of Science®, and MedRxiv® up to 26th June 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality.Results: We identified 161 original studies reporting 3,985 cases of pregnant women with COVID-19 (1,007 discharged while pregnant). The 2,059 published cases with pregnancy outcomes resulted in 42 abortions, 21 stillbirths, and 2,015 live births. Preterm birth occurred in 23% of cases. Around 6% of pregnant women required admission to an intensive care unit and 28 died. There were 10 neonatal deaths. From the 163 cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus, 10 were positive. Sixty-one newborns were positive for SARS-CoV-2. Four breast milk samples from 92 cases showed evidence of SARS-CoV-2.Conclusion: Emerging evidence suggests that vertical transmission is possible, however, there is still a limited number of reported cases with intrapartum samples. Information, counseling and adequate monitoring are essential to prevent and manage adverse effects of SARS-CoV-2 infection during pregnancy.

Summary: Considerable progress has been made regarding children’s morbidity and mortality. Nonetheless, recent developments have been insufficient to meet set targets. This study aims to evaluate trends and outcomes in respiratory management following a 14-year collaboration with the Vermont Oxford Network (VON). Methods: Data were collected prospectively at a Level III NICU in the North of Portugal and submitted to the VON between 2000 and 2013. The primary outcome was bronchopulmonary dysplasia (BPD). Pneumothorax and respiratory distress syndrome were secondary outcomes. Results: A total of 323 very low birth weight infants hospitalised in our centre met the inclusion criteria. Significant changes were observed with supplemental oxygen use and endotracheal intubation decreasing, whilst surfactant use rose. Conventional ventilation techniques at any time were used less often. No differences in the rates of BPD were observed. Conclusion: A review of current practice has led to a more cautious approach, privileging less invasive ventilatory techniques and pondered oxygen supplementation, albeit with no significant improvement in the evaluated respiratory outcomes.

Abstract Background Maternal country of birth has been associated with perinatal health outcomes but less is known regarding breastfeeding practices in contemporary European settings. This study investigated effect of maternal country of birth on breastfeeding initiation and duration by comparing native Portuguese and migrant mothers. Methods We analyzed data of 7065 children of the Generation XXI (GXXI) birth cohort recruited at birth (2005–06) and followed-up 4 years later. Logistic regression was used to assess the effect of maternal country of birth on breastfeeding initiation. Kaplan-Meier estimate was used to compare breastfeeding duration by maternal country of birth and length of residence by migrant mothers in Portugal. Results Breastfeeding initiation and the type of breastfeeding practice were similar for native Portuguese and migrant mothers. The migrants had significantly higher median duration in months of any breastfeeding (Odds Ratio [OR] 6.0, 95% Confidence Interval [CI] 5.4,6.6) and exclusive breastfeeding (OR 4.0, 95% CI 3.8,4.2) than native Portuguese mothers (OR 4.0, 95% CI 3.8,4.2 and OR 3.0, 95% CI 2.9,3.0). Migrant mothers who resided in Portugal for either ≤5 years (OR 5.0, 95% CI 3.9,6.1 and OR 4.0, 95% CI 3.8,4.2) or > 5 years (OR 6.0, 95% CI 5.5,6.5 and OR 4.0, 95% CI 3.7,4.3) years had similar duration of any breastfeeding or exclusive breastfeeding, in both cases higher than the native Portuguese mothers. No significant differences were found when world regions were compared. Conclusions Maternal country of birth does not influence breastfeeding initiation and type of feeding practice. However, migrant mothers have longer breastfeeding duration of either exclusive or any breastfeeding, which was not changed by length of residence in Portugal.

En este texto se pretende realizar un análisis comparativo de dos libros-álbum portugueses, Bernardino (Bacelar, 2005) y Tão tão grande [Tan, tan grande] (Sobral, 2016), de Manuela Bacelar (Coimbra, 1943) y Catarina Sobral (Coimbra, 1985), respectivamente, que recrean, recurriendo a narraciones protagonizadas por animales, la cuestión de la diferencia, del crecimiento y de la construcción identitaria, pero también su aceptación y valoración en términos personales y sociales. Las dos ilustradoras seleccionadas, perteneciendo a diferentes generaciones, son referencia nacional e internacional en el marco de la creación de libros-álbum de autoría única, un ‘género’ casi sin tradición en Portugal, y presentan un recorrido marcado por varias semejanzas. Distinguidas con algunos de los mayores premios internacionales en el área de la ilustración, las creadoras presentan obras singulares, capaces de comunicar simultáneamente con sus lectores previstos, que se identifican de forma fácil e inmediata con los imaginarios construidos, sin renunciar a la inclusión de referencias artísticas y culturales.

Introdução: A mortalidade por cancro do colo do útero em Portugal apresenta valores mais elevados em relação a outros países europeus. O objetivo deste estudo é avaliar a variação da mortalidade por cancro do colo do útero, observada em Portugal nas últimas seis décadas. Material e Métodos: Obtivemos taxas de mortalidade por cancro do colo do útero (padronizadas para a idade) reportadas em Portugal (1955–2014), através da International Agency for Research on Cancer. Utilizando análise de regressão linear joinpoint, obtivemos a percentagem de variação anual da taxa (%VA) e respetivo intervalo de confiança a 95% (IC 95%) de acordo com a idade (30–39; 40–49, 50–64; 65–74 e ≥ 75 anos) Resultados: No grupo com 30–39 anos, a mortalidade por CCU diminuiu 1,9% ao ano, durante todo o período (IC 95%: –2,3; –1,4), atingindo 0,5/100 000 em 2014. Nas mulheres com 40–49 anos houve decréscimo acentuado entre 1971 e 1981 (%VA = –11,6; IC 95%: –14,6; –8,6), com subsequente aumento de 2,4% ao ano (IC 95%: 1,0; 3,8) até 2001, mas que reverteu a partir desse ano (%VA = –5,2; IC 95%: –7,7; –2,6), atingindo 3,0/100 000 em 2014. A mortalidade por cancro do colo do útero diminuiu de 29,2 para 6,7/100 000, de 34,3 para 7,7/100 000, e de 24,7 a 9,2/100 000, respetivamente, nas mulheres com 50–64, 65–74 e com 75 ou mais anos. Nestes três grupos o decréscimo ocorreu principalmente nas décadas de 70 e 80, não havendo variação significativa da taxa nas últimas três décadas. Discussão: O maior decréscimo da mortalidade por cancro do colo do útero observada em Portugal ocorreu na década de 70 em paralelo com profundas alterações no Sistema Nacional de Saúde caracterizadas pelo aumento do acesso ao diagnóstico precoce e da qualidade do tratamento. Nas últimas três décadas, a mortalidade por cancro do colo do útero estabilizou em idades mais avançadas, o que pode ser explicado parcialmente por fatores com impacto na adesão aos programas de rastreio. Conclusão: Houve marcado declínio da mortalidade por cancro do colo do útero em todos os grupos etários, embora com estagnação deste indicador desde meados da década de 80 para grupos etários mais avançados. Os resultados sugerem a necessidade de incrementar a adesão a programas de rastreio em Portugal.

Bipolar disorder (BD) is a severe and chronic psychiatric disorder, characterized by recurrent mood episodes of depression and mania. Some studies have indicated that there are ERK and JNK pathways alterations in the brain from bipolar patients. The animal model of mania induced by dextroamphetamine (d-AMPH) has been considered an excellent model to study intracellular alterations related to BD. The present study aimed to evaluate the effects of lithium (Li) and valproate (VPA) on the behavioral and ERK1/2/JNK1/2 signaling pathway in an animal model of mania induced by d-AMPH. Wistar rats were first given d-AMPH or saline (Sal) for 14 days, and then, between the 8th and 14th days, the rats were treated with Li, VPA, or Sal. The open-field test was used to evaluate the locomotion and exploration behaviors of rats. The levels of phosphorylated ERK1/2 and JNK1/2 were assessed in the hippocampus and frontal cortex of the rats. Li and VPA reversed the increased of locomotion and exploration induced by d-AMPH. The treatment with VPA or AMPH per se decreased the levels of pERK1 in the hippocampus. The treatment with VPA in the animals submitted to the administration of d-AMPH decreased the levels of ERK1, JNK-1, and JNK-2 phosphorylated in the hippocampus of the animals. The treatment with Li decreased the JNK-1 phosphorylated in the hippocampus of the animals submitted to the animal model of mania induced by d-AMPH. Although the association of VPA plus amphetamine alters some proteins involved in the JNK pathway in the hippocampus, these alterations were very random and seemed that were not related to the d-AMPH-induced manic-like behavior. These results suggest that the manic-like effects induced by d-AMPH and the antimanic effects of mood stabilizers, Li and VPA, are not related to the alteration on ERK1/2 and JNK1/2 pathways.

Neste estudo objetivou-se investigar o efeito da aplicação tópica dos óleos de chia, girassol e canola, por meio de biometria cutânea, mensurando a hidratação, Perda Transepidérmica de Água (PTEA), oleosidade e eritema. Tratase de uma pesquisa experimental, com amostra de 44 voluntários, que utilizaram os respectivos óleos no cotovelo esquerdo por 28 dias e foram avaliados nos dias 0, 7, 14, 21 e 28. Observou-se que todos os óleos estudados aumentaram a hidratação do cotovelo, porém, o óleo de chia apresentou o melhor resultado. Na avaliação da PTEA o óleo de canola apresentou o menor índice, porém, todos os óleos testados aumentaram a oleosidade do cotovelo, em especial o óleo de girassol. O óleo que teve menor reação tecidual foi o óleo de chia, quando comparado aos outros óleos testados. Logo, conclui-se que este estudo comprova a efetividade do óleo de chia na hidratação e diminuição de eritema da pele, prevenindo dano tissular e proporcionando efeitos benéfi cos na pele. Palavras-chave: Enfermagem; Ácidos Graxos Essenciais; Biometria Cutânea. ABsTRAcT The present study aims to investigate the effects of the topical application of chia, sunfl ower and canola oils by cutaneous biometry, measuring hydration, Transepidermal Water Loss (TEWL), oiliness and erythema. This is an experimental study, with a sample of 44 volunteers, who used the respective oils in the left elbow for 28 days, and so on days 0, 7th, 14th, 21th and 28th. It was observed that all the oils studied increased hydration of the elbow, however, the chia oil showed the best result. In the evaluation of the PTEA, the canola oil had the lowest index, but all the oils tested increased the oiliness of the elbow, especially the sunfl ower oil. The oil that had the lowest tissue reaction was chia oil, when compared to the other oils tested. Therefore, it is concluded that this study proves the effectiveness of chia oil on the hydration and reduction of erythema of the skin, preventing tissue damage and providing benefi cial effects on the skin. Keywords: Nursing; Essential Fatty Acids; Skin Biometry

Objective: To compare the clinical approach and outcomes of bron­chopulmonary dysplasia (BPD) patients in the last two decades (1996-2005 vs 2006-2015) in a neonatal intensive care unit. Methods: Out of 1,196 admissions of very low birth weight and/or less than 32 weeks of gestational age infants, 96 had BPD and were dichotomized into two groups according to the year of birth (1996-2005 and 2006-2015). Their clinical data were studied and conclusions were drawn about their morbidity and mortality. Results: There was a decrease in mortality (23.3% vs. 14.4%, p < 0.001) and in BPD prevalence (9.7% vs 6.1%, p = 0.023); in the delivery room, early nasal continuous positive airways pressure (nCPAP) was used in 41.2% vs 1.6%, p < 0.001 and tracheal intubation in 70.6% vs 96.8%, p < 0.001. We observed an increase on the duration of non-invasive ventilation (nCPAP, 22.5 vs 45.5 days, p < 0.001) and a decrease of invasive ventilation (39.5 vs 20 days, p = 0.013) from the first to the second period. Conclusions: Improvement in perinatal and neonatal intensive care practices, namely the use of non-invasive methods of mechanical ventilation implemented in the last years, probably contributed to the better evolution of preterm infants with BPD.

O acidente ocorrido em Porto das Caixas, Itaboraí/RJ, com o trem que descarrilou e despejou 60 mil litros de óleo diesel em uma região habitada, resultou em impacto ambiental e humano. O principal objetivo deste trabalho foi investigar o impacto psicológico que o acidente causou na população. A população estudada constituiu-se de 28 pessoas de ambos os sexos expostas ao óleo diesel, com idade entre 18 e 60 anos. O instrumento utilizado na investigação das estratégias de enfrentamento do estresse foi o Inventário de Estratégias de Coping. Foi observado que a estratégia mais utilizada foi fuga e esquiva e a menos utilizada foi a de confronto. O que se constata é que existiu um impacto psicossocial em função do acidente naquela comunidade e que danos oriundos de um evento estressor podem ser observados em momentos diferenciados e seus efeitos prejudiciais podem se estender ao ambiente e à saúde da população do entorno.El accidente ocurrido en Porto das Caixas, Itaboraí/RJ, con el tren que descarrilló y despejó 60 mil litros de aceite diesel en una región habitada, resultó en impacto ambiental y humano. El principal objetivo de este trabajo fue investigar el impacto psicológico que el accidente causó en la población. La población estudada se constituyó de 28 personas de ambos los sexos expuestas al aceite diesel, con edad entre 18 y 60 años. El instrumento utilizado en la investigación de las estrategias de enfrentamiento del estrés fue el Inventario de Estrategias de Coping. Fue observado que la estrategia más utilizada fue la de huir y esquivar y la menos utilizada fue la de confrontar. El que se constata es que existió un impacto psicosocial en función del accidente en aquella comunidad y que daños oriundos de un evento estresor pueden ser observados en momentos diferenciados y sus efectos perjudiciales pueden estenderse al ambiente y a la salud de la población del entorno.The accident occurred in Porto das Caixas, Itaboraí/RJ with the train that derailed and poured 60 thousand litters of the diesel oil carried in a region, resulted in an environmental and human impact. The aim of this paper was to investigate the psychological impact that the accident caused in the displayed population. 28 people exposed to the diesel oil were investigated (men and women) , between 18 and 60 years. In the inquiry of the coping strategies was observed that the most used strategy was to escape and avoidance and the less most used was confrontation. What was evidenced is that a psychosocial impact caused by the environmental accident in that community existed and that deriving damages of a stressor event can be observed at different moments, being able to have the prolongation of its harmful effect to the environment and the health of the population around.

A criação de oferta formativa numa modalidade de ensino a distância (EaD) trouxe novos desafios a uma instituição organizada para um ensino presencial e que teve de iniciar um caminho para se adaptar a esta nova realidade sem perder a qualidade das suas formações. A Unidade de Ensino a Distância do Instituto Politécnico de Leiria (IPLeiria) criou em 2008 o curso de e-Tutores com o objetivo de dotar os futuros professores EaD de competências para prepararem e lecionarem uma unidade curricular EaD. Estes 6 anos de experiência no EaD permitiram ao IPLeiria solidificar práticas e procedimentos a nível pedagógico, organizacional e tecnológico. Com 5 licenciaturas e 3 mestrados oferecidos na modalidade a distância, o IPLeiria já formou cerca de um terço dos seus professores capacitando-os para atuarem nesta modalidade.

Frecuentemente, las obras escritas para niños tienen como tema la propia literatura, los libros o la lectura. Muchas veces, incluso, podemos ver en las ilustraciones a los personajes leyendo un libro en el que no podemos distinguir el nombre del autor o el título: es lo que llamamos "architextos” o "libros indeterminados”, que proponen un enigma al lector "real" y lo obligan a adelantar una hipótesis que a menudo está relacionada con el sentido de la obra que está leyendo. Estas representaciones podrían desempeñar un papel crucial en la promoción de la lectura y de la recepción artística, mediante la identificación del lector con las obras literarias y la activación de saberes y destrezas relacionadas con la tradición literaria (especialmente la infantil) y con las artes: pintura, escultura, cine, cómic, ilustración. Este estudio es una aproximación al análisis de la función que cumplen estos libros “pintados” e "irreconocibles”, sin palabras, que los personajes tienen en sus manos y en los que a menudo podemos identificar el género o el tono, entre otros datos. Por sus peculiaridades, estos libros “ficticios”, “escritos” en el lenguaje universal de la ilustración, han cruzado las fronteras idiomáticas y culturales. Para una aproximación a su descripción, partimos de la condición dialógica implícita en toda relación transtextual.

BACKGROUND: Discussion of the benefits of moderate alcohol consumption is ongoing. Broadly, research focusing on ethanol consumption tends to report no benefits. However, studies that distinguish between different types of alcoholic beverages, particularly beers, often reveal positive effects. The present study evaluated the genotoxic and mutagenic effects of moderate chronic consumption of India Pale Ale (IPA) craft beer. Sixty‐four adult male Swiss mice were used and divided into control and treatment groups receiving water, IPA beer with 55.23 g of ethanol per liter of beer, aqueous solution with 55.23 g of ethanol per liter, and hop infusion ad libitum for 30 days. After this period, the animals were genetically evaluated with a comet assay. For the ex vivo comet assay, blood was collected and exposed to hydrogen peroxide (H2O2). For the in vivo assay, the alkylating agent cyclophosphamide (CP) was administered to the groups after blood collection and sacrificed after 24 h. Brain, liver, and heart tissues were analyzed. Bone marrow was collected and submitted to the micronucleus test. RESULTS: The groups treated with IPA beer, ethanol, and hops did not show genotoxic and mutagenic action in the blood, brain, heart, or liver. The antigenotoxic action of IPA beer and hops was observed in both in vivo and ex vivo models, showing a similar reduction in DNA damage caused by CP. There was no significant difference between the groups with regard to the formation of micronuclei by CP. CONCLUSION: Moderate chronic consumption of IPA beer and hops infusion showed antigenotoxic effects in mice but no antimutagenic action. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]