Unraveling of Borrelia burgdorferi sensu lato genospecies diversity in Portugal towards the development of more efficient diagnostic tools for Lyme disease

Ixodídeos (carraças de corpo-duro), são importantes vetores de agentes patogénicos, responsáveis por doenças emergentes como a doença de Lyme (DL). Esta zoonose é causada por espiroquetas do complexo Borrelia burgdorferi sensu lato (s.l.) transmitidas por carraças da espécie Ixodes ricinus, o principal vetor na Europa. A DL é uma doença multisistémica com diversas apresentações clínicas e diagnóstico complexo. Em Portugal é ainda pouco diagnosticada e a notificação, apesar de obrigatória, é escassa. A presente investigação teve como principal objetivo desenvolver ferramentas moleculares, nomeadamente um algoritmo de PCR em tempo real e uma amplificação isotérmica, para identificar as espécies de B. burgdorferi s.l. mais prevalentes em Portugal. O desenvolvimento deste objetivo permitiu também avaliar as características bioecológicas da ixodofauna presente em nove distritos do país (norte, centro e sul) nos quais o vetor I. ricinus havia sido anteriormente reportado, e ainda determinar a taxa de infeção por B. burgdorferi s.l. no vetor e hospedeiros. Os resultados obtidos são apresentados sob a forma de artigos científicos (dez), dos quais sete estão publicados, dois em submissão e um em preparação. Do conjunto dos resultados alcançados, importa realçar as variações observadas na distribuição das carraças para possivelmente para novas regiões, provavelmente relacionadas com alterações ao nível da paisagem, clima e vegetação, às quais as carraças são muito sensíveis. Acresce o facto de várias espécies de B. burgdorferi s.l. terem sido detetadas em carraças que não aquelas até agora reconhecidas como vetores. A espécie B. lusitaniae foi a mais prevalente no vetor, estando este presente em seis dos nove distritos selecionados. Surpreendentemente no decurso deste estudo, identificaram-se três espécies do complexo Borrelia recorrente em carraças da vegetação, nomeadamente, B. miyamotoi numa ninfa I. ricinus, e duas possíveis ‘novas’ espécies do complexo Borrelia recorrente em carraças da espécie Haemaphysalis punctata e Rhipicephalus sanguineus. Paralelamente, foi identificado DNA de B. burgdorferi s.l. em amostras biológicas de animais de estimação (cães e gatos) e de animais silváticos (javalis), confirmando a importância destes animais, principalmente os de estimação, enquanto sentinela para uma deteção precoce da DL, ajudando na determinação do risco de transmissão das espiroquetas de B. burgdorferi s.l. a humanos e outros animais com importância económica (ex. bovinos), em áreas geográficas restritas. Foi também possível otimizar dois protocolos moleculares para o diagnóstico laboratorial da DL, um dos quais, um algoritmo de PCR em tempo real que permite a identificação de quatro das espécies de B. burgdorferi s.l. mais prevalentes em Portugal, apresentando elevada sensibilidade e especificidade e contribuindo para um diagnóstico mais preciso da DL. Alguns dos aspetos introduzidos e explorados nesta tese necessitam ainda de uma investigação mais detalhada. No entanto, este trabalho alerta para a introdução de possíveis ‘novas’ espécies do complexo de Borrelia recorrente em carraças de corpo-duro da vegetação, cuja patogenicidade é ainda desconhecida, mas que poderão tornar-se um risco para a saúde pública; contribui para a atualização espacial de áreas importantes na ecoepidemiologia da DL em Portugal; e inova no diagnóstico molecular desta zoonose, constituindo um valioso suporte para os clínicos, permitindo uma terapêutica mais direcionada dos doentes.Ixodids (hard-body ticks), are the most important vectors of pathogenic agents, responsible for emerging diseases like Lyme disease (LD). This zoonosis is caused by spirochetes of Borrelia burgdorferi sensu lato (s.l.) complex, transmitted by Ixodes ricinus tick, the main vector in Europe. LD is a multisystem disorder with different clinical presentations, and a complex diagnosis. In Portugal is still underdiagnosed and the notification, although mandatory, is scarce. The main goal of this research was to develop molecular protocols, namely a TaqMan realtime PCR algorithm and an isothermal amplification, for the identification of the most prevalent genospecies of B. burgdorferi s.l. in Portugal. The development of this goal, also allowed to evaluate the bio-ecological characteristics of the ixodofauna in nine districts of the country (north, center and south), where the presence of I. ricinus tick was previously reported, and also to determinate B. burgdorferi s.l. infection rate in the vector and hosts. The obtained results are presented in 10 scientific papers, from which seven are published, two in submission and one in preparation. Of all the achieved results, is important to highlight the variations in the distribution of ticks possible into new regions, probably related to changes in the landscape, climate and vegetation, to which ticks are very sensitive. Moreover, several B. burgdorferi s.l. species were detected in ticks, apart from those commonly recognized as vectors. B. lusitaniae species was the most prevalent species in the vector, which was collected in six of the nine selected districts. Unexpectedly, during this study, three species from Relapsing Fever Borrelia complex were identified in questing ticks, namely B. miyamotoi in an I. ricinus nymph, and two possible new Relapsing Fever like-Borrelia in Haemaphysalis punctata and Rhipicephalus sanguineus tick species. Alongside, B. burgdorferi s.l. DNA was identified in biological samples from pets (dogs and cats) and sylvatic animals (wild boars), confirming the importance of these animals, mostly pets, as sentinel for early detection of emerging LD, helping to access the risk of B. burgdorferi s.l. spirochetes transmission to humans and other animals with economic importance (e.g. cattle), in restricted geographical areas. It was also possible to optimized two molecular protocols for LD laboratory diagnosis, one of which, a TaqMan real-time PCR algorithm allowing the identification of four of the most prevalent species of B. burgdorferi s.l. in Portugal, presenting high sensitivity and specificity, and contributing for a more accurate diagnosis of LD. Some of the subjects introduced and developed in this thesis deserve more detailed investigation. However, this work alerts for the introduction of possible ‘new’ Relapsing Fever Borrelia species in questing hard-body ticks, whose pathogenicity is still unknown, but it may become a risk to public health; contributes to the spatial update of important areas for LD eco-epidemiology in Portugal; and innovates in the molecular diagnosis of this zoonosis, being a valuable tool to clinicians, allowing a more accurate therapy of the patients

Recurrent idiopathic parotitis in childhood

Introduction: Recurrent idiopathic parotitis (RIP) is a frequent etiology of repeated inflammatory episodes of the parotid gland, in childhood. Objectives: To review current literature on the etiology, clinical presentation, diagnosis and treatment of RIP. Development: RIP is characterized by repeated episodes of swelling and pain in the parotid gland, usually accompanied by fever and malaise. Aetiology is multifactorial and, to date, unclear. Diagnosis is essentially clinical. Despite its benign character, recurrent parotitis can be a signal of other diseases, particularly in case of delayed onset of symptoms (from six-year-old) and bilateral involvement. The use of complementary tests should be individualized. Ultrasound is the diagnostic tool of choice and shows non-obstructive dilatation of glandular ducts (sialectasis). Treatment is mainly symptomatic. Prognosis is good with tendency to remission at puberty. Conclusions: RIP is a benign and self-limited condition. However, recurrent parotitis episodes should prompt investigation for underlying diseases, particularly in cases of late onset of symptoms (after age six years) and bilateral involvement.Introdução: Na infância, a parotidite recorrente idiopática (PRI) é uma causa frequente de inflamação recorrente e autolimitada da glândula parótida. Objetivo: O presente trabalho tem como objetivo fazer uma revisão bibliográfica atual sobre a etiologia, apresentação clínica, diagnóstico e tratamento da PRI. Desenvolvimento: A PRI caracteriza-se por episódios repetidos de tumefação e dor parotídea habitualmente acompanhados de febre e mal-estar. A sua etiologia é multifatorial e, até hoje, pouco esclarecida. O diagnóstico é essencialmente clínico. Apesar do caráter benigno e autolimitado, a parotidite recorrente poderá ser uma manifestação de doenças subjacentes, em especial quando os episódios se iniciam a partir dos seis anos de idade e o atingimento é bilateral. O recurso a exames complementares deve ser ponderado caso a caso. A ecografia é o exame de eleição e evidencia dilatações não obstrutivas dos canais glandulares. O tratamento é sobretudo sintomático. O prognóstico é favorável com tendência para a remissão a partir da puberdade. Conclusão: A PRI é uma entidade benigna e autolimitada. Contudo, face a episódios frequentes, deve ser pesquisada doença subjacente, especialmente quando o início dos episódios é posterior aos seis anos e o atingimento bilateral

Transition to “fathering”: Dyadic adjustment and father attachment before and after birth

Pregnancy, although physically conditioned to women, does not exclude paternal involvement. Studies suggest that attachment begins during pregnancy, increases after birth and it’s associated to a decrease in the quality of the couples’ relationship. Childbirth it’s considered a milestone in couples’ life, and a transition to parenthood not often addressed in the father’s perspective. The present study to verify the relation between dyadic adjustment and prenatal attachment (study 1) and the effect of childbirth in the dyadic adjustment and the postnatal attachment (study2). In the 3rd trimester of partner’s pregnancy, 130 men, completed Antenatal Emotional Attachment Scale and Dyadic Adjustment Scale (DAS). A repeated measures design (+ Postnatal Attachment Scale) was developed with a sub-sample of 22 fathers from initial study, 2 months after the child was born. Results found in the 1st study are in line with previous findings: Younger and first time fathers tend to be more attached to the unborn baby and to present lower scores of couples’ dyadic cohesion. In the 2nd study paternal prenatal attachment and couples’ cohesion are strong predictors of paternal postnatal attachment. Even though fathers’ attachment decreases after the baby is born, contrasting to previous studies, dyadic adjustment increases. Cohesion, consensus and marital satisfaction appear as relevant to fathers´ evaluation of relationship quality. So, for recent fathers the transition to parenthood may act as a relevant factor to bring couples together, in the important task of nurture and caring for the newborn. We conclude that the dyadic adjustment exerts an influence on paternal attachment. Results stress the need for further research on the fathers’ role, its evolution, and the relevant impact of couples’ relationship adjustment for fathers’ attachment, involvement and overall family functioning

Positive selection in the evolution of Helicobacter pylori outer membrane proteins

Homologous recombination in Helicobacter pylori has been extensively described to occur via Outer Membrane Proteins (OMPs), regulating protein expression and generating allelic diversity, while the importance of single nucleotide polymorphisms (SNP) remains little studied. We used an OMP-encoding gene, homC, as a model to evaluate the weight of positive selection in the evolution of H. pylori, by using G200 sequences obtained from strains collected worldwide. N-site and branch-site phylogenetic analysis by maximum likelihood models were used to identify specific codons that may be important in homC evolution, and to evaluate the impact of selective pressure on the geographic segregation of strains, respectively. The N-site overall analysis showed that 14 of the 742 (1.9%) homC codons are likely under positive selection (likelihood-ratio test (LRT), p < 10-61). Four of these codons are located in the most variable allelic gene middle region, probably reflecting recombination-derived hitchhiking events. On the other hand, eight codons are located in the more conserved 5¢and 3¢ gene regions, although the significance of this distribution remains to be clarified. Branch-site analysis revealed 36 codons (4.9%) under positive selection (LRT, p < 10-41), showing a non-random distribution, and 89% of these particular codons (p < 10-3) support the phylogenetic segregation of European strains from both African and East Asian strains. The lack of visible recombination within this segment suggests an important biological role of point mutations in the evolution of H. pylori OMPs. In conclusion, homC SNP analysis suggests that, besides recombination, positive selection contributes as well to the evolution of H. pylori OMPs

Fathers parenting role: self-esteem, parenting styles and parental self-efficacy

This study aims to explore the relation between fathers parenting styles (PS), self-esteem (SE) and parental self-efficacy (PSE). Research points out the complex potential relations between SE and PSE. Although PSE has been studied in association to PS, there’s a research gap concerning the influence of fathers’ SE in this process. In a cross-sectional study a questionnaire comprising personal data, PS, SE and PSE was completed by 157men (age: M=38.41, SD=6.03) of pre-school/school age children. Hierarchical multiple regression analyses and structural equation models (SEM) were performed. Like other studies, authoritative PS is associated to positive outcomes, explaining 25% of PSE variance, in opposition to permissiveness, associated to a negative sense of PSE. Education level and SE emerge as significant predictors for fathers PS exerting indirect effects on PSE. Father’s higher levels of SE and education are important individual variables to fathers-child relation with implications on family affective climate and health

A commentary on spiritual leadership and workplace spirituality in nursing management

Aim: Bring to discussion how spiritual leadership and workplace spirituality, on a health care system that faces constant challenges and seeks constant adaptations, as a way to guarantee nurses’ well-being and quality of care Background: The work environment has shown to have impact on staff well-being. Workplace spirituality relates to sense of belonging, motivation and commitment. A spiritual leadership is fundamental to develop workplace spirituality. Evaluation: Starting from literature, a reflection on the theme was carried out based on the results of the development of spiritual leadership and workplace spirituality in health care institutions, in professionals and in patients. Key issues: Nurses have spiritual needs which need to be also addressed in order to promote the sense of identification with the institutions vision and goals. A relation between spiritual leadership, workplace spirituality and subjective well-being is often found in literature, and this is critical evidence towards new management and leadership dynamics and models in health care institutions, that should integrate workplace spirituality. Conclusion: Nursing leaders are responsible for workplace spirituality facilitation. Nursing leadership and workplace spirituality seem both an answer and way to the change of health institutions management paradigm, but more studies are needed to inform this change in practice.info:eu-repo/semantics/acceptedVersio

Plano de comunicação integrada de marketing para a empresa Order2Party

Mestrado Bolonha em MarketingEste trabalho tem como objetivo a elaboração um Plano de Comunicação Integrada de Marketing (CIM) para a empresa de artigos de festa e organização de eventos, Order2Party. Por isso, a literatura que o suporta prende-se com a CIM, o seu planeamento e o contexto de desenvolvimento da mesma em ambiente digital e de e-commerce. Este plano pretende aumentar a notoriedade da marca e contribuir para melhorar a sua performance de vendas, aplicando as ferramentas de comunicação necessárias para trabalhar o seu posicionamento desejado. É um estudo descritivo, cross-sectional e a metodologia utilizada para a elaboração deste plano inspirou-se na estratégia de action research. O estudo utilizou métodos mistos, que incluíram entrevistas semiestruturadas, um questionário e um focus group. A recolha de dados primários foi complementada com uma recolha de dados secundários e ambas serviram de ponto de partida para a estratégia de comunicação proposta. Este plano inclui 7 áreas de atuação, integrando diversas táticas e formas de avaliação específicas. Os resultados obtidos permitiram concluir que o canal digital mais utilizado é a rede social Instagram e que por isso deve ser usado como a principal ferramenta de comunicação da organização e que é fulcral que a notoriedade da marca seja melhorada.This project is an Integrated Marketing Communications Plan (IMC) for the company of party articles and event organization, Order2Party. Therefore, the literature that supports it includes the topics of IMC, its planning and the context of its development in a digital and e-commerce environment. This plan aims to increase brand awareness and contribute to improving its brand sales performance, applying the necessary communication tools to work on its desired positioning. It is a descriptive, cross-sectional study and the methodology used to prepare this plan was inspired by the action research strategy. The study used mixed methods, that included semi-structured interviews, a questionnaire, and a focus group. The collection of primary data was complemented with a collection of secondary data, and both served as a starting point for the proposed communication strategy. This plan includes 7 areas of action, integrating different tactics and specific forms of assessment. The results obtained led to the conclusion that the most used digital channel is the social network Instagram and that it should therefore be used as the organization’s main communication tool and that the brand awareness must be improved.info:eu-repo/semantics/publishedVersio

LexEmo.pt: Uma nova base de dados do léxico afetivo português

Este estudo teve sete objetivos: (i) rever a base de dados lexical EMOTAIX.PT, originalmente concebida em francês e adaptada para Português por Costa et al. (2017) - o EMOTAIX.PT é uma base lexical cujas palavras se encontram organizadas em categorias emocionais: neste trabalho, reorganizaram-se essas palavras em categorias emocionais mais adequadas por acordo entre juízes (ii) expandiu-se a base lexical acrescentando palavras que nela não estavam presentes; (iii) lematizaram-se as palavras da base lexical EMOTAIX.PT e associaram-se a cada lema todas as flexões do mesmo; (iv) colocaram-se as palavras do EMOTAIX.PT segundo o Acordo Ortográfico; (v) categorizaram-se as palavras do SentiLex-PT segundo as categorias emocionais do EMOTAIX.PT; (vi) criou-se uma nova base de dados léxico-afetiva designada LexEmo.pt, resultado da junção da base lexical EMOTAIX.PT, já revista, expandida e lematizada, com o SentiLex-PT, entretanto categorizado; e, por fim, (vii) organizou-se a nova base léxico-afetiva de forma a estar preparada para ser integrada no software HandSpy que permitirá análises do vocabulário afetivo de textos. No final deste estudo disponibilizaremos uma nova base de dados lexical afetiva mais completa e abrangente que estará disponível por forma a facilitar a análise afetiva de textos em português e as investigações na área da Linguística e da Psicologia e, esperançosamente, outras áreas que vejam vantagens no usufruto desta ferramenta.This study had seven objectives: (i) review the EMOTAIX.PT lexical database, originally conceived in French and adapted to Portuguese by Costa et al. (2017) - EMOTAIX.PT is a lexical base whose words are organized into emotional categories: in this work, these words were reorganized into more appropriate emotional categories by agreement between judges (ii) the lexical base was expanded by adding words that were not present in that same lexical base; (iii) words from the EMOTAIX.PT lexical base were lemmatized and all the inflections of the same were associated with each lemma; (iv) the words of EMOTAIX.PT were placed according to the Orthographic Agreement; (v) SentiLex-PT words were categorized according to the emotional categories of EMOTAIX.PT; (vi) a new lexical-affective database called LexEmo.pt was created, resulting from the merger of the lexical base EMOTAIX.PT, already revised, expanded, and lemmatized, with SentiLex-PT, meanwhile categorized; and, finally, (vii) the new lexical-affective base was organized in order to be ready to be integrated into the HandSpy software that will allow the analysis of the affective vocabulary of texts. At the end of this study, we will make available a new, more complete, and comprehensive affective lexical database that will be available in order to facilitate the affective analysis of texts in Portuguese and research in the areas of Linguistics and Psychology and, hopefully, other areas that see advantages in using this tool

Performance do olhar e espaço da imagem: representação, encenação, simulação ou utopia espacial?

Mestrado em Criação Artística e ContemporâneaEsta dissertação destaca a intersecção da performance com a imagem e como essa intersecção mudou formas de ver e olhar a obra de arte. Com o intuito de compreender a problemática do real, encenação ou utopias proporcionada pela própria constituição da imagem, foi feita a contextualização na história do séc. XX notavelmente por este período ter sido palco de grandes mudanças sociais e consequentemente artísticas, nomeadamente pela inserção das novas tecnologias da comunicação no processo criativo. Este estudo parte de alguns exemplos de artistas que utilizaram a imagem do próprio corpo como obra e a forma como essa imagem interagiu com o público e o público com a imagem no contexto da instalação artística. Assim sendo, interessou-me explorar a representação espacial do corpo em relação à manipulação da imagem. A problematização do estudo é enfatizada em três projectos artísticos que utilizam a imagem vídeo associada à tecnologia que lhe está inerente.This dissertation highlights the performance intersection with the image and how image modified the way to see and look to an art creation. To understanding the real’s problematic, staging or utopias provided by the own image’s constitution, was made a contextualization on the history of XX’s century remarkably because this period was a big social change’s and consequently artistic stage, to be precise by the insertion of new communication technologies on the creative process. This study began from some artist examples that used the image of their own body as work and the form how that image interacted with the audience and the audience with the image on the artistic system context. Then, the searching of the spatial body representation interested me concerning to the image manipulation. The problematic of the study is emphasized on tree artistic projects that use the video image associated to the technology inherent

A fiscalização prévia da contratação pública e as imposições da União Europeia no contexto da autonomia das instituições de ensino superior de direito público

Tese de Mestrado em MPA - Administração PúblicaO presente estudo descreve o regime da fiscalização prévia da contratação pública pelo Tribunal de Contas e confronta-o em termos gerais com outros regimes. Analisa numa perspetiva histórica, as alterações introduzidas na legislação nacional e as respetivas imposições da União Europeia, quer as vigentes, decorrentes do Memorando de Entendimento sobre as Condicionalidades de Política Económica [Memorando de Entendimento (celebrado entre o Governo e a Comissão)], quer as constantes da proposta de Diretiva de 20.12.2011 COM (2011) 896 (destinada a substituir a Diretiva 2004/18/CE). Em especial, efetua o enquadramento da fiscalização prévia dos contratos públicos celebrados pelas instituições de ensino superior de direito público e conjuga-o com o regime legal e constitucional destas, em particular com a sua autonomia. Expõem-se os números dos contratos submetidos a fiscalização prévia pelas instituições de ensino superior de direito público no último triénio, comparando-os com a generalidade dos submetidos ao Tribunal de Contas. Faz-se referência aos casos de recusa de visto decorrentes da qualificação das instituições de ensino superior de direito público como entidades compradoras vinculadas ao Sistema Nacional de Compras Públicas. Apresenta-se a perceção dos intervenientes (Tribunal de Contas e instituições de ensino superior de direito público), obtida a partir de entrevistas e questionários, concluindo-se que os dados recolhidos, combinados com o regime da fiscalização prévia no âmbito da contratação pública às instituições de ensino superior de direito público admitem a introdução de alterações neste, face ao imposto pela União Europeia, ao regime constitucional vigente e à proposta de Diretiva. Indicam-se ainda pistas para a reflexão da evolução do regime da fiscalização prévia da contratação pública em Portugal.The present study describes the system of prior control of public procurement by the Court of Auditors and confronts it, in general terms, with other assessment schemes. It analyses, in a historical perspective, the changes in national legislation and the respective impositions of the European Union, either the current ones, resulting from the Memorandum of Understanding on Specific Economic Policy Conditionality [Memorandum of Understanding (signed between the Government and the Commission)], or the ones that result from a proposal of directive 20.12.2011 (intended to replace the directive 2004/18/CE). It particularly reviews the framework of prior supervision of procurement by higher education institutions of public law, and assesses its legal and constitutional framework, mainly their autonomy. The numbers of contracts submitted to prior inspection by higher education institutions of public law in the last three years are exposed and compared with the general contracts submitted at Court of Auditors. Reference is made to cases of visa refusal due to the qualification of the higher education institutions of public law as procuring entities linked to the National System of Public Procurement. The perceptions of stakeholders (Court of Auditors and higher education institutions of public law), obtained from interviews and questionnaires, are presented. The data collected, combined with the analyses of the framework of prior supervision of public procurement to higher education institutions of public law, recommend amendments to latter, taking into account what is required by the European Union, by the Constitution and by the proposal Directive. Slopes for reflection of the evolution of the system of prior control of public procurement in Portugal are also referred