Estudo qualitativo

Perante um paradigma de educação em mutação, em que os indivíduos se veem confrontados com exigências que ultrapassam os recursos que têm disponíveis, surge a necessidade de repensar a educação numa ótica de aprendizagem ao longo da vida, muitas vezes, como forma de ultrapassar o flagelo do desemprego. A formação pode ser encarada como um “novo começo”, em que os indivíduos são encorajados a procurar novos objetivos para as suas vidas, os quais acabarão por conferir sentido à sua existência. Perante estas considerações faz sentido questionar a realidade portuguesa e analisar o processo de desenvolvimento da resiliência no percurso educativo/formativo de adultos desempregados. Este estudo empírico tem como objetivo analisar a resiliência em adultos pouco escolarizados, que tenham passado por uma situação de desemprego, e que posteriormente tenham frequentado Cursos de Educação e Formação de Adultos de nível secundário. Participaram no estudo nove mulheres, com idades compreendidas entre os 40 e os 55 anos. Foi desenvolvido um estudo qualitativo com recurso aos “grupos de focagem” (focus group). As discussões foram gravadas em áudio/vídeo, tendo sido posteriormente transcritas na íntegra. O tratamento das respostas consistiu na análise de conteúdo, de onde derivou a codificação e categorização do material. Os resultados deste estudo indicam que a problemática dos adultos pouco escolarizados encontra-se muitas vezes associada ao risco de exclusão, como tal, torna-se importante analisar de que forma as ofertas de educação e formação de adultos, que têm sido implementadas, conseguem chegar aos que aparentemente mais precisam. Este pressuposto remete-nos para a noção de resiliência que pode ser entendida como, a realização de uma adaptação bem sucedida por parte do indivíduo, apesar do mesmo se encontrar exposto ao risco e à adversidade. Assim os resultados sugerem que a educação e formação constitui uma importante estratégia no desenvolvimento de competências profissionais, pessoais e sociais.Against a changing educational paradigm, in which individuals are confronted with demands that exceed the resources they have available, the need arises to rethink education in a perspective of lifelong learning, often as a way of overcoming the scourge unemployment. The training can be seen as a "fresh start", in which individuals are encouraged to seek new goals for their lives, which will ultimately give meaning to their existence. Given these considerations makes sense to question the Portuguese reality and analyze the process of development of resilience in the course educational/training for unemployed adults. This empirical study aims at examining resilience in adults with little education, who have experienced a situation of unemployment, and subsequently have attended Education and Adult Education at the secondary level. Nine women participated in the study, aged between 40 and 55 years. We developed a qualitative study using the "focus groups" (focus group). The discussions were audio/video, and was later transcribed. The treatment consisted of responses on content analysis, from which derived the coding and categorization of the material. The results of this study indicate that the problem of adults with little schooling is often associated with risk of exclusion, as such, it becomes important to analyze how the supply of education and training of adults, that have been implemented, can reach those who apparently need it most. This assumption leads us to the notion of resilience can be understood as the realization of successful adaptation by the individual, although the same is exposed to risk and adversity. Thus the results suggest that education and training is an important strategy in the development of professional skills, personal and social

Validación de encuesta de evaluación del impacto de la demencia en la familia

Objective: To validate a questionnaire to assess the impact of dementia on one of the household members. Methods: Methodological study. The instrument was designed based on literature review, expert opinion, and researchers’ experience and then applied to a non-probability convenience sample consisting of 262 family members who live daily with a person with dementia. The construct validity was studied by exploratory factor analysis, principal components method, with varimax rotation of the items. Results: An instrument with 30 items was obtained, distributed in four dimensions: “Emotional dimension,” “Economic dimension,” “Family relations dimension,” and “Support-seeking dimension.” Factor analysis revealed a total explained variance of 54.96% and a total Cronbach’s alpha of .899. Conclusions: The instrument presents high internal consistency, grouped into four dimensions, all closely related to the family’s adaptation to the onset of dementia in one of its members.Objetivo: Validar um questionário de avaliação do impacto da demência num dos membros do agregado familiar. Métodos: Estudo metodológico. O instrumento foi construído, com base na revisão da literatura, na opinião de peritos e na experiência dos investigadores. Foi aplicado a uma amostra não probabilística de conveniência constituída por 262 familiares de pessoas que coabitam diariamente com a pessoa com demência. A validade de constructo foi estudada pela análise fatorial exploratória, método dos componentes principais, com rotação varimax dos itens. Resultados: Obteve-se um instrumento com 30 itens distribuídos por quatro dimensões “Dimensão emocional”, “Dimensão económica”, “Dimensão relações familiares” e “Dimensão procura de suporte”. A análise fatorial revelou uma variância explicada total de 54,96% e um alfa de Cronbach total de ,899. Conclusões: O instrumento apresenta uma consistência interna elevada agrupando-se em quatro dimensões, todas elas intimamente ligadas à adaptação da família ao aparecimento da demência num dos seus membros.Objetivo: Validar encuesta de evaluación del impacto de la demencia en uno de los miembros del agregado familiar. Métodos: Estudio metodológico. El instrumento fue construido basado en la revisión de la literatura, opinión de peritos y experiencia de los investigadores y, en seguida, aplicado a una muestra no probabilística de conveniencia constituida por 262 familiares que cohabitan diariamente con una persona con demencia. La validez de constructo fue estudiada por análisis factorial exploratorio, método de los componentes principales, con rotación varimax de los ítems. Resultados: Obtuvo un instrumento con 30 ítems, distribuidos en cuatro dimensiones: “Emocional”, “Económica”, “Relaciones familiares” y “Búsqueda de soporte”. El análisis factorial reveló variancia explicada total de 54.96% y alfa de Cronbach total de .899. Conclusiones: El instrumento presenta consistencia interna elevada agrupándose en cuatro dimensiones, todas íntimamente relacionadas a la adaptación de la familia delante el aparecimiento de la demencia en uno de sus miembros.info:eu-repo/semantics/publishedVersio

Impact of Pancreatic Autoantibodies in Pancreas Graft Survival After Pancreas-Kidney Transplantation

In simultaneous pancreas-kidney transplantation (SPKT), persistence or recurrence of pancreatic autoantibodies (PAs) has been associated with pancreas graft (PG) autoimmune-driven injury. Our aim was to analyze the impact of PAs on PG survival.Methods. Between January 1, 2000, and December 31, 2017, we studied 139 patients with post-SPKT antieglutamic acid decarboxylase (GAD) autoantibody. Alloimmune (ALI) events were defined as PG rejection and/or de novo donor-specific antibodies (DSA).Hence, 3 groups were defined: patients without ALI events or anti-GAD (n ¼ 42), those with ALI events (n ¼ 14), or those only with autoimmune events (positive for anti-GAD and no ALI events; n ¼ 83). Results. Male sex was predominant (n ¼ 72, 52%). Median age was 35 years (interquartile range: 31-39) and median follow-up was 6-7 years (interquartile range: 4.1-9.2). Regarding anti-GAD positivity post-SPKT (n ¼ 90, 65%), no differences were observed concerning age, sex, anti-HLA antibodies, HLA mismatch number and de novo DSA. ALI events were present in 10% (n ¼ 14). PG survival 15 years post-SPKT was better in patients without immune events (96%) followed by those with ALI (69%) and autoimmune events (63%) (P ¼ .025). Anti-GAD was associated to higher annualized mean Hb1AC (P ¼ .006) and lower mean C-peptide (P ¼ .013). According to pre- and post-SPKT anti-GAD status, conversion from negative to positive was associated to worse (63%) 10-year PG survival (P ¼ .044), compared to persistence of negative (100%) or positive anti-GAD (88%). Anti-islet cell and anti-insulin autoantibodies had no impact. Conclusion. Anti-GAD presence post-SPKT was associated to higher pâncreas disfunction and lower PG survival. De novo anti-GAD seems to offer a particular risk of PG failure.info:eu-repo/semantics/publishedVersio

Monocytes as Endothelial Progenitor Cells (EPCs), Another Brick in the Wall to Disentangle Tumor Angiogenesis

The project was funded by IPOLFG, EPE, by iNOVA4Health (UID/Multi/04462/2019) a program financially supported by Fundação para a Ciência e Tecnologia/Ministério da Educação e Ciência, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement and by Fundação para a Ciência eTecnologia (PhD student fellowship: PD/BD/128337/2017).Bone marrow contains endothelial progenitor cells (EPCs) that, upon pro-angiogenic stimuli, migrate and differentiate into endothelial cells (ECs) and contribute to re-endothelialization and neo-vascularization. There are currently no reliable markers to characterize EPCs, leading to their inaccurate identification. In the past, we showed that, in a panel of tumors, some cells on the vessel wall co-expressed CD14 (monocytic marker) and CD31 (EC marker), indicating a putative differentiation route of monocytes into ECs. Herein, we disclosed monocytes as potential EPCs, using in vitro and in vivo models, and also addressed the cancer context. Monocytes acquired the capacity to express ECs markers and were able to be incorporated into blood vessels, contributing to cancer progression, by being incorporated in tumor neo-vasculature. Reactive oxygen species (ROS) push monocytes to EC differentiation, and this phenotype is reverted by cysteine (a scavenger and precursor of glutathione), which indicates that angiogenesis is controlled by the interplay between the oxidative stress and the scavenging capacity of the tumor microenvironment.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

Predictors of cardiac involvement in idiopathic inflammatory myopathies

Copyright © 2023 Bandeira, Dourado, Melo, Martins, Fraga, Ferraro, Saraiva, Sousa, Parente, Soares, Correia, Almeida, Dinis, Pinto, Oliveira Pinheiro, Rato, Beirão, Samões, Santos, Mazeda, Chícharo, Faria, Neto, Lourenço, Brites, Rodrigues, Silva-Dinis, Dias, Araújo, Martins, Couto, Valido, Santos, Barreira, Fonseca and Campanilho-Marques. 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.Objectives: Idiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM. Methods: Multicenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered. Results: 230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results. Conclusion: Anti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.info:eu-repo/semantics/publishedVersio

Innovation of Textiles through Natural By-Products and Wastes

Nowadays, the competitiveness of the textile industry and the consumers’ interest have been increasing the demand for innovative and functional textiles. Allied to this, sustainable developments are playing an increasingly important role in the textile industry. Such concerns led to a new development strategy based on the valorization of bio-based wastes and by-products of different industries, inserting this in the circular economy paradigm. These bio-based wastes and by-products come from several industries, as the agri-food industry. These resources present an enormous potential for valorization in the textile finish due to their intrinsic properties (antimicrobial, prebiotic, antioxidant activity, among others). This chapter will review the latest innovation and textile product development through different by-products and wastes, their main properties and characteristics and the advantages that they offer to the textile industry

uma nova ferramenta de vigilância transnacional da tuberculose no espaço lusófono

A Tuberculose (TB) permanece um grave problema de saúde pública na Comunidade dos Países de Língua Portuguesa (CPLP). Apesar da ampla variância da incidência da TB nos seus estados-membro e de um fluxo migratório contínuo entre os países que integram este grupo, existe uma enorme lacuna no que diz respeito ao conhecimento da estrutura populacional conjunta do Mycobacterium tuberculosis e circulação de estirpes entre estes países. Para fazer face a esta necessidade, foi agregado e analisado o maior conjunto de dados respeitante à diversidade genotípica e resistência fenotípica na CPLP que compreende um total de 1447 isolados clínicos, incluindo 423 isolados multirresistentes de cinco países da CPLP. Por forma a tornar estes dados disponíveis para a comunidade científica e autoridades de saúde pública, foi desenvolvida a CPLP-TB (disponível em http://cplp-tb.ff.ulisboa.pt), uma base de dados disponível online e provida de aplicativos para análise exploratória do conteúdo. Como ferramenta de saúde pública, espera-se que venha a contribuir para um conhecimento mais aprofundado da estrutura populacional do M. tuberculosis e circulação de estirpes na CPLP de forma a apoiar a avaliação de risco e tendências específicas para diversos clones. Tuberculosis (TB) remains a major health problem within the Community of Portuguese Language Speaking Countries (CPLP). Despite the marked variation in TB incidence across its member-states and continued human migratory flux between countries, a considerable gap in the knowledge on the Mycobacterium tuberculosis population structure and strain circulation between the countries still exists. To address this, we have assembled and analyzed the largest CPLP M . tuberculosis molecular and drug susceptibility dataset, comprised by a total of 1447 clinical isolates, including 423 multidrug-resistant isolates, from five CPLP countries. To make this data available to the scientific community and public health authorities we developed CPLP-TB (available at http://cplp-tb.ff.ulisboa.pt), an online database coupled with web-based tools for exploratory data analysis. As a public health tool, it is expected to contribute to improved knowledge on the M. tuberculosis population structure and strain circulation within the CPLP, thus supporting the risk assessment of strain-specific trends.publishersversionpublishe

Livro Verde dos Montados

O Livro Verde dos Montados apresenta diversos objectivos que se interligam: Em primeiro lugar, o Livro Verde pretende reunir e sistematizar, de uma forma simples e acessível ao público, o conhecimento produzido em Portugal pelos investigadores e técnicos de várias instituições de investigação ou de gestão que estudam o Montado. Assume-se como uma oportunidade de caracterizar o sistema tendo em conta as suas várias dimensões, identificando as principais ameaças à sua preservação assim como os caminhos que podem ajudar à sua sustentabilidade. Não sendo um documento científico, baseia-se no conhecimento científico e pretende constituir a base para uma plataforma de organização, tanto dos investigadores como do conhecimento científico actualmente produzido em Portugal sobre o Montado.Em segundo lugar, o Livro Verde deverá contribuir para um entendimento partilhado do que é o Montado, por parte do público, de técnicos e de especialistas, conduzindo a uma classificação mais clara do que pode ser considerado Montado e de quais os tipos distintos de Montados que podem ser identificados. Em terceiro lugar, o Livro Verde estabelece as bases para uma estratégia coordenada de disponibilização de informação sobre o sistema Montado, visando o seu conhecimento, apreciação e valorização pela sociedade portuguesa no seu conjunto. Deste modo, o Livro Verde poderá constituir um instrumento congregador e inspirador para a realização de acções de sensibilização e informação sobre o Montado. Em quarto lugar, pretende-se que o Livro Verde contribua para um maior reconhecimento e valorização do Montado como sistema, a nível do desenho das políticas nacionais por parte dos vários sectores envolvidos.Finalmente, o Livro Verde constituirá um documento parceiro do Livro Verde das Dehesas, produzido em Espanha em 2010, de forma a reforçar o reconhecimento e a devida valorização destes sistemas silvo-pastoris no desenho das estratégias e políticas relevantes pelas instituições europeias. Em suma, os autores pretendem que o Livro Verde dos Montados se afirme como o primeiro passo para uma efectiva definição e implementação de uma estratégia nacional para os Montados