Browsing by Author "Rodrigues, Ana Rita"
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- Critically ill patient mortality by age: long-term follow-up (CIMbA-LT)Publication . Gonçalves-Pereira, João; Oliveira, André; Vieira, Tatiana; Rodrigues, Ana Rita; Pinto, Maria João; Pipa, Sara; Martinho, Ana; Ribeiro, Sofia; Paiva, José-ArturBackgroundThe past years have witnessed dramatic changes in the population admitted to the intensive care unit (ICU). Older and sicker patients are now commonly treated in this setting due to the newly available sophisticated life support. However, the short- and long-term benefit of this strategy is scarcely studied.MethodsThe Critically Ill patients' mortality by age: Long-Term follow-up (CIMbA-LT) was a multicentric, nationwide, retrospective, observational study addressing short- and long-term prognosis of patients admitted to Portuguese multipurpose ICUs, during 4 years, according to their age and disease severity. Patients were followed for two years after ICU admission. The standardized hospital mortality ratio (SMR) was calculated according to the Simplified Acute Physiology Score (SAPS) II and the follow-up risk, for patients discharged alive from the hospital, according to official demographic national data for age and gender. Survival curves were plotted according to age group.ResultsWe included 37.118 patients, including 15.8% over 80 years old. The mean SAPS II score was 42.8 +/- 19.4. The ICU all-cause mortality was 16.1% and 76% of all patients survive until hospital discharge. The SAPS II score overestimated hospital mortality [SMR at hospital discharge 0.7; 95% confidence interval (CI) 0.63-0.76] but accurately predicted one-year all-cause mortality [1-year SMR 1.01; (95% CI 0.98-1.08)]. Survival curves showed a peak in mortality, during the first 30 days, followed by a much slower survival decline thereafter. Older patients had higher short- and long-term mortality and their hospital SMR was also slightly higher (0.76 vs. 0.69). Patients discharged alive from the hospital had a 1-year relative mortality risk of 6.3; [95% CI 5.8-6.7]. This increased risk was higher for younger patients [21.1; (95% CI 15.1-39.6) vs. 2.4; (95% CI 2.2-2.7) for older patients].ConclusionsCritically ill patients' mortality peaked in the first 30 days after ICU admission. Older critically ill patients had higher all-cause mortality, including a higher hospital SMR. A long-term increased relative mortality risk was noted in patients discharged alive from the hospital, but this was more noticeable in younger patients.
- Gestão democrática participativa: realidade de um agrupamento de escolas no concelho de AlbufeiraPublication . Rodrigues, Ana Rita; Valadas, Sandra TeodósioNeste trabalho analisamos em que medida um agrupamento de escolas adota práticas de gestão do tipo democrática e participativa. Foram utilizados questionários e entrevistas, apontando os resultados para a existência de algumas práticas de promoção da participação dos intervenientes, embora existam algumas lacunas, nomeadamente na aplicação de estratégias de articulação escola/encarregados de educação.
- Influence of particle size on ecotoxicity of low-density polyethylene microplastics, with and without adsorbed benzo-a-pyrene, in Clam Scrobicularia planaPublication . Rodrigues, Ana Rita; Mestre, Nélia; FONSECA, TAINÁ; Pedro, Paulo; Carteny, Camilla C.; Cormier, Bettie; Keiter, Steffen; Bebianno, Maria JoãoThis study investigated the ecotoxicological effects of differently sized (4–6 µm and 20–25 µm) low-density polyethylene (LDPE) microplastics (MPs), with and without adsorbed benzo-a-pyrene (BaP), in clam Scrobicularia plana. Biomarkers of oxidative stress (superoxide dismutase—SOD; catalase—CAT), biotransformation (glutathione-S-transferases—GST), oxidative damage (lipid peroxidation—LPO) and neurotoxicity (acetylcholinesterase—AChE) were analysed in gills and digestive glands at different time intervals for a total of 14 days of exposure. In order to have a better impact perspective of these contaminants, an integrated biomarker response index (IBR) and Health Index were applied. Biomarker alterations are apparently more related to smaller sized (4–6 µm) MPs in gills and to virgin LDPE MPs in the digestive gland according to IBR results, while the digestive gland was more affected by these MPs according to the health index.