Questionário de antecipação do parto (QAP)

Este artigo descreve a construção e validação de um instrumento “Questionário de Antecipação do Parto” (QAP) constituído por 52 questões que tem por objectivo principal estimar a antecipação da grávida em relação ao parto: o planeamento e preparação que está a realizar, as suas expectativas relativas ao parto, ao pós-parto, à relação com o bebé e com o companheiro, e ao suporte social, e as suas preocupações com a saúde e com as consequências adversas do parto em si e no bebé. Para o efeito, uma amostra de 305 mulheres primíparas e multíparas, preencheu o QAP, entre as 4 e as 40 semanas de gestação, das quais 170 realizaram medidas repetidas. A Análise Hierárquica de Clusters permitiu identificar 6 sub-escalas que se referem a dimensões importantes da avaliação da antecipação da experiência de parto: 1. Planeamento e preparação para o parto, 2. Expectactivas quanto ao parto, 3. Preocupações quanto à saúde e consequências adversas do parto, 4. Expectativas quanto ao pós-parto, 5. Expectativas quanto à relação com o bebé e com o companheiro, e 6. Expectativas quanto ao suporte social. Considerando as suas características psicométricas, o questionário mostrou-se fidedigno (Teste-reteste = 0,690), com boa consistência interna (Alpha de Cronbach = 0,8512 e Split-Half = 0,5895) e com boa validade preditiva em relação à posterior ocorrência de depressão pós-parto. O QAP é assim um instrumento fidedigno, capaz de estimar adequadamente a antecipação que a grávida faz do parto e vem colmatar uma importante necessidade dos investigadores e clínicos, uma vez que é o primeiro instrumento validado em Portugal construído para este propósito.This article describes the construction and reliability of a 52 item questionnaire “Anticipation of Childbirth Questionnaire” (QAP), aiming to analyse the mother’s anticipation of childbirth, namely, the planning, the expectations towards the delivery, the postpartum recovery, the relation with the baby and the partner, social support, the worries about health and the adverse consequences of delivery for herself and for the baby. A sample of 305 primiparous and multiparous pregnant women participated in the study and answered the QAP, between 4 and 40 weeks of pregnancy, some (n=170) made repeated measures. The Hierarquical Clusters Analysis aloud us to identify 6 sub-scales which constitute important dimensions for evaluating the anticipation of childbirth: 1. Preparation and planning of childbirth; 2. Expectations concerning delivery; 3. Worries about health and negative consequences of childbirth; 4. Expectations regarding postpartum; 5. Expectations regarding the relation with the baby and with the partner; and 6. Expectations of social support. The questionnaire has proven to be reliable (Test-retest = 0,690) and has a good internal consistency (Alpha de Cronbach = 0,8512 and Split-Half = 0,5895) as well as good predictive validation regarding postpartum depression incidence. Given its psychometric properties, the QAP is a reliable instrument, able to estimate the pregnant women anticipation of delivery. This is the only available instrument in Portugal constructed for this objective for investigators and clinicians.Cet article décrit la construction et validation d’un instrument « Questionnaire d’Anticipation de l’Accouchement » (QAP) constitué par 52 questions qui à pour objectif principal estimer l’anticipation de l’accouchement de la femme enceinte: la planification et préparation qu’elle réalise; ses expectatives relatives à l’accouchement, au post-partum, à la relation avec le bébé et le partenaire et au support social; ses préoccupations quand à la santé et aux conséquences adverses de l’accouchement en elle-même et son bébé. Pour cet effet un échantillon de 305 femmes enceintés primipare et multipare à accompli le QAP, entre la 4ème et la 40ème semaine de gestation, desquels 170 ont réalisé des mesures répétées. L’Analyse Hiérarchique de Clusters à permit identifier 6 sub-échelles qui mesuré des importantes dimensions de l’anticipation de l’expérience d’accouchement: 1. Planification et préparation de l’accouchement; 2. Expectatives quand à l’accouchement; 3. Préoccupation quand à la santé et aux conséquences adverses de l’accouchement; 4. Expectatives quand au post-partum; 5. Expectatives quand à la relation avec le bébé et le partenaire et 6. Expectatives quand au support social. Considèrent ses caractéristiques psychométriques, le questionnaire c’est montré fidigne (Test-retest = 0,690), ayant une très bonne consistance interne (Alpha de Cronbach = 0,8512 et Split-Half = 0,5895) et une bonne validité prédictive en relation à la postérieur occurrence de dépression du post-partum. Le QAP est ainsi un instrument fidigne, capable d’estimer adéquatement l’anticipation que la femme enceinte fait de l’accouchement, et répond à une nécessité des investigateurs et cliniciens, une fois que c’est le premier instrument validé au Portugal construit avec ce purpose

Questionário de experiência e satisfação com o parto (QESP)

Este artigo apresenta a construção e validação do “Questionário de Experiência e Satisfação com o Parto” (QESP), destinado a avaliar a experiência e satisfação da mulher com o parto (preocupações, sentimentos, relaxamento, cuidados e condições disponíveis, dor, satisfação e confirmação de expectativas prévias, bem como suporte por parte de significativos durante o parto). O QESP foi administrado a uma amostra de 306 mulheres nos primeiros 5 dias do pós-parto, das quais 103 realizaram uma medida repetida do instrumento e preencheram a “Edinburgh Postnatal Depression Scale” (EPDS) aos 3 meses de vida do bebé. A Análise Hierárquica de Clusters permitiu identificar 8 sub-escalas que compõem o questionário: 1. condições e cuidados prestados, 2. experiência positiva, 3. experiência negativa, 4. relaxamento, 5. suporte, 6. suporte do companheiro, 7. preocupações e 8. pós-parto. O estudo psicométrico mostra que o QESP tem muito boa consistência interna (Alpha de Cronbach = 0,9087, Coeficiente de Split-half = 0,6828), é fidedigno (Teste-Reteste=0,586) e possui boa validade preditiva em relação à posterior ocorrência de depressão pós-parto. Por permitir a identificação de experiências de parto menos positivas, susceptíveis de se traduzirem em dificuldades de ajustamento após o parto, o QESP é um instrumento que pode revelar-se útil para os técnicos e investigadores da área da saúde reprodutiva.Este estudo foi desenvolvido com o apoio do Serviço de Saúde e Desenvolvimento Humano da Fundação Calouste Gulbenkian e da Fundação Bial

Envolvimento emocional inicial dos pais com o bebé

Embora a vinculação da criança aos pais tenha sido largamente investigada, a vinculação dos pais à criança está praticamente por estudar. A ideia de que o envolvimento emocional dos pais é uma circunstância determinante para a qualidade da interacção e dos cuidados que providenciam, e, por consequência, um factor que influencia o desenvolvimento da criança, tem sido contudo amplamente divulgada na literatura. O estudo que apresentamos neste artigo destina-se a investigar o envolvimento emocional inicial dos pais com o bebé. Desenvolve-se em torno de 3 objectivos principais: 1) descrever o envolvimento emocional com o recém-nascido, das mães e dos pais, na primeira semana que se segue ao parto; 2) analisar diferenças, entre mães e pais, no envolvimento emocional inicial com o filho; 3) avaliar mudanças no envolvimento emocional com o bebé das mães, durante a primeira semana do pós-parto. Para esse efeito, a escala Bonding (Figueiredo, Marques, Costa, Pacheco, & Pais, 2004) foi administrada nas 24 horas seguintes ao parto, a 150 mães, e, entre as 24 e as 48 horas do pós-parto, a 315 mães e 141 pais (N=456), cujos bebés nasceram na Maternidade Júlio Dinis (Porto). Os resultados obtidos mostram que, na semana seguinte ao parto, a maior parte das mães e dos pais relata: (1) elevado envolvimento emocional positivo (respectivamente, 71% e 73%), (2) pelo menos uma emoção não claramente relacionada com o ‘bonding’ (respectivamente, 76% e 70.9%), (3) ausência de emoções negativas para com o filho (embora algum envolvimento emocional negativo esteja presente em 21% das mães e 16.3% dos pais). Mostram também que, embora não seja muito diferente o envolvimento emocional das mães e dos pais em relação ao recém-nascido, as mães sentem-se, contudo, significativamente mais tristes, mais possessivas e mais receosas e, no geral, exibem mais emoções não claramente relacionadas com o ‘bonding’ e estão menos vinculadas ao bebé do que os pais, 48 horas depois do parto. Da análise dos resultados surge ainda que, 48 horas depois do parto, as mães estão significativamente menos receosas na presença do bebé do que nas primeiras 24 horas e que as emoções não claramente relacionadas com o ‘bonding’ tendem a diminuir ao longo dos primeiros dias do puerpério. Conclui-se assim que, na semana seguinte ao nascimento do bebé, (1) a generalidade das mães e dos pais exibe elevado envolvimento positivo, pelo menos uma emoção não claramente relacionada com o ‘bonding’, diminuto ou ausente envolvimento emocional negativo com o filho. (2) Os pais têm um melhor envolvimento emocional inicial com o recém-nascido do que as mães. (3) Num tão curto espaço de tempo quanto um dia, observam-se ligeiras mudanças positivas na qualidade das emoções que as mães dirigem ao bebé. Conclui-se ainda a propósito da importância de investigar o envolvimento emocional inicial dos pais com o bebé e de reflectir acerca das condições que podem beneficiar o ‘bonding’ das mães e dos pais, nos momentos que se seguem ao parto.Although child attachment toward the parents has been largely studied, we still have a lot to know about how parents attach to infants. Nevertheless, the literature has been highlighting for so long that the parents’ emotional involvement is a determinant factor in the quality of the interaction and the care that they provided to the child. This study investigates the parents’ initial emotional bonding toward the newborn, attending to 3 main objectives: (1) to describe parents’ emotional involvement with the infant in the first postpartum week, (2) to analyse differences in the initial emotional bonding, between mothers and fathers; 3) to evaluate changes in the mother’s emotional involvement with the infant during the first postpartum week. The Bonding Scale (Figueiredo, Marques, Costa, Pacheco, & Pais, 2004) was administrated to 150 mothers, 24 hours after the delivery, and to 315 mothers and 141 fathers (N=456), at 1 to 2 days postpartum (at the Júlio Dinis Maternity Hospital. Porto). The results show that in the week following the delivery, most mothers and fathers report: (1) high positive emotional involvement (71% and 73%, respectively); (2) at least one emotion not clearly related with bonding (76% and 70.9%, respectively); (3) no negative emotions toward the infant (although some negative emotional involvement is present in 21% of the mothers and 16.3% of the fathers). Results also show that 48 hours after delivery mother’s and father’s emotional involvement toward the newborn is not so different, but mothers feel significantly more sad, possessive and fearful, and in general have more emotions not clearly related with bonding as well as worse bonding than fathers. The results also show that mothers are significantly less fearful in the presence of the infant at day 2 than at day 1, and emotions not clearly related with bonding tend to decrease in the first following delivery days. We conclude that in the first week after childbirth, (1) most mothers and fathers have high positive involvement, at least one emotion not clearly related with bonding, low or absent negative emotional involvement with the infant. (2) Fathers have a better initial bonding with the newborn than mothers. (3) In a very short period of time (1 day) slightly positive changes in the quality of the mother’s emotions toward the child can be observed. We also conclude that studying the parents’ emotional involvement with the baby and considering the conditions that might benefit the mother’s and father’s emotional involvement, in the moments that follow childbirth, are very important issues.Serviço de Saúde e Desenvolvimento Humano da Fundação Calouste Gulbenkian

International Centre for Coastal Ecohydrology: applying the ecohydrology approach for the sustainable functioning of coastal ecosystems

Coastal areas are among the most sensitive and productive ecosystems around the world, providing for the subsistence of large numbers of people, particularly in developing countries. Human pressure on coastal areas has dramatically increased during the last decades and climate changes will pose new threats to these areas, as expected from sea-level rise and the decrease in freshwater discharges from rivers (Chicharo et al., 2009). The International Centre for Coastal Ecohydrology (ICCE) a newly approved centre under the auspices of UNESCO, in October 2009, is located in the Algarve region (south Portugal). The centre acts as a facilitator and synergetic structure by providing the articulation of different scientific and institutional stakeholders at national and international levels. ICCE aims are to contribute scientific knowledge, capacity-building, educational and dissemination activities to support, design and implement adaptation and mitigation strategies and policies for coastal zones, including the impacts of climate change, addressing the goals of the Strategic Plan of the 7th Phase of UNESCO-IHP, the Millennium Development Goals (UN-MDGs) and the key themes for the United Nations Decade of Education for Sustainable Development (UN-DESD), particularly in African and Mediterranean regions.info:eu-repo/semantics/publishedVersio

Biofortified Diets Containing Algae and Selenised Yeast: Effects on Growth Performance, Nutrient Utilization, and Tissue Composition of Gilthead Seabream (Sparus aurata)

Efforts have been made to find natural, highly nutritious alternatives to replace fish meal (FM) and fish oil (FO), which can simultaneously promote fish health and improve the nutritional quality of filets for human consumption. This study evaluated the impact of biofortified diets containing microalgae (as replacement for FM and FO), macroalgae (as natural source of iodine) and selenised yeast (organic source of selenium) on gilthead seabream growth, nutrient utilization, tissue composition and gene expression. A control diet (CTRL) with 15% FM and 5.5% FO was compared with three experimental diets (AD1, AD2, and AD3), where a microalgae blend (Chlorella sp., Tetraselmis sp., and DHA-rich Schizochytrium sp.) replaced 33% of FM. Diet AD1 contained 20% less FO. Diets were supplemented with Laminaria digitata (0.4% AD1 and AD2; 0.8% AD3) and selenised yeast (0.02% AD1 and AD2; 0.04% AD3). After feeding the experimental diets for 12 weeks, growth was similar in fish fed AD1, AD2, and CTRL, indicating that microalgae meal can partially replace both FM and FO in diets for seabream. But AD3 suppressed fish growth, suggesting that L. digitata and selenised yeast supplementation should be kept under 0.8 and 0.04%, respectively. Despite lower lipid intake and decreased PUFAs bioavailability in fish fed AD3, compared to CTRL, hepatic elovl5 was upregulated resulting in a significant increase of muscle EPA + DHA. Indeed, filets of fish fed AD2 and AD3 provided the highest EPA + DHA contents (0.7 g 100 g–1), that are well above the minimum recommended values for human consumption. Fish consuming the AD diets had a higher retention and gain of selenium, while iodine gain remained similar among diets. Upregulation of selenoproteins (gpx1, selk, and dio2) was observed in liver of fish fed AD1, but diets had limited impact on fish antioxidant status. Overall, results indicate that the tested microalgae are good sources of protein and lipids, with their LC-PUFAs being effectively accumulated in seabream muscle. Selenised yeast is a good fortification vehicle to increase selenium levels in fish, but efforts should be placed to find new strategies to fortify fish in iodineThis work has received funding from the European Union’s Horizon 2020 Research and Innovation Programe under Grant Agreement No. 773400 (SEAFOODTOMORROW) and from the project ATLANTIDA (ref. NORTE-01-0145-FEDER-000040), supported by the Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement and through the European Regional Development Fund (ERDF). This work received financial support from REQUIMTE/LAQV national funds (FCT) through project UID/QUI/50006/2019. LV acknowledges national funds provided by FCT to CIIMAR (UIDB/04423/2020 and UIDP/04423/2020), PP-F acknowledges MAR2020 national funds provided to IPMA (DIVERISAQUA project - 16-02-01-FEAM-66) and MF acknowledges FCT for the grant SFRH/BD/144843/2019.info:eu-repo/semantics/publishedVersio

In vivo performance of chitosan/soy-based membranes as wound dressing devices for acute skin wounds

Wound management represents a major clinical challenge on what concerns healing enhancement and pain control. The selection of an appropriate dressing plays an important role in both recovery and esthetic ap- pearance of the regenerated tissue. Despite the wide range of available dressings, the progress in the wound care market relies on the increasing interest in using natural-based biomedical products. Herein, a rat wound- dressing model of partial-thickness skin wounds was used to study newly developed chitosan/soy (cht/soy)- based membranes as wound-dressing materials. Healing and repair of nondressed, cht/soy membrane-dressed, and Epigard -dressed wounds were followed macroscopically and histologically for 1 and 2 weeks. cht/soy membranes performed better than the controls, promoting a faster wound repair. Re-epithelialization, ob- served 1 week after wounding, was followed by cornification of the outermost epidermal layer at the second week of dressing, indicating repair of the wounded tissue. The use of this rodent model, although in impaired healing conditions, may enclose some drawbacks regarding the inevitable wound contraction. Moreover, being the main purpose the evaluation of cht/soy-based membranes’ performance in the absence of growth factors, the choice of a clinically relevant positive control was limited to a polymeric mesh, without any growth factor influencing skin healing/repair, Epigard. These new cht/soy membranes possess the desired features regarding healing/repair stimulation, ease of handling, and final esthetic appearance-thus, valuable prop- erties for wound dressings.The author Tircia C. Santos acknowledges the Portuguese Foundation for Science and Technology (FCT) for her PhD grant (SFRH/BD/40861/2007). This work was developed under the scope of the European Network of Excellence EXPERTISSUES (NMP3-CT-2004-5000283)

An integrated in vitro approach unveils the biocompetence and glutathiolomic profile of a human hepatocyte-like cell 3d model

Funding: This work was supported by FCT (Portugal) through the research grant PTDC/MED-TOX/29183/2017. Acknowledgments: The authors thank ECBio S.A. for providing the hnMSCs and F.A. Beland (NCTR, Jefferson, AR, USA) for the kind donation of nevirapine. FCT (UID/DTP/04138/2019, UID/QUI/00100/2019, RECI/QEQ-MED/0330/2012, SFRH/BD/144130/2019 to J.S.R., SFRH/BD/110945/2015 to P.F.P. and CEECIND/02001/2017 to A.M.M.A) are also acknowledged.The need for competent in vitro liver models for toxicological assessment persists. The differentiation of stem cells into hepatocyte-like cells (HLC) has been adopted due to its human origin and availability. Our aim was to study the usefulness of an in vitro 3D model of mesenchymal stem cell-derived HLCs. 3D spheroids (3D-HLC) or monolayer (2D-HLC) cultures of HLCs were treated with the hepatotoxic drug nevirapine (NVP) for 3 and 10 days followed by analyses of Phase I and II metabolites, biotransformation enzymes and drug transporters involved in NVP disposition. To ascertain the toxic effects of NVP and its major metabolites, the changes in the glutathione net flux were also investigated. Phase I enzymes were induced in both systems yielding all known correspondent NVP metabolites. However, 3D-HLCs showed higher biocompetence in producing Phase II NVP metabolites and upregulating Phase II enzymes and MRP7. Accordingly, NVP-exposure led to decreased glutathione availability and alterations in the intracellular dynamics disfavoring free reduced glutathione and glutathionylated protein pools. Overall, these results demonstrate the adequacy of the 3D-HLC model for studying the bioactivation/metabolism of NVP representing a further step to unveil toxicity mechanisms associated with glutathione net flux changes.publishersversionpublishe

Using stem cells in skin regeneration: possibilities and reality

Tissue-engineered skin has a long history of clinical applications, yet current treatments are not capable of completely regenerating normal, uninjured skin. Nonetheless, the field has experienced a tremendous development in the past 10 years, encountering the summit of tissue engineering (TE) and the arising of stem cell research. Since then, unique features of these cells such as self-renewal capacity, multi-lineage differentiation potential, and wound healing properties have been highlighted. However, a realistic perspective of their outcome in skin regenerative medicine applications is still absent. This review intends to discuss the directions that adult and embryonic stem cells (ESCs) can take, strengthening the skin regeneration field. Distinctively, a critical overview of stem cellsâ differentiation potential onto skin main lineages, along with a highlight of their participation in wound healing mechanisms, is herein provided. We aim to compile and review significant work to allow a better understanding of the best skin TE approaches, enabling the embodiment of the materialization of a new era in skin regeneration to come, with a conscious overview of the current limitations

Activation pathway to amino acid adducts

Funding: This work was supported in part by Fundação para a Ciência e a Tecnologia (FCT), Portugal (PTDC/QUI-QUI/113910/2009, RECI/QEQ-MED/0330/2012, UID/QUI/00100/2013 and IF/ 01091/2013/CP1163/CT0001), and by Interagency Agreement Y1ES1027 between the National Center for Toxicological Research/Food and Drug Administration and the National Institute of Environmental Health Sciences/National Toxicology Program. The opinions expressed in this paper do not necessarily represent those of the U.S. Food and Drug Administration. RW, ALG, ILM and SGH thank FCT for postdoctoral and doctoral fellowships (SFRH/BPD/70953/2010, SFRH/BD/72301/2010, SFRH/BD/75426/2010 and SFRH/BD/ 80690/2011, respectively). AMM also acknowledges Programa Operacional Potencial Humano from FCT and the European Social Fund (IF/01091/2013), and the LRI Innovative Science Award. We thank the Portuguese NMR and MS networks (IST nodes) for providing access to the facilities.Nevirapine (NVP) is the non-nucleoside HIV-1 reverse transcriptase inhibitor most commonly used in developing countries, both as a component of combined antiretroviral therapy and to prevent mother-to-child transmission of the virus; however, severe hepatotoxicity and serious adverse cutaneous effects raise concerns about its safety. NVP metabolism yields several phenolic derivatives conceivably capable of undergoing further metabolic oxidation to electrophilic quinoid derivatives prone to react with bionucleophiles and initiate toxic responses. We investigated the ability of two phenolic NVP metabolites, 2-hydroxy-NVP and 3-hydroxy-NVP, to undergo oxidation and subsequent reaction with bionucleophiles. Both metabolites yielded the same ring-contraction product upon oxidation with Frémy's salt in aqueous medium. This is consistent with the formation of a 2,3-NVP-quinone intermediate, which upon stabilization by reduction was fully characterized by mass spectrometry and nuclear magnetic resonance spectroscopy. Additionally, we established that the oxidative activation of 2-hydroxy-NVP involved the transient formation of both the quinone and a quinone-imine, whereas 3-hydroxy-NVP was selectively converted into 2,3-NVP-quinone. The oxidations of 2-hydroxy-NVP and 3-hydroxy-NVP in the presence of the model amino acids ethyl valinate (to mimic the highly reactive N-terminal valine of hemoglobin) and N-acetylcysteine were also investigated. Ethyl valinate reacted with both 2,3-NVP-quinone and NVP-quinone-imine, yielding covalent adducts. By contrast, neither 2,3-NVP-quinone nor NVP-derived quinone-imine reacted with N-acetylcysteine. The product profile observed upon Frémy's salt oxidation of 2-hydroxy-NVP in the presence of ethyl valinate was replicated with myeloperoxidase-mediated oxidation. Additionally, tyrosinase-mediated oxidations selectively yielded 2,3-NVP-quinone-derived products, while quinone-imine-derived products were obtained upon lactoperoxidase catalysis. These observations suggest that the metabolic conversion of phenolic NVP metabolites into quinoid electrophiles is biologically plausible. Moreover, the lack of reaction with sulfhydryl groups might hamper the in vivo detoxification of NVP-derived quinone and quinone-imine metabolites via glutathione conjugation. As a result, these metabolites could be available for reaction with nitrogen-based bionucleophiles (e.g., lysine residues of proteins) ultimately eliciting toxic events.publishersversionpublishe