A new measure to assess pain in people with haemophilia: the Multidimensional Haemophilia Pain Questionnaire (MHPQ)

People with haemophilia (PWH) experience acute pain during joint bleeds and might develop chronic pain due to joint degeneration. However, there is a lack of standardized measures to comprehensively assess pain in PWH. This study aimed to develop a multidimensional questionnaire for haemophilia-related pain, the Multidimensional Haemophilia Pain Questionnaire (MHPQ), and to present initial validation data among adults.The questionnaire distinguishes between acute/chronic pain and queries about pain locations, duration, frequency, triggering factors, intensity, interference, strategies, specialists for pain management and satisfaction with treatment. An initial version was tested with 16 patients to ensure item comprehensibility and face validity. The final version was answered by 104 adults, with 82 (78.8%) reporting haemophilia-related pain in the previous year (mean age = 43.17; SD = 13.00). The non-response analysis revealed good item acceptability. Exploratory and confirmatory factor analysis (EFA/CFA), reliability (internal consistency, test-retest, inter-item and item-total correlations) and convergent validity were analysed for the intensity and interference dimensions of the questionnaire. A combined EFA with these two constructs supported a 2-factor structure distinguishing intensity (α = 0.88) from interference items (α = 0.91). CFA was tested for the interference dimension, demonstrating suitability for this sample. Item-total correlations were >0.30 on both dimensions and most inter-item correlations were 0.30).This questionnaire is a comprehensible tool, achieving a thorough assessment of relevant pain dimensions. The MHPQ can help guide treatment recommendations by highlighting relevant topics and contributing to more effective, integrated treatments.This work is supported by a grant from the Novo Nordisk HERO Research Grant 2015. P. R. Pinto has a post-doctoral grant (SFRH/BPD/ 103529/2014) from the Portuguese Foundation of Science and Technology.info:eu-repo/semantics/publishedVersio

Remote support to victims of violence against women and domestic violence during the COVID-19 pandemic

Purpose – This paper aims to characterize the type of support provided to victims of violence against women and domestic violence (VAWDV) during the first lockdown, assessing the training of professionals to use remote support (RS). Design/methodology/approach – This cross-sectional study involves a sample of 196 support professionals, mainly women (91.8%) and who integrate the Portuguese National Support Network for victims of domestic violence (NSNVDV) (Mean age = 36.49; SD = 10.52). Findings – Telephone emerges as themain RS communication media used in the lockdown (43.9%) and the emergency state periods (57.1%). Participants reported to have never used any social applications (41.8% vs 41.8%) or videoconference (46.4% vs 58.2%), in both periods assessed, i.e. lockdown and emergency state, respectively, and 82.7% assumed to have no training with RS to assist VAWDV victims. However, support professionals recognized several advantages in using RS such as dealing with isolation, reducing inhibition, fear and shame and in promoting the victims’ empowerment. Research limitations/implications – Given the exploratory nature of this study, only descriptive analyzes were conducted. Originality/value – During the COVID-19 pandemic, little is known about effective RS given by professionals to victims of VAWDV in the Portuguese context. The paper aims to add knowledge to the studied field.info:eu-repo/semantics/publishedVersio

Spilled volum, oxygen saturation, and heart rate during feeding of preterm newborns : comparison between two alternative feeding methods

Objetivo: comparar o uso da seringa e da técnica sonda-dedo para a oferta de dieta a prematuros, considerando-se volume de dieta oferecido e volume derramado, variação da saturação de oxigênio periférico e frequência cardíaca. Métodos Estudo quasi-experimental, com 30 prematuros, 13 do gênero feminino e 17 do masculino. As médias das idades gestacionais ao nascimento e no momento da avaliação (idade corrigida) foram de 33 4/7±4/7 e 36±4/7, respectivamente. Os pesos médios ao nascimento e na avaliação foram de 1.800±140 e 1.972±88 gramas. Foi avaliado um momento de alimentação com a seringa e outro com a sonda-dedo para a mesma criança, sendo caso e controle de si mesma. Utilizou-se oxímetro de pulso portátil para verificar a variação da saturação de oxigênio e a frequência cardíaca. Uma gaze foi colocada sob o queixo do bebê como anteparo da dieta derramada. Foram utilizados os testes ANOVA, t de Student pareado, Comparação Múltipla de Tukey e Correlação de Pearson, com nível de significância de 5%. Resultados Houve diferença para o volume oferecido e para o volume de leite derramado com os dois valores, sendo maiores quando a seringa foi utilizada. A frequência cardíaca foi diferente: antes/durante e antes/depois para ambas as formas de oferta, mas com valores considerados normais, assim como a saturação de oxigênio, que apontou aumento entre os momentos antes e depois da oferta para a seringa. Conclusão A técnica sonda-dedo proporciona menor derramamento da dieta, sendo as variações da saturação de oxigênio e frequência cardíaca consideradas normais para o neonato.Purpose: to compare the use of syringe and finger feeding to feed preterm newborns considering amount of milk offered, amount of milk spilled, variation of oxygen saturation, and heart rate. Methods Quasi-experimental study with 30 preterm newborns. Thirteen infants were females and 17 were males. The mean gestational age at birth and during evaluation (corrected age) was 33 4/7 ± 4/7 and 36 ± 4/7, respectively. Newborns’ mean birthweight and mean weight when evaluated was 1,800 ± 140 and 1,972 ± 88 grams. We assessed one feeding session using a syringe and another feeding session using the finger feeding technique. Both techniques were used in the same infant, so that the preterm newborns were controls for themselves. A portable pulse oximeter was used to check the variation of oxygen saturation and heart rate. A gauze pad was placed under the infants’ chin to absorb the spilled milk. The statistical tests used were: ANOVA, paired Student’s t test, Tukey Multiple Comparison test, and Pearson Correlation Coefficient. The level of significance was set at 5%. Results We found a difference between the techniques in terms of both amount of milk offered and amount of milk spilled. These amounts were larger when the syringe was used. Heart rate was different at two specific times: before/during and before/after feeding for both techniques. However, the values were within normal limits. Oxygen saturation values were also different, showing higher values after syringe feeding. Conclusions Finger feeding proved to cause less spillage, whereas the variations of oxygen saturation and heart rate were within normal limits

Violence against women during the COVID-19 pandemic: from children to the elderly

Women of all ages can be exposed to violence both within and outside of the home, especially in the context of the COVID-19 pandemic. The purpose of this study is to analyze violence against women (VAW) before and during the first year of the pandemic in Portugal. Crimes perpetrated against female victims from 17 years old and younger to 65 years old and older were analyzed by comparing requests for help in 2019 and 2020. A total of 12,045 requests for help for VAW were received by the Portuguese Association for Victim Support and analyzed in the current study. The findings reveal a 16% increase in requests for help in 2020 and a 95% increase when the lockdown was implemented. That said, the most reported, intimate partner violence (IPV), showed a decrease of 5% in 2020. Furthermore, compared to 2019, requests for help concerning criminal offenses involving psychological violence in non-IPV contexts increased 79% in 2020, especially for victims 17 years old or younger (116%), and attempted femicide/femicide requests for help increased 53%. We are still in the early stages of understanding how the pandemic will affect this situation. Future directions concerning support of female victims during the pandemic are outlined.This work is financed by national funds through the FCT—Foundation for Science and Technology, I.P., under the project UIDB/04585/2020. This study was also conducted at the Psychology Research Centre (PSI/01662), School of Psychology, University of Minho, supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (Ref.: UIDB/PSI/01662/2020) and at the Department of the Faculty of Psychology and Education Sciences of University of Coimbra, CINEICC—Center for Research in Neuropsychology and Cognitive Behavioural Intervention (Ref.: 2020.07799.BD)

The different contexts of domestic violence before and during the COVID-19 pandemic: a portuguese overview

The COVID-19 pandemic and the subsequent restrictions impacted the world in numerous ways. These restrictions resulted in victims of domestic violence spending more time with their abuser, contributing to a rise in requests for help. The contexts for domestic violence include intimate partner violence (IPV), abuse of children/adolescent and victimization of the elderly within the family. This article compares the prevalence of domestic violence contexts between a pandemic and a non-pandemic year. Based on the assessment of data, taken from a Service Management Platform (PLAGA) and provided by the Portuguese Association for Victim Support (APAV), 12,576 requests from 2019 to 2020 were analyzed. Findings revealed that a 13.3% increase in requests for help, mainly from child/adolescent victims, was registered in 2020 compared with 2019, with a 100.7% increase solely during the lockdown period. Physical and psychological violence, often reported by victims of IPV, children/adolescents and elders, also increased during this period. Requests for help through distance support increased substantially in the pandemic year. The importance of support for victims during the pandemic and the need for new support strategies have been highlighted if victims, bystanders and professionals are to be assisted.This work was supported by FCT - Fundação para a Ciência e a Tecnologia, I.P., under the project Gender Research 4 COVID-19 [grant number 9598419]

A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, posttreatment, and long-term follow-up records for the patient are presented

MicroRNA signature refine response prediction in CML

microRNAs (miRs) dysregulation have emerged as a crucial step in tumorigenesis, being related with cancer development, progression and response to treatment. In chronic myeloid leukaemia (CML), the resistance to tyrosine kinase inhibitors (TKI) is responsible for treatment failure and could be linked to changes in miRs expression. This work aimed to correlate the expression levels of 3 miRs, miR-21, miR-26b and miR-451, with response to TKI treatment in CML patients. miR-451 levels at diagnosis were significantly higher in patients with optimal response after 6 and 12 months of therapy. Conversely, patients without optimal response had highest levels of miR-21. miR-21 and miR-451 appear to be good biomarkers of response, able to predict optimal TKI responders (p < 0.05). Using the combined profile of both miRs, we create a predictive model of optimal response after one year of treatment. This study highlights the role of miR-21 and miR-451 expression levels at diagnosis in predicting which patients achieve the optimal response.info:eu-repo/semantics/publishedVersio

Effectiveness of hypnosis for pain management and promotion of health-related quality-of-life among people with haemophilia: a randomised controlled pilot trial

Joint deterioration and associated chronic pain are common among people with haemophilia (PWH), having an impact on quality-of-life. Though non-pharmacological strategies are recommended, psychological interventions to promote pain control and quality-of-life have scarcely been tested in haemophilia. This randomised controlled pilot trial aimed to assess feasibility, acceptability and effectiveness of hypnosis for pain management and promotion of health-related quality-of-life (HRQoL) among PWH. Twenty adults were randomised either to four weekly hypnosis sessions plus treatment-as-usual (experimental group; EG) or treatment-as-usual only (control group; CG). Participants completed sociodemographic and clinical assessment, measures of pain, HRQoL and emotional distress before (T1) and after (T2) intervention. Changes were analysed by calculating the differences between T1 and T2, and the groups were compared through independent-sample t tests (or chi-squared). Retention rates (90%) and analysis of patient satisfaction showed good acceptability and feasibility of the intervention. The EG (n = 8) had a higher reduction on pain interference than the CG (n = 10) (d = -0.267). A higher improvement on HRQoL (EQ-5D index: d = 0.334; EQ-5D VAS: d = 1.437) and a tendency towards better haemophilia-related quality-of-life (A36-Hemofilia QoL) were also evident in the EG. This is the first study showing the effectiveness of hypnosis to reduce pain interference and promote HRQoL among PWH.Novo Nordisk HERO Research Grant 2015. P. R. Pinto has a post-doctoral grant (SFRH/BPD/103529/2014) from the Portuguese Foundation of Science and Technolog

Hierarchical HRP-crosslinked silk fibroin/ZnSr-TCP scaffolds for osteochondral tissue regeneration: assessment of the mechanical and antibacterial properties

"Article 49"The biomaterials requirements for osteochondral (OC) defects restoration simultaneously include adequate mechanical behavior, and the prevention of bacterial adherence and biofilm formation, without impairing local tissue integration. Bilayered and hierarchical scaffolds combining a cartilage-like layer interconnected to an underlying subchondral bone-like layer appeared as innovative technological solutions able to mimic the native OC tissue hierarchical architecture. This study is focused on the assessment of the combined compression-shear stresses and possible bacterial biofilm formation of hierarchical scaffolds prepared from a horseradish peroxidase-crosslinking reaction of silk fibroin (SF) combined with zinc (Zn) and strontium (Sr)-doped β-tricalcium phosphate (β-TCP) for OC tissue regeneration. Scaffolds with undoped-β-TCP incorporation were used as control. Results showed that the bilayered scaffolds presented suitable aptitude to support compression and shear loading for OC tissue, with better mechanical properties for the ZnSr-containing structures. Young and shear moduli presented values close to 0.01 MPa in the region 10â 20% strain. The investigation of biomaterials surface ability to prevent biofilm formation showed reduced bacterial adhesion of Escherichia coli (E. coli, gram-negative) and Staphylococcus aureus (S. aureus, gram-positive) on both scaffolds, thus suggesting that the proposed hierarchical scaffolds have a positive effect in preventing gram-positive and gram-negative bacteria proliferation.This research was funded by the Portuguese Foundation for Science and Technology for the Hierarchitech project (M-era-Net/0001/2014), and by the Research and Innovation Staff Exchanges (RISE) action (H2020 Marie Skłodowska-Curie actions) for the BAMOS project (H2020-MSCA-RISE-2016- 734156). The authors also thank the funds provided under the distinctions attributed to JO (IF/01285/2015) and SP (CEECIND/03673/2017)

Effect of the “spiritual support” intervention on spirituality and the clinical parameters of women who have undergone mastectomy: a pilot study

This study aimed to evaluate the effect of the spiritual support intervention on spirituality and the clinical parameters of women who have undergone mastectomy. This is a pilot study of a randomized clinical trial. The spiritual support intervention was composed of meditation, guided imagery, music, and respiratory relaxation. The outcomes were: spirituality, blood pressure, heart rate, and oxygen saturation. A total of 27 patients were recruited for the study (intervention group, n = 13; control group, n = 14) (Clinical Trials: NCT 01866670/CAE: 00896312.0.0000.5393). The intervention helped patients with breast cancer to increase expression of their spirituality (p = 0.040) and it also decreased heart rate on the first (p = 0.038) and third day (p = 0.017). There was a difference in oxygen saturation on the second day in the control group (p = 0.039). Patients reported that their participation in the research was positive. This intervention had an effect on the sample of women who had undergone mastectomy