Region Of Portugal Research Articles

Prehospital Care Times and Interventions for Victims of Major Trauma in the Central Region of Portugal: A Retrospective Study

The quality and promptness of prehospital care for major trauma patients are vital in order to lower their high mortality rate. However, the effectiveness of this response in Portugal is unknown. The objective of this study was to analyze response times and interventions for major trauma patients in the central region of Portugal. This was a retrospective, descriptive study, using the 2022 clinical records of the National Institute of Medical Emergency's differentiated resources. Cases of death prior to arrival at the hospital and other non-transport situations were excluded. Five-time intervals were determined, among which are the response time (T1, between activation and arrival at the scene), on-scene time (T2), and transportation time (T5; between the decision to transport and arrival at the emergency service). For each ambulance type, averages and dispersion times were calculated, as well as the proportion of cases in which the nationally and internationally recommended times were met. The frequency of recording six key interventions was also assessed. Of the 3366 records, 602 were eliminated (384 due to death), resulting in 2764 cases: nurse-technician ambulance (SIV) = 36.0%, physician- nurse ambulance (VMER) = 62.2% and physician-nurse helicopter = 1.8%. In a very large number of records, it was not possible to determine prehospital care times: for example, transport time (T5) could be determined in only 29%, 13% and 8% of cases, respectively for SIV, VMER and helicopter. The recommended time for stabilization (T2 ≤ 20 min) was met in 19.8% (SIV), 36.5% (VMER) and 18.2% (helicopter). Time to hospital (T5 ≤ 45 min) was achieved in 80.0% (SIV), 93.1% (VMER) and 75.0% (helicopter) of the records. The administration of analgesia (42% in SIV) and measures to prevent hypothermia (23.5% in SIV) were the most recorded interventions. There was substantial missing data on statuses and a lack of information in the records, especially in the VMER and helicopter. According to the records, the time taken to stabilize the victim on-scene often exceeded the recommendations, while the time taken to transport them to the hospital tended to be within the recommendations.

Adherence to mediterranean diet and aromatic plants intake are related with gustatory function: A case-study from a Portuguese region

The Mediterranean Diet has been recognized as one of the healthiest and most sustainable dietary patterns and is flavor rich due to the use of different seasonings, such as aromatic plants, in dish confection. Based on the hypotheses that: 1) gustatory function will affect food choices; 2) seasoning flavors may be differently accepted according to individuals’ gustatory functions; the aim of the present study was to assess the association between taste sensitivity and/or preference with Mediterranean Diet adherence and seasoning consumption. A total of 383 adults (18–59 years old; 198 female, 185 male) from North Alentejo region of Portugal were enrolled in this study, with 291 (145 female and 146 male) also evaluated for gustatory function. Recognition thresholds were obtained for four tastes (sweet, sour, salty, and bitter) and astringency, as well as preference level for the highest concentration of each stimulus tested. A validated Food Frequency Questionnaire was filled out, and MD adherence was extrapolated from the answers of the Food Frequency Questionnaire according to the Mediterranean Diet Adherence Screener (MEDAS) score.In total, 20.8% of the individuals presented low, 58.2% medium, and 21.0% high adherence. Adherence was higher in women than men and in older individuals than younger adults. Adherence to the Mediterranean Diet was positively correlated with aromatic plants consumption but not spices. Seasonings were associated with gustatory function, and the cluster with higher consumption presented higher preferences for bitter and salty tastes. Total sodium intake was also higher in this cluster, suggesting that these individuals prefer stronger oral sensations. In conclusion, this study shows that MD adherence is not high, even in regions with rural characteristics. The observed association of MD and seasoning intake with gustatory function do underline the usefulness of this information in strategies aimed at promoting healthy and sustainable eating patterns.

Podejście oparte na GIS analizie do relacji między jednostkami gruntów a użytkowaniem gruntów w centralnym regionie Portugalii

Land units refer to coherent spatial areas characterized by a degree of homogeneity concerning certain properties like geology, soils, and climate. The Land use mosaic corresponds to a circumstantial layer representing the landscape’s present state, depicting the present resource allocation factors. Nevertheless, the stable potential layer is related to the stable characteristics of each site and allows the identification of use constraints or potentials. In this study, we use a methodology based on the land unit concept to define a stable potential layer at a regional level. Therefore, land units were delimited for the Central region of Portugal, resulting from the combination of geomorphology, soil parent material, and bioclimatic influence. For each land unit representative sample areas were characterized in terms of their land use mosaic characteristics. For that purpose, selected landscape metrics were used to quantify the land use mosaic geometrical attributes: Shannon’s Diversity Index, Edge Density, Mean Patch Size, and Number of Patches. The existing land use types were also quantified. Finally, a cluster analysis was performed to define groups of samples representing the land units with similar land-use mosaic types. The landscape metrics that best explain the influence of the permanent structure of the territory on the circumstantial structure of use are Shannon's Diversity Index, Edge Density, and Number of Patches. The highest diversity land cover patterns are located in formations with a lithology rich to very rich in silica under Mesomediterranean dry to subhumid climate. The validation of the previously defined land units confirmed the reliability of the proposed methodology, with most of the land units strongly influencing the land use mosaic. The delimitation and characterization of homogeneous land units are useful for the definition of soil suitability and for the choice of the most appropriate uses and activities by the stakeholders.

Climate correlates of bluetongue incidence in southern Portugal.

Model forecasts of the spatiotemporal occurrence dynamics of diseases are necessary and can help understand and thus manage future disease outbreaks. In our study, we used ecological niche modelling to assess the impact of climate on the vector suitability for bluetongue disease, a disease affecting livestock production with important economic consequences. Specifically, we investigated the relationship between the occurrence of bluetongue outbreaks and the environmental suitability of each of the four vector species studied. We found that the main vector for bluetongue disease, Culicoides imicola, a typically tropical and subtropical species, was a strong predictor for disease outbreak occurrence in a region of southern Portugal from 2004 to 2021. The results highlight the importance of understanding the climatic factors that might influence vector presence to help manage infectious disease impacts. When diseases impact economically relevant species, the impacts go beyond mortality and have important economic consequences.

Modeling soil moisture from in situ portable X-ray spectrometer measurements: A novel approach for correcting geochemical data across different environments and climatic conditions

The portable X-ray fluorescence (pXRF) spectrometer is widely employed for in situ analysis of both contaminated and uncontaminated soils. However, the accuracy of the measurements can be significantly affected by soil moisture, resulting in unreliable soil pollution monitoring. This effect has already been studied and quantified, but this is ineffective if the soil moisture in the field is unknown. Given the considerable variability of soil moisture conditions across time and space, significant bias during in situ investigations remains a main issue. This study introduces a novel method to estimate soil moisture directly from pXRF field measurements, enabling its reliable use in almost any field condition. The study was conducted using soil samples and in situ pXRF soil surface measurements in Estarreja (Portugal) and Vicdessos (France). In the first experiment, the innovative approach involved modeling soil moisture directly from the raw XRF measurement errors obtained in moist soils using multiple regression. In the second experiment, metal concentrations were modeled as an exponential function of the moisture content. The final model integrates both approaches to correct field data from geochemical mapping in diverse environments, including a coastal region in Portugal and a mountainous region in France. Our findings demonstrate that this simple, efficient and cost-effective method accurately predicts soil moisture (U) using pXRF, as shown by the equation Umeasured = 1.0028 x Uestimated (r2 = 0.9715). The model effectively corrected up to 70% of moisture-induced errors in metal concentrations in the wettest soils and produced more reliable soil Fe, Pb, and Zn maps. Specifically, the accuracy improvement was at least 32% in drier soils (Portugal) and at least 55% in wetter soils (France). This study offers a cost-effective, efficient solution for employing pXRF in geochemical mapping across different climatic conditions and soil environments.

Heavy metal and metalloid concentrations in red deer (Cervus elaphus) and their human health implications from One Health perspective

The red deer is an ungulate and large game species. The contamination of the ecosystems by metal(loid)s may lead to the exposure of animals (as well as humans) through water and food resources. The direct contact of hunters and wild animal meat consumers with deer carcasses may be a potential contaminant source. This study aimed to determine the metal(loid)s’ concentrations in the liver and kidney of red deer from two regions of Portugal (Idanha-a-Nova and Lousã), and to relate these with histopathologic lesions. Thirteen young male deer were submitted to metal(loid) determination (As, Cd, Co, Cr, Cu, Pb, and Zn) by inductively coupled plasma mass spectrophotometry (ICP-MS) and histopathology examination. Renal Cd (8.072 ± 5.766 mg/kg dw) and hepatic Pb (3.824 ± 6.098 mg/kg dw) mean values were high, considering the maximum values for consumption established by the European Commission. The hepatic mean value of Cu was significantly higher in Idanha-a-Nova (150.059 ± 33.321 mg/kg dw), and it is at the Cu toxicity limit considered for ruminants (150 mg/kg). The pollution induced by Panasqueira mines (Castelo Branco) may be a possible explanation for some of the findings, especially the higher values of hepatic Cu and Pb found in Idanha-a-Nova deer. These results have high importance under a One Health perspective, since they have implications in public health, and pose at risk the imbalance of animal populations and ecosystems.

Modelling the rainfall threshold for shallow landslides considering the landslide predisposing factors in Portugal

Rainfall-triggered landslides pose a significant threat to both infrastructure and human lives, making it crucial to comprehend the factors that contribute to their occurrence. Specifically, understanding the relationship between these factors and the amount of rain that is necessary for triggering such events is essential for effective prediction and mitigation strategies. To address this issue, our study proposes a statistical modelling approach using machine learning, specifically the Random Forest algorithm, to investigate the connection between landslide predisposing factors and the daily rainfall intensity threshold necessary for the initiation of shallow landslides in Portugal. By leveraging a comprehensive dataset comprising historical landslide events, associated critical rainfall, and ten distinct landslide predisposing factors, we developed several models and used cross-validation technique to evaluate their performance. Our findings demonstrate that the Random Forest model effectively captures a relationship among landslide predisposing factors, critical daily rainfall intensity, and landslide occurrences. The models exhibit a satisfactory accuracy in assessing the spatial variation of critical daily rainfall intensity based on the predisposing factors, with a mean absolute percentage error (MAPE) of around 17%. Furthermore, the models provide valuable insights into the relative importance of various predisposing factors in landslide triggering, highlighting the significance of each factor. It was found that it takes higher rainfall intensity to trigger shallow landslides in the north region of Portugal when considering critical rainfall events of 3 and 13 days. Slope aspect, slope angle, and clay content in the soil are among the main predisposing factors used for defining the spatial variation of the daily rainfall intensity threshold.

Interparental violence and development of antisocial behaviors in Portuguese adolescents

Juvenile delinquency is one of the main problems of adolescents. The objective of the present investigation was to verify the relationship between antisocial behaviors, measured by the Antisocial Conduct Questionnaire (CCA) and witnessing interparental violence assessed through the Conflict Tactics Scales (CTS). The sample consisted of 671 adolescents (12 and 20 years old) from the northern region of Portugal. The results indicated that female adolescents revealed to have witnessed higher levels of psychological aggression, perpetrated by both father and mother, compared to males. The results suggest a positive association between emotional and physical violence perpetrated by parents and the different types of antisocial behaviors. Overall, it was found that the more exposed to interparental violence, the more likely they are to develop conduct problems. The results stressed the importance of developing more intervention programs towards violence domestic to prevent violence in that context.

Prevalence and Classification of Pediatric Neuromuscular Disorders in the Central Region of Portugal.

Neuromuscular disorders are a group of rare heterogenous diseases with profound impact on quality of life, for which overall pediatric prevalence has rarely been reported. The purpose of this study was to determine the point prevalence of pediatric neuromuscular disorders and its subcategories in the central region of Portugal. Retrospective case identification was carried out in children with neuromuscular disorders seen between 1998 and 2020 from multiple data sources. Demographics, clinical and molecular diagnoses were registered. On January 1, 2020, the point overall prevalence in the population <18 years of age was 41.20/100 000 (95% confidence interval 34.51-49.19) for all neuromuscular disorders. The main case proportion were genetic disorders (95.7%). We found a relatively higher occurrence of limb-girdle muscular dystrophies, congenital myopathies, and spinal muscular atrophy and a slightly lower occurrence of Duchenne muscular dystrophy, hereditary spastic paraparesis, and acquired neuropathies compared to previous studies in other countries. Molecular confirmation was available in 69.5% of pediatric neuromuscular patients in our cohort.Total prevalence is high in comparison with the data reported in the only previous study on the prevalence of pediatric neuromuscular disorders in our country. Our high definitive diagnostic rate underscores the importance of advances in investigative genetic techniques, particularly new sequencing technologies, in the diagnostic workup of neuromuscular patients.

The All4Children project to assess the initial implementation of the Integrated Model of Family Foster Care in Portugal: A description of the study protocol.

The All4Children project addresses the urgent need to transition from institutionalization to family-based care for out-of-home children in Portugal. Despite evidence highlighting the detrimental effects of institutionalization, only a small percentage of children (less than 4%) are currently placed in family foster care in the country. In response to European directives for deinstitutionalization, Portuguese legislation now prioritizes non-kinship family foster care as the preferred alternative for young children in need of care. To facilitate this transition, the Integrated Model of Family Foster Care (MIAF) was developed, offering a comprehensive framework covering the entire spectrum of family foster care. This research aims to investigate the initial implementation stage of the MIAF to promote high-quality family foster care in Portugal. The study will conduct a mixed-method and longitudinal research project in family foster care agencies across different regions of Portugal, focusing on evaluating the implementation and outcomes of the MIAF model using a multi-informant and multi-method approach. The participants will include caseworkers, children aged 0-9 years entering foster care, and their respective foster families enrolled in the MIAF program. Process evaluation will assess fidelity, feasibility, appropriateness, and acceptability of MIAF modules, while outcome evaluation will examine child safety, stability, well-being, as well as foster family well-being and quality of relational care. The insights gained from this research initiative will serve as a foundation for the ongoing enhancement of MIAF. Consequently, this project has the capacity to advance evidence-based child welfare practices by refining processes and strategies to better serve vulnerable children and youth. Facilitated by a multidisciplinary team, this project will contribute to advancing research in the field, enhancing practice, and informing policy during a pivotal stage of deinstitutionalization in Portugal.

Municipalities and Their Use of Social Media as Communication Tools: An Overview of Some Current Practices in the Aveiro Region In Portugal

Social media has gradually evolved into a phenomenon that transcends its purely technical nature and has become an almost ubiquitous part of the communication activities of our modern society, playing an essential role in numerous sectors, such as public administration, where its potential as a communication tool has helped local authorities to develop agile and easily accessible communication channels with their communities. Traditional communication strategies using leaflets, local television, newspaper and radio advertising, and even the authorities' institutional website are being replaced by more engaging communication strategies based on social media. The research presented in this paper took up the challenge of mapping and analysing during a short period the online presence of the 11 municipalities of the Intermunicipal Community of the Region of Aveiro (CIRA) in Portugal in terms of their use of social media as tools for communicating with their constituents and others living in the region. The information collected focused on the municipalities' activities on Facebook, Instagram, Twitter, and YouTube. Particular attention was paid to consistency and coherence of communication, engagement, and shared content. An empirical study was conducted based on quantitative information collected over 30 days through a web-based web analytics tool, with further review of some of the data collected by the researchers directly from each municipality's social media profile. The results show that municipalities are engaged in developing communication strategies and activities on social media, providing audiovisual content is becoming more critical, and followers are more engaged with audiovisual content and issues less related to political and administrative matters. The information gathered shows that followers are more engaged with content about cultural and sports-related news and that there is still room for improving the use of YouTube for sharing information about each municipality. The results also suggest municipalities can improve their current practices by developing their communication team's new communication design skills. These conclusions have already been shared with decision-makers to help them improve current practices and design future communication strategies based on concepts linked to new media and transmedia experiences.

The Regional Firm Density and the Growth of Firms in the Portuguese Textile and Clothing Industry

This paper focuses on the relationship between the regional firm density and the growth of firms in the Portuguese textile and clothing industry to investigate how their geographic clustering influences said growth. Despite the concentration of this industry in the Northern region of Portugal in only four poles, our results show that the location of firms in the cluster is not relevant for growth when the whole industry is considered. However, disaggregate analysis shows that the clothing industry does exhibit both location externalities and cross-location effect, while textile manufacture exhibits neither. In addition, our empirical evidence reveals that the growth of firms located in the cluster is positively correlated with external finance. This result suggests that location becomes a solvency signal for firms, and, specifically, this might help to explain why textile manufacturers firms are located in the cluster. These findings are relevant for entrepreneurs and Portuguese policymakers, as it jeopardizes the optimal allocation of scarce resources in the Portuguese textile cluster.

Physical and mental wellbeing, teaching efficacy and school connectedness—A study with preschool teachers in Portugal

This article aims to investigate correlations between physical and mental wellbeing, teaching efficacy and school connectedness and to explore the relationship between those dimensions and sociodemographic variables such as age, teaching experience, academic qualifications, education sector, and geographical regions. For this purpose, an online questionnaire was applied to 450 preschool teachers. To assess physical and mental wellbeing the PISA 2020 teacher questionnaire was used, and to evaluate teaching efficacy and school connectedness the Subjective Teacher Wellbeing Questionnaire was applied. Descriptive statistics were calculated for all variables. The reliability, internal consistency and suitability of the data for factor analysis. were assessed for each of the questionnaires. The ANOVA test and Kruskal–Wallis’s test were used to identify significant differences between the dimensions under analysis and sociodemographic variables. The results show that school connectedness is positively related to teaching efficacy and the same positive association occurs between physical and mental wellbeing. A negative association is observed between school connectedness and physical and mental wellbeing and teaching efficacy and physical wellbeing and mental wellbeing. The results also indicate that older preschool teachers and those with more years of experience had a significantly higher score in teaching efficacy than their younger and less experienced counterparts. The preschool teachers from the Porto and North Regions of Portugal had significantly higher scores in the mental wellbeing dimension when compared with their colleagues from other regions of the country.

Mycobacterium avium subsp. paratuberculosis in Wild Boar (Sus scrofa) in Portugal.

Paratuberculosis, or Johne's disease, caused by Mycobacterium avium subsp. paratuberculosis (MAP), is a chronic granulomatous enteritis affecting both domestic and wild ruminants. The agent was also found in wild mammals such as wild boar (Sus scrofa); however, the role of wild mammals in the epidemiology of MAP is unclear. During the research period, 941 free-ranging wild boar (S. scrofa) legally hunted in two locations in the central-eastern region of Portugal were examined. Ninety-seven wild boars exhibited one or more gross lesions and were tested for the presence of Mycobacterium avium subsp. paratuberculosis using acid-fast staining, mycobacterial culture, polymerase chain reaction (PCR), and histopathological examination. Forty-five animals (46.4%, 95% CI: 36.5-56.3%) were identified as infected, as indicated by positive results in culture and/or PCR. The findings revealed that the most significant risk factor was being a juvenile compared to yearlings and adults (OR = 10.2, 95% CI: 2.2-48.0). Based on our results, 37.9% (n = 11) of the infected animals were considered suitable for human consumption. Our findings offer novel insights into mycobacterial infections in wild boar populations in Portugal and suggest that wild boar could be a source of human infection if zoonotic potential is considered.

Health professionals’ intervention in the context of domestic violence against women: exploring perceptions and experiences of providing healthcare

ABSTRACT Domestic violence against women is a complex social phenomenon and a widely recognised issue of public health, which requires that all sectors of society, including the health sector, take the necessary action to prevent and address it. This paper aims to contribute to the discussion on the role of the primary health care in addressing domestic violence against women, by analysing health professionals’ perceptions of their practice as well as the difficulties they experience in providing healthcare to victims. To fulfil this aim, a qualitative approach was chosen, using focus groups with health professionals working in the area of primary health care in an inland region of Portugal. The main findings point to the lack of a specific protocol and insufficient information and skills to respond to domestic violence situations, which hinders health professionals’ confidence to intervene and tends to orientate them towards a more medical response. Resulting from these findings, implications for practice are discussed: the need for clear and specific orientations to guide health professionals’ intervention; the need to offer training that enables them to provide appropriate healthcare to women experiencing domestic violence; and the need to position themselves in the context of an integrated, multi-sectoral intervention.

Characterisation of Patients With Chronic Obstructive Pulmonary Disease (COPD) From an Urban Municipality in the Northern Region of Portugal: A Cross-Sectional Study.

Background Pulmonary rehabilitation (PR) is formally indicated to all COPD patients in groups B and E. It positively impacts dyspnoea, health-related quality of lifeand exercise tolerance, reducing admissions among people with chronic obstructive pulmonary disease (COPD) who have had a recent exacerbation and symptoms of anxiety and depression. There is limitedaccess to PR programmes in Portugal, partially due to insufficient resources or referrals. This study aims to characterise COPD patients and assess whether they have criteria for PR programmes. Data from this study may provide strategic information for healthcare organisations to differentiate and innovate their response to COPD patients. Methodology A cross-sectional study was conducted in an urban municipality in the northern region of Portugal. The sample was randomly extracted from the national primary electronic health records. The sample size (n = 339) was determined considering the population ofCOPD patients in this region (N = 2818), a 95% confidence level and a margin of error of 5%. Results In this population, the prevalence of COPD is 1.8%. Furthermore, in this sample, 40% (n = 136) of people diagnosed with COPD have a formal indication to participate in PR programmes, although only 14.2% (n = 48) of these patients had access to PR. Conclusion COPD is probably underdiagnosed in this Portuguese region. Most COPD patients have eligibility criteria to be offered PR programmes, although most of them do not benefit from this vital treatment. Investing in community and home-based programmes may increase PR access, reducing acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admissions.

Mortality burden of cardiovascular disease attributable to ambient PM2.5 exposure in Portugal, 2011 to 2021

BackgroundExposure to high levels of environmental air pollution causes several health outcomes and has been associated with increased mortality, premature mortality, and morbidity. Ambient exposure to PM2.5 is currently considered the leading environmental risk factor globally. A causal relationship between exposure to PM2.5 and the contribution of this exposure to cardiovascular morbidity and mortality was already demonstrated by the American Heart Association.MethodsTo estimate the burden of mortality attributable to environmental risk factors, a comparative risk assessment was performed, considering a “top-down” approach. This approach uses an existing estimate of mortality of the disease endpoint by all causes as a starting point. A population attributable fraction was calculated for the exposure to PM2.5the overall burden of IHD and stroke was multiplied by the PAF to determine the burden attributable to this risk factor. The avoidable burden was calculated using the potential impact fraction (PIF) and considering the WHO-AQG 2021 as an alternative scenario.ResultsBetween 2011 and 2021, the ambient exposure to PM2.5 resulted in a total of 288,862.7 IHD YLL and a total of 420,432.3 stroke YLL in Portugal. This study found a decreasing trend in the mortality burden attributable to PM2.5 exposure, for both males and females and different age-groups. For different regions of Portugal, the same trend was observed in the last years. The mortality burden attributable to long-term exposure to PM2.5 was mainly concentrated in Lisbon Metropolitan Area, North and Centre. Changes in the exposure limits to the WHO recommended value of exposure (WHO-AQG 2021) have a reduction in the mortality burden due to IHD and stroke attributable to PM2.5 exposure, in Portugal.ConclusionBetween 2011 and 2021, approximately 22% and 23% of IHD and stroke deaths were attributable to PM2.5 exposure. Nevertheless, the mortality burden attributable to cardiovascular diseases has been decreasing in last years in Portugal. Our findings provide evidence of the impact of air pollution on human health, which are crucial for decision-making, at the national and regional level.

Spatial Distribution and Pathogen Profile of Dermacentor reticulatus Ticks in Southeastern Poland: A Genetic and Environmental Analysis

In recent years, significant changes have been observed in the distribution and abundance of local Dermacentor reticulatus populations. However, changes in D. reticulatus dynamics have not been studied in southeastern Poland. Our objective was to enhance our understanding of the environmental factors influencing the occurrence and density of D. reticulatus in this area. Additionally, we sought to investigate the genetic diversity of the tick population and the prevalence of tick-borne pathogens (TBPs). To this end, we established 45 study sites in the Subcarpathian province. Ticks were collected during their peak activity in both spring and autumn. A subset of randomly selected specimens underwent molecular analysis for TBPs screening, using high-throughput microfluidic real-time PCR. Positive amplicons were then sequenced, and phylogenetic analyses were conducted. Our findings confirmed the presence of D. reticulatus ticks in 24 surveyed sites, primarily concentrated in the northern and eastern parts of the region. The mean density of D. reticulatus ticks in their compact range was 5.8 ± 6.4 specimens/100 m2. Notably, air temperature and altitude emerged as significant factors influencing the species’ activity. We also identified a high prevalence of Rickettsia raoultii infections in adult D. reticulatus, reaching up to 84.21%. Additionally, 9.52% of ticks were found to be infected with R. helvetica and 4.76% with Anaplasma phagocytophilum. Furthermore, our genetic analyses confirmed the identity of D. reticulatus in the Subcarpathian region, aligning with haplotypes found in other regions of Poland, Czechia, Croatia, and Portugal. In conclusion, our study suggests that the surveyed region represents the current boundary of the compact range of D. reticulatus in Poland in which this tick species exhibits low genetic diversity and a narrow spectrum of detected TBPs.

Ramomarthamyces octomerus sp. nov. and Insights into the Evolution and Diversification of Ramomarthamyces (Ascomycota, Leotiomycetes, Marthamycetales).

The apothecial fungus Ramomarthamyces octomerus sp. nov. is described from specimens collected in Mediterranean climate regions in southern Portugal, Spain (Canary Islands), and the Dalmatian region of Croatia. Presumably saprobic, R. octomerus occurs on intact, decorticated wood of Laurus novocanariensis and Olea europaea. Ascospores are cylindric-ellipsoid and seven-septate. Surprisingly, in our four-locus phylogenetic analysis (nuSSU, ITS1-5.8S-ITS2, LSU, mtSSU), this fungus clusters among species of Cyclaneusma, Marthamyces, Naemacyclus, and Ramomarthamyces in a core Marthamycetaceae clade that circumscribes primarily leaf-inhabiting, filiform-spored species. In addition, the asci of R. octomerus possess an amyloid pore, but the reaction varies between specimens collected in the Canary Islands and those collected in Portugal and Croatia. The occurrence of an amyloid reaction in the asci of R. octomerus challenges the characterization of Marthamycetales taxa as possessing inamyloid asci. In our discussion we provide background and analysis of these notable observations.

Nurses' perception of the impact of professional development sessions on their pre-hospital clinical practice with trauma victims.

Continuing education is important for the quality of clinical practice because it complements it and focuses primarily on producing qualified pre-hospital nurses with operationally defined competence in nursing standards. The objective of this study was to assess pre-hospital nurses' opinion of the impact of professional development sessions on their clinical practice. A descriptive and quantitative study was carried out involving Portuguese pre-hospital nurses. Six professional development sessions were presented in 2020 to pre-hospital registered nurses in four of Portugal's main cities. To collect the data, at the end of each session, we apply a questionnaire designed specifically for this study. This data collection instrument consists of 11 questions, six designed to evaluate the session and five designed to evaluate the trainer responsible for the session. A five-point Likert scale was used for each question, where 1 corresponds to very dissatisfied and 5 to extremely satisfied. Two hundred and two nurses, which represents 55% of all Portuguese pre-hospital nurses, took part in the assessment of the professional development sessions. The nurses were from the Northern region of Portugal (51%; n = 102), the Centre region (29%; n = 59) and the Southern region of Portugal (20%; n = 41). Nurses found the session extremely satisfactory. All the assessment scores ranged between 4.4 and 4.7 points, on a scale of 1 to 5. 76.2% of the participants considered that the knowledge acquired could have a major impact [score = 5] on their future clinical practice. The majority of pre-hospital nurses (96.5%) felt that the session could have a major impact [score = 5; 76.2%, n = 154] or a very important impact [score = 4; 20.3%, n = 41] on their clinical practice. The professional development sessions provide pre-hospital nurses with the latest research findings and the majority of nurses considered that the training had a huge impact on their clinical practice. However, it is important that future research aims to explore the cause-effect relationship between training and improved clinical practice.