Dinâmica de uma floresta tropical manejada na Amazônia oriental

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Florestal, 2016.

Effect of organic amendments on the afforestation performance of plant species on degraded semiarid conditions

Vegetation plays a fundamental role in soil conservation, so it is common to consider an increase in vegetation cover as one of the techniques to mitigate the effects of desertification in Mediterranean forest environments. There are two factors limiting the establishment and growth of seedlings in dry environments: (i) an excessive radiation and, (ii) the limited availability of water during the summer drought. During an afforestation plan, soil preparation is always necessary to reduce sapling mortality. The goal of this study was to analyze the effect of various organic amendments on soil according to chemical and hydrological properties, and to assess the effects of these parameters on an afforestal proposal under Mediterranean climate conditions. Five amendments were applied in an experimental set of plots: straw mulching (SM); mulch with chipped branches of Aleppo Pine (PM); TerraCotten hydroabsobent polymers (HP); sewage sludge (RU); sheep manure (SH) and control (C). Plots were afforested following the same spatial pattern, and amendments were mixed with the soil at the rate 10 Mg ha -1 . Under bare soil conditions (C), most of mortalities occurred during the summer period of the first year. A substantial positive effect of SM, PM and HP on the survival rates have been clearly observed. Conversely, when the soil was amended with SH, the survival rate quickly decreased or remained more or less constant regarding to C. In this study, the lack of differences on chemical properties indicates that there may exist other reasons to justify the differences that were found in the pattern of vegetation. However, regarding to the hydrological properties some differences have been found. In C, soils were registered below the wilting point during 4 months a year, and therefore, in the area of water unusable by plants. These months were coinciding with the summer Mediterranean drought and can justify the high mortality found on plants. Conversely, in SM, PM and HP, soil moisture remained below the wilting point less period than C and, the plant available water was also higher. In these treatments, the survival sapling rates measured were the highest. SH showed water holding capacity slightly more limited than C. For this treatment, the survival sapling rates measured were the lowest. In conclusion, from a land management standpoint, the PM, SM and HP have been proved as a significant method to reduce sapling mortality rates during the Mediterranean summer drought.

Life expectancy of type 1 diabetic patients during 1997-2010: a national Australian registry-based cohort study

AIMS/ HYPOTHESIS:
There is limited information about the impact of type 1 diabetes on life expectancy in a contemporary population. We examined the life expectancy of type 1 diabetic patients and explored the contribution of mortality at different ages and of different causes of death to years of life lost (YLL) compared with the general population.

METHODS:
We derived mortality rates of Australians with type 1 diabetes listed on the National Diabetes Services Scheme (NDSS) between 1997 and 2010 (n = 85,547) by linking the NDSS to the National Death Index. The Chiang method was used to estimate life expectancy and Arriaga's method was used to estimate the contributions of age-specific and cause-specific mortality to the YLL.

RESULTS:
A total of 5,981 deaths were identified during the 902,136 person-years of follow up. Type 1 diabetic patients had an estimated life expectancy at birth of 68.6 years (95% CI 68.1, 69.1), which was 12.2 years (95% CI 11.8, 12.7) less than that in the general population. The improvement in life expectancy at birth in 2004-2010 compared with 1997-2003 was similar for both type 1 diabetic patients (men, 1.9 years [95% CI 0.4, 3.3]; women, 1.5 years [95% CI 0.0, 3.2]) and the general population (men, 2.2 years; women, 1.4 years). Deaths at age <60 years accounted for 60% of the YLL from type 1 diabetes for men and 45% for women. The major contribution to YLL was mortality from endocrine and metabolic disease at age 10-39 years (men, 39-59%; women, 35-50%) and from circulatory disease at age ≥40 years (men, 43-75%; women, 34-75%).

CONCLUSIONS/ INTERPRETATION:
Data from 1997 to 2010 showed that Australian type 1 diabetic patients had an estimated loss in life expectancy at birth of 12.2 years compared with the general population.

Obesity in adulthood and its consequences for life expectancy: a life-table analysis

BACKGROUND: Overweight and obesity in adulthood are linked to an increased risk for death and disease. Their potential effect on life expectancy and premature death has not yet been described. OBJECTIVE: To analyze reductions in life expectancy and increases in premature death associated with overweight and obesity at 40 years of age. DESIGN: Prospective cohort study. SETTING: The Framingham Heart Study with follow-up from 1948 to 1990. PARTICIPANTS: 3457 Framingham Heart Study participants who were 30 to 49 years of age at baseline. MEASUREMENTS: Mortality rates specific for age and body mass index group (normal weight, overweight, or obese at baseline) were derived within sex and smoking status strata. Life expectancy and the probability of death before 70 years of age were analyzed by using life tables. RESULTS: Large decreases in life expectancy were associated with overweight and obesity. Forty-year-old female nonsmokers lost 3.3 years and 40-year-old male nonsmokers lost 3.1 years of life expectancy because of overweight. Forty-year-old female nonsmokers lost 7.1 years and 40-year-old male nonsmokers lost 5.8 years because of obesity. Obese female smokers lost 7.2 years and obese male smokers lost 6.7 years of life expectancy compared with normal-weight smokers. Obese female smokers lost 13.3 years and obese male smokers lost 13.7 years compared with normal-weight nonsmokers. Body mass index at ages 30 to 49 years predicted mortality after ages 50 to 69 years, even after adjustment for body mass index at age 50 to 69 years. CONCLUSIONS: Obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality. These decreases are similar to those seen with smoking. Obesity in adulthood is a powerful predictor of death at older ages. Because of the increasing prevalence of obesity, more efficient prevention and treatment should become high priorities in public health.

Lifetime risk and projected population prevalence of diabetes

AIMS/HYPOTHESIS: With incidence rates for diabetes increasing rapidly worldwide, estimates of the magnitude of the impact on population health are required. We aimed to estimate the lifetime risk of diabetes, the number of years lived free of, and the number of years lived with diabetes for the Australian adult population from the year 2000, and to project prevalence of diabetes to the year 2025. METHODS: Multi-state life-tables were constructed to simulate the progress of a cohort of 25-year-old Australians. National mortality rates were combined with incidence rates of diabetes and the RR of mortality in people with diabetes derived from the Australian Diabetes, Obesity and Lifestyle study (a national, population-based study of 11,247 adults aged >or=25 years). RESULTS: If the rates of mortality and diabetes incidence observed over the period 2000-2005 continue, 38.0% (95% uncertainty interval 36.6-38.9) of 25-year-olds would be expected to develop diabetes at some time throughout their life. On average, a 25-year-old Australian will live a further 56 years, 48 of these free of diabetes. On average, a 45-year-old person with diabetes can expect to live 6 years less than a person free of diabetes. The prevalence of diabetes is projected to rise from 7.6% in 2000 to 11.4% by 2025. CONCLUSIONS/INTERPRETATION: If we maintain current diabetes incidence rates, more than a third of individuals will develop diabetes within their lifetime and in Australia there will an additional 1 million cases of diabetes by the year 2025.

Prognostic value of fat mass and skeletal muscle mass determined by computed tomography in patients who underwent transcatheter aortic valve implantation

Body composition (fat mass [FM] and skeletal muscle mass [SMM]) predicts clinical outcomes. In particular, loss of SMM (sarcopenia) is associated with frailty and mortality. There are no data on the prevalence and impact of FM and SMM in patients undergoing transcatheter aortic valve implantation (TAVI). The objective of this study is to determine body composition from pre-TAVI computed tomography (CT) and evaluate its association with clinical outcomes in patients who underwent TAVI. A total of 460 patients (mean age 81 ± 8 years, men: 51%) were included. Pre-TAVI CTs of the aorto-ilio-femoral axis were analyzed for FM and SMM cross-sectional area at the level of the third lumbar vertebrae (L3). Regression equations correlating cross-sectional area at L3 to total body FM and SMM were used to determine prevalence of sarcopenia, obesity, and sarcopenic obesity in patients (64%, 65%, and 46%, respectively). Most TAVI procedures were performed through a transfemoral approach (59%) using a balloon-expandable valve (94%). The 30-day and mid-term (median 12 months [interquartile range 6 to 27]) mortality rates were 6.1% and 29.6%, respectively. FM had no association with clinical outcomes, but sarcopenia predicted cumulative mortality (hazard ratio 1.55, 95% confidence interval 1.02 to 2.36, p = 0.04). In conclusion, body composition analysis from pre-TAVI CT is feasible. Sarcopenia, obesity, and sarcopenic obesity are prevalent in the TAVI population, with sarcopenia predictive of cumulative mortality.

Providing end-of-life care in the intensive care unit : issues that impact on nurse professionalism

With death a frequent event in intensive care units how, people die and the impact on family and staffs is becoming increasingly recognised as an issue requiring significant attention. Caring for a dying patient in these environments challenges the dominant ethos of seeking to cure critically ill patients. Family members require particular care as they keep vigil with their loved one and this forms a major area of work and concern for nurses. Mortality rates are higher in intensive care units than in most other settings and this impacts on staff. This paper builds on a qualitative exploratory study utilising focus groups that was undertaken to describe how nurses support family members during and after a death in the intensive care unit. This study identified issues that challenged the nurses' ability to maintain professionalism and the ways in which nurses ensured self-care. They highlighted organisational constraints, support for families and for their nursing colleagues as important issues for discussion.

Exploring Aboriginal patients’ experiences of cardiac care at a major metropolitan hospital in Melbourne

Objectives: The aim of the present study was to explore Aboriginal patients' lived experiences of cardiac care at a major metropolitan hospital in Melbourne.Methods: The study was a qualitative study involving in-depth interviews with a purposive sample of 10 Aboriginal patients who had been treated in the cardiology unit at the study hospital during 2012-13. A phenomenological approach was used to analyse the data.Results: Eight themes emerged from the data, each concerning various aspects of participants' experiences: 'dislike of hospitals', 'system failures', 'engagement with hospital staff', 'experiences of racism', 'health literacy and information needs', 'self-identifying as Aboriginal', 'family involvement in care' and 'going home and difficulties adapting'. Most participants had positive experiences of the cardiac care, but hospitalisation was often challenging because of a sense of dislocation and disorientation. The stress of hospitalisation was greatly mediated by positive engagements with staff, but at times exacerbated by system failures or negative experiences.Conclusion Cardiac crises are stressful and hospital stays were particularly disorienting for Aboriginal people dislocated from their home land and community.What is known about the topic? Aboriginal people have higher mortality rates due to cardiovascular diseases compared with other Australians. Along with different factors contributing to the life expectancy gap, Aboriginal people also face significant barriers in the use of the healthcare system.What does this paper add? Aboriginal patients' lived experience of cardiac care at a major metropolitan hospital in Melbourne is explored in this paper. Different issues were revealed during their interaction with the hospital staff and the hospital system in conjunction with their cultural aspect of patient care.What are the implications for practitioners? Positive interactions with staff, ongoing support from family and community, culturally appropriate cardiac rehabilitation programs can improve the cardiac care experiences of Aboriginal patients.

Candida infective endocarditis: an observational cohort study with a focus on therapy

Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.

Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke

BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.

Routines in a European aquaculture company and the development of a Flavobacterium psychrophilum dose response pre-model in adult Rainbow Trout

An internship in a European company dealing with aquaculture and biotechnology - AquaBioTech Group, Malta - was undertaken to complete the Master Degree of Science in Aquaculture of the School of Tourism and Maritime Technology of the Polytechnic Institute of Leiria. Biotechnology and aquaculture are two areas that have been synergistically used to contribute for the progress and improvement of fish production. The AquaBioTech Group is an example of a company able to integrate these areas to maximizing their services. Located in Mosta (Malta) the company operates in a sustainable way using Recirculation Aquaculture Systems (RAS) to maintain aquaculture species. In collaboration with several companies and institutions, the AquaBioTech Group is involved and supports the development of important international research projects. The present report focuses on two important parts of the internship performed during 6 months. Initially, it will cover the operation and constitution of the company, describing the routines and techniques acquired. Then, it will describe a pathology trial that forms the practical and scientific component of this report. Despite the limitation to describe some confidential assays, this trial consisted in the infection of Rainbow Trout (Oncorhynchus mykiss) with the bacterium Flavobacterium psychrophilum in order to evaluate the mortality rates over time. The internship served to solidify theoretical knowledge acquired during the academic training, develop professional skills and provide an understanding of jobs available on the market.

Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City

Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic Blood Pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2., and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

The effect of predation on artificial reef juvenile demersal fish species

There is a concern that artificial reefs (AR) may act purely as fishing aggregation devices. Predators attracted to ARs can influence the distribution and abundance of prey fish species. Determining the role of predators in AR is important in advancing the understanding of community interactions. This paper documents the effects of predation on fish assemblages of AR located near a coastal lagoon fish nursery. The Dicentrarchus labrax is a very opportunistic species preying on juveniles (0(+) and 1(+) age classes) of several demersal fish species on the ARs. Reef prey and sea bass abundance were negatively correlated. The mean numbers of prey per sea bass stomach increased with the increase of reef fish prey abundance, suggesting that predation has a significant influence, resulting in a decrease in prey abundance. Prey mortality (4-48%) of demersal reef fish associated species depends on bass density. Prey selection was related both with prey abundance and vulnerability. Results showed that D. labrax predation on AR-fish associated species can increase prey natural mortality. However, the role of bass predation on the ecological functioning of exploited ARs is not clear. There may be increases in local fishing yields due either to an increase in predator biomass through aggregation of sea bass attracted to ARs or to greater production. In contrast, predation on juveniles of economically important reef fish preys, especially the most frequent and abundant (Boops boops), can contribute to a decrease in recruitment to the fishery. Our results indicate that inter-specific interactions (predator-prey) are important in terms of conservation and management, as well as for the evaluation of the long-term effects of reef deployment. Thus, it is necessary to consider ecological interactions, such as predation, prior to the development and deployment of artificial habitats as a tool for rehabilitation.

Demography of a deep-sea lantern shark (Etmopterus spinax) caught in trawl fisheries of the northeastern Atlantic: Application of Leslie matrices with incorporated uncertainties

The deep-sea lantern shark Etmopterus spinax occurs in the northeast Atlantic on or near the bottoms of the outer continental shelves and slopes, and is regularly captured as bycatch in deep-water commercial fisheries. Given the lack of knowledge on the impacts of fisheries on this species, a demographic analysis using age-based Leslie matrices was carried out. Given the uncertainties in the mortality estimates and in the available life history parameters, several different scenarios, some incorporating stochasticity in the life history parameters (using Monte Carlo simulation), were analyzed. If only natural mortality were considered, even after introducing uncertainties in all parameters, the estimated population growth rate (A) suggested an increasing population. However, if fishing mortality from trawl fisheries is considered, the estimates of A either indicated increasing or declining populations. In these latter cases, the uncertainties in the species reproductive cycle seemed to be particularly relevant, as a 2-year reproductive cycle indicated a stable population, while a longer (3-year cycle) indicated a declining population. The estimated matrix elasticities were in general higher for the survivorship parameters of the younger age classes and tended to decrease for the older ages. This highlights the susceptibility of this deep-sea squaloid to increasing fishing mortality, emphasizing that even though this is a small-sized species, it shows population dynamics patterns more typical of the larger-sized and in general more vulnerable species. (C) 2014 Elsevier Ltd. All rights reserved.

Factores asociados a mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, Hospital de la Samaritana 2007-2013

Introducción y objetivos: Las enfermedades autoinmunes en cuidado intensivo están relacionadas con tasas de mortalidad elevadas. El propósito del presente estudio fue buscar factores asociados a mortalidad en estos pacientes. Materiales y métodos: estudio observacional de casos incidentes, retrospectivo, en base a revisión de historias clínicas de los pacientes que ingresaron a la unidad de cuidado intensivo del Hospital Universitario de la Samaritana; se recolecto un total de 68 eventos con los que se evaluó la relación de las variables estudiadas con mortalidad. Resultados: Las enfermedades autoinmunes se presentan más frecuentemente en mujeres (66%), el lupus eritematoso sistémico fue la afección reumatológica más común (36%), el promedio de edad fue de 46 años, la media de días en ventilación mecánica fue de 10 (desviación estándar 13 días), el valor del APACHE promedio fue de 19 puntos, el sistema orgánico más afectado fue el renal (58,5%) y la mortalidad global fue de 40%. Se encontró asociación estadísticamente significativa con cinco variables: presencia de shock al ingreso a UCI OR: 7,368 (IC95% 1,886-28,794); nivel de procalcitonina mayor a 10 OR: 5,231 (IC95% 1,724-15,869); complemento C3 consumido OR: 4,014 (IC95% 1,223-13,173); serositis en la radiografía de tórax OR: 3,771 (IC95% 1,238-11,492); recuento de plaquetas menor a 100.000 OR: 3,33 (IC95%: 1,037-10,714). Conclusión: Existen factores que pueden estar asociados con mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, su detección temprana y manejo oportuno podría mejorar el pronóstico de estos pacientes.