ABSTRACT Patient and Public Involvement (PPI) in research should focus on the engagement of patients/carers in every stage of the research cycle. However, the inconsistent level of education and research experience may compromise this involvement and training and support are recommended. In Portugal, consistent training to empower patients in their health decisions, or to be involved in research is neither available nor adapted for the patients and public. Our main goal is to develop and deliver the first high-quality and comprehensive online educational programme for adult patients with asthma and their carers, based on patients’/carers’ needs and preferences. The project includes four tasks. In Task 1, we will identify and organise the most important topics on asthma and health research, based on the identification of educational needs of adult patients/carers with asthma and the expertise of asthma specialists, using Delphi methodology. In Task 2, we will design and implement a high-quality, free, online self-learning programme based on reliable sources of information and on patients’/carers’ preferences. In Task 3, we will assess its feasibility, satisfaction and impact. Finally, Task 4 will be centred on the management and dissemination. Patients and carers will be actively engaged in all stages of this project as co-researchers, including the writing of this protocol. By the end of this project, we expect to have implemented the first high-quality, free-of-charge, online self-learning programme on asthma and health research, adapted for adult patients with asthma and their carers. It will be available for all patients/carers not only from Portugal but also from all Lusophone countries. This programme will empower patients and carers to increase their knowledge about the disease, develop new skills and have the opportunity to learn about research. Ultimately, it will introduce the knowledge patients/carers need to represent themselves and influence health policies in Portugal successfully.

RESUMO O envolvimento dos doentes e cidadãos na investigação (PPI) deve ocorrer em todas as etapas do ciclo de investigação. No entanto, a inconsistência nos níveis educacionais e na experiência de investigação pode ser um entrave significativo de uma participação ativa. Assim, ações de formação e suporte são recomendadas. Em Portugal, não existe formação específica para capacitar os doentes nas suas decisões de saúde, ou para se envolverem em investigação. O objetivo principal é desenvolver e tornar acessível o primeiro programa educacional online de elevada qualidade para doentes adultos com asma e seus cuidadores, com base nas suas necessidades e preferências. O projeto inclui 4 tarefas. Na tarefa 1 iremos identificar os tópicos mais importantes na área da asma e investigação em saúde, a partir da identificação das necessidades educacionais de doentes/cuidadores e da experiência de especialistas em asma, usando o método Delphi. Na tarefa 2 pretendemos desenhar e implementar um programa de elevada qualidade, gratuito e online, baseado em fontes de informação fiáveis e nas preferências de doentes/cuidadores. Na tarefa 3 vamos disseminar o programa e avaliar a sua exequibilidade, aceitabilidade e impacto. A tarefa 4 irá incidir na gestão e disseminação do projeto. Doentes e cuidadores estarão ativamente envolvidos em todas as tarefas do projeto como coinvestigadores, onde se inclui a escrita deste protocolo. No final deste projeto, esperamos ter implementado o primeiro programa de auto-aprendizagem de elevada qualidade, gratuito e online para a asma e investigação em saúde, adaptado para doentes/cuidadores com asma. Este programa irá capacitar doentes e cuidadores para aumentar o seu conhecimento sobre a doença, para desenvolver novas competências, e será uma oportunidade para aprenderem sobre investigação. Este programa permitirá também a introdução a conhecimentos necessários para doentes e cuidadores se fazerem representar e influenciarem as políticas em saúde em Portugal.

RESUMO Objetivo. Avaliar os fatores ocupacionais associados à ocorrência de COVID-19 em profissionais de saúde expostos a diferentes níveis de risco utilizando a política de gestão de crises elaborada pelas Nações Unidas para a COVID-19. Métodos. Pesquisa transversal realizada entre abril e maio de 2021. O grupo de risco baixo (GRB) consistia em profissionais que tinham contato mínimo com os pacientes; o grupo de risco médio (GRM) incluía profissionais que tinham contato com pacientes sem COVID-19 e não realizavam intervenções instrumentais nas vias aéreas; e grupo de risco alto (GRA), profissionais que cuidavam de pacientes com COVID-19 e realizavam intervenções instrumentais com geração de aerossóis. Para estabelecer o desfecho, considerou-se a história de COVID-19 do profissional de saúde e a detecção de anticorpos IgG anti- SARS-CoV-2 por Elecsys® Anti-SARS-CoV-2. Resultados. A doença foi diagnosticada em 43,8% dos profissionais no GRB, 46,7% no GRM (razão de chances ajustada: 1,125; intervalo de confiança de 95% [IC95%]: 0,896-1,414; p = 0,311) e 48,6% no GRA (razão de chances: 1,214; IC95%: 0,964-1,530; p = 0,10). Conclusões. Pertencer ao GRM e ao GRA em função do nível de exposição a pacientes confirmados com COVID-19 no ambiente de trabalho não foi associado a um aumento da ocorrência da doença ou da soroconversão.

RESUMEN Objetivo. Evaluar los factores laborales asociados con la ocurrencia de COVID-19 en el personal de salud expuesto a distinta magnitud de riesgo con el uso de la política de gestión de crisis de las Naciones Unidas para COVID-19. Métodos. Encuesta transversal realizada entre abril y mayo del 2021. Se consideraron como grupo de riesgo bajo (GRB) quienes tenían contacto mínimo con pacientes; de riesgo medio (GRM) a quienes tenían contacto con pacientes no-COVID-19 y no realizaban intervención instrumental de vías respiratorias; y de riesgo alto (GRA) a quienes atendían pacientes COVID-19 y realizaban intervención instrumental con generación de aerosoles. Se consideró como desenlace el antecedente de enfermedad diagnosticada de COVID-19 y la presencia de anticuerpos IgG positivos contra el SARS-CoV-2 medida con Elecsys® anti-SARS-CoV-2. Resultados. Desenlace en 43,8% en el GRB; 46,7% en el GRM (razón de momios [RM]: 1,125; intervalo de confianza de 95% [IC95%]: 0,896-1,414; p = 0,311); y 48,6% en el GRA (RM: 1,214; IC95%: 0,964-1,530; p = 0,10). Conclusión. Pertenecer al GRM y al GRA por el grado de exposición a pacientes confirmados de COVID-19 en el área de trabajo no se asoció con mayor ocurrencia de enfermedad o de seroconversión.

ABSTRACT Objective. To assess the occupational factors associated with the occurrence of COVID-19 in health personnel who were exposed to different magnitudes of risk and who followed the United Nations crisis management policy for COVID-19. Methods. Cross-sectional survey conducted between April and May 2021. The low-risk group (LRG) were considered to be those who had minimal contact with patients; the medium-risk group (MRG) had contact with non-COVID-19 patients and did not perform instrumental airway intervention; and the high-risk group (HRG) were those who cared for COVID-19 patients and performed instrumental intervention with aerosol generation. Diagnosed COVID-19 disease and the presence of positive IgG antibodies for SARS-CoV-2 measured with Elecsys® anti-SARS-CoV-2 were considered as outcomes. Results. Outcome recorded in 43.8% of the LRG, versus 46.7% in the MRG (odds ratio [OR]: 1.125; 95% confidence interval [CI 95% ]: 0.896–1.414; p = 0.311), and 48.6% in the HRG (OR: 1,214; CI 95%: 0.964–1.530; p= 0.10). Conclusion. Belonging to the high-risk group and the medium-risk group, based on the degree of exposure to confirmed COVID-19 patients in the work area, was not associated with a higher occurrence of disease or seroconversion.

Resumen: Los hongos micorrízicos arbusculares (HMA) son simbiontes obligados que requieren una planta huésped (trampa) y un soporte (sustratos) para ser aplicados como biofertilizantes en la agricultura. El objetivo de este estudio fue evaluar ocho consorcios nativos de HMA de zonas semiáridas (C1-ART, C2-GEC, C3-PAR, C4-VIE, C5-CUC, C6-SAC, C7-SAB and C8-MUZ) y su multiplicación en tres sustratos orgánicos: pulpa de café (PC), estiércol bovino (EB) y bagazo de caña de azúcar (BC) en planta de frijol Phaseolus vulgaris. Se midió la altura, el diámetro de tallo, el número de hojas, la longitud de raíz, la biomasa fresca y seca y contenido mineral en raíz. Los sustratos orgánicos (CP y BM) y los consorcios C5-CUC y C8‑MUZ aumentaron considerablemente la altura de la planta, longitud de las raíces y biomasa total fresca y seca. Luego de 75 días de inoculación, la colonización radicular osciló entre 5.7% en C8-MUZ y 46.1% en C2-GEC y C4-VIE; el mayor número de esporas (201) se obtuvo en el sustrato PC en una muestra seca de 100 g. Los contenidos de N, P, K, Ca, Mg, Fe, Zn, Cu y Mn en raíces y hojas fueron altamente significativos (P < 0.001). Se concluye que la inoculación de estos HMA nativos y sustratos tuvo efectos positivos sobre el contenido de biomasa y los niveles de nutrientes en hoja y raíz con los consorcios C2-GEC y C3-PAR y los sustratos PC y BM, que produjeron mejores efectos en frijol, los cuáles pueden ser utilizados como biofertilizantes en cultivos agrícolas.

Summary. Arbuscular mycorrhizal fungi (AMF) are obligate symbionts that require a host plant (tramp) and support (substrates) to be applied as bio-fertilizers in agriculture. The objective of this study is to assess eight native AMF consortia of semi-arid zones (C1-ART, C2-GEC, C3-PAR, C4-VIE, C5-CUC, C6-SAC, C7-SAB, and C8-MUZ) and their reproduction response in three organic substrates: coffee pulp (CP), bovine manure (BM) and sugarcane bagasse (SB) on bean Phaseolus vulgaris. Plant height, stem diameter, number of leaves, root length, fresh and dry biomass, and mineral content in root were measured. The organic substrates (CP and BM) and C5-CUC and C8-MUZ consortia increased plant height, root length, and total fresh and dry biomass considerably. After day 75 of inoculation, root colonization oscillated from 5.7% in C8-MUZ to 46.1% in C2-GEC and C4-VIE; the greatest number of spores (201) was obtained in CP substrate in a 100-g sample. N, P, K, Ca, Mg, Fe, Zn, Cu, and Mn contents in root and leaves were significantly high (P ≤ 0.001). To conclude, native AMF inoculation and substrates had positive effects on biomass content and nutrient levels in leaf and root with the C2-GEC and C3-PAR consortia and CP and BM substrates, which produced better effects in beans, making them a biofertilization alternative in agricultural crops.

Abstract Introduction: People infected with the human immunodeficiency virus (HIV) - People living with HIV/AIDS (PLWHA) - seem to have an increased risk of incidence and prevalence of cardiovascular diseases, namely stroke of ischemic nature. Additional etiological mechanisms, in addition to aging, appear to lie in chronic virus-mediated inflammation as well as in antiretroviral therapy (ART). The aim of this study was to carry out a retrospective review with descriptive analysis of cases of PLWHA and with a diagnosis of carotid atherosclerotic disease in a tertiary referral center as well as a non-systematic review of the literature. Methods: All patients diagnosed with HIV infection and concomitantly diagnosed with carotid atherosclerotic disease, in a tertiary center, between October 2007 and December 2019, were selected. A descriptive analysis of the sample and additionally a non-systematic review of the literature using the MEDLINE database, were performed. Results: Nine patients who met the inclusion criteria were selected, 7 (78%) being male. The mean age at diagnosis of carotid disease was 59 years. The diagnosis of HIV infection preceded, on average, 12 years before the diagnosis of carotid disease, while the start of ART preceded this diagnosis by about 11 years. The most common cardiovascular risk factors are dyslipidemia (89%), high blood pressure (56%) and smoking (56%). Approximately 33% had peripheral arterial disease and 22% had coronary artery disease. Only two (22%) patients underwent carotid endarterectomy over a median follow-up of 5 years, both for asymptomatic stenosis. Since the diagnosis of carotid disease, there have been no major cardiovascular events (stroke or acute myocardial infarction). During follow-up there were two deaths. Conclusion: PLWHA have a high prevalence of multisite artery disease, manifesting it at a relatively earlier age compared to the general population. These patients benefit from multidisciplinary follow-up for therapeutic optimization in order to obtain better results. However, larger prospective studies are needed to clarify the results in these patients and to improve the therapeutic approach, particularly in those with concomitant carotid disease.

Neste trabalho foram analisados os índices de conforto térmico de poedeiras na fase de cria e recria, em galpões cobertos com diferentes tipos de materiais de cobertura, instalados no Nordeste do Brasil. Todos os galpões foram avaliados através do índice de temperatura do globo negro e umidade (ITGU), da carga térmica de radiação (CTR) e da umidade relativa do ar (UR). A análise das médias mostrou que o ambiente construído proporcionou índices ambientais desconfortáveis tanto na fase de cria, onde os índices ficaram abaixo da zona de conforto, como na fase final, quando os índices ficaram acima da zona de conforto. Nos horários mais quentes do dia o galpão com cobertura de telhas cerâmicas apresentou melhor resultado na CTR, em comparação com o galpão com cobertura de telha de cimento amianto, proporcionando melhor conforto térmico para poedeiras na fase de recria.

In this study the thermal comfort indexes were analyzed in the growth phase of laying hens housed in installation with different types of roofing materials in the Northeast of Brazil. The laying hen-houses were assessed through black globe temperature and humidity index (WBGT), radiating thermal load (RTL) and the relative humidity. The mean analysis had showed that the laying-hen houses provided uncomfortable environmental indexes in all growth phases, where the thermal comfort indexes were below the thermal comfort zone during the early begining of chicken growing as well as in final phase when the indices were above the zone. During the hottest hours of the day, the laying-hen houses under ceramic roof tiles showed results in RTL better than the laying-hen houses using asbestos roofing tiles, providing best thermal comfort for laying hens in the growth phase.