Qualidade dos instrumentos de autorresposta que medem a funcionalidade do membro superior em condições músculo-esqueléticas do ombro : revisão sistemática

Contextualização: Dada a prevalência de disfunções no ombro, os registos de avaliação segundo a perspetiva do utente constituem ferramentas úteis na seleção das estratégias de intervenção. A escolha do instrumento adequado deve-se basear em grande parte na força das suas propriedades psicométricas, contudo não existem estudos que analisem sistematicamente a qualidade destas medidas. Objetivo: Análise de estudos referente às propriedades psicométricas de instrumentos de autorresposta na funcionalidade do ombro. Metodologia: Revisão da literatura em inglês/português, nas bases de dados: PubMed, PEDro, Google Académico, B-On e RCAAP. Foram analisados estudos realizados até 2015. A qualidade metodológica e as propriedades psicométricas foram avaliadas e resumidas através de dois critérios padronizados, seguindo a ideologia COSMIN. Resultados: Nesta revisão foram incluídos 6 estudos. O Disabilities of the Arm Shoulder and Hand (DASH) e o Neck and Upper Limb Index (NULI-20) demonstram boas propriedades psicométricas e uma metodologia de fraca a excelente; o Shoulder Pain And Disability Index (SPADI) e o Weelchair User’s Shoulder Pain Index (WUSPI) exibem boas propriedades psicométricas e qualidade metodológica fraca; tanto no Shoulder Rating Questionnaire (SRQ-PT) como no Upper Extremity Functional Index (UEFI) não foram avaliadas propriedades psicométricas relevantes, contudo as analisadas apresentam boas propriedades psicométricas e uma metodologia fraca. Conclusão: Devido às falhas na metodologia dos estudos incluídos, não é possível inferir qual o questionário mais apropriado à prática clínica. São necessários mais estudos de validação de instrumentos de autorresposta com melhor qualidade metodológica

Experimental analysis of niti alloy during strain-controlled low-cycle fatigue

PTDC/CTM-CTM/29101/2017- POCI-01-0145-FEDER-029101 UIDB/EMS/00285/2020 UIDB/50025/2020-2023The interaction between the stress-induced martensitic transformation and resistivity behavior of superelastic NiTi shape memory alloy (SMA) was studied. Strain-controlled low-cycle fatigue up to 6% was monitored by in situ electrical resistivity measurements. The experimental results show that a great motion of martensite fronts results in a significant accumulation of defects, as evidenced by transmission electron microscopy (TEM), before and after the tensile cycles. This gives rise to an overall increase of the resistivity values up to the maximum deformation. Therefore, the research suggests that shape memory alloy wire has great potential as a stress sensor inside bulk materials.publishersversionpublishe

Influence of processing and content of vinyl acetate on the properties of Eva/organophilic montmorillonite nanocomposites

O copolímero Etileno Acetato de Vinila (EVA) é uma poliolefina utilizada principalmente em filmes para embalagens, onde a sua flexibilidade, tenacidade, elasticidade e transparência são atributos desejáveis. As propriedades mecânicas, térmicas e de barreira do EVA podem ser melhoradas pela incorporação de cargas inorgânicas. O EVA apresenta polaridade variável de acordo com o teor de Acetato de Vinila, o que promove a viabilidade para obtenção de nanocompósitos com argilas organicamente modificadas, tornando desnecessária a adição de agentes compatibilizantes. Neste trabalho foram preparados nanocompósitos de EVA e montmorilonita organofílica comercial pelo método de intercalação do fundido em um reômetro de torque, com rotores tipo roller, a 150°C durante 10minutos, com monitoramento do torque em função do tempo. A fim de investigar a influência da polaridade do EVA, da concentração da argila e das condições de processamento nas características dos nanocompósitos, variou-se a concentração de Acetato de Vinila (19% e 28%), o teor de argila (2% e 5%) e a velocidade de rotores (60 rpm e 100 rpm). Foram avaliadas a estrutura da argila, a estabilidade térmica e as propriedades mecânicas e de barreira dos nanocompósitos, mediante as técnicas de difração de raios X, análise termogravimétrica, ensaio de tração e análises de taxa de permeabilidade ao oxigênio e ao vapor d’água. A partir dos dados de permeabilidade foi aplicado o modelo de Nielsen para avaliar o grau de esfoliação da argila. Dentre os principais resultados com o planejamento fatorial destacam-se: (a) o aumento da polaridade do EVA aumentou a permeabilidade ao oxigênio e ao vapor d’água dos materiais; (b) o teor de argila não modificou a estabilidade térmica dos nanocompósitos e a estrutura da argila; (c) o aumento da concentração da argila aumentou o módulo elástico, reduziu a deformação de ruptura e reduziu significativamente o coeficiente de permeabilidade ao oxigênio e ao vapor d’água; (d) o fator rotação não implicou em alterações significativas em nenhuma das respostas avaliadas245579586sem informaçãoThe copolymer Ethylene Vinyl Acetate (EVA) is a polyolefin used mainly in packaging films, where its flexibility, toughness, elasticity and transparency are desirable attributes. The mechanical, thermal and barrier properties of EVA can be improved by the incorporation of inorganic fillers. Its polarity varies according to the content of Vinyl Acetate, which allows for nanocomposites to be obtained with organically modified clay, with no need to add compatibilizing agents. In this work nanocomposites of EVA and commercial organophilic montmorillonite were prepared by melt intercalation in a torque rheometer with rotors roller type, at 150°C for 10 minutes, monitoring the torque versus time. The concentration of Vinyl Acetate (19% and 28%), clay content (2% to 5%) and the rotors rotation (60 rpm to 100 rpm) were varied in order to investigate their influence on the characteristics of the nanocomposites. The clay structure, thermal stability, mechanical and barrier properties of the nanocomposites were evaluated by X-ray diffraction, thermal analysis, tensile testing, oxygen and water vapor transmission rates. Based on the permeability data, Nielsen´s model was applied to assess the degree of clay exfoliation. The main results obtained from the factorial design are: (a) increasing the polarity of EVA led to an increase in the permeability to oxygen and water vapor of the material, (b) the clay content did not change the clay structure or the thermal stability of the nanocomposites, (c) increasing the concentration of clay increased the elastic modulus, decreased the elongation at break and significantly reduced the coefficient of permeability for oxygen and water vapor, (d) the rotation factor did not result in significant changes in any of the evaluated responsessem informaçã

Influenza virus type/subtype and different infection profiles by age group during 2017/2018 season

DDI-INSA em colaboração com a Rede Portuguesa de Laboratórios para o Diagnóstico da GripeBackground: Influenza has a major impact in hospitalization during each influenza season. We analysed the influenza type/subtype distribution by age group and medical care wards (ambulatory, hospital, intensive care unit). Material and Methods: During 2017/2018 season, 14 hospitals from Portugal mainland and Atlantic Island (Azores and Madeira) reported to the National Influenza Centre 13747 cases of respiratory infection, all tested for influenza type and/or subtype. Epidemiological data: age, sample collection, hospital dwelling service and patient outcome were reported. Results: From the 13747 reported cases, 3717(27%) were influenza positive of which 2033 (55%) were influenza B, 722 (19%) A unsubtyped, 505 (14%) AH3, 442 (12%) AH1pdm09 and 15(0,1%) mixed infections. Influenza A was detected in 71% (204/208) of toddlers(<5 years) although in the remaining age groups influenza B was detected in more than 50% of the confirmed flu cases. Influenza B was the predominant virus in hospitalized and ICU influenza cases between 5-14 years (69% and 75%, respectively) and played a major role in elderly (65+ years) hospitalized and ICU cases(57% and 67%, respectively). AH1pdm09 virus was detected in 30% of the influenza confirmed ICU patients, 2.1 times more than in hospitalized cases in other wards and 3.3 times more than influenza AH1pdm09 cases in ambulatory care. Influenza mixed infection were detected sporadically,mainly in hospitalized and ICU patients. From 2080 known outcomes, 40(1.9%) patients deceased, influenza was confirmed in 11(28%) of these cases. Conclusions: Cocirculation of different influenza virus type/subtype may indicate different infection profiles by age groups and should guide influenza preventive/treatment measures.N/

Functional polymorphisms in the p53 pathway genes on the genetic susceptibility to zika virus teratogenesis

Congenital Zika Syndrome (CZS) occurs in up to 42% of individuals exposed to ZIKV prenatally. Deregulation in gene expression and protein levels of components of the p53 signaling pathway, such as p53 and MDM2, due to ZIKV infection has been reported. Here, we evaluate functional polymorphisms in genes of the p53 signaling pathway as risk factors to CZS. Forty children born with CZS and forty-eight children exposed to ZIKV, but born without congenital anomalies were included in this study. Gestational and sociodemographic information as well as the genotypic and allelic frequencies of functional polymorphisms in TP53, MDM2, MIR605 and LIF genes were compared between the two groups. We found children with CZS exposed predominantly in the first trimester and controls in the third trimester (p<0.001). Moreover, children with CZS were predominantly from families with a lower socioeconomic level (p=0.008). We did not find a statistically significant association between the investigated polymorphisms and development of CZS; however, by comparing individuals with CZS and lissencephaly or without lissencephaly, we found a significative difference in the allelic frequencies of the TP53 rs1042522, which is associated with a more potent p53-induced apoptosis (p=0.007). Our findings suggest that the TP53 rs1042522 polymorphism should be better investigate as a genetic risk factor for the development of lissencephaly in children with CZS

Infraestrutura e processo de trabalho na atenção primária à saúde: PMAQ no Ceará

OBJETIVO: Analisar a qualidade da infraestrutura e do processo de trabalho da Estratégia Saúde da Família nos municípios do Ceará entre 2012 e 2014. MÉTODOS: Estudo transversal, utilizando dados secundários da avaliação externa do 1º (2012) e 2º (2014) ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica no Ceará. Vinte indicadores compostos foram utilizados para averiguar a qualidade da infraestrutura e do processo de trabalho. RESULTADOS: Dados de 183 (99,4%) dos 184 municípios foram avaliados nos dois ciclos. Avaliaram-se 1.441 equipes para infraestrutura e 800 equipes para processo de trabalho. Dentre os 20 indicadores compostos avaliados, houve melhoria em 18, porém de forma não homogênea, variando de 0,0 a 413,5%. Observou-se que quanto menor o valor inicial do indicador, maior a variação na qualidade entre 2012 e 2014. Os indicadores da infraestrutura e do processo de trabalho foram influenciados pela região de saúde e porte populacional do município, sendo mais evidente a influência nas variáveis de processo de trabalho. CONCLUSÕES: Identificou-se que melhorias da qualidade referentes à infraestrutura e ao processo de trabalho ocorreram no período de implantação do programa no estado do Ceará de forma equitativa, sendo influenciadas pelo porte populacional e pela região, demonstrando a influência do contexto na implementação de políticas públicas dessa natureza.OBJECTIVE: To analyze the quality of the infrastructure and work process of the Family Health Strategy in the municipalities of Ceará between 2012 and 2014. METHODS: Cross-sectional study, using secondary data from the external evaluation of the 1st (2012) and 2nd (2014) cycle of the National Program for Improvement of Access and Quality of Primary Care in Ceará. A total of 20 composite indicators were used to verify the quality of infrastructure and work process. RESULTS: Data from 183 (99.4%) of the 184 municipalities of Ceará were collected in both cycles. A total of 1,441 teams were evaluated for the infrastructure and 800 for the work process. Among the 20 composite indicators evaluated, 18 presented an improvement, but in a non-homogeneous way, ranging between 0.0 and 413.5%. We observed that the lower the initial value of the indicator, the greater the variation in quality between 2012 and 2014. The indicators of infrastructure and work process were influenced by the regional health system and population size of the municipality, being more evident the influence on the variables of the work process. CONCLUSIONS: We identified that quality improvements related to infrastructure and work process occurred in the period of implementation of the program in the state of Ceará in an equitable manner, being influenced by population size and regional health system, showing the influence of the context in the implementation of public policies of this nature

O PAPEL DO DIAGNÓSTICO POR IMAGEM RADIOLÓGICO NO COMBATE À COVID-19

Introduction: Diagnostic imaging has played a key role in the Covid-19 frontline, os its diagnostic imaging exams allow the medical team to evaluate the structures affected by the virus. Objective: To demonstrate the relevance of diagnostic imaging in the context of Covid-19. Metodologia: It was based on an integrative Literature Review, through the guiding question "What is the role of diagnostic radiological imaging in combating Covid-19?'‘. The following electronic databases were used: Latin American and Caribbean Health Sciences Literature (LILACS) and International Health Sciences Literature (MEDLINE) through the Regional Portal of the Virtual Health Library (VHL) and the Scientific Electronic Library Online (SciELO). Thus, 147 publications were detected, of which, after applying the inclusion and exclusion criteria, 14 articles, published in the period from 2019 to 2021, were selected for the sample of this review. Results: Computed tomography (CT) and then X-ray. This is because CT allows the thoracic region to be evaluated in all dimensions, identifying changes already at the beginning. The X-ray, in turn, is more limited, allowing visualization of only the most severe changes in the lung. Final considerations: It can be concluded that CT, in relation to X-rays, presents a greater possibility of diagnosis because of its complexity in demonstrating the structure in focus with a wealth of details.Introducción: El diagnóstico por imagen ha prestado un papel fundamental en la línea de frente al Covid-19, ya que sus exámenes de diagnóstico por imagen permiten al equipo médico una evaluación de las estructuras afectadas por el virus. Objetivo: Demostrar la relevancia del diagnóstico por imagen en el contexto del COVID-19. Metodología: Se basa en una revisión integradora de la literatura, a través de la pregunta norteamericana "¿Cuál es el papel del diagnóstico por imagen radiológica en el combate a la Covid-19?". Se utilizaron las siguientes bases de datos electrónicas: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Literatura Internacional en Ciencias de la Salud (MEDLINE) a través del Portal Regional de la Biblioteca Virtual en Salud (BVS) y la Scientific Electronic Library Online (SciELO). Así, se detectaron 147 publicaciones, de las cuales, tras aplicar los criterios de inclusión y exclusión, se seleccionaron 14 artículos, publicados en el periodo comprendido entre 2019 y 2021, para la muestra de esta revisión. Resultados: La tomografía computarizada (TC) y luego la radiografía. Esto se debe a que la TC permite evaluar la región torácica en todas sus dimensiones, identificando los cambios ya desde el principio. La radiografía, por su parte, es más limitada y sólo permite visualizar los cambios más graves en el pulmón. Consideraciones finales: Se concluye que la tomografía en relación a las radiografías presenta mayores posibilidades diagnósticas por su complejidad para demostrar con gran detalle la estructura enfocada.Introdução: O diagnóstico por imagem tem prestado um papel fundamental na linha de frente a Covid-19, pois seus exames de diagnóstico imagens possibilitam à equipe médica uma avaliação das estruturas afetadas pelo vírus. Objetivo: Demonstrar a relevância do diagnóstico por imagem no contexto da COVID-19. Metodologia: Baseou-se em uma Revisão integrativa de literatura, através de questão norteadora “Qual o papel do diagnóstico por imagem radiológico no combate à Covid-19?’’. Utilizou-se as bases de dados eletrônicas: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Literatura Internacional em Ciências da Saúde (MEDLINE) por meio do Portal Regional da Biblioteca Virtual em Saúde (BVS) e a Scientific Eletronic Library Online (SciELO). Assim, detectaram-se 147 publicações, das quais, após aplicação dos critérios de inclusão e exclusão, foram selecionados para a amostra desta revisão 14 artigos, publicados no período de 2019 a 2021. Resultados: A tomografia computadorizada (TC) e, em seguida, o raio X. Isso porque a TC permite avaliar a região torácica em todas as dimensões, identificando mudanças já no início. O raio X, por sua vez, é mais limitado, permitindo visualizar apenas alterações mais graves no pulmão. Considerações finais: Conclui-se, que a tomografia em relação às radiografias apresenta maior possibilidade de diagnóstico por conta de sua complexibilidade em demonstrar com riqueza de detalhes a estrutura em foco

Spatial analysis of probable cases of dengue fever, chikungunya fever and zika virus infections in Maranhao State, Brazil

Dengue fever, chikungunya fever, and zika virus infections are increasing public health problems in the world, the last two diseases having recently emerged in Brazil. This ecological study employed spatial analysis of probable cases of dengue fever, chikungunya fever, and zika virus infections reported to the National Mandatory Reporting System (SINAN) in Maranhao State from 2015 to 2016. The software GeoDa version 1.10 was used for calculating global and local Moran indices. The global Moran index identified a significant autocorrelation of incidence rates of dengue (I=0.10; p=0.009) and zika (I=0.07; p=0.03). The study found a positive spatial correlation between dengue and the population density (I=0.31; p&lt;0.001) and a negative correlation with the Performance Index of Unified Health System (PIUHS) by basic care coverage (I=-0.08; p=0.01). Regarding chikungunya fever, there were positive spatial correlations with the population density (I=0.06; p=0.03) and the Municipal Human Development Index (MHDI) (I=0.10; p=0.002), and a negative correlation with the Gini index (I=-0.01; p&lt;0.001) and the PIUHS by basic care coverage (I=-0.18; p&lt;0.001). Lastly, we found positive spatial correlations between Zika virus infections and the population density (I=0.13; p=0.005) and the MHDI (I=0.12; p&lt;0.001), as well as a negative correlation with the Gini index (I=-0.11; p&lt;0.001) and the PIUHS by basic care coverage (I=-0.05; p=0.03). Our results suggest that several socio-demographic factors influenced the occurrence of dengue fever, chikungunya fever, and zika virus infections in Maranhao State

Influenza seroprotection correlates with predominant circulating viruses during 2014/15 and 2015/16 seasons in Portugal

Rede Portuguesa de Laboratórios para o Diagnóstico da GripeBACKGROUND: Population immune profile for influenza is highly affected by circulating influenza viruses, thus changing the risk of infection for influenza. This study aims to assess influenza immunity in the Portuguese population by age groups, during 2014 and 2015 and establish a relationship between seroprotection and circulating influenza viruses in 2014/15 and 2015/16 seasons. METHODS: Two cross-sectional studies were developed based on a convenience serum sample collected in June 2014 (n=626) and July 2015 (n=675) in hospitals from mainland and Azores and Madeira.Serums equally represent all age groups. Antibody titers were evaluated by HI assay for strains recommended for seasonal influenza vaccine northern hemisphere,2014/15 and 2015/2016. Seroprevalences were estimated for each strain by age group and the association with seasonal cumulative influenza-like illness (ILI) rates for influenza virus during both seasons was analised. RESULTS: In June 2014 the highest seroprotection was observed for influenza A(H3) (39.0%; 95% CI: 36.2-43.8%) and A(H1)pdm09 (29.7; 95% CI: 26.3-33.4%), with higher levels in children 5-14 years old. In 2014/2015 a dominant circulation of influenza B/Yamagata was observed with high incidence rates in individuals under 65 years old, the ones that had lower seroprotection. Although before the start of the season high protection for A(H3) was observed, the circulation of the new drift A(H3) strains had gained an immunological advantage,in accordance with A(H3) elevated incidence rates observed during 2014/15. In July 2015 the highest seroprotection was observed for influenza B/ Yamagata (55.1%; 95% CI: 51.4-58.9%), 2.4 times the estimated 2014.This increase was even more pronounced in younger (≤ 4 years old), 6.3 times increase in 2015.This fact is in agreement with the predominant influenza B virus detected and the high ILI incidence rate observed in children during 2014/2015 epidemic. Seroprotection levels for influenza A in July 2015 were not significantly different from 2014.During 2015/16 season, influenza A(H1N1)pdm09 was predominant, with high incidence rate in < 65 year old. Influenza B/Victoria lineage,although detected at low levels increased in frequency, in agreement with the lowest level of seroprotection detected in the general population before the start of 2015/2016 season (21.8%; 95% CI: 18.7-24.0%). CONCLUSIONS There was a correlation between virus circulation, incidence rates for each age group and the previous seroprotection for seasonal influenza viruses.Our study highlights the value of measuring the serological profile for influenza to establishe risk groups for infection for which an increase preventive measures, including vaccination, should be fostered.info:eu-repo/semantics/publishedVersio

A Investigação e a escrita: Publicar sem Perecer

Research and Writing: Publish do not Perish is a collection of texts published in Portuguese, based on the problematization of a five-year experience of advanced extracurricular training in information literacy, writing and scientific publication (i.e., Publish do not Perish: Survive the Stampede). It is a questioning of the role of science in a context that appears to reproduce neoliberalism and the commodification of academia. This work results from the collaboration of national and international authors who consider a diversity of theoretical and empirical fields that deal with that phenomenon. This book aims to identify and question the subsequent problems, trying to point out solutions to the growing malaise in the academic world