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

Label-free Detection of Microcystin-LR in Waters Using Real-Time Potentiometric Biosensors Based on Single-Walled Carbon Nanotubes Imprinted Polymers

Microcystin-LR (MC-LR) is a dangerous toxin found in environmental waters, quantified by high performance liquid chromatography and/or enzyme-linked immunosorbent assays. Quick, low cost and on-site analysis is thus required to ensure human safety and wide screening programs. This work proposes label-free potentiometric sensors made of solid-contact electrodes coated with a surface imprinted polymer on the surface of Multi-Walled Carbon NanoTubes (CNTs) incorporated in a polyvinyl chloride membrane. The imprinting effect was checked by using non-imprinted materials. The MC-LR sensitive sensors were evaluated, characterized and applied successfully in spiked environmental waters. The presented method offered the advantages of low cost, portability, easy operation and suitability for adaptation to flow methods

An SOS-regulated operon involved in damage-inducible mutagenesis in Caulobacter crescentus

DNA polymerases of the Y-family, such as Escherichia coli UmuC and DinB, are specialized enzymes induced by the SOS response, which bypass lesions allowing the continuation of DNA replication. umuDC orthologs are absent in Caulobacter crescentus and other bacteria, raising the question about the existence of SOS mutagenesis in these organisms. Here, we report that the C.crescentus dinB ortholog is not involved in damage-induced mutagenesis. However, an operon composed of two hypothetical genes and dnaE2, encoding a second copy of the catalytic subunit of Pol III, is damage inducible in a recA-dependent manner, and is responsible for most ultraviolet (UV) and mitomycin C-induced mutations in C.crescentus. The results demonstrate that the three genes are required for the error-prone processing of DNA lesions. The two hypothetical genes were named imuA and imuB, after inducible mutagenesis. ImuB is similar to proteins of the Y-family of polymerases, and possibly cooperates with DnaE2 in lesion bypass. The mutations arising as a consequence of the activity of the imuAB dnaE2 operon are rather unusual for UV irradiation, including G:C to C:G transversions

Calcaneus stress fracture: a case report

Calcaneal stress fracture is a rare clinical entity associated with diverse etiological factors such as high intensity training, female sex, smoking and poor nutrition. The authors present a case of a calcaneal stress fracture treated conservatively with immobilization, limited weight bearing and vitamin D supplementation.

Effect of Tumor Necrosis Factor Inhibitor Therapy on Osteoclasts Precursors in Rheumatoid Arthritis

Objective. Tumor necrosis factor (TNF) increases circulating osteoclast (OC) precursors numbers by promoting their proliferation and differentiation. The aim of this study was to assess the effect of TNF inhibitors (TNFi) on the differentiation and activity of OC in rheumatoid arthritis (RA) patients. Methods. Seventeen RA patients treated with TNFi were analyzed at baseline and after a minimum follow-up period of 6 months. Blood samples were collected to assess receptor activator of nuclear factor kappa-B ligand (RANKL) surface expression on circulating leukocytes and frequency and phenotype of monocyte subpopulations. Quantification of serum levels of bone turnover markers, in vitro OC differentiation assays, and qRT-PCR for OC specific genes was performed. Results. After TNFi therapy, patients had reduced RANKL surface expression in B-lymphocytes and the frequency of circulating classical CD14(bright) CD16-monocytes was decreased. Serum levels of sRANKL, sRANKL/OPG ratio, and CTX-I were reduced in RA patients after TNFi treatment. Moreover, after exposure to TNFi, osteoclast differentiation and activity were decreased, as well as the expression of TRAF6 and cathepsin K. Conclusion. We propose that TNFi arrests bone loss and erosion, through two pathways: direct reduction of osteoclast precursor numbers and inhibition of intracellular signaling pathways acting through TRAF6.Peer reviewe

Exploring Perceived Barriers to Physical Activity among Older Adults Living in Low-Population Density Regions: Gender Differences and Associations with Activity Dimensions

This study was funded by PORTUGAL2020 and by the Fundação para a Ciência e a Tecnologia (FCT, I.P.), under project SAICT-POL/23811/2016 and through the Portuguese Foundation for Science and Technology, I.P., under project UID04045/2020. The Polytechnic of Guarda partly supported the research reported in this publication.[Abstract] : Older people in low-population density regions tend to have fewer resources to engage in regular physical activity (PA) compared to their counterparts in urban areas. Moreover, PA assumes different dimensions, and the amount of PA related to each dimension may differ between women and men, predisposing them to different PA practices. Therefore, this cross-sectional study aims to describe the prevalence of barriers to PA, gender differences, and their associations with different PA dimensions. A total of 259 older adults (153 women and 106 men; age, 75.17 ± 8.05 years old) living in the community in the region of Guarda (Portugal) were interviewed face to face to record their sociodemographic characteristics, general health status (comorbidity index and self-reported health), PA behaviour, and barriers to PA. Women were more likely to report “low” income and living alone (p ≤ 0.05), while men reported a higher negative health status than women (p < 0.05). Two intrinsic (“Fear of injury” (40.1%) and “Need for rest” (26.3%)) and two extrinsic barriers (“Lack of nearby facilities” (30.5%) and “I don’t have transport” (25.6%)) were the most prevalent. For women, age, self-reported health, comorbidity index, and intrinsic and extrinsic barriers were similarly associated with the different PA dimensions. However, only self-reported health and extrinsic barriers were the variables associated with the different PA dimensions in men. Therefore, strategies to promote active ageing in low-population density regions should be focused on reducing intrinsic and extrinsic barriers based on gender and the PA dimension to be achieved.PORTUGAL2020; SAICT-POL/23811/2016Fundação para a Ciência e a Tecnologia (FCT, I.P.); SAICT-POL/23811/2016Portuguese: Fundação para a Ciência e a Tecnologia; UID04045/202

Exploring perceived barriers to physical activity among older adults living in low-population density regions: gender differences and associations with activity dimensions

Older people in low-population density regions tend to have fewer resources to engage in regular physical activity (PA) compared to their counterparts in urban areas. Moreover, PA assumes different dimensions, and the amount of PA related to each dimension may differ between women and men, predisposing them to different PA practices. Therefore, this cross-sectional study aims to describe the prevalence of barriers to PA, gender differences, and their associations with different PA dimensions. A total of 259 older adults (153 women and 106 men; age, 75.17 8.05 years old) living in the community in the region of Guarda (Portugal) were interviewed face to face to record their sociodemographic characteristics, general health status (comorbidity index and self-reported health), PA behaviour, and barriers to PA.Women were more likely to report “low” income and living alone (p 0.05), while men reported a higher negative health status than women (p < 0.05). Two intrinsic (“Fear of injury” (40.1%) and “Need for rest” (26.3%)) and two extrinsic barriers (“Lack of nearby facilities” (30.5%) and “I don’t have transport” (25.6%)) were the most prevalent. For women, age, self-reported health, comorbidity index, and intrinsic and extrinsic barriers were similarly associated with the different PA dimensions. However, only self-reported health and extrinsic barriers were the variables associated with the different PA dimensions in men. Therefore, strategies to promote active ageing in low-population density regions should be focused on reducing intrinsic and extrinsic barriers based on gender and the PA dimension to be achieved.This study was funded by PORTUGAL2020 and by the Fundação para a Ciência e a Tecnologia (FCT, I.P.), under project SAICT-POL/23811/2016 and through the Portuguese Foundation for Science and Technology, I.P., under project UIDB/04045/2020. The Polytechnic of Guarda partly supported the research reported in this publication.info:eu-repo/semantics/publishedVersio

Ankylosing Spondylitis Patients Have Impaired Osteoclast Gene Expression in Circulating Osteoclast Precursors

Introduction: Ankylosing spondylitis (AS) is typically characterized by focal bone over-growth and also by systemic bone loss. We hypothesize that the increased osteoproliferation found in AS might be partially due to reduced ability of osteoclast precursors (OCPs) to differentiate into osteoclasts (OCs). Therefore, our aim was to characterize bone remodeling and pro-osteoclastogenesis inflammatory environment, monocytes' phenotype, and in vitro osteoclast differentiation in AS patients. Methods: Patients with active AS without any ongoing therapy and age-and gender matched healthy donors were recruited. Receptor activator of nuclear factor-K13 (RANKL) surface expression on circulating leukocytes and frequency and phenotype of monocyte subpopulations were assessed. Quantification of serum levels of bone turnover markers and cytokines, in vitro OC differentiation assay and quantitative reverse transcription real-time PCR for OC-specific genes were performed. Results: Pro-and anti-inflammatory cytokine serum levels were higher in AS patients than in controls. RANKL neutrophil expression was higher in AS patients when compared to healthy donors, but CD51/CD61 expression was lower in the classical monocyte subpopulation. Concerning osteoclastogenesis, we found no differences in the in vitro osteoclast differentiating potential of these cells when compared to healthy donors. However, we observed low expression of CSF1R, RANK, and NFATc1 in AS OCPs. Conclusion: Despite the high levels of pro-inflammatory cytokines present in AS patients, no differences in the number of OC or resorbed area were found between AS patients and healthy donors. Moreover, we observed that OCPs have low OC specific gene expression. These findings support our hypothesis of an impaired response of OCPs to pro-osteoclastogenic stimuli in vivo in AS patients.Peer reviewe