"A not so special one": O efeito do treinador na confiança e eficácia de uma equipa

Dissertação de Mestrado apresentada no ISPA - Instituto Universitário para a obtenção de grau de Mestre na especialidade de Psicologia Social e das OrganizaçõesO presente estudo teve como objetivo não só verificar o impacto que a percepção de Confiança na Equipa tem na percepção de Eficácia Coletiva, mas também explorar o efeito mediador que a percepção de Confiança no Treinador poderá ter nessa relação. A amostra é constituída por 151 atletas masculinos de futebol profissional com idades compreendidas entre os 17 e os 44 anos. De forma a avaliar a percepção de Confiança na Equipa, foi utilizada a escala proposta por Adams e Sartori (2006) – Team Trust Scale – traduzida e adaptada para a língua portuguesa por três professores com domínio de língua inglesa e psicólogos organizacionais; a percepção de Confiança no Treinador foi avaliada através da escala proposta por Adams e Sartori (2006) – Leader Trust Scale – que foi igualmente traduzida e adaptada para a língua portuguesa; e a percepção de Eficácia Coletiva foi avaliada pela escala Collective Efficacy Questionnaire for Sports (CEQS) (Short, Sullivan e Feltz, 2001), adaptada por Francisco (2005). Os resultados confirmam a relação positiva e significativa existente entre a percepção de Confiança na Equipa e a percepção de Eficácia Coletiva. Foi ainda verificado o efeito mediador, apesar de parcial, que a percepção de Confiança no Treinador tem na relação entre percepção de Confiança na Equipa e percepção de Eficácia Coletiva. Este estudo vem acrescentar uma nova visão relativamente aos treinadores, questionando várias realidades que fazem parte do mundo desportivo atual.The main goal of this study is not only to verify the impact that the perception of the team’s trust has in the perception of it’s colective efficacy, but also to explore the mediation effect that the percpetion of the trust in the coach might have in this relationship. The sample is composed of 151 professional football athletes, whose age ranges between 17 and 44 years old. In order to evaluate the perception of trust in the team, it was used the scale – Team Trust Scale – developed by Adams and Sartori (2006). This scale was translated and adapted to the portuguese language by three psychologists professors, fluent in english. The perception of trust in the coach was evaluated based on the proposed scale by Adams and Sartori (2006) – Leader Trust Scale – translated and adapted, as well. The perception of collective efficacy was evaluated using the scale – Collective Efficacy Questionnaire for Sports (CEQS) (Short, Sullivan & Feltz, 2001), adapted by Francisco (2005). ‘ The results confirm the positive and significant relationship between the perception of trust in the team and the perception of collective efficacy. Moreover, the mediate effect that the perception of trust in the coach has on the relation between the perception of trust in the team and the perception of collective efficacy was verified, despite being partial. This study brings a diferent ligth towards the idea of the coach, and questions other ideas that tend to be part of the world of sports, in the present day

Doença de Dupuytren em doentes diabéticos: um estudo de prevalência

INTRODUÇÃO: A etiopatogenia da Doença de Dupuytren permanece pouco entendida, tendo sido associada a vários fatores, nomeadamente diabetes mellitus. A prevalência desta patologia é inconsistente entre os países estudados, variando entre 0,2% e 56%, e mais especificamente entre 16% e 42% para doentes diabéticos, justificando a necessidade de estudos nacionais. Até à data, ainda nenhum estudo publicado revela a prevalência desta patologia em Portugal. O objetivo principal deste estudo consistiu em determinar a prevalência de Doença de Dupuytren numa população portuguesa de diabéticos. Secundariamente pretendeu-se relacionar a Doença e a sua gravidade com a diabetes mellitus. MÉTODOS: Através de um estudo epidemiológico observacional transversal, foram entrevistados 190 diabéticos, de modo oportunista, durante consultas de seguimento previamente agendadas pela Medicina Interna. Para cada participante foram obtidos dados relativos à história clínica e realizou-se a observação clínica das mãos dos doentes pelo autor do projeto. Nos casos diagnosticados foi medido o Défice de Extensão Passiva Total com recurso a um goniómetro e foi pedido o preenchimento do questionário Disabilities of the Arm, Shoulder and Hand, validado para português. Os restantes dados foram recolhidos após consulta do processo clínico. Consideraram-se os resultados significativos para p inferior a 0,05. RESULTADOS: A amostra foi composta por 190 diabéticos, 43,2% do sexo masculino e 56,8% do sexo feminino. A média das idades foi de 65,56 anos (DP=13,397). A prevalência de Doença de Dupuytren foi de 34,2% (IC-95%: 27,5%-40,9%). A prevalência foi de 39,0% nos homens e de 30,6% nas mulheres, mas estas diferenças não foram estatisticamente significativas. As diferenças na prevalência entre as classes etárias foram estatisticamente significativas, tendo sido apenas diagnosticados casos a partir dos 50 anos. A Doença foi frequentemente bilateral. Os raios mais afetados foram o 4º e o 3º. A prevalência foi significativamente superior nos doentes com história familiar para a Doença, nos doentes com pelo menos 10 anos de duração da diabetes, nos diabéticos tipo 2, nos doentes com neuropatia, nos hipertensos e nos doentes com doença vascular periférica. Relativamente à gravidade da Doença, verificou-se que os doentes com história familiar de diabetes apresentaram maior disfunção do membro superior e que os doentes tratados com insulina apresentaram um Défice de Extensão Passiva Total menos severo. CONCLUSÃO: A prevalência de Doença de Dupuytren nesta amostra foi concordante com os resultados do norte da Europa. Seria interessante explorar o possível efeito protetor da insulina na gravidade sugerido neste estudo.INTRODUCTION: Dupuytren’s disease is a fibroproliferative disorder that affects the fascia of the hand and usually progresses to finger contraction. It is thought that several factors may be associated, including diabetes mellitus. The prevalence of this disease is inconsistent among the studied countries, ranging between 0.2% and 56%, and more specifically between 16% and 42% for the diabetic population, justifying the requirement for national data. Until this date, none of the published studies reveals the prevalence of this pathology in Portugal. The main objective of this study was to determine the prevalence of Dupuytren's disease in a population of diabetic Portuguese patients. Secondarily we sought to relate the disease and its severity with diabetes mellitus. METHODS: Through a cross-sectional observational epidemiological study, 190 diabetic patients were opportunistically interviewed throughout follow-up appointments booked in advance by an Internal Medicine physician. For each participant, data on clinical history was obtained and clinical observation of the patients’ hands was realized by the author of the project. In diagnosed cases, Total Passive Extension Deficit was measured thanks to a goniometer and the patients were asked to complete the validated version for the Portuguese language of the Disabilities of the Arm, Shoulder and Hand questionnaire. The remaining data was collected after consulting the clinical process. The results we considered significant for p less than 0.05. RESULTS: The sample consisted of 190 diabetic patients, 43.2% males and 56.8% females. The average age was 65.56 years (SD=13,397). The prevalence of Dupuytren's disease was 34.2% (95%-CI: 27.5%-40.9%). The prevalence was 39.0% in men and 30.6% in women, but these differences were not statistically significant. The differences in prevalence between age groups were statistically significant and cases only were diagnosed in patients older than 50. The disease was often bilateral. The most affected rays were the 4th and 3rd. The prevalence was significantly higher in patients with positive family history of the Disease, in patients with at least 10 years of duration of diabetes, in type 2 diabetics, in patients with neuropathy, in hypertensive patients and in patients with peripheral vascular disease. Regarding the severity of the disease, it was found that patients with a family history of diabetes had greater dysfunction of the upper limb and that patients treated with insulin showed a Total Passive Extension Deficit less severe. CONCLUSION: The prevalence of Dupuytren's disease in a Portuguese diabetic population was concordant with the results published in northern Europe. It would be interesting to explore the possible protective effect of insulin on the severity suggested by the results of this study

The RPGRIP1-deficient dog, a promising canine model for gene therapy

PURPOSE: To evaluate the RPGRIP1-deficient miniature longhaired dachshund (MLHD) dog as a potential candidate for gene therapy. METHODS: Six RPGRIP1-deficient MLHD dogs from our dog colony have been observed for two years using a variety of noninvasive procedures. These included bilateral full-field electroretinograms (ERG) to evaluate retinal function, fundus photographs to evaluate retinal vascularization, and optical coherence tomographs (OCT) to evaluate retinal thickness. We also performed histological examination of hematoxylin- and eosin-stained retinal sections as well as sections labeled in situ by the terminal dUTP nick end labeling (TUNEL) method. RESULTS: ERG findings showed that as early as 2 months of age, cone function was lost while rod function was preserved. However, by 9 months of age, both cone and rod functions could not be detected. Functional visual assessment based on the ability to avoid obstacles showed that vision was retained up to the age of 11 months. Both OCT and histopathology studies revealed a progressive thinning of the outer nuclear layer (ONL) over the first 2 years of age. TUNEL labeling identified apoptotic photoreceptor cell death as the cause of this thinning of the ONL. CONCLUSIONS: A treatment strategy should consist in initiating gene therapy as early as possible after birth to prevent or delay the loss of rod function. In the MLHD, successful subretinal delivery of a therapeutic vector is feasible at 2 months of age and may prevent or delay the loss of rod function

Is the reason to switch relevant?

57763]. AS is supported by a doctoral grant from “Fundação para a Ciência e Tecnologia” (SFRH/BD/108246/2015).Background: To investigate whether the reason to discontinue the first TNF inhibitor (TNFi) affects the response to the second TNFi in axial spondyloarthritis (axSpA). Methods: Patients with axSpA from the Rheumatic Diseases Portuguese Register (ReumaPt), who discontinued their first TNFi and started the second TNFi between June 2008 and May 2018, were included. Response was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement (ASDAS-CII), major important improvement (ASDAS-MI), low disease activity (ASDAS-LDA), and inactive disease (ASDAS-ID). The reason for discontinuation of the first TNFi was defined, according to ASDAS-CII as primary failure (no response ≤ 6 months), secondary failure (response ≤ 6 months but lost thereafter), adverse events, and others. The association between the reason for discontinuation of the first TNFi and response to the second TNFi over time was assessed in multivariable generalized equation (GEE) models. Results: In total, 193 patients were included. The reason for discontinuation of the first TNFi did not influence the response to the second TNFi, according to the ASDAS-CII. However, a difference was found with more stringent outcomes, e.g., there was a higher likelihood to achieve ASDAS-ID with the second TNFi for patients discontinuing the first TNFi due to secondary failure (OR 7.3 [95%CI 1.9; 27.7]), adverse events (OR 9.1 [2.5; 33.3]), or other reasons (OR 7.7 [1.6; 37.9]) compared to primary failure. Conclusion: Patients with axSpA with secondary failure to their first TNFi, compared to those with primary failure, have a better response to the second TNFi according to stringent outcomes.publishersversionpublishe

Optimization of zirconia surface textured designs using Nd:Yag laser for biomedical applications

The development of surface textured designs has influence in primary stability of surgically placed implants since a textured surface allows to firmer mechanical link to the surrounding tissue. Laser technology has been investigated to develop new surface designs on green zirconia compacts by cold pressing. Nd:Yag laser were used to produce several strategies and different laser parameters (laser power, speed and laser passages) were tested to evaluate their impact on cavities geometry and depth. The surface texture designs were analysed by Scanning Electron Microscopy (SEM) and regular geometries such as cavities or pillars were observed. The distance between lines have a strong impact on texturing quality and should be combined with optimum power and speed conditions. Regarding the optimized conditions, several surface textured patterns were created in both green and sintered zirconia compacts. This study allowed to conclude that only some texturing strategies are suitable to obtain high quality surface textured patterns. Otherwise, the remaining strategies are potential solutions for obtaining high quality machined structures (laser does not machine cavities but crosses the entire bulk). High strength zirconia scaffolds were machined by laser and CNC machining technologies and the two promising technologies were compared.This work is supported by FCT (Fundação para a Ciência e a Tecnologia) through the grant SFRH/BD/148031/2019, the project UIDB/04436/2020 and UIDP/04436/2020

going beyond BASDAI

This work was supported by a Research Grant from the InvestigatorInitiated Studies program of Merck Sharp & Dohme (Grant No. 56078). The sponsor did not interfere with the study question, analysis or interpretation of results. AS is supported by a doctoral grant from Fundação para a Ciência e Tecnologia (Foundation for Science and Technology) (SFRH/BD/108246/2015).OBJECTIVES: To compare definitions of high disease activity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in selecting patients for treatment with biologic disease-modifying antirheumatic drugs (bDMARDs). METHODS: Patients from Rheumatic Diseases Portuguese Register (Reuma.pt) with a clinical diagnosis of axial spondyloarthritis (axSpA) were included. Four subgroups (cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of high disease activity) were compared regarding baseline characteristics and response to bDMARDs at 3 and 6 months estimated in multivariable regression models. RESULTS: Of the 594 patients included, the majority (82%) had both BASDAI≥4 and ASDAS ≥2.1. The frequency of ASDAS ≥2.1, if BASDAI<4 was much larger than the opposite (ie, ASDAS <2.1, if BASDAI≥4): 62% vs 0.8%. Compared to patients fulfilling both definitions, those with ASDAS ≥2.1 only were more likely to be male (77% vs 51%), human leucocyte antigen B27 positive (79% vs 65%) and have a higher C reactive protein (2.9 (SD 3.5) vs 2.1 (2.9)). Among bDMARD-treated patients (n=359), responses across subgroups were globally overlapping, except for the most 'stringent' outcomes. Patients captured only by ASDAS responded better compared to patients fulfilling both definitions (eg, ASDAS inactive disease at 3 months: 61% vs 25% and at 6 months: 42% vs 25%). CONCLUSION: The ASDAS definition of high disease activity is more inclusive than the BASDAI definition in selecting patients with axSpA for bDMARD treatment. The additionally 'captured' patients respond better and have higher likelihood of predictors thereof. These results support using ASDAS≥2.1 as a criterion for treatment decisions.publishersversionpublishe

Risk factors for infection, predictors of severe disease, and antibody response to COVID-19 in patients with inflammatory rheumatic diseases in Portugal: a multicenter, nationwide study

Copyright © 2022 Cruz-Machado, Barreira, Bandeira, Veldhoen, Gomes, Serrano, Duarte, Rato, Miguel Fernandes, Garcia, Pinheiro, Bernardes, Madeira, Miguel, Torres, Bento Silva, Pestana, Almeida, Mazeda, Cunha Santos, Pinto, Sousa, Parente, Sequeira, Santos, Fonseca and Romão. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Objective: To identify risk factors for SARS-CoV-2 infection and for severe/critical COVID-19, and to assess the humoral response after COVID-19 in these patients. Methods: Nationwide study of adult patients with inflammatory RMDs prospectively followed in the Rheumatic Diseases Portuguese Register-Reuma.pt-during the first 6 months of the pandemic. We compared patients with COVID-19 with those who did not develop the disease and patients with mild/moderate disease with those exhibiting severe/critical COVID-19. IgG antibodies against SARS-CoV-2 were measured ≥3 months after infection and results were compared with matched controls. Results: 162 cases of COVID-19 were registered in a total of 6,363 appointments. Patients treated with TNF inhibitors (TNFi; OR = 0.160, 95% CI 0.099-0.260, P < 0.001) and tocilizumab (OR 0.147, 95% CI 0.053-0.408, P < 0.001) had reduced odds of infection. Further, TNFi tended to be protective of severe and critical disease. Older age, major comorbidities, and rituximab were associated with an increased risk of infection and worse prognosis. Most patients with inflammatory RMDs (86.2%) developed a robust antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21-81.85, P = 0.005) and tended to be blunted by TNFi (OR 0.17, 95% CI 0.03-1.05; P = 0.057). Conclusions: TNFi and tocilizumab reduced the risk of infection by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with increased risk for infection and worse prognosis, in line with previous reports. Most patients with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease.We acknowledge the generous sharing of the expression constructs by Dr. Florian Krammer, Icahn School of Medicine at Mount Sinai, New York, USA [Development of SARS-CoV-2 reagents was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C] and the protein production by Drs. Paula Alves and Rute Castro at Instituto de Biologia Experimental e Tecnológica (iBET) Oeiras, Portugal as part of the Serology COVID consortium.info:eu-repo/semantics/publishedVersio

Reuma.pt/vasculitis - the Portuguese vasculitis registry

BACKGROUND: The vasculitides are a group of rare diseases with different manifestations and outcomes. New therapeutic options have led to the need for long-term registries. The Rheumatic Diseases Portuguese Register, Reuma.pt, is a web-based electronic clinical record, created in 2008, which currently includes specific modules for 12 diseases and > 20,000 patients registered from 79 rheumatology centres. On October 2014, a dedicated module for vasculitis was created as part of the European Vasculitis Society collaborative network, enabling prospective collection and central storage of encrypted data from patients with this condition. All Portuguese rheumatology centres were invited to participate. Data regarding demographics, diagnosis, classification criteria, assessment tools, and treatment were collected. We aim to describe the structure of Reuma.pt/vasculitis and characterize the patients registered since its development. RESULTS: A total of 687 patients, with 1945 visits, from 13 centres were registered; mean age was 53.4 ± 19.3 years at last visit and 68.7% were females. The most common diagnoses were Behçet's disease (BD) (42.5%) and giant cell arteritis (GCA) (17.8%). Patients with BD met the International Study Group criteria and the International Criteria for BD in 85.3 and 97.2% of cases, respectively. Within the most common small- and medium-vessel vasculitides registered, median [interquartile range] Birmingham Vasculitis Activity Score (BVAS) at first visit was highest in patients with ANCA-associated vasculitis (AAV) (17.0 [12.0]); there were no differences in the proportion of patients with AAV or polyarteritis nodosa who relapsed (BVAS≥1) or had a major relapse (≥1 major BVAS item) during prospective assessment (p = 1.00, p = 0.479). Biologic treatment was prescribed in 0.8% of patients with GCA, 26.7% of patients with AAV, and 7.6% of patients with BD. There were 34 (4.9%) deaths reported. CONCLUSIONS: Reuma.pt/vasculitis is a bespoke web-based registry adapted for routine care of patients with this form of rare and complex diseases, allowing an efficient data-repository at a national level with the potential to link with other international databases. It facilitates research, trials recruitment, service planning and benchmarking.publishersversionpublishe