Prevalência de úlceras de pressão em dois hospitais portugueses: Impacto da Escala de Braden associada a um protocolo de prevenção

As úlceras de pressão constituem um importante problema de saúde pública comum a diversos cenários de cuidados, em todo o mundo, e também em Portugal, nomeadamente para a população mais idosa. O presente estudo teve como objectivos determinar o impacto da escala de Braden associada a um protocolo de prevenção de úlceras de pressão na prevalência destas lesões, assim como, monitorizar o problema das úlceras de pressão em dois hospitais portugueses, em que o Hospital A utiliza estes instrumento e o Hospital 8 não usa esses instrumentos. Foi utilizado o Instrumento de Prevalência de Úlceras de Pressão validado para Portugal na recolha dos dados. Os dados foram obtidos através da observação directa dos doentes. Foram realizadas duas avaliações com um intervalo de três meses em cada hospital. Os resultados encontrados revelaram que as úlceras de pressão constituem um problema de saúde para os dois hospitais observados. No entanto, o Hospital A apresenta menor taxa de prevalência de úlceras de pressão, menor número de úlceras de pressão mais graves, menor possibilidade de um doente adquirir uma úlcera de pressão e maior utilização de medidas preventivas. Os valores encontrados foram estatisticamente significativos para p <0,05. Confirma-se que a utilização da escala de Braden associada a um protocolo de prevenção de úlceras de pressão é uma medida eficaz na redução do número de úlceras de pressão. Para uma maior eficácia deste instrumento será importante a sua utilização como ferramenta de controlo da adequação das medidas preventivas. ABSTRACT; Pressure ulcers are an important public health problem common to several scenarios of care in the world, and also in Portugal, particularly for the elderly. This study aims to determine the impact of the Braden scale associated with a protocol for prevention of pressure ulcers in prevalence of these lesions, as well as monitor the problem of pressure ulcers in two Portuguesa hospitais, the Hospital A uses these instrument and Hospital B doesn’t. It was used the instrument of Prevalence of pressure ulcers validated for Portugal in the data collection. Data were collected through direct observation of patients. There were two assessments with an interval of three months in each hospital. The results showed that the pressure ulcers are a health problem for both hospitals observed. However, the Hospital A provides a lower prevalence rate of pressure ulcers, lower number of pressure ulcers more serious, less possibility of a patient acquiring a pressure ulcer and increased use of preventive measures. The values were statistically significant for p<0.05. lt is confirmed that the use of the Braden scale associated with a protocol for prevention of pressure ulcers is an effective measure in reducing the number of pressure ulcers. For greater efficiency will be important to use it as a tool for monitoring the adequacy of preventive measures.

SOLEDAD GÓMEZ NAVARRO, Mirando al cielo sin dejar el suelo: Los jerónimos cordobeses de Valparaíso en el Antiguo Régimen. Estudio preliminar y edición crítica del libro “Protocolo” de la comunidad

Review of the book: SOLEDAD GÓMEZ NAVARRO, Mirando al cielo sin dejar el suelo: Los jerónimos cordobeses de Valparaíso en el Antiguo Régimen. Estudio preliminar y edición crítica del libro “Protocolo” de la comunidad, Visión Libros-Colegio Notarial de Andalucía-Instituto Escurialense de Investigaciones Históricas y Artísticas, Colección de Historia Religiosa, Madrid, 2014, 824 pp.

Enzymatic activity on sediments and nematode assemblage responses during seagrass beds habitat recovery following the disturbance of the traditional digging activity of bivalves harvesting.

Sediment digging is an anthropogenic activity connected to the exploitation of living resources in estuarine and marine environments. The knowledge on the functional responses of the benthic assemblages to the physical disturbance is an important baseline to understand the ecological processes of the habitat recovery and restoration and to develop tools for the management of the harvesting activities. To investigate the effects of the digging activity of the bivalves on Zostera noltii seagrass beds a manipulative field experiment was conducted that included the enzymatic activity of sediments and the associated nematode assemblages. Four plots (two undisturbed serving as control and two dug to collect bivalves - treatment) with 18 subplots were randomly located at seagrass beds in the Mira estuary at the SW coast of Portugal. Samples were randomly and unrepeatably collected from three subplots of each plot in five different occasions, before sediment digging (T0) up to six months after disturbance (T5). Microbial activity in sediments was assess by determining the extracelular enzymatic activity of six hydrolytic enzymes (sulfatase, phosphatase, b -N-acetilglucosaminidase, b-glucosidase, urease, protease) and two oxidoreductases (phenol oxidase and peroxidase). The microbial community status was also assessed through the measurement of dehydrogenase, which reflects microbial respiration. The nematode assemblages composition, biodiversity and trophic composition at different sampling occasions were also analyzed. The fluorometric and biochemical parameters analysed of the Z. noltii plants during the experimental period showed a recovery of the seagrass beds, and it was detected an increase of the enzymatic activity of the sediments after disturbance. The nematodes assemblages were similar in all sampling occasions. The seagrass beds and the nematodes assemblages associated showed a high resilience to the stress caused by the traditional bivalves digging activity. The obtained results allow the development of a management programme for the commercial fishing activity to maintain the good environmental status and minimized the secondary environmental effects on marine and estuarine habitats through the establishment of a baseline for the regulation of the harvesting frequency.