Abstract Introduction: Peer learning is a differentiated educational tool, including the traditional tutoring model and the interaction of individuals within the same training level. The general practice (GP) residency programme, updated in 2019, introduced peer learning as part of residents’ weekly schedule. In Lisbon and Tagus Valley region (ARSLVT), peer learning was implemented through the so-called Relational Learning Sessions (SAR). Methods: The present study sought to establish a state point regarding this practice in continental Portugal, in order to promote local adaptations necessary for the residents to reach relational learning’s full potential. Residents from the 54th group of the specialized training programme in GP were included. Data were collected between November 12nd and December 12nd 2020 through an online questionnaire sent via e-mail by the residency coordinators (CIMMGF). Results: Out of a total of 416 residents, 86 answers were obtained, 60 of which were from ARSLVT. At the time data was collected, in the North region, no model of peer learning had been implemented. In ARSLVT all residents had SAR, except for one group of Healthcare Units (ACeS). In the Center, Alentejo, and Algarve, this practice was not uniform between ACeS. In the implemented SAR, there is a wide variety of activities being performed, planning is mostly done according to the CIMMGF recommendations, and the majority of resident doctors recognize its usefulness. However, the impact on clinical activities, the distance between healthcare units, and the lack of support from local residency directors are pointed out as the main difficulties while planning these sessions. The adoption of a rotative schedule, the implementation of online sessions, and the issuing of guidelines might be possible solutions. Conclusion: Aiming for the adjustment and equality of training opportunities, effective local solutions must be sought so that peer learning becomes a fruitful reality for all residents.

Resumo Introdução: A aprendizagem interpares é uma ferramenta educacional diferenciada, incluindo o modelo tradicional de tutoria e a interação de indivíduos com o mesmo grau de formação. O programa de formação especializada em medicina geral e familiar (MGF) introduziu, em 2019, a aprendizagem relacional no horário semanal dos médicos internos. Na Administração Região de Saúde de Lisboa e Vale do Tejo (ARSLVT) foi adotado o modelo das Sessões de Aprendizagem Relacional (SAR). O presente estudo procurou perceber como está a ser implementada esta prática em Portugal continental, de forma a promover adaptações que permitam alcançar todo o seu potencial. Métodos: Foram incluídos os internos do 54.o grupo da formação especializada em MGF. Os dados foram recolhidos entre 12/nov e 12/dez de 2020, através de um questionário online divulgado por correio eletrónico pelas coordenações do Internato Médico de MGF (CIMMGF). Resultados: De um total de 416 internos obtiveram-se 86 respostas, 60 das quais da ARSLVT. À data da recolha dos dados verificou-se que na ARS Norte não tinha sido implementado qualquer modelo formal de aprendizagem relacional. Na ARSLVT apenas um ACeS não realizava SAR. Nas ARS Centro, Alentejo e Algarve, esta prática não era uniforme. Nas SAR implementadas parecem desenvolver-se diversas atividades, o planeamento é maioritariamente feito de acordo com as orientações publicadas e a maioria dos internos reconhece a sua utilidade. São apontadas como principais dificuldades o impacto na atividade assistencial, a distância entre unidades e a ausência de apoio da direção de internato. A adoção de um horário rotativo, a implementação de sessões online e a existência de documentos orientadores são possíveis soluções. Conclusão: Tendo em vista a harmonização do percurso e a igualdade de oportunidades formativas devem ser procuradas estratégias locais efetivas para que a aprendizagem relacional seja uma realidade profícua para todos os internos.

Avian mycoplasmas occur in a variety of bird species. The most important mycoplasmas for chickens and turkeys are Mycoplasma gallisepticum (MG), M. synoviae (MS), and M. meleagridis. Besides, M. iowe (MI) is an emerging pathogen in turkeys, but of little concern for chickens. Mycoplasmas are bacteria that lack cell wall and belong to the class Mollicutes. Although they have been considered extracellular agents, scientists admit nowadays that some of them are obligatory intracellular microorganisms, whereas all other mycoplasmas are considered facultative intracellular organisms. Their pathogenic mechanism for disease include adherence to host target cells, mediation of apoptosis, innocent bystander damage to host cell due to intimate membrane contact, molecular (antigen) mimicry that may lead to tolerance, and mitotic effect for B and/or T lymphocytes, which could lead to suppressed T-cell function and/or production of cytotoxic T cell, besides mycoplasma by-products, such as hydrogen peroxide and superoxide radicals. Moreover, mycoplasma ability to stimulate macrophages, monocytes, T-helper cells and NK cells, results in the production of substances, such as tumor necrosing factor (TNF-alpha), interleukin (IL-1, 2, 6) and interferon (<FONT FACE=Symbol>a, b, g</FONT>). The major clinical signs seen in avian mycoplasmosis are coughing, sneezing, snicks, respiratory rales, ocular and nasal discharge, decreased feed intake and egg production, increased mortality, poor hatchability, and, primarily in turkeys, swelling of the infraorbital sinus(es). Nevertheless, chronic and unapparent infections are most common and more threatening. Mycoplasmas are transmitted horizontally, from bird to bird, and vertically, from dam to offspring through the eggs. Losses attributed to mycoplasmosis, mainly MG and MS infections, result from decreased egg production and egg quality, poor hatchability (high rate of embryonic mortality and culling of day-old birds), poor feed efficiency, increase in mortality and carcass condemnations, besides medication costs. Mycoplasmas are diagnosed by serologic tests, culture and PCR and are sensitive to antimicrobials whose action sites are other than the bacterial cell wall, such as tetracyclines, macrolides, quinolones and tiamulin. However, mycoplasma control is more efficiently achieved by acquisition of birds free of MG, MS, MM and/or MI, vaccination of layers, and monitoring of breeder flocks, followed by elimination of the infected flocks that are detected.