Meanings attributed by family and patients to family presence in emergency rooms

Objective: to understand the process that leads adult and family patients to support family presence in emergency care. Method: a qualitative study that adopted Symbolic Interactionism as a theoretical reference and the Grounded Theory as a methodological framework. The theoretical sample consisted of 15 relatives and 15 patients assisted at two emergency units in the South of Brazil. Data were analyzed using open, axial and selective coding. Results: the central category ¿Convergence of ideas: family members and patients supporting family presence in emergency care? is supported by the categories: Affectionate relationship among family members?; Tacit obligation to care for the sick relative?; Benefits for the family?; Benefits for the patient?; and Benefits for the health team?. Conclusion: family presence in emergency care provides maintenance and strengthening of affectionate bonds among relatives and the experience of more sensitive and qualified care.Objetivo: comprender el proceso que lleva a pacientes adultos y familiares a apoyar la presencia de la familia en la atención de emergencia. Método: estudio cualitativo que adoptó el Interaccionismo Simbólico como referencial teórico y la Teoría Fundamentada en los Datos como referencial metodológico. El muestreo teórico fue compuesta por 15 familiares y 15 pacientes atendidos en dos unidades de emergencia en el sur de Brasil. Los datos fueron analizados por medio de codificación abierta, axial y selectiva. Resultados: la categoría central “Convergencia de ideas: familiares y pacientes apoyando la presencia de la familia en la atención de emergencia” es sostenida por las categorías: “Afetuosa relación entre los miembros de la familia”; “Obligación tácita de cuidar del familiar enfermo “; “Beneficios para la familia”; “Beneficios para el paciente”; y “Beneficios para el equipo de salud”. Conclusión: la presencia familiar en la atención de emergencia proporciona el mantenimiento y el fortalecimiento de los lazos afectivos entre los familiares y la vivencia de cuidados más sensibles y calificados.Objetivo: compreender o processo que leva pacientes adultos e familiares a apoiarem a presença da família no atendimento emergencial. Método: estudo qualitativo que adotou o Interacionismo Simbólico como referencial teórico e a Teoria Fundamentada nos Dados como referencial metodológico. A amostragem teórica foi composta por 15 familiares e 15 pacientes atendidos em duas unidades emergenciais no Sul do Brasil. Os dados foram analisados por meio de codificação aberta, axial e seletiva. Resultados: a categoria central “Convergência de ideias: familiares e pacientes apoiando a presença da família no atendimento emergencial” é sustentada pelas categorias: “Afetuosa relação entre os membros da família”; “Obrigação tácita de cuidar do familiar enfermo”; “Benefícios para a família”; “Benefícios para o paciente”; e “Benefícios para a equipe de saúde”. Conclusão: a presença familiar no atendimento emergencial proporciona a manutenção e o fortalecimento dos laços afetivos entre os familiares e a vivência de cuidados mais sensíveis e qualificados

Development of an edible coating for preservation of Serra da Estrela cheese : surface characterization and coating formulation

Serra da Estrela cheese is the most prestigious traditional Portuguese cheese, being recognized worldwide. In order to prolong the shelf life of this product, which occurs mostly by external spoilage and growth of fungi and moulds on its surface, the application of an edible coating has been considered. For this purpose, the external surface characterization was performed and the type of surface determined. For this, the sessile drop method was applied, i.e. the contact angle between the surface and the droplet of three pure liquids - bromonaphthalene, formamide and water - was calculated and the surface energy was determined. Polar and apolar components obtained were 7.09 mN/m and 35.53 mN/m, being the cheese surface tension 42.62 mN/m, which means that the cheese has a low surface energy (i.e. <100 mN/m). This value allows using Zisman’s method and calculating the critical surface tension (32.68 mN/m). In order to determine the coating formulation with the best composition for application on cheese, the wettability of 27 formulations (three different polymers were used - alginate, guar gum and chitosan - with different concentrations of glycerol and Tween 20, totaling 9 formulations for each polymer) was evaluated. Formulations with 1% (w/v) alginate with 0.1% (w/v) of glycerol and 0.15% (w/v) of Tween 20; 1% (w/v) guar gum with 0.3% (w/v) of glycerol and 0.15% (w/v) of Tween 20; 1% (w/v) chitosan with 0.3% (w/v) of glycerol and 0.15% (w/v) of Tween 20, were the solutions with better wetting capacity on cheese surface. The spreading coefficients were -15.20 mN/m, -21.83 mN/m and -15.07 mN/m for alginate, guar gum and chitosan solutions, respectively. Pareto charts analysis allowed concluding that for alginate-based coatings, the variation of the polymer formulation, together with glycerol and Tween 20 concentrations have significant influence on the values obtained. The same happened in guar gum films. Regarding the coatings containing chitosan, it is only the biopolymer concentration that has significant influence on the values of wettability. These three alternative compositions for edible coatings can now be tested aiming at valorizing this traditional cheese by improving its shelf-life and marketing potential

Motor uncoordination and neuropathology in a transgenic mouse model of Machado-Joseph disease lacking intranuclear inclusions and ataxin-3 cleavage products

Machado-Joseph disease (MJD) is a late-onset neurodegenerative disorder caused by a polyglutamine (polyQ) expansion in the ataxin-3 protein. We generated two transgenic mouse lineages expressing the expanded human ataxin-3 under the control of the CMV promoter: CMVMJD83 and CMVMJD94, carrying Q83 and Q94 stretches, respectively. Behavioral analysis revealed that the CMVMJD94 transgenic mice developed motor uncoordination, intergenerational instability of the CAG repeat and a tissue-specific increase in the somatic mosaicism of the repeat with aging. Histopathological analysis of MJD mice at early and late stages of the disease revealed neuronal atrophy and astrogliosis in several brain regions; however, we found no signs of microglial activation or neuroinflammatory response prior to the appearance of an overt phenotype. In our model, the appearance of MJD-like symptoms was also not associated with the presence of ataxin-3 cleavage products or intranuclear aggregates. We propose the transgenic CMVMJD94 mice as a useful model to study the early stages in the pathogenesis of MJD and to explore the molecular mechanisms involved in CAG repeat instability.We would like to thank to Dr. Henry Paulson for providing the anti-ataxin-3 serum, Dr. Monica Sousa for the pCMV vector and to Eng. Lucilia Goreti Pinto for technical assistance. AS-F., M.C.C., S.S. and C.B. received FCT fellowships (SFRH/BD/15910/2005; SFRH/BPD/28560/2006; PTDC/SAU-GMG/64076/2006; SFRH/BPD/20987/2004). This research was funded by Fundacao para a Ciencia e Tecnologia through projects FEDER/FCT, POCI/SAU-MMO/60412/2004, PTDC/SAU-GMG/64076/2006; and Ataxia MJD Research Project

Genotypes at the APOE and SCA2 loci do not predict the course of multiple sclerosis in patients of Portuguese origin

Prova tipográfica (In Press)Multiple sclerosis (MS) is a demyelinating disease that affects about one in 500 young Europeans. In order to test the previously proposed influence of the APOE and SCA2 loci on susceptibility to MS, we studied these loci in 243 Portuguese patients and 192 healthy controls and both parents of 92 patients. We did not detect any significant difference when APOE and SCA2 allele frequencies of cases and controls were compared, or when we compared cases with different forms of the disease. Disequilibrium of transmission was tested for both loci in the 92 trios, and we did not observe segregation distortion. To test the influence of the APOE o4 and SCA2 22 CAGs alleles on severity of disease, we compared age at onset and progression rate between groups with and without those alleles. We did not observe an association of the o4 or the 22 CAGs alleles with rate of progression in our total patient population; allele o4 was associated with increased rate of progression of MS in a subset of patients with less than 10 years of the disease. However, globally in the Portuguese population, the APOE and SCA2 genes do not seem to be useful in the clinical context as prognostic markers of this disorder.Fundação para a Ciência e a Tecnologia (FCT) - grant SFRH/BD/9111/2002.Serono Portugal

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