Browsing by Author "Alves, Sara Elisa Brás"
Now showing 1 - 10 of 11
Results Per Page
Sort Options
- Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefightersPublication . Barros, Bela; Paiva, Ana Margarida; Oliveira, Marta; Alves, Sara Elisa Brás; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana A.; Slezakova, Klara; Costa, Solange; Teixeira, João Paulo Fernandes; Morais, SimoneAvailable literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 mu g/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.
- Biomonitoring of firefighters' exposure to priority pollutant metal(loid)s during wildland fire combat missions: Impact on urinary levels and health risksPublication . Paiva, Ana Margarida; Barros, Bela; Azevedo, Rui; Oliveira, Marta; Alves, Sara Elisa Brás; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana A.; Alves, Maria José; Slezakova, Klara; Pereira, Maria do Carmo; Teixeira, João Paulo Fernandes; Costa, Solange; Almeida, Agostinho; Morais, SimoneWildland firefighters are exposed to metal(loid)s released during wildfires through vegetation combustion, which also promotes remobilization of accumulated anthropogenic metal(loid)s. Studies biomonitoring metal(loid)s exposure promoted exclusively by wildfire suppression activities are lacking. This work aimed to characterize, for the first time, the impact of real-life wildland firefighting operations on urinary levels of priority pollutant metal(loid)s [14 included in ATSDR, 11 in USEPA, and 4 in Human Biomonitoring for Europe Initiative priority lists] in firefighters. Spot urines were sampled pre-exposure (105 non-smokers, 76 smokers) and post-exposure to firefighting activities (20 non-smokers, 25 smokers); among those, paired samples were collected from 14 nonsmoking and 24 smoking firefighters. Smokers displayed significantly higher baseline levels of zinc (28 %), lithium (29 %), cadmium (55 %), rubidium (13 %), and copper (20 %) than non-smokers. Following wildfire suppression, the concentration of the WHO potentially toxic metal(loid)s rose from 2 % to 3 % in smokers and 2 % to 5 % in non-smokers (up to 4 % for all firefighters and up to 5 % in paired samples). Levels of nickel (33–53 %), antimony (45–56 %), and cesium (40–47 %) increased significantly post-exposure in non-smokers (in all firefighters and in paired samples), whose urinary concentrations were generally more impacted by wildfire emissions than those of smokers. Arsenic (80 %) displayed the only significant increase post-exposure in smokers, being the best discriminant of exposure to wildfire emissions in these subjects. Significant positive correlations were found for age and/or career length with cadmium, lead, barium, strontium, and mercury, and for body mass index with arsenic. The reference/guidance values were exceeded for arsenic, zinc, cesium, nickel, antimony, cadmium, lead, thallium, mercury, copper, and cobalt in 1–90 % of firefighters suggesting augmented health risks due to wildfire combating and emphasizing the need of mitigation strategies. This study also provides biomonitoring data to help setting reference values for the occupationally exposed part of population.
- Biomonitoring of polycyclic aromatic hydrocarbons exposure and short-time health effects in wildland firefighters during real-life fire eventsPublication . Paiva, Ana Margarida; Barros, Bela; Oliveira, Marta; Alves, Sara Elisa Brás; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana A.; Slezakova, Klara; Teixeira, João Paulo Fernandes; Costa, Solange; Morais, SimoneHuman biomonitoring data retrieved from real -life wildland firefighting in Europe and, also, worldwide are scarce. Thus, in this study, 176 Portuguese firefighters were biomonitored pre- and post- unsimulated wildfire combating (average:12-13 h; maximum: 55 h) to evaluate the impact on the levels of urinary polycyclic aromatic hydrocarbons hydroxylated metabolites (OHPAH; quantified by high-performance liquid chromatography with fluorescence detection) and the associated short-term health effects (symptoms, and total and differentiated white blood cells). Correlations between these variables and data retrieved from the self -reported questionnaires were also investigated. Firefighters were organized into four groups according to their exposure to wildfire emissions and their smoking habits: non-smoking non -exposed (NSNExp), non-smoking exposed (NSExp), smoking non -exposed (SNExp), and smoking and exposed (SExp). The most abundant metabolites were 1-hydroxynaphthalene and 1-hydroxyacenaphthene (1OHNaph + 1OHAce) (98-99 %), followed by 2-hydroxyfluorene (2OHFlu) (0.2-1.1 %), 1-hydroxyphenanthrene (1OHPhen) (0.2-0.4 %), and 1-hydroxypyrene (1OHPy) (0.1-0.2 %); urinary 3-hydroxybenzo(a)pyrene was not detected. The exposure to wildfire emissions significantly elevated the median concentrations of each individual and total OHPAH compounds in all groups, but this effect was more pronounced in non-smoking (1.7-4.2 times; p < 0.006) than in smoking firefighters (1.3-1.6 times; p < 0.03). The greatest discriminant of exposure to wildfire emissions was 1OHNaph + 1OHAce (increase of 4.2 times), while for tobacco smoke it was 2OHFlu (increase of 10 times). Post -exposure, white blood cells count significantly increased ranging from 1.4 (smokers, p = 0.025) to 3.7 -fold (non-smokers, p < 0.001), which was accompanied by stronger significant correlations (0.480 < r < 0.882; p < 0.04) between individual and total OHPAH and total white blood cells (and lymphocytes > monocytes > neutrophils in non-smokers), evidencing the impact of PAH released from wildfire on immune cells. This study identifies Portuguese firefighters with high levels of biomarkers of exposure to PAH and points out the importance of adopting biomonitoring schemes, that include multiple biomarkers of exposure and biomarkers of effect, and implementing mitigations strategies.
- Conhecimentos das mães face à criança com febrePublication . Alves, Sara Elisa Brás; Sousa, Marta; Mata, Maria Augusta; Sousa, FilomenaA febre é o motivo mais frequente de procura de cuidados de saúde em idade pediátrica. Para a DGS(2018) esta representa pelo menos 20% das causas de recurso aos serviços às urgências hospitalares e cerca de 50% das urgências realizadas em consultórios pediátricos. A febre é tradicionalmente, encarada pelos pais com uma situação grave, considerada não como um sintoma/sinal, mas sim como doença. A importância da febre na criança transcende do facto de sr tão comum e um dos principais motivos de consulta em pediatria.
- Current nursing education considering southern europe’s reality and legal framework: a two-phased research approachPublication . Antão, Celeste; Antolí-Forner, Aloma; Fernandes, Hélder; Alves, Sara Elisa Brás; Pimentel, Maria HelenaNursing education and formation is still heterogenous in spite of The Bologna Declaration in 1999. Apart from the existence of basic curriculum standards, universities have flexibility regarding its design. The objective of this study is to provide an overview of contemporary nursing education and contrast it with the legal frameworks in place in four Southern European countries: Portugal, Spain, Italy, and Greece. A scoping review was conducted in order to revise and obtain an up-to-date review of current nursing education and quality. Then, a content evaluation of the legal public framework was conducted. A total of nine articles were included in the review. Data analysis evoked three main themes from the results: nursing education heterogeneity owing to ECTS increased from 180 to 240 for the diversity of clinical practice hours; the nursing framework lacked a definition; and the evolution of nursing education, alongside quality improvement and more accurate guidelines were required. Regarding their legal framework, the main directives and legislation standards were assessed and compared with the current curriculum. To conclude, nursing heterogeneity education evokes competence inequality among students and future professionals as larger curricular programs (240 ECTS) offer more clinical practice. Nursing education uniformity could enhance international mobility and promote knowledge exchange and nursing competence framework definitions. These are facts that certainly bring nursing empowerment. This study was not registered.
- Exploring clinical trials to manage firefighters’ sleep quality: a PRISMA compliant systematic reviewPublication . Alves, Sara Elisa Brás; Vaz, Josiana A.; Fernandes, AdíliaSleep research has grown over the past decades and investigators are deeply involved in studying sleep and its impact on human health and body regulation. Despite the understanding that insufficient sleep is strongly linked to the development of several disorders, unsatisfactory sleep exposes health and safety to innumerous risks. The present study aims to review and analyze the main results of clinical trials, registered at ClinicalTrials.gov and ICTRT databases, and developed construct strategies to improve sleep quality on firefighters and enhance professionals’ sleep and health conditions. The protocol was registered in PROSPERO under number CRD42022334719. Trials registered between first registry and 2022 were included. We retrieved 11 registered clinical trials; seven met eligibility criteria and were included in the review. A relation between sleep disorders, shift work, and occupational health problems was found, and retrieved trials showed that sleep education programs can improve sleep quality and sleep hygiene. Science has already recognized sleep’s importance for metabolic functioning and survivorship. Nevertheless, it continues to play a major role in discovering methods to diminish the problems faced. Strategies contemplating sleep education, or intervention, should be presented to fire services to tackle this problem and promote healthier and safer environments.
- Gerontology and geriatrics in undergraduate nursing education in Portugal and Spain: an integrative and comparative curriculum reviewPublication . Alves, Sara Elisa Brás; Magalhães, Carlos Pires; Fernandes, Adília; Fermoso Palmero, Maria José; Fernandes, HélderNurses play a critical role in caring for elderly patients; however, the emphasis on aging care in undergraduate programs may be insufficient. The present study aims at identifying the relevance given to theoretical and/or practical gerontological and geriatric contents in undergraduate study plans in Portugal and Spain. Presenting a two-part investigation, an integrative review approach examines nursing education on a global scale and a comparative analysis, using Bereday’s comparative method, to assess the nursing curricula between Portugal and Spain. The search found 117 documents, with 16 being included. Studies covered diverse educational practices in geriatric and gerontological nursing, emphasizing curriculum development, faculty expertise, practical training, attitudes towards elderly care, and future directions. The comparative analysis of nursing curricula revealed that Portugal places a priority on building foundational theoretical knowledge in the first year and then gradually integrating practical training. In contrast, Spain emphasizes an extensive and integrated approach with a strong focus on practical skills and comprehensive assessments. Our research emphasizes the need to incorporate aging-focused education into nursing curricula and update the curriculum, providing hands-on training with early exposure to these environments. Additionally, simulation classes can enhance critical thinking by allowing students to experience aging effects firsthand.
- Qualidade do sono em estudantes de EnfermagemPublication . Ribeiro, Maria Isabel; Certo, Ana; Louçano, Ana; Alves, Sara Elisa BrásA qualidade do sono é imprescindível para manter o bem estar físico e psicológico do ser humano. A vida universitária constitui um inevitável fator de alteração de diversos hábitos e estilos de vida com particular influência na qualidade do sono dos estudantes, uma vez que ocorrem várias alterações no seu quotidiano1. Objetivos: Este trabalho teve como objetivos, avaliar a qualidade do sono em estudantes de Enfermagem que frequentam a Escola Superior de Saúde de Bragança, determinar o tempo médio que os estudantes demoram a adormecer e quantificar o número de horas médio de sono. Metodologia: Foi recolhida uma amostra, aleatória simples, constituída por 138 estudantes de um total de 361 que frequentavam o curso de Enfermagem, lecionado na Escola Superior de Saúde de Bragança, no ano letivo de 2014/2015. Foi utilizado como instrumento o Índice da Qualidade de Pittsburgh (PSQI). Este instrumento é constituído por 19 itens, avaliados numa escala de 0 a 3, podendo o score global atingir um máximo de 21 pontos. Quanto maior o valor do score global pior será a qualidade do sono. Posteriormente, os itens foram agrupados em sete dimensões, nomeadamente, latência, qualidade subjetiva do sono, duração do sono, eficiência habitual do sono, alterações ao sono, uso de medicação para o sono e disfunção diurna. A maioria dos inquiridos é do género feminino (82,6%), tem entre 18 a 22 anos (62,3%), está em situação de deslocado (65,7%), vive numa habitação localizada num espaço com grande movimento (63,5%) e consome substâncias tais como álcool, café, entre outras (79%). De salientar que uma percentagem significativa dos estudantes, com frequência, demora mais de 30 minutos (13,8%) a adormecer e acorda a meio da noite ou muito cedo da parte da manhã (16,7%). Resultados e discussão: Em média os estudantes dormem 6,71 horas por noite (DP=1,624). Contudo há estudantes que dormem apenas 2 horas por noite e outros há que dormem cerca de 10 horas por noite. O tempo que os estudantes demoram a adormecer é de cerca de 19 a 20 minutos, embora se registe uma grande dispersão em relação a este valor. De acordo com Pascotto e Santos (2013)2 a maioria dos jovens estudantes demoram cerca de 15 minutos a adormecer. Para a maioria dos inquiridos a hora de deitar varia entre a 00.00 horas e a 1.00 da manhã (56,6%). A grande maioria classifica a sua qualidade do sono como boa (60,9%) a muito boa (10,1%), embora cerca de 25% a classifique como má ou muito má. De acordo com o que é referenciado na literatura, a necessidade basal de sono varia com a idade e de pessoa para pessoa, embora haja um consenso de que pode variar entre as 7 e as 9 horas por noite3. Conclusão: Os problemas de sono são muito frequentes entre os estudantes do ensino superior, uma vez que estes estão expostos a alterações dos estilos de vida e a comportamentos que podem influenciar a qualidade do sono. A experiência de um sono insatisfatório ou insuficiente é imensamente desagradável e tem reflexos no desempenho, no comportamento e no bem estar, afetando as atividades diárias. Contudo, de acordo com os resultados encontrados neste trabalho, a maioria dos estudantes considera a qualidade do sono boa.
- Risco de diabetes Mellitus tipo 2 e hipertensão arterial em estudantes do ensino superiorPublication . Alves, Sara Elisa Brás; Mata, Maria Augusta; Brás, Manuel AlbertoA diabetes é uma doença metabólica que afeta um grande número de pessoas a nível mundial. Apresenta causas diversas sendo caraterizada pelo aumento anormal de açúcar no sangue e transtornos no metabolismo devido a problemas na produção ou na ação da insulina. Com o decorrer do tempo, esta patologia pode provocar a disfunção e insuficiência de vários órgãos. A Hipertensão Arterial, frequente nos portadores de Diabetes Mellitus Tipo 2, representa um dos maiores problemas de saúde pública devido à sua cronicidade e morbilidade elevadas, implicando um elevado investimento em cuidados de saúde constantes. A educação para uma literacia em saúde e dieta saudável, aliada a atividade física regular e controlo do peso corporal, podem prevenir a Diabetes Tipo 2 e/ou a Hipertensão Arterial e/ou retardar o seu aparecimento. Objetivos: conhecer o risco de desenvolver Diabetes Mellitus Tipo 2 num espaço temporal de 10 anos nos estudantes do ensino superior; identificar prováveis situações de Hipertensão Arterial; Compreender e analisar a distribuição dos valores de Tensão Arterial e do Risco de Diabetes Mellitus Tipo 2 segundo variáveis de caraterização; consciencializar a população para a adoção de estilos de vida saudáveis. Metodologia: Estudo Quantitativo Descritivo-Analítico, num plano transversal. De um universo de 6291 estudantes inscritos na instituição, foi selecionada uma amostra proporcional de 363 indivíduos, tendo em consideração a representatividade de cada escola. Resultados: após o cálculo de risco de desenvolvimento de diabetes, verificou-se que 87,9% apresenta baixo risco de DM2 e 12,1% apresenta risco de desenvolver a patologia num espaço temporal de 10 anos. Relativamente aos valores tensionais realça-se que 26,6% dos estudantes apresentam valores compatíveis com HTA. Aquando da análise verificou-se que existe associação estatística significativa entre a DM2 e as variáveis “grupo etário”, “Açúcar no sangue”, “Diabetes na Família”, “IMC”; “Perímetro da Cintura abdominal” e “Tensão Arterial”. Relativamente aos valores Tensionais, observou-se associação estatística significativa com as variáveis “Sexo”, IMC” e “Perímetro da Cintura abdominal”. Conclusão: É fundamental intervir preventivamente no sentido de promover a modificação dos hábitos diários dos indivíduos, consciencializando a população sobre a importância da adoção de uma prática de hábitos de vida saudáveis, nomeadamente a alimentação e a prática de exercício físico, por forma a diminuir a incidência e prevalência da Diabetes Mellitus e das doenças cardiovasculares.
- Sleep quality in nursing studentsPublication . Ribeiro, Maria Isabel; Certo, Ana; Louçano, Ana; Alves, Sara Elisa BrásIntroduction: The quality of sleep is imperative to maintain the physical and psychological well-being of human beings. University life is an inevitable change factor of habits and lifestyles with particular influence on students’ sleep quality (Kloss, Nash, Horsey & Taylor, 2011). Objectives: To evaluate sleep quality in nursing students from Bragança School of Health. To find out the time each student takes to fall asleep. To calculate students’ hours of sleep. Materials and Methods: A sample of 138 students was collected from a total of 361 students enrolled in the nursing degree in 2014/2015. The Quality Index Pittsburgh Sleep survey was used to collect the data during October 2014 to January 2015. This instrument has a maximum score of 21 points. For a score greater than five points, the quality of sleep was considered bad. Most students were female (82.6%) with ages between 18 and 20 years (62.3%) and didn’t live with their parents (66.0%). Results and Discussion: Most respondents classify his/her sleep quality as "good". On average, students sleep 6.7 hours per night. According to referenced literature, healthy adults should sleep between 7 to 9 hours per night. On average, students take about 20 minutes to fall asleep. According PaConclusion: Sleep problems are common among university students, since they are exposed to changes in their lifestyle, adopting behaviors that affect sleep quality. However, according to the results, most students consider their sleep quality as good. References: Kloss, J.; Nash, C.; Horsey, S. & Taylor, D. (2011). The delivery of behavioral sleep medicine to college students. J Adolesc Health, 48(6):553-61. Pascotto, A. & Santos, B. (2013). Avaliação da qualidade do sono em estudantes de ciências da saúde. J. Health Sci Inst, 31(3):306-10. scotto e Santos (2013) the majority college students take about 15 minutes to fall asleep