Qualidade de vida e sintomatologia emocional e comportamental em adolescentes com doença das células falciformes

Dissertação de mestrado, Psicologia (Área de Especialização em Psicologia Clínica e da Saúde - Psicologia da Saúde e da Doença), Universidade de Lisboa, Faculdade de Psicologia, 2021Enquadramento: estudos têm verificado que as manifestações e características da Doença das Células Falciformes (DCF) têm impacto nos domínios da Qualidade de Vida Relativa à Saúde (QVRS) dos adolescentes e que os coloca em risco para perturbações psicossociais. Esses resultados foram reforçados na revisão sistemática de literatura apresentada neste estudo, que seguiu as recomendações da Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) e incluiu 29 artigos na análise. Objetivo: identificar os níveis da QVRS e os indicadores de problemas emocionais e comportamentais em adolescentes com DCF. Método: a amostra integrou 22 participantes, 11 adolescentes com DCF com idades entre 13 e 17 anos e 11 pais/cuidadores, que preencheram o Pediatric Quality of Life Sickle Cell Disease Module (PedsQL-SCD), o KIDSCREEN-10 e o Pediatric Symptom Checklist-17 (PSC-17). Foi realizada uma análise descritiva e correlacional. Resultados: os adolescentes da amostra apresentam QVRS baixa, com resultados piores nas subescalas relativas ao impacto e controlo da dor, tanto no relato dos adolescentes como dos pais/cuidadores. No KIDSCREEN-10, verificou-se uma QVRS moderada, em ambos os relatos. No relato dos adolescentes verificaram-se associações significativas entre perturbações emocionais e de comportamento e dificuldades na comunicação com os cuidadores formais sobre a doença; e entre o risco para problemas de internalização e as subescalas relativas a emoções negativas direcionadas à DCF e dificuldades de compreensão por outras pessoas do diagnóstico. No relato dos pais/cuidadores, foram identificadas associações negativas entre o risco de perturbações emocionais e de comportamento e a subescala Emoções e a perceção de que a QVRS dos adolescentes é afetada por dificuldades de compreensão da sua doença por outros. Conclusões: este estudo reforça os resultados de estudos similares sobre a prevalência de risco de perturbações psicossociais e emoções negativas em relação à doença, avaliadas pelos adolescentes e pelos seus pais/cuidadores, e colocando em evidência a relação entre a QVRS e as características da DCF, especificamente, o impacto da dor e o seu controlo.Background: studies have found that the manifestations and characteristics of Sickle Cell Disease (SCD) have an impact on domains of adolescents’ health-related quality of life (HRQoL), and that it puts them at risk for psychosocial disorders. These results were reinforced in the systematic review presented in this study, which followed the recommendations of the Preferred Reporting Item for Systematic Reviews and Meta-Analysis and included 29 articles. Objective: identify HRQoL levels and signs of emotional and behavioral problems in adolescents with SCD. Method: the sample consisted of 22 participants, 11 adolescents with SCD, ages 13 to 17 years, and 11 parents/caregivers, who completed the Pediatric Quality of Life Sickle Cell Disease Module (PedsQL-SCD), the KIDSCREEN- 10 and the Pediatric Symptom Checklist-17 (PSC-17). Descriptive and correlational analysis were performed. Results: the adolescents in this sample have a low HRQoL and, as shown in the self and parent proxy reports, the subscales related to pain impact and control have the worst results. KIDSCREEN-10 showed a moderate HRQL in both reports. In the adolescents' self-report, significant associations were found between emotional and behavioral problems, and difficulties in communicating with medical staff about the disease; as well as between risk for internalizing problems and the subscales related to negative emotions directed towards SCD and difficulty when others don’t understand what is like having SCD. In parent-proxy negative associations were identified between the risk of emotional and behavioral disturbances and negative emotions like anger, as well as the perception that the adolescents' HRQoL is affected when other people don’t understand what is like having SCD. Conclusions: this study reinforces the results of similar studies about the prevalence of risk for psychosocial problems and negative emotions related to the disease, assessed by adolescents and parents/caregivers and highlights the relation between HRQoL and SCD’s characteristics, especially the impact and control of pain

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved