“The impact of teaching-learning anatomy in the training and performance of medical doctors in Mozambique"

Student Number : 9713472V - PhD thesis - School of Anatomical Sciences - Faculty of Health SciencesThe medical professional requires expertise in a wide range of disciplines as well as competence encompassing knowledge, skills and attitudes. Of these, the knowledge and skills gained in Anatomy play a fundamental role in contributing to the quality and performance of the medical practitioner. The present study aimed to evaluate the role of the teaching-learning Anatomy in the training of doctors at Universidade Eduardo Mondlane in Mozambique and therefore to contribute to the effectiveness of the medical curriculum to ensure that it produces high quality medical professionals. The following questions were addressed: i) Is the Anatomy course perceived by the students to be structured to address their needs regarding medical practice? ii) Is there a relationship between performance in Anatomy and other disciplines as recalled by the students? iii) Do medical students demonstrate a satisfactory knowledge of Anatomy in dealing with patients in practice? The study involved the medical students in the clinical cycle and the junior doctors employed at the Central Hospital of Maputo City. Data obtained by means of questionnaires, examination of clinical reports and interviews was analysed statistically by the SPSS programme. The results showed that overall the students have a positive view of how well the Anatomy course meets their clinical needs, and that there is a direct relationship between knowledge of Anatomy and the ability to perform in the clinical setting. There is however a need to review the current medical curriculum in order to achieve better integration between the courses and cycles and particularly to improve the efficacy of the teaching-learning process by selecting the content more appropriately and adjusting the assessment procedures. From this study recommendations may be made to help improve the students’ application of anatomical knowledge by increasing vertical and horizontal integration in the curriculum and introducing earlier exposure to clinical problem solving. Further studies are needed to better understand the impact of assessing the outcomes of the basic sciences such as Anatomy on the educational process as well as on medical practice

The Right to Data Protection and the Commission's Adequacy Decision

ABSTRACT: Data protection is a fundamental right protected by the EU as well as several international human rights instruments. However, an adequate relation of this right faces new challenges every day. A complicated area for the effectiveness of EU data protection law is the cross-border transfer of personal data. In European law, the main principle applicable to international data flows is the principle of adequate protection. This principle implies that a transfer to a third country/international organization is only permissible if an adequate level of protection of the personal data transferred is guaranteed. In this regard, this paper examines the application of this principle in the adequacy decisions adopted by the European Commission.info:eu-repo/semantics/publishedVersio

Students perceptions about the pedagogic strategies for teaching-learning anatomy at university Eduardo Mondlane in Mozambique

Background: From the need to develop a new curriculum for the medical course, changing the traditional model used for teaching Gross Anatomy it was sought to incorporate active teaching methodologies which can allow students to be more involved in the process of knowledge construction. The way in which Gross Anatomy is delivered in most Faculties of Medicine has been seen as a big challenge to the teachers and the students too as a consequence of permanent changes that are required in order to be in line with the technological development. This study aimed to explore the student's perceptions about the effectiveness of the strategies and resources, used in teaching-learning Gross Anatomy in the medical course at EMU.Methods: Data were collected using a questionnaire administrated to those medical students who attended (1st and 2nd year) Gross Anatomy subjects, in November 2018. Descriptive statistics and data content analysis were performed. The sample comprised 171 students.Results: A convergence of strategies preferred by the students involved in the study was seen. It was recognized that Gross Anatomy curriculum was designed based on the limitations of the use of cadaver dissection, with the emphasis on applied anatomy and learning in small groups using other resources, including computer assisted learning based on the 3-D Slicer software.Conclusions: It appears that the students' desire is that the teaching-learning strategies used in Anatomy classrooms at UEM might contribute to their better training for the professional challenges when graduated. They perceived that with the strategies used for teaching Anatomy, they are being very well prepared to get in an entrepreneurial, transformative profile and are able to learn more complex contents in order to provide a qualified health care to people in the performance of their future functions as doctors

Dendroarchaeology applied to the Portuguese cultural heritage between the XV and XIX enturies: paintings and musical instruments as witnesses of artwork and wood trades between Portugal and Europe

Doutoramento em Engenharia Florestal e dos Recursos Naturais / Instituto Superior de Agronomia. Universidade de LisboaThe current study focuses on the dendrochronological dating of seventy Portuguese and foreign artworks from the XV to the XIX centuries from public and private collections. Among the artworks examined are a collection of 34 Portuguese and Flemish paintings, as well as 36 musical instruments of Portuguese and foreign construction. The study investigates the wood's provenance within the historical context of Portuguese maritime commerce with Europe. This research aims to develop a reference chronology, which will be useful for future dendrochronological studies, with a focus on artworks on Baltic oak wood support. The adopted methodology took into consideration the impossibility of obtaining samples from artworks and musical instruments, as well as the restrictions to their handling. Therefore, the dendrochronological analysis was based on direct observation using photographic and video material adapted to the size and shape of each piece, followed by statistical processing by ARSTAN, COFECHA, TRiCYCLE, and TSAPWIN software. The dating of each piece and the study of the dendroprovenance used public and restricted access reference chronology databases. The results obtained from the study of the support of Portuguese and Flemish paintings reinforce their chronological attributions and confirm the use of Baltic oak. The dendrochronological data obtained from these pieces, in conjunction with data provided by the IJF-DGPC and research projects conducted by the CEF-ISA, enabled the construction of a reference chronology spanning between the years 1149 to 1599. The pioneering dendrochronological study on Portuguese violins, cellos, and pianofortes from the XVIII and XIX centuries corroborates the historical dates inscribed on the respective musical instruments. It also revealed that the Portuguese workshops used woods from the Alpine region of Switzerland, Germany, Austria, and Italy, which is consistent with the several historical sources on the Portuguese maritime trade with Europe. In conclusion, dendrochronology based on artworks enabled the construction of historical knowledge, as well as the interpretation of paintings and musical instruments as evidence of goods traded between Portugal and Europe between the XV and XIX centuries.N/

A pesquisa em arquivística na pós-graduação no Brasil : balanço e perspectivas

Quando se pretende falar de pesquisa em Arquivística em nível de pós-graduação, não se pode ignorar o percurso mesmo da disciplina no Brasil. As reflexões e as práticas arquivísticas têm sido tradicionalmente desenvolvidas nas instituições de arquivo - os arquivos públicos. No entanto, a criação dos cursos de graduação em Arquivologia no País pode ter modificado essa situação com conseqüências diretas na delimitação de um campo de pesquisa e no reconhecimento da disciplina diante da comunidade acadêmica que, em última instância, confere "autoridade" a uma área do conhecimento. Neste artigo, apresenta-se um balanço preliminar das pesquisas desenvolvidas no campo da Arquivística em nível de pós-graduação no Brasil, seja nos programas de Pós, nas suas linhas de pesquisa, ou nos Programas de Iniciação Científica (PIBIC), com destaque para o caso da Universidade de Brasília

Development and optimization of production and purification of the human protein BMP-2 in Escherichia coli for biomedical applications

Dissertação de mestrado em Biomedical EngineeringBone morphogenetic protein 2 (BMP-2) is one of the main representatives osteoinductive protein of a group of the transforming growth factor-β (TGF-β) superfamily of multifunctional cytokines. BMP-2 plays a critical role in cartilage and bone formation during skeletal development and repair. Several clinical studies have proven the clinical benefit of BMP-2 in the treatment of bone defects, being an effective alternative to bone grafts. Nowadays, BMP-2 is one of the two bone morphogenetic proteins approved as biological method to stimulate bone repair in humans. However, these commercial solutions are expensive, the protein purification is a laborious process and the obtained yields are low. A landmark occurred with the cloning of the human BMP-2 gene and its production by DNA recombinant technology. Production of recombinant human BMP- 2, using prokaryotic systems is the preferred method, being Escherichia coli one of the most popular systems for protein production. The bacterium E. coli is a well studied expression system, which provides a fast and economical production of recombinant proteins. Various studies on the production and purification of BMP-2 protein using E. coli as expression system have been reported; however BMP-2 is difficult to express in soluble form and its purification under native conditions remains a challenge. In this work, the soluble expression of the recombinant BMP-2 protein in E. coli was studied using the fusion protein technology, with the novel FH8 tag. The production of soluble recombinant fusion protein was initially achieved using as backbone the pQE-30FH8 vector, with the study of different culture conditions, in order to determine the conditions that maximize this soluble expression. Then, in order to increase soluble expression of FH8BMP-2, the cloning of bmp-2 gene was performed in two other different vectors: the pETMFH8 and pStaby1.2FH8, using different E. coli strains. Purification strategy of FH8BMP-2 was performed by the following chromatography techniques: using the FH8 as purification tag by hydrophobic interaction (HIC); affinity chromatography with nickel (using the His tag as purification tag) and ion exchange. The results presented in this work showed that recombinant fusion protein was successfully soluble expressed in the three vectors used. The pETM system was the one that showed the highest soluble expression. In relation to purification, the FH8-HIC technique, when combined with calcium addition to soluble fraction, shows good results in purification profile of target protein and a high yield of purified protein. Calcium ions and the own conformation of FH8 can have an important role on the aggregation of FH8BMP-2 into a dimer. Overall, the BMP-2 was efficiently expressed in E. coli as a soluble protein and an optimized purification strategy was developed to obtain this bone morphogenetic protein under native conditions. This work may be important for further steps for an in vitro production and biomedical application of recombinant BMP-2 protein.A proteína morfogenética do osso tipo 2 (BMP-2) é uma das proteínas osteoindutoras mais representativas da superfamília do fator de transformação do crescimento β (TGF-β) que agrupa um conjunto de citoquinas multifuncionais. A proteína BMP-2 desempenha um papel crítico na formação e regeneração do osso e cartilagem, durante o desenvolvimento do esqueleto. Vários estudos clínicos têm demonstrado o benefício clínico da BMP-2 no tratamento de defeitos ósseos, sendo uma alternativa eficaz aos enxertos do osso. Atualmente, a BMP-2 é uma das duas proteínas morfogenéticas do osso que se encontra aprovada como método biológico para estimular a reparação óssea em seres humanos. No entanto, estas soluções comerciais são dispendiosas, a purificação da proteína é um processo laborioso e os rendimentos obtidos são baixos. Um marco importante ocorreu com a clonagem do gene humano da proteína BMP-2 e a sua produção através da tecnologia de DNA recombinante. A produção desta proteína humana recombinante, utilizando os sistemas procarióticos é o método preferido, sendo a bactéria Escherichia coli um dos sistemas mais populares de produção proteica. A bactéria E. coli é um sistema de expressão bem estudado, que proporciona uma produção rápida e económica de proteínas recombinantes de interesse. Vários estudos têm reportado a produção e purificação da proteína BMP-2, usando como sistema de expressão a E. coli; contudo, a proteína BMP-2 é difícil de expressar na forma solúvel e sua purificação em condições nativas continua a ser um desafio. Neste trabalho, a expressão solúvel da proteína BMP-2 recombinante em E.coli foi estudada através da tecnologia de proteínas de fusão, com o novo tag de fusão FH8. A produção solúvel da proteína de fusão recombinante foi conseguida usando como vetor inicial o pQE-30FH8, com o estudo das diferentes condições de cultura, com o objetivo de determinar as condições que maximizam essa expressão solúvel. Em seguida, com a finalidade de aumentar a expressão solúvel da FH8BMP-2, foi realizada a clonagem do gene da BMP-2 em dois vetores diferentes: o pETMFH8 e pStaby1.2FH8, usando diferentes estirpes de E. coli. A estratégia de purificação da proteína FH8BMP-2 envolveu a realização das seguintes técnicas de cromatografia: interação hidrofóbica (HIC), usando o tag FH8 como tag de purificação; cromatografia de afinidade com níquel (usando o His tag como tag de purificação) e troca iónica. Os resultados apresentados neste trabalho mostraram que a proteína de fusão recombinante foi expressa solúvel com sucesso nos três vetores utilizados. O sistema pETM foi aquele que apresentou um maior nível de expressão solúvel. Em relação à purificação, a técnica de FH8-HIC, quando combinada com a adição de cálcio à fração solúvel, apresenta bons resultados em relação ao perfil de purificação da proteína alvo e um elevado rendimento de proteína purificada foi obtido. Os iões de cálcio e a própria conformação do tag FH8 podem ter um importante papel na agregação da FH8BMP-2 na forma dimérica. Em geral, a BMP-2 foi eficientemente expressa no sistema E. coli como proteína solúvel e uma estratégia de purificação otimizada foi delineada para obter esta proteína morfogenética do osso em condições nativas. Este trabalho pode ser importante para novas etapas de uma produção in vitro e aplicação biomédica da proteína BMP-2 recombinante

Aplicação de um programa de estimulação multissensorial a doentes com alterações severas do estado de consciência

A multisensorial stimulation programme (MSP) was implemented in patients with severe changes in their awareness disabilities, created and implemented with the main purpose of improving the quality of nursing care. “Assessment and stimulation in patients with major disabilities in their cognitive ability “(1). Our objective with this programme was focused on promoting a clear enhancement in patients’ cognitive ability and awareness. This programme was applied to 22 people/ participants with an average age of 57,95 years old (+ 17,27), being 63,64% male patients. The majority of the patients included the ones affected by hemorrhagic stroke (59,09%), followed by brain traumatic injury (31,82%). The two chosen methods were: the Glasgow Coma Scale (EGC) as well as Rancho los Amigos Levels of Cognitive Functioning Scale (LCSF) to assess patients. After the data analysis, the results were as follows: more than a half of the patients showed a clear improvement in their cognitive awareness, 63,64% increased the EGC score and 54, 55 in the LCSF. The patients whose families were effectively involved in the programme improved six times more in the EGC average. We have come to the conclusion that the introduction of our multisensorial programme led to an improvement in most of these patients.Se ha implementado un Programa de Estimulación Multisensorial (PEM) en enfermos con alteraciones severas del estado de conciencia, integrado en un proyecto de mejora continua de la calidad de los cuidados de enfermería: “Evaluación y estimulación del enfermo con alteraciones del estado de conciencia” (1). Su objetivo general fue la promoción de mejoras en el estado de conciencia de los enfermos. Fue aplicado a 22 personas con edad media de 57,95 años (+17,27), 63,64% de los cuales eran hombres. La tipologia de los enfermos fue mayoritariamente AVC Hemorragico (59,09%), seguida de Traumatismo Craneo-encefálico (31,82%). Se ha elegido la Escala de Coma de Glasgow (ECG) y la Escala Rancho los Amigos Levels of Cognitive Functioning Scale (LCSF) para evaluar los enfermos. De los resultados destaca que más de la mitad de los enfermos han evolucionado en su estado de conciencia, 63,64% han mejorado su score según la ECG y 54,55% progresaron su nivel según la LCFS; aquellos enfermos cuya familia se ha involucrado en el proyecto han evolucionado seis veces más según la ECG, promedia. Se concluye que, con la aplicación del PEM se puede contribuir a mejorar el estado de conciencia de la mayoría de dichos enfermos.Implementámos um Programa de Estimulação Multissensorial (PEM) a doentes com alterações severas do estado de consciência, integrado num projeto de melhoria contínua da qualidade dos cuidados de enfermagem: “Avaliação e estimulação do doente com alterações do estado de consciência” (1). Tivemos como objetivo geral promover a melhoria do estado de consciência destes doentes. Foi aplicado a 22 pessoas com média de idade de 57,95 anos (+17,27), sendo 63,64% homens. A tipologia de doentes foi maioritariamente AVC Hemorrágico (59,09%), seguida de Traumatismo Crânio-Encefálico (31,82%). Escolhemos a Escala de Coma de Glasgow (ECG) e a Rancho los Amigos Levels of Cognitive Functioning Scale (LCSF) para avaliar o doente. Dos resultados destacamos: mais de metade dos doentes evoluíram no estado de consciência, 63,64% melhoraram o Score na ECG e 54, 55% progrediram no nível LCFS; os que tiveram a família envolvida evoluíram seis vezes mais em média na ECG. Concluímos que com a aplicação do nosso PEM poderemos contribuir para a melhoria do estado de consciência da maioria destes doentes