Relatório de Estágio de Enfermagem Comunitária

O estágio de enfermagem comunitária, integrado no Mestrado em Enfermagem na área de especialização em enfermagem comunitária da ESSP decorreu no período de 14 de Fevereiro a 27 de Junho de 2011. Este foi desenvolvido em duas áreas de intervenção comunitárias distintas: a primeira na área da educação sexual na adolescência realizada aos alunos do 8.º, 9.º, 10.º ano e CEF das Escolas Secundárias Mouzinho da Silveira e São Lourenço; a segunda na área da promoção de hábitos de vida saudáveis nos adolescentes do 9.º ano e 12.º ano da Área Ciências e Tecnologia das escolas do Concelho de Portalegre integrada na promoção da imagem da Escola Superior de Saúde de Portalegre (realizada nas instalações da ESSP). Deste modo com este relatório pretendo:  Descrever e analisar de forma crítica os objetivos, intervenções e recursos utilizados durante o estágio;  Analisar o desenvolvimento das competências adquiridas;  Refletir sobre a prática do enfermeiro na intervenção comunitária; Para se atingir os objetivos propostos foram realizadas sessões e atividades de educação para a saúde quer no âmbito da educação sexual quer da promoção de estilos de vida saudáveis. Nestas sessões e atividades foram abrangidos 276 e 317 alunos respetivamente. Ao longo do estágio pude adquirir e desenvolver competências como enfermeiro especialista, para tal foi importantíssimo a utilização da metodologia de planeamento em saúde

Malignant Transformation Of An Odontogenic Cyst In A Period Of 10 Years.

Primary intraosseous carcinoma of the jaws (PIOSCC) might arise from odontogenic epithelium, more commonly from a previous odontogenic cyst. The aim of this case is to illustrate that the clinician should consider that an apparent benign dentigerous cyst can suffer malignant transformation and that all material removed from a patient must be evaluated histologically. A 44-year-old man presented in a routine periapical X-ray an impacted lower left third molar with radiolucency over its crown. Ten years later, the patient complained of pain in the same region and the tooth was extracted. After one month, the patient still complained of pain and suffered a fracture of the mandible. A biopsy was performed and carcinoma was diagnosed. The patient was treated surgically with adjuvant radio- and chemotherapy and after 8 years, he is well without signs of recurrences. This report describes a central mandibular carcinoma probably developed from a previous dentigerous cyst.

Transiting exoplanets from the CoRoT space mission XII. CoRoT-12b: a short-period low-density planet transiting a solar analog star

We report the discovery by the CoRoT satellite of a new transiting giant planet in a 2.83 days orbit about a V = 15.5 solar analog star (M(*) = 1.08 +/- 0.08 M(circle dot), R(*) = 1.1 +/- 0.1 R(circle dot), T(eff) = 5675 +/- 80 K). This new planet, CoRoT-12b, has a mass of 0.92 +/- 0.07 M(Jup) and a radius of 1.44 +/- 0.13 R(Jup). Its low density can be explained by standard models for irradiated planets.

Interface roughness in short-period InGaAs/InP superlattices

Electron mobility was studied in lattice-matched short-period InGaAs/InP superlattices as a function of the width of the wells. The decreasing mobility with decreasing well width was shown to occur due to the interface roughness. The roughnesses of InGaAs/InP and GaAs/AlGaAs interfaces were compared. Much smoother InGaAs/InP interfaces resulted in higher electron mobility limited by interface roughness.

Manipulation of rest period length induces different causes of fatigue in vertical jumping

The aim of this study was to directly compare the causes of fatigue after a short- and a long-rest interval between consecutive stretch-shortening cycle exercises. Eleven healthy males jumped with different resting period lengths (short = 6.1 +/- 1 s, long = 8.6 +/- 0.9 s), performing countermovement jumps at 95% of their maximal jump height until they were unable to sustain the target height. After short- and long-rest, the maximal voluntary isometric contraction knee extension torque decreased (-7%; p = 0.04), comparing to values obtained before exercise protocols. No change was seen from pre- to post-exercise, for either short- or long-rest, in biceps femoris coactivation (-1%; p = 0.95), peak-to-peak amplitude (1%; p = 0.95) and duration (-8%; p = 0.92) of the compound muscle action potential of the vastus lateralis. Evoked peak twitch torque reduced after both exercise protocols (short = -26%, long = -32%; p = 0.003) indicating peripheral fatigue. However, central fatigue occurred only after short-rest evidenced by a reduction in voluntary activation of the quadriceps muscle (-14%; p = 0.013) measured using the interpolated twitch technique. In conclusion, after Stretch-shortening cycle exercise using short rest period length, the cause of fatigue was central and peripheral, while after using long rest period length, the cause of fatigue was peripheral.

The impact of a 17-day training period for an international championship on mucosal immune parameters in top-level basketball players and staff members

This investigation examined the impact of a 17-d training period (that included basketball-specific training, sprints, intermittent running exercises, and weight training, prior to an international championship competition) on salivary immunoglobulin A (SIgA) levels in 10 subjects (athletes and staff members) from a national basketball team, as a biomarker for mucosal immune defence. Unstimulated saliva samples were collected at rest at the beginning of the preparation for the Pan American Games and 1 d before the first game. The recovery interval from the last bout of exercise was 4 h. The SIgA level was measured using enzyme-linked immunosorbent assay and expressed as absolute concentrations, secretion rate, and SIgA level relative to total protein. The decrease in SIgA levels following training was greater in athletes than in support staff; however, no significant differences between the two groups were detected. A decrease in SIgA level, regardless of the method used to express IgA results, was verified for athletes. Only one episode of upper respiratory tract illness symptoms was reported, and it was not associated with changes in SIgA levels. In summary, a situation of combined stress for an important championship was found to decrease the level of SIgA-mediated immune protection at the mucosal surface in team members, with greater changes observed in the athletes.

The influence of resting period length on jumping performance

Pereira, G, Almeida, AG, Rodacki, ALF, Ugrinowitsch, C, Fowler, NE, Kokubun, E. The influence of resting period length on jumping performance. J Strength Cond Res 22: 1259-1264, 2008-The purpose of this study was to determine a resting interval between countermovement jumps (i.e., volleyball spikes) that allows the maintenance of maximal jumping performance. Ten male volleyball players (1.85 +/- 0.05 m, 77.2 +/- 10.6 kg, 21.6 +/- 5.3 years) performed 6 experimental jumping sessions. In the first and sixth sessions, maximal countermovement jump height was measured, followed by submaximal countermovement jumps to the point of volitional fatigue. The number of countermovement jumps was used as a reference to test the effect of rest period between volleyball spikes. From the second to fifth experimental sessions, 30 maximal volleyball spikes were performed with different resting periods (i.e., 8, 14, 17, and 20 seconds) followed by countermovement jumps. Between the 15th and 30th spikes, the blood lactate concentration and heart rate were measured. Because the performance on the first and sixth sessions was the same, no training effects were noticed. During the 8-second resting interval set, the lactate concentration increased significantly between the 15th and 30th spikes (i.e., from 3.37 +/- 1.16 mmol to 4.94 +/- 1.49 mmol); the number of countermovement jumps decreased significantly after spikes compared to those performed without a previous effort (i.e., from 23 +/- 7 jumps to 17 +/- 9 jumps); and these variables were significantly correlated (r = -0.7). On the other hand, the lactate concentration and number of countermovement jumps were stable across the other resting intervals, without a heart rate steady state. The results indicate that an adequate resting period between spikes allowed participants to achieve a lactate steady state in which the performance was maintained during the exercise. These findings show that resting intervals between 14 and 17 seconds, typical during volleyball matches, are indicated to use in volleyball spike drills due to their capacity to maintain maximal jumping performance.

A method to estimate EMG crosstalk between two muscles based on the silent period following an H-reflex

The crosstalk phenomenon consists in recording the volume-conducted electromyographic activity of muscles other than that under study. This interference may impair the correct interpretation of the results in a variety of experiments. A new protocol is presented here for crosstalk assessment between two muscles based on changes in their electrical activity following a reflex discharge in one of the muscles in response to nerve stimulation. A reflex compound muscle action potential (H-reflex) was used to induce a silent period in the muscle that causes the crosstalk, called here the remote muscle. The rationale is that if the activity recorded in the target muscle is influenced by a distant source (the remote muscle) a silent period observed in the electromyogram (EMG) of the remote muscle would coincide with a decrease in the EMG activity of the target muscle. The new crosstalk index is evaluated based on the root mean square (RMS) values of the EMGs obtained in two distinct periods (background EMG and silent period) of both the remote and the target muscles. In the present work the application focused on the estimation of the degree of crosstalk from the soleus muscle to the tibialis anterior muscle during quiet stance. However, the technique may be extended to other pairs of muscles provided a silent period may be evoked in one of them. (C) 2009 IPEM. Published by Elsevier Ltd. All rights reserved.

A generalized multi-period mean-variance portfolio optimization with Markov switching parameters

In this paper, we deal with a generalized multi-period mean-variance portfolio selection problem with market parameters Subject to Markov random regime switchings. Problems of this kind have been recently considered in the literature for control over bankruptcy, for cases in which there are no jumps in market parameters (see [Zhu, S. S., Li, D., & Wang, S. Y. (2004). Risk control over bankruptcy in dynamic portfolio selection: A generalized mean variance formulation. IEEE Transactions on Automatic Control, 49, 447-457]). We present necessary and Sufficient conditions for obtaining an optimal control policy for this Markovian generalized multi-period meal-variance problem, based on a set of interconnected Riccati difference equations, and oil a set of other recursive equations. Some closed formulas are also derived for two special cases, extending some previous results in the literature. We apply the results to a numerical example with real data for Fisk control over bankruptcy Ill a dynamic portfolio selection problem with Markov jumps selection problem. (C) 2008 Elsevier Ltd. All rights reserved.

Influence of egg pre-storage heating period and storage length on incubation results

This experiment aimed at evaluating the influence of different heating times of settable eggs of Cobb 500 (R) broiler breeders before submitting them to different storage periods on egg weight loss, embryo mortality, and hatchability. A total number of 1,980 eggs were distributed in a completely randomized experimental design with a 3 x 3 factorial arrangement, comprising nine treatments with 22 replicates of 10 eggs each. The following factors were analyzed: pre-storage heating periods (0, 6, 12 hours at 36.92 degrees C) and storage periods (4, 9, 14 days at 12.06 degrees C). After storage, eggs were incubated under usual conditions, and were transferred to the hatcher at 442 hours of incubation. Eggs were weighed before heating, incubation, and transference to determine weight loss. Partial hatchability was determined at 480 hours, and total hatchability at 498 hours of incubation. Embryo mortality was determined in non-hatched eggs. It was concluded that heating eggs for six hour before storage improves incubation results as it decreases incubation length and late embryo mortality, therefore its use can be indicated in commercial operations. Storing eggs for 14 days and pre-heating for 14 days and pre-heating for 12 hours severely impair incubation results, and therefore are not recommended.

Influence of egg pre-storage heating period and storage length on the digestive tract of newly-hatched broiler chicks

An experiment was carried out to evaluate the effect of different heating times of settable eggs of Cobb 500 (R) broiler breeders before submitting them to different storage periods on body weight, digestive tract organ weights, and intestinal mucosa morphology of newly-hatched chicks. Settable eggs were distributed in a completely randomized experimental design with a 3 x 3 factorial arrangement: pre-storage heating periods (0, 6, 12 hours at 36.92 degrees C) and storage periods (4, 9, 14 days at 12.06 degrees C). Body weight and relative weights of the yolk sac, heart, liver, proventriculus+gizzard, and intestinal segments were measured in chicks hatching at 480 and 498 hours of incubation. Villi height, width and perimeter, and crypt depth < im) were measured in duodenal histological sections. It was concluded that pre-storage healing for six hours of eggs stored for four or nine days increases small intestine weight of newly-hatched chicks, but does not influence the morphology of the duodenal mucosa. Pre-storage heating for 12 hours negatively influences body weight and duodenal mucosa development, and therefore this practice is not recommended. Storage length does not have consistent effect on body weight and development of the gastrointestinal tract.

Bioequivalence Evaluation of Single Doses of Two Tramadol Formulations: A Randomized, Open-Label, Two-Period Crossover Study in Healthy Brazilian Volunteers

Background: Tramadol is a well tolerated and effective analgesic used to treat moderate to severe pain. Several generic formulations of tramadol are available in Brazil; however, published information regarding their bioequivalence in the Brazilian population is not available. A study was designed for Brazilian regulatory authorities to allow marketing of a generic formulation. Objective: The purpose of this study was to compare the bioequivalence of 2 commercial tablet preparations containing tramadol 100 mg marketed for use in Brazil. Methods: A randomized, open-label, 2 x 2 crossover study was performed in healthy Brazilian volunteers under fasting conditions with a washout period of 12 days. Two tablet formulations of tramadol 100 mg (test and reference formulations) were administered as a single oral dose, and blood samples were collected over 24 hours. Tramadol plasma concentrations were quantified using a validated HPLC method. A plasma concentration time profile was generated for each volunteer and then mean values were determined, from which C(max), T(max), AUC(0-t), AUC(0-infinity), k(e), and t(1/2) were calculated using a noncompartmental model. Bioequivalence between the products was determined by calculating 90% CIs for the ratios of C(max), AUC(0-t), and AUC(0-infinity) values for the test and reference products using log-transformed data. Tolerability was assessed by monitoring vital signs (temperature, blood pressure, heart rate), laboratory tests (hematology, blood biochemistry, hepatic function, urinalysis), and interviews with the volunteers before medication administration and every 2 hours during the study. Results: Twenty-six healthy volunteers (13 men, 13 women) were enrolled in and completed the study. Mean (SD) age was 30 (6.8) years (range, 21-44 years), mean weight was 64 (8.3) kg (range, 53-79 kg), and mean height was 166 (6.4) cm (range, 155-178 cm). The 90% CIs for the ratios of C(max) (1.01-1.17), AUC(0-t) (1.00-1.13), and AUC(0-infinity) (1.00-1.14) values for the test and reference products fell within the interval of 0.80 to 1.25 proposed by most regulatory agencies, including the Brazilian regulatory body. No clinically important adverse effects were reported; only mild somnolence was reported by 4 volunteers and mild headaches by 5 volunteers, and there was no need to use medication to treat these symptoms. Conclusion: Pharmacokinetic analysis in these healthy Brazilian volunteers suggested that the test and reference formulations of tramadol 100-mg tablets met the regulatory requirements to assume bio-equivalence based on the Brazilian regulatory definition. (Clin Ther 2010;32:758-765) (C) 2010 Excerpta Medica Inc.

Magma Flow Instabilities in a Volcanic Conduit: Implications for Long-Period Seismicity

Silicic volcanic eruptions are typically accompanied by repetitive Long-Period (LP) seismicity that originates from a small region of the upper conduit. These signals have the capability to advance eruption prediction, since they commonly precede a change in the eruption vigour. Shear bands forming along the conduit wall, where the shear stresses are highest, have been linked to providing the seismic trigger. However, existing computational models are unable to generate shear bands at the depths where the LP signals originate using simple magma strength models. Presented here is a model in which the magma strength is determined from a constitutive relationship dependent upon crystallinity and pressure. This results in a depth-dependent magma strength, analogous to planetary lithospheres. Hence, in shallow highly-crystalline regions a macroscopically discontinuous brittle type of deformation will prevail, whilst in deeper crystal-poor regions there will be a macroscopically continuous plastic deformation mechanism. This will result in a depth where the brittle-ductile transition occurs, and here shear bands disconnected from the free-surface may develop. We utilize the Finite Element Method and use axi-symmetric coordinates to model magma flow as a viscoplastic material, simulating quasi-static shear bands along the walls of a volcanic conduit. Model results constrained to the Soufrière Hills Volcano, Montserrat, show the generation of two types of shear bands: upper-conduit shear bands that form between the free-surface to a few 100 metres below it and discrete shear bands that form at the depths where LP seismicity is measured to occur corresponding to the brittle-ductile transition and the plastic shear region. It is beyond the limitation of the model to simulate a seismic event, although the modelled viscosity within the discrete shear bands suggests a failure and healing cycle time that supports the observed LP seismicity repeat times. However, due to the paucity of data and large parameter space available these results can only be considered to be qualitative rather than quantitative at this stage.

Deconvolving the delta O-18 seawater component from subseasonal coral delta O-18 and Sr/Ca at Rarotonga in the southwestern subtropical Pacific for the period 1726 to 1997

To reconstruct oceanographic variations in the subtropical South Pacific, 271-year long subseasonal time series of Sr/Ca and delta(18)O were generated from a coral growing at Rarotonga (21.5degreesS, 159.5degreesW). In this case, coral Sr/Ca appears to be an excellent proxy for sea surface temperature (SST) and coral delta(18)O is a function of both SST and seawater delta(18)O composition (delta(18)O(sw)). Here, we focus on extracting the delta(18)O(sw) signal from these proxy records. A method is presented assuming that coral Sr/Ca is solely a function of SST and that coral delta(18)O is a function of both SST and delta(18)O(sw). This method separates the effects of delta(18)O(sw) from SST by breaking the instantaneous changes of coral delta(18)O into separate contributions by instantaneous SST and delta(18)O(sw) changes, respectively. The results show that on average delta(18)O(sw) at Rarotonga explains similar to39% of the variance in delta(18)O and that variations in SST explains the remaining similar to61% of delta(18)O variance. Reconstructed delta(18)O(sw) shows systematic increases in summer months (December-February) consistent with the regional pattern of variations in precipitation and evaporation. The delta(18)O(sw) also shows a positive linear correlation with satellite-derived estimated salinity for the period 1980 to 1997 (r = 0.72). This linear correlation between reconstructed delta(18)O(sw) and salinity makes it possible to use the reconstructed delta(18)O(sw) to estimate the past interannual and decadal salinity changes in this region. Comparisons of coral delta(18)O and delta(18)O(sw) at Rarotonga with the Pacific decadal oscillation index suggest that the decadal and interdecadal salinity and SST variability at Rarotonga appears to be related to basin-scale decadal variability in the Pacific. Copyright (C) 2002 Elsevier Science Ltd.