35 research outputs found

    Influence of psychosocial risks on the quality of life of employees in a higher education institution : a critical perspective

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    According to Muchinsky (2000), the activity in which humans are most involved in their lives is work. Thus, there is an increasing trend towards the humanization of work. Consequently, it is imperative to study the best ways to manage human resources in 21st-century organizations. The main objective of this study is to understand the influence that psychosocial risks in the workplace may have on the personal lives of employees in a Higher Education Institution (HEI), through the application of the Portuguese version of COPSOQ II. Both exploratory and confirmatory statistical analyses were conducted on the results to determine if factors related to work could influence aspects of personal life. It was concluded that great importance is given to employment and that factors related to the professional realm can indeed influence dimensions of these employees' personal lives. Among other things, it was observed that, in the case of the analyzed HEI, cognitive demands directly impact job satisfaction, quantitative demands have direct effects on work-family conflict, and job satisfaction directly influences somatic and cognitive stress. On the other hand, it was found that work-family conflict is primarily influenced by quantitative demands, highlighting the importance of a well-balanced distribution of workload among employees and the definition of concrete objectives.8316-FD77-85EB | Pedro Miguel Fonseca Moreira de Carvalhoinfo:eu-repo/semantics/publishedVersio

    Impact of temperature during beer storage on beer chemical profile

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    LA/P/0140/2020Aiming to gain insights into the impact of storage conditions on the chemical profile of beer samples, changes on the relative amount of several chemical classes of compounds was monitored. The influence of storage conditions was statistically discerned using the hierarchical cluster analysis complemented by heatmap date visualization. Aldehydes, furanic compounds and esters showed a clear role in beers stored at 37 ± 1 °C (contribution >1, as obtained in the heatmap data visualization). The reaction rate constant and temperature dependence was well described by the Arrhenius equation for these compound classes, for which the reaction rate increased with increasing temperatures. The rate of development of furanic compounds, aldehydes and esters showed to be almost 140, 90 and 20 times higher in beers stored at higher temperatures (37 ± 1 °C) when compared to beers stored at 4 ± 1 °C, respectively. These results indicate that temperature was the main parameter contributing to the major changes in beer chemical profile. Through olfactometric analysis, the major difference was found in aged beers, both naturally and forced aged, where the prevalence of sweet and papery aroma notes were noticed, linked to the development of β-damascenone and E-2-nonenal, respectively.publishersversionpublishe

    a Portuguese and Brazilian collaborative analysis

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    OBJECTIVE: To investigate the relationship between body mass index (BMI) and disease activity in patients with Juvenile Idiopathic Arthritis (JIA). METHODS: Patients with JIA, aged ≤18 years, registered at the Rheumatic Diseases Portuguese Register (Reuma.pt) in Portugal and Brazil were included. Age- and sex-specific BMI percentiles were calculated based on WHO growth standard charts and categorized into underweight (P 97). Disease activity was assessed by Juvenile Arthritis Disease Activity Score (JADAS-27). Uni- and multivariate analyses were performed. RESULTS: A total of 275 patients were included. The prevalence of underweight, normal weight, overweight and obesity was 6.9%, 67.3%, 15.3% and 10.5%, respectively. Underweight patients had significantly higher number of active joints (p <0.001), patient's/parent's global assessment of disease activity (PGA) (p=0.020), physician's global assessment of disease activity (PhGA) (p <0.001), erythrocyte sedimentation rate (ESR) (p=0.032) and overall higher JADAS-27 (p <0.001), compared to patients with normal weight, overweight and obesity. In the multivariate regression, underweight persisted significantly associated with higher disease activity, compared to normal weight (B=-9.430, p <0.001), overweight (B=-9.295, p=0.001) and obesity (B=-9.120, p=0.001), when adjusted for age, gender, country, ethnicity, JIA category and therapies used. The diagnosis of RF- (B=3.653, p=0.006) or RF+ polyarticular JIA (B=5.287, p=0.024), the absence of DMARD therapy (B=5.542, p <0.001) and the use of oral GC (B=4.984, p=0.002) were also associated with higher JADAS-27. CONCLUSION: We found an independent association between underweight and higher disease activity in patients with JIA. Further studies are needed to understand the underlying mechanisms of this association.publishersversionpublishe

    Comparison with adult-onset rheumatic diseases

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    Objective To compare physical disability, mental health, fatigue and health-related quality of life (HRQoL) across juvenile idiopathic arthritis (JIA) categories in adulthood and between JIA and adult-onset rheumatic diseases. Methods Cross-sectional analysis nested in a cohort of adult patients with JIA registered in the Rheumatic Diseases Portuguese Register (Reuma.pt). Physical disability (Health Assessment Questionnaire - Disability Index), mental health symptoms (Hospital Anxiety and Depression Scale), fatigue (Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F)) and HRQoL (EuroQol-5D (EQ5D) and Short Form (SF-36)) were compared across JIA categories. Patients with polyarticular JIA and enthesis-related arthritis (ERA) JIA were compared respectively to patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), matched for gender and age, adjusted for disease duration and activity. Results 585 adult patients with JIA were included. Comparison across JIA categories showed that persistent oligoarthritis and patients with ERA reported a higher score in EQ5D and SF-36 physical component when compared with other JIA categories. Polyarticular JIA reported less disability and fatigue than patients with RA (median Health Assessment Questionnaire of 0.25 vs 0.63; p<0.001 and median FACIT-F score 42 vs 40; p=0.041). Polyarticular JIA had also better scores on EQ5D and all domains of SF-36, than patients with RA. Patients with ERA reported less depression and anxiety symptoms (0% vs 14.8%; p=0.003% and 9% vs 21.3%; p=0.002) and less fatigue symptoms (45 vs 41; p=0.01) than patients with SpA. Conclusion Persistent oligoarticular JIA and ERA are the JIA categories in adulthood with better HRQoL. Overall, adult polyarticular and patients with ERA JIA have lower functional impairment and better quality-of-life than patients with RA and SpA.publishersversionpublishe

    Direct tissue-sensing reprograms TLR4+ Tfh-like cells inflammatory profile in the joints of rheumatoid arthritis patients

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    Funding Information: We thank Cláudia Andrade for technical support and Juliana Gonçalves for testing samples for SARS-CoV-2 exposure. We are extremely grateful to all the participants of the study and to the whole rheumatology department at Hospital Egas Moniz that made this study possible. This work was supported by Fundação para a Ciência e Tecnologia (FCT) PTDC/MEC-REU/29520/2017, by iNOVA4Health UID/Multi/04462 and by Portuguese Society for Rheumatology (SPR) grants to H.S. H.S. is supported by FCT through IF/01722/2013 and CEECIND/01049/2020, DAS and RCT were supported by FCT through PD/BD/137409/2018 and UID/Multi/04462, respectively. Publisher Copyright: © 2021, The Author(s).CD4+ T cells mediate rheumatoid arthritis (RA) pathogenesis through both antibody-dependent and independent mechanisms. It remains unclear how synovial microenvironment impinges on CD4+ T cells pathogenic functions. Here, we identified a TLR4+ follicular helper T (Tfh) cell-like population present in the blood and expanded in synovial fluid. TLR4+ T cells possess a two-pronged pathogenic activity whereby direct TLR4+ engagement by endogenous ligands in the arthritic joint reprograms them from an IL-21 response, known to sponsor antibody production towards an IL-17 inflammatory program recognized to fuel tissue damage. Ex vivo, synovial fluid TLR4+ T cells produced IL-17, but not IL-21. Blocking TLR4 signaling with a specific inhibitor impaired IL-17 production in response to synovial fluid recognition. Mechanistically, we unveiled that T-cell HLA-DR regulates their TLR4 expression. TLR4+ T cells appear to uniquely reconcile an ability to promote systemic antibody production with a local synovial driven tissue damage program.publishersversionpublishe

    Results from the portuguese register

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    Objective Our aims were to evaluate the correlation between Juvenile Arthritis Disease Activity Score 27-joint reduced count (JADAS27) with erythrocyte sedimentation rate (ESR) and JADAS27 with C-reactive protein (CRP) scores and to test the agreement of both scores on classifying each disease activity state. We also aimed at verifying the correlation of the 2 scores across juvenile idiopathic arthritis (JIA) categories and to check the correlation between JADAS27-ESR and clinical JADAS27 (JADAS27 without ESR). Methods A nationwide cohort of patients with JIA registered in the Portuguese Register, Reuma.pt, was studied. JADAS27-CRP was adapted by replacing ESR with CRP level as the inflammatory marker. JADAS27-CRP was calculated similarly to JADAS27-ESR as the simple linear sum of its 4 components. Pearson's correlations and K statistics were used in the analyses. Results A total of 358 children had full data to calculate JADAS27; 65.4% were female and the mean ± SD disease duration was 11.8 ± 9.1 years. The correlation coefficient between JADAS27-ESR and JADAS27-CRP was 0.967 (P < 0.0001), although the correlation coefficient between ESR and CRP level was 0.335 (P < 0.0001). The strong correlation between JADAS27-ESR and JADAS27-CRP was maintained when compared within each JIA category. The agreement between JADAS27-ESR and JADAS27-CRP across the 4 activity states was very good, showing 91.1% of the observations in agreement; K = 0.867 (95% confidence interval 0.824-0.91). The correlation between JADAS27 with ESR and JADAS27 without ESR was high (r = 0.97, P < 0.0001). Conclusion JADAS27 based on CRP level correlated closely with JADAS27-ESR across all disease activity states and JIA categories, indicating that both measures can be used in clinical practice. Moreover, the correlation of JADAS27 with and without ESR was also high, suggesting that this tool might be useful even in the absence of laboratorial measures.publishersversionpublishe

    Comparative effectiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis

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    Funding Information: positions on two Pfizer sponsored trials and has directed an educational course supported by Bristol Myers Squibb. He serves as an epidemiology consultant to CORRONA. J.A.P.S. has received honoraria as a speaker or consultant and benefited from research support from several pharmaceutical companies involved in the production of biologic agents (Abbott, Amgen, MSD, Pfizer and Roche), always at sums less than E10 000. All other authors have declared no conflicts of interest. Funding Information: Funding: This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/ 2010.Objectives: Adalimumab, etanercept and infliximab are effective TNF inhibitors (TNFis) in the treatment of RA, but no randomized clinical trials have compared the three agents. Prior observational data are not consistent. We compared their effectiveness over 1 year in a prospective cohort.Methods: Analyses were performed on subjects' first episode of TNFi use in the Rheumatic Diseases Portuguese Register, Reuma.pt. The primary outcome was the proportion of patients with European League Against Rheumatism good response sustained at two consecutive observations separated by 3 months during the first year of TNFi use. Comparisons were performed using conventional adjusted logistic regression, as well as matching subjects across the three agents using a propensity score. In addition, baseline predictors of treatment response to TNFi were identified.Results: The study cohort included 617 RA patients, 250 starting etanercept, 206 infliximab and 161 adalimumab. Good response was achieved by 59.6% for adalimumab, 59.2% for etanercept and 51.9% for infliximab (P = 0.21). The modelled probability of good response did not significantly differ across agents (etanercept vs adalimumab OR = 0.97, 95% CI 0.55, 1.71; etanercept vs infliximab OR = 1.25, 95% CI 0.74, 2.12; infliximab vs adalimumab OR = 0.80, 95% CI 0.47, 1.36). Matched propensity score analyses also showed no significant treatment response differences. Greater educational attainment was a predictor of better response, while smoking, presence of ACPA, glucocorticoid use and worse physician assessment of disease activity at baseline each predicted a reduced likelihood of treatment response.Conclusion: Over 1 year, we found no difference in effectiveness between adalimumab, etanercept and infliximab.publishersversionpublishe

    Application of ROC methodology to evaluate performance of clinical severity indexes in neonatology units in Portugal

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    Tese de Doutoramento em Engenharia Industrial e de SistemasOs cuidados intensivos pediátricos em Portugal são prestados por uma diversidade de Unidades de Cuidados Intensivos interessando neste estudo, em particular, as unidades que prestam cuidados a recém nascidos de muito baixo peso (<1500 g) e/ou com menos de 32 semanas de gestação. Atualmente, são usadas escalas/índices para medir a gravidade clínica de recém-nascidos, sendo as mais utilizadas no território nacional a Clinical Risk Index for Babies (CRIB) e a Score for Neonatal Acute Physiology II (SNAPPE II). Cada unidade procede a uma recolha individualizada dos dados referentes à sua atividade e que são enviados para o Registo Nacional de Recém-Nascidos de Muito Baixo Peso (RNMBP), que é a entidade responsável pelo armazenamento desta informação. Os dados que integram o presente estudo foram recolhidos pelas unidades de cuidados intensivos neonatais do território português (Continente e Ilhas) entre 2010 e 2012, e o objetivo passa pela avaliação e comparação do desempenho desses dois indicadores (CRIB e SNAPPE II), no que respeita à sua capacidade preditiva da mortalidade neonatal, com recurso à metodologia ROC (Receiver Operating Characteristic), quer a nível do território nacional (Continente e Ilhas) quer a nível diferenciado pela Nomenclatura das Unidades Territoriais para fins Estatísticos (NUTS II). Segundo essa Nomenclatura, consideram-se as regiões: Norte (Viana do Castelo, Braga, Porto, Vila Real e Bragança), Centro (Coimbra, Castelo Branco, Leiria, Viseu, Aveiro e Guarda), Lisboa/Vale do Tejo (Lisboa e Setúbal), Alentejo (Évora, Santarém, Beja e Portalegre), Algarve (Faro) e Ilhas (Açores e Madeira). É avaliada também a influência do sexo do recém-nascido e da idade materna, no poder discriminante das duas escalas, como possíveis covariáveis com expressão na previsão da mortalidade. Neste trabalho aplica-se a análise ROC como metodologia base, ajustando-se curvas ROC empíricas, alisadas (por aplicação do estimador de núcleo) e condicionadas a covariáveis, quer pelo método induzido quer aplicando modelos de regressão linear ROC-GLM, tendo sido obtidas as respetivas medidas de precisão (área abaixo da curva ROC e erro padrão). Para a amostra em estudo, quando considerado todo o território nacional, a escala CRIB provou ser melhor a predizer a mortalidade para recém-nascidos de muito baixo peso, e tem a seu favor um menor número de variáveis comparativamente ao SNAPPE II. A comparação entre a capacidade preditiva das duas escalas, quando utilizado o estimador do núcleo para a obtenção das curvas ROC e as correspondentes curvas ROC empíricas, mostram que as últimas apresentam melhor desempenho. A introdução das covariáveis, sexo do recém-nascido e idade materna, no modelo obtido pelo método induzido mostra que nem a escala CRIB nem a escala SNAPPE II, a nível global, apresentam um desempenho diferenciado na previsão da mortalidade (software R). Considerando que uma relação linear existe entre cada uma das escalas e as covariáveis sexo do recém-nascido, idade da mãe e combinando a informação das duas, utilizando o software STATA, verificou-se que a capacidade discriminante e preditiva da escala CRIB é influenciada pela idade da mãe enquanto a da escala SNAPPE II não se altera sob alguma das possibilidades. A combinação das duas covariáveis faz aumentar o poder discriminante dessa escala. Avaliou-se como contribuem as Unidades de Neonatologia que integram os centros hospitalares das regiões classificadas pela Nomenclatura NUTS II, na capacidade discriminante e preditiva das duas escalas. Na região Norte e na região Lisboa/Vale do Tejo a escala CRIB provou ser melhor na previsão da mortalidade. Para as restantes regiões, o desempenho das escalas é idêntico na previsão da mortalidade. Nas UCIN's das Ilhas, a escala CRIB, quando comparada com a SNAPPE II, provou ter um melhor desempenho na avaliação da mortalidade para recém-nascidos do sexo feminino, enquanto que a introdução da idade da mãe provou que, com base nos valores estimados, a CRIB, para recém-nascidos cujas mães têm idade igual ou superior a 35 anos, apresenta um melhor desempenho nas UCIN's da região Norte e do Algarve. A execução prática deste estudo foi suportada com auxílio a programas estatísticos próprios para a análise ROC, como o SPSS, ROCNPA, ROCR e STATA.Pediatric intensive care in Portugal are provided by a variety of Intensive Care Units. In this study, in particular, the interest lies on units providing care to babies of very low birth weight (<1500 g) and/or less than 32 weeks gestation. Currently, scores/indexes are used to measure the clinical severity of newborns. The most used in Portugal are the Clinical Risk Index for Babies (CRIB) and the Score for Neonatal Acute Physiology II (SNAPPE II). Each unit carries out an individualized collection of data on its activity and that are sent to the National Register of Very Low Birth Weight Newborn (VLBWN), which is responsible for storing this information. The data that are part of the present study were collected by the neonatal intensive care units of the Portuguese territory (mainland and islands) between 2010 and 2012, and the goal involves the evaluation and comparison of the performance of these two indicators (CRIB and SNAPPE II) as regards its predictive ability of neonatal mortality, using the ROC (Receiver Operating Characteristic) methodology. This analysis was performed at the level of mainland Portugal and for the Nomenclature of Territorial Units for Statistics (NUTS II). According to this nomenclature, the regions considered are: Northern (Viana do Castelo, Braga, Porto, Vila Real and Bragança), Center (Coimbra, Castelo Branco, Leiria, Viseu, Aveiro and Guarda), Lisbon/Tejo's Valley (Lisbon and Setúbal), Alentejo (Évora, Santarém, Beja and Portalegre), Algarve (Faro) and Islands (Azores and Madeira). It is also evaluated the influence of the newborn sex and maternal age, on the discriminating power of the two scores as potential covariates with expression in predicting mortality. In this work, the ROC analysis is used as a base methodology, to adjust empirical ROC curves, smoothed ROC curves (using kernel estimator) and for adjusting conditioned ROC curves. For the latest, induced method and models of ROC-GLM regression were applied. For the sample under study, when considering the national territory, the CRIB scale proved better to predict mortality for newborns with very low weight, and has in its favor a smaller number of variables compared to SNAPPE II. Compared the smoothed estimator of the ROC curve with the empirical estimator, the latter shows up more predictive capacity, then better performance. The introduction of covariates (newborn sex and maternal age) when used induced method (software R), shows that neither the CRIB score nor the SNAPPE II, have a differentiated performance in predicting mortality. When a linear relationship between each scale and the covariates is considered (software STATA) it was found that the discriminatory and predictive capacity of the CRIB score is influenced by maternal age while the SNAPPE II scale does not change under any of the possibilities. The combination of the two covariates increases the discriminating power of CRIB score. It was evaluated as contributing the neonatology units that integrate the hospital centers of the regions classified by the nomenclature NUTS II, in discriminant and predictive capacity of the two scales. In North and Lisbon/Tejo's Valley regions the CRIB score proved to be better in predicting mortality. For all other regions, the performance of the two scales in predicting mortality is identical. In the NICU's Islands, the CRIB scale compared with SNAPPE II, proved to perform better in the evaluation of mortality for female newborns; the introduction of the mother's age proved that CRIB score, for newborns whose mothers are aged less than 35 years, presents a better performance in the NICU's of northern and Algarve regions. The practical implementation of this study was supported by statistical programs for ROC analysis, such as SPSS, ROCNPA, ROCR and STATA

    Fostering Customer Loyalty in Kitesurfing: The Case of a Nautical Sports Centre in Portugal

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    In this study, the relationship between service quality, customer satisfaction, and behavioural intention is investigated within a specialised nautical sports centre that offers kitesurfing in Portugal. Using a path analysis model, this study aims to evaluate the effect of the dimensions of service quality on satisfaction and behavioural intention, as well as the effect of satisfaction on the customer’s behavioural intention. According to the results, customer satisfaction is influenced directly by service quality dimensions such as responsiveness, assurance, empathy, and tangibility. This, in turn, positively impacts their behavioural intention to make future purchases. The responsiveness dimension directly affects behavioural intention, while empathy contributes to it indirectly through customer satisfaction. This study addresses a gap in current water sports research by examining the antecedents of customers’ behavioural intention, for the first time, to a nautical sports centre, deriving important managerial implications. Thus, to increase customer satisfaction and increase the likelihood of repeating their experience, it is advised that the sports centre implement clear work procedures, offer training to staff on responsiveness and empathy, and regularly gather feedback from customers to facilitate continuous improvement of their service design

    Beyond Recidivism: A Scoping Review Exploring Comprehensive Criteria for Successful Reintegration After Prison Release

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    Numerous studies have concentraded on recidivism as the primary measure for successful community reintegration. The present study aims to identify and delineate additional criteria for successful social reintegration subsequent to incarceration. Our research aims to furnish valuable insights that can inform correctional policies and, in turn, facilitate the rehabilitation of individuals within the prison system. The review will encompass studies employing the PECO strategy (Population, Exposure, Comparison, Outcome). Sole consideration will be given to studies involving adults who have been released from prisons. Inclusion criteria encompass cross-sectional and longitudinal studies identifying pertinent indicators for reintegration. Conversely, studies falling within the purview of grey literature, commentaries, reviews, conference papers, or academic works will be excluded. The research will be conducted across multiple databases, including but not limited to SCOPUS®, EBSCO®, PubMed®, and WEB OF SCIENCE - CORE COLLECTION®. Keywords will be employed to locate relevant articles. Two independent reviewers will assess the studies and extract the data, with a third author serving as a consultant in cases of uncertainties or conflicts pertaining to the inclusion or exclusion of specific studies. Screening will initially be conducted based on the titles and abstracts of the articles, followed by a comprehensive review of the full articles. All screening decisions will be meticulously documented. The presentation of data extraction will incorporate visual elements complemented by a narrative summary aligned with the review’s objective. The results will furnish insights into the current state of literature regarding criteria for successful social reintegration post-imprisonment. Ultimately, these findings results may enable the formulation of guidelines for correctional policies, thereby promoting the rehabilitation of incarcerated individuals
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