Repositório RCAAP

This article discusses the self-perceived integration of Swedes permanently residing in Portugal. The knowledge of how EU citizens, particularly Swedes, live and integrate into Portuguese society is limited. The conceptual framework on self-perceived integration takes its points of departure from the concepts of a sense of belonging to society and place, feelings of discomfort and coping tactics. Using a semi-structured interview guide, 36 in-depth interviews with Swedes permanently residing in Portugal were conducted. Whereas some of the permanently residing Swedes have no ambition of integrating into Portuguese society, others display a strong selfperceived feeling of being integrated within the community where they live. The added value of this paper is that it shows the complexity behind the construction of the feeling of self-perceived integration of Swedes in Portugal. Building a feeling of self-perceived integration depends on many factors and is not a linear process.

The Sendai Framework for Disaster Risk Reduction provides several guidelines that countries should follow. Still, some scientific papers discussed the limitations, difficulties, and strategies in the implementation of these guidelines. Therefore, the objective of this review is to understand what Setubal has done to cope with disasters, and the practical strategies to mitigate them. To achieve this, several methodological guidelines and Portuguese legal documents were analyzed. The results focus on the top four natural disasters that impacted the study area (landslides, earthquakes, tsunamis, and floods), and the current pandemic of COVID-19. The practical strategies implemented on the territory involve the installation of equipment such as emergency signs and electronic panels that allow the dissemination of information to the communities in real-time. Also, the collaboration with national and international scientists provided new insight to cope with disasters, by bridging the gap between law enforcement agencies, science, first responders, and the practical needs that local stakeholders must solve on the territory. Moreover, Setubal has implemented a variety of practical and innovative measures, and therefore, could be used as a model not only to other Portuguese municipalities but also to other countries

The neuropeptide substance P (SP) is known to increase cell-mediated immune responses in animal models and healthy subjects. Several studies have suggested an involvement of neuropeptides in the immunopathogenesis of some diseases. The study of the immunomodulatory effects of neuropeptides, namely SP, may represent a model for the analysis of immunoregulatory defects in HIV infection at the level of the interaction between the immune and nervous systems, both of which are known to be affected by the virus. In the present study, we investigate the possibility of a disturbance in the immunomodulatory properties of SP in HIV infection by analysing the effects of SP (10(-10)-10(-6) M) on the lymphocyte proliferative responses to concanavalin A (Con A) and phytohaemagglutinin (PHA) assessed by 3H-thymidine incorporation in peripheral blood lymphocytes from 34 HIV-infected patients (16 asymptomatic (ASY)/persistent generalized lymphadenopathy (PGL); 18 ARC/AIDS) and in 37 healthy subjects. In ASY/PGL HIV-infected patients, SP 10(-7) M was identified as the concentration inducing the maximal increase in the lymphocyte responses to Con A and PHA, similarly to what was observed in healthy subjects. In ARC/AIDS patients, SP appeared to inhibit the mitogenic responses, particularly those induced by Con A, in contrast to the effects found either in healthy subjects or in ASY/PGL patients. These results suggest the existence of an alteration in the in vitro immunomodulatory properties of SP in ARC/AIDS patients compared with healthy subjects and ASY/PGL patients. In conclusion, the unexpected finding of an inhibitory effect of SP on lymphocyte proliferation from ARC/AIDS patients justifies further investigation of the neuropeptide-dependent immunoregulatory systems in HIV infection.

Introduction: Metabolic control plays an important role on major cardiovascular events (MACE) prevention. The 2019 ESC guidelines on dyslipidaemia management recommend tighter LDL-cholesterol (LDL-C) control in order to prevent cardiovascular events. However, it is not yet proven that thigh control of dyslipidaemia, glycaemic levels and body mass index (BMI) in Heart Failure (HF) patients (pts) have an impact on prognosis. Objective: To evaluate the impact of LDL-C, HbA1c and BMI values on HF pts mortality and MACE rates.

Objectives: We sought to describe the frequency and location of headache in intracerebral hematoma (ICH) and to analyze its clinical and CT predictors by means of multivariate analysis. Background: Headache is more common in intracerebral hemorrhage than in ischemic stroke, and its frequency varies with hematoma location, but the pathophysiologic mechanisms of headache associated with ICH are not fully known. Methods: We examined a cohort of 289 patients with ICH during a 14-month period in a university hospital. Clinical, including the presence and location of headache, and CT features were collected by two neurologists. Results: One hundred and sixty-five (57%) patients with ICH had a headache at the onset of their stroke. Headache was more common in cerebellar and lobar hemorrhages than in deep ones (thalamic, caudate, capsuloputaminal, brainstem). Headache was also more common in women, patients younger than 70 years, those who vomited, and those with meningeal signs, a Glasgow Coma Scale score < 10, a hematoma volume > 10 ml or CT evidence of intraventricular or subarachnoid bleeding, moderate to severe hydrocephalus, or transtentorial herniation or midline shift. In multiple logistic regression analysis, only meningeal signs (odds ratio [OR] = 2.3), cerebellar or lobar location (OR = 2.1), transtentorial herniation (OR = 1.8), and female gender (OR = 1.6) were significant predictors of headache at the onset of ICH. Conclusions: Hematoma location, meningeal signs, and gender are more predictive of headache than hematoma volume, suggesting that headache is more often related to the activation of an anatomically distributed system in susceptible individuals and to subarachnoid bleeding than to intracranial hypertension.

This project reflects on the practical and theoretical developments of the research Between images and databases: possible paths and poetics deepened in the master's degree in Multimedia Art at the Faculty of Fine Arts, University of Lisbon. This exploratory research within the scope of an investigation in the arts, analyses the relationship between images and databases by contrasting concepts and writings of authors with authorial and non-authorial works of art. The research seeks, finally, to reflect on the role of the image in the condition of poetic, political and economic actor within the context in which we live and on how artistic works can help us in this task. The proposed practical project aims to consolidate knowledge at the intersection between different means of creation and artistic production. A transdisciplinary universe was called up, making it stand out for the dialogue between the different areas involved, such as painting, video and digital media, thus proposing new discourses and poetics about our days. Analysing the spaces occupied by this global set of images, some questions become necessary. How can we relate the impact in the most diverse spheres in which the relationship between images and database interferes, such as the social, economic, political and financial spheres, with the advancement of access and the dispersion of these images? What is the relationship between this global image database and the new relations of power, contemporary art production and image consumption? In this world that seems to be an endless and unstructured collection of images, texts and other image records, how can we rethink and develop a poetics, aesthetics and ethics of the image of our times? What are the implications of our relationship with this database, for our interpersonal, political and economic relationships? And its use within contemporary art? How can works of art question a changing reality, in which we are constantly changing and being changed as a database, upgradeable, manipulable and controlled by specific systems? How should we think about control and rights from an imaginary perspective, what were the major changes in the status of the image that directly affect these issues?

Cost-containment in health care has become a major issue in today's practice of medicine. With its needs in advanced technologies and skilled personnel, intensive care is among the most expensive of all hospital activities. This fact makes the analysis of indications for intensive care unit admission, as well as early discharge, of paramount importance: patients who are not likely to benefit from intensive care are at the extremes of disease severity, since low-risk patients are not ill enough to need ICU admission and high-risk patients have a very high mortality, irrespective of intensive care treatment. In this paper we discuss, based on published evidence, the formulation of recommendations for admission and early discharge from ICUs, and also present the Society of Critical Care Medicine guidelines, on this subject.

A queda de algumas construções da Modernidade e o fim de algumas das cosmovisões que nela foram floresceram, bem como as dimensões social e ambientalmente destrutivas da nossa economia colocam em questão a possibilidade de existência de uma ética empresarial. Afirma-se aqui que a economia é inseparável da ética, e que as falhas existentes são uma demonstração disso mesmo. Partimos de uma reflexão sobre política, ciência, sociedade e indivíduo para estabelecer as bases de tal afirmação. Prosseguimos no sentido de estabelecer a ponte entre dois universos vistos como absolutamente apartados: a filosofia e as empresas. Determinamos de seguida a ética discursiva como mediadora entre os vários contributos que a filosofia pode dar a esta ética aplicada e definimos os pontos cardeais da actividade de uma empresa: os seus sujeitos e o seu campo de acção. Tendo em conta os pressupostos estabelecidos anteriormente debruçamo-nos de seguida sobre as dimensões organizacional, social e ambiental da actividade empresarial. Terminaremos com uma abordagem às correntes de gestão concordantes com a perspectiva aqui defendida e ainda com uma descrição dos principais mecanismos de institucionalização da ética empresarial.

Objectivos: Os principais objectivos deste estudo foram verificar a existência de diferenças na micro-estrutura do sono, nomeadamente movimentos rápidos dos olhos e micro-alertas, entre indivíduos com Síndrome de Apneia Obstrutiva do Sono (SAOS) de grau moderado e indivíduos controlo; verificar a existência de diferenças na micro-estrutura do sono entre sexos em indivíduos com SAOS de grau moderado e ainda, verificar a existência de relação entre a apresentação clínica da SAOS e os elementos referidos da micro-estrutura do sono. Metodologia: Foram considerados na apresentação clínica da SAOS sintomas como sonolência diurna excessiva (SDE), cansaço, cefaleias, depressão e insónias e como sinais a roncopatia, a saturação mínima da oxi-hemoglobina e o tempo de registo com saturação de oxihemoglobina inferior a 90%. A amostra com SAOS (IAH 15-29/hora) foi constituída por 30 indivíduos (15 do sexo feminino e 15 do sexo masculino). A amostra controlo foi constituída por 14 indivíduos (7 do sexo feminino e 7 do sexo masculino). Todos os indivíduos realizaram polissonografia nocturna no laboratório do sono do Hospital de Santarém, EPE e preencheram a Escala de Sonolência de Epworth (ESE). Foram consultados os processos clínicos dos indivíduos da amostra com SAOS de forma a recolher os dados necessários à realização do estudo. Com o intuito de verificar a ausência de queixas de sono na amostra controlo todos os indivíduos desta amostra preencheram o Índice de Qualidade de Sono de Pittsburgh (IQSP). Estes indivíduos assinaram também o consentimento informado. Resultados: Verificou-se Índice de Micro-Alerta (IMA) total e Índice de Micro-Alerta em sono NREM significativamente aumentados na amostra com SAOS. Não se verificaram diferenças significativas na densidade de REM’s entre a amostra com SAOS e a amostra controlo, assim como entre a amostra feminina e masculina. Verificou-se elevada prevalência de SDE (76,7%), de cansaço (43,3%) e de cefaleias (43,3%), verificando-se menor prevalência de depressão (13,3%) e de insónias (10%). Não se verificaram diferenças significativas nos micro-alertas e na densidade de REM’s, entre os indivíduos com e sem os sintomas referidos anteriormente. Não se verificaram correlações significativas entre micro-alertas, densidade de REM’s e todos os sinais estudados. Em relação a outros parâmetros avaliados neste estudo, verificou-se que a amostra com SAOS e a amostra masculina apresentaram percentagens superiores de fase 1; que as mulheres apresentaram aumento da latência para sono REM. Os homens apresentaram valores superiores de IAH total, de IDO total e de tempo de registo com saturação de oxi-hemoglobina inferior a 90%. Concluindo, de acordo com estudos prévios verifica-se aumento do número de microalertas total na SAOS. Não se verificou aumento da densidade de REM’s na SAOS, nem se verificou existência de relação significativa entre os elementos da microestrutura da SAOS e a sua apresentação clínica.

This research starts from epiphenomena resulting from the technological hyperconversion of music consumption habits in the post-digital era, for the identification of reception and image production trends for music. In the first part, the social implications of the overlapping of mobile audio reproduction devices are identified, such as the routinization and privatization of listening to music, and also of streaming platforms in music discovery, as algorithmic systems that generate individual content counselling playlists. The second part is directed to the identification of phenomena around the production of visual content for music. The contribution of the democratization of image production tools to the existence of the self-taught user-producer is analysed, the thumbnail format is considered as a closed space on protocol platforms and, finally, a possible programmatic approach to the design practice is pointed out, which suggests that the designer may become a systems programmer whose authorial feature involves defining the parameters on which these systems are based. The research culminates in a practical project, the Soma web platform - plataforma-soma.pt - which is an archive of original interviews with musicians, designers, editors, and others whose practice focuses on exploring the relationships between music and image. The promotion and publication of these interviews, collected using individualized scripts whose guidelines cross the practice of the selected actors with the personal analysis of subjects referred to in the research, is expected to add a relevant contribution to the discussion of the theme of the image for music in the present.

Background: We reviewed current understanding of the pathophysiology of the uremic bleeding diathesis and discuss accepted therapeutic interventions that minimize the risk of bleeding in the uremic patient. Methods: Computerized literature searches and references from previous publications, including articles describing original research and reviews pertaining to the pathophysiology of and clinical approach to uremic bleeding. Results: The most common hemorrhagic manifestations in uremia are prolonged bleeding from puncture sites; nasal, gastrointestinal and genitourinary bleeding; and subdural hematomas. The most useful clinical laboratory test to assess both bleeding risk and response to therapy is bleeding time. It correlates better with clinical bleeding complications than indices of azotemia (eg, blood urea nitrogen [BUN], creatinine) or in vitro platelet aggregation tests. A low hematocrit is also correlated with increased bleeding risk. Anemia plays an important role in the bleeding diathesis of uremia and its correction with red cell transfusions or human recombinant erythropoietin is critical. Anticoagulation during hemodialysis may transiently exacerbate the bleeding diathesis. Hemodialysis and peritoneal dialysis improve the hemostatic defect and renal transplantation totally corrects it. Cryoprecipitate has been largely replaced by desmopressin acetate, which acts promptly (in less than 1 hour) but has a short duration of action (hours) and exhibits tachyphylaxis. Conjugated estrogens are slower in the onset of action (about 6 hours) but their effect lasts for about 2 weeks. Conclusions: The pathophysiology of the bleeding diathesis of uremia is complex and incompletely understood but useful clinical tests and therapies have evolved empirically. Broadly available dialysis and the advent of erythropoietin are likely to reduce the magnitude of this problem.

O objectivo da Newsletter do Instituto de Saúde Baseado na Evidência (ISBE) é a disponibilização de informação sobre áreas relevantes para a prática clínica, baseada na melhor evidência científica. São localizados estudos relevantes e de alta qualidade, criticamente avaliados pela sua validade, importância dos resultados e aplicabilidade prática e resumidos numa óptica de suporte à decisão clínica. É dada prioridade aos estudos de causalidade – revisões sistemáticas, ensaios clínicos, estudos de coorte prospectivos/retrospectivos, estudos seccionais cruzados e caso‐controlo – incluindo‐se ainda, quando justificado, estudos qualitativos considerados de elevada qualidade metodológica e importância clínica.

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We eagerly read the article entitled “Later high school start time is associated with lower migraine frequency in adolescents” by Gelfand and colleagues. This interesting paper addresses an essential and recurring theme with clinically impactful results on the association of late start times in high schools with the frequency of headaches in adolescents with migraine. However, some relevant considerations should be made to complement the results and subsequent discussion.

Quais os fatores que contribuem para o declínio e a extinção do amor romântico? A que aspetos deveremos estar atentos caso não queiramos perder esse amor que nos une a alguém? Ou, em sentido inverso, haverá algo que se possa fazer para extinguir o amor que se sente por alguém? O presente estudo procurou compreender quais os mecanismos que estão por trás desse declínio. Através da realização de 24 entrevistas, foi possível identificar os fatores principais (que atuam numa primeira linha) e complementares (que potenciam os anteriores) que mais contribuíram para o colapso do amor romântico. Foram identificados dois tipos de declínio, que seguem processos relativamente diferentes: o declínio não intencional – que ocorre de forma espontânea – e o declínio intencional – que ocorre de forma propositada. Entre os fatores principais encontrados destacam-se a desilusão e as faltas de compromisso, de segurança e de intimidade. O crescimento individual, a falta de reciprocidade, a desconsideração e – com menor expressão – a falta de paixão revelaram ser também aspetos relevantes no processo de declínio. No caso do declínio intencional, foi a adoção de estratégias específicas – das quais se destaca o afastamento – que mais contribuíram para o declínio e a extinção do amor romântico. Em ambos os tipos de declínio, verificou-se a existência de quatro fatores complementares (a perda da esperança, terceiras pessoas, a autoestima e o tempo) que desempenham um papel essencial no desencadeamento ou na consolidação do processo de declínio amoroso. O presente estudo permite aumentar a nossa compreensão dos aspetos envolvidos no declínio e extinção do amor romântico, cuja pertinência poderá estender-se ao trabalho clínico em terapia individual ou de casal, quando se pretenda conservar a ligação amorosa ou quando o amor seja causa de sofrimento.

The Núcleo Museológico de Alverca do Ribatejo has a fundamental role in the development of the sense of belonging of the residents of the parish of Alverca do Ribatejo. With a collection from the city's own residents, the Núcleo Museológico presents us with objects that tell how the city developed and how its inhabitants lived/live. Through the history of origin of the occupation in Alverca do Ribatejo, going through its economic and population growth to the present day, it is possible to have a glimpse into the daily life, customs and traditions of a local village which is little known but very proud of its roots. With the purpose of creating something beyond just another master’s degree paper, this thesis aims to produce a document referencing international preventive conservation norms and indications, considering the collection of the Núcleo Museológico de Alverca do Ribatejo. Such a document should already exist, but like most of all the small museums in the world, this is not a reality. This thesis does not intended to go into detail about the physical and/or chemical reactions of museum objects when exposed to deteriorating agents, but aims to be a practical and basic manual for how a layman, as not everyone has a technical background, should react when an objetct in the collection of Núcleo Museológico de Alverca do Ribatejo is at risk. All museums have a responsibility for the collection under their control, regardless of whether they have millions of museum objects in their collection or if it is just a small local museum. The Núcleo Museológico de Alverca do Ribatejo made me understand the importance of local history and how the sense of identity and belonging can mobilize many people for one purpose, in this case the creation of a museum. Finding out about the history of Alverca do Ribatejo and later the reasons that led to the creation of this museum captivated me during the research for this dissertation and I hope that anyone reading this work will feel as curious and interested as I was, and come visit the Núcleo Museológico de Alverca do Ribatejo. Without a doubt, the museum doors will always be open!

Esta investigação aborda a temática do processo de envelhecimento e procura estudar as atitudes face ao envelhecimento, a resiliência e variáveis sociodemográficas, em dois grupos de idosos, com diferentes perceções de qualidade de vida (QV). Assenta em três objetivos principais, baseados na comparação entre o grupo “elevada QV” e o grupo “baixa/moderada QV”: (1) explorar as diferenças nas atitudes face ao envelhecimento e na resiliência; (2) explorar a relação entre atitudes face ao envelhecimento, resiliência e variáveis sociodemográficas; (3) explorar os modelos de regressão que predizem as atitudes face ao envelhecimento, tendo como preditores as dimensões da resiliência. A amostra deste estudo divide-se em dois grupos, ambos com participantes com idade igual ou superior a 65 anos de idade: (1) grupo “baixa/moderada QV”, com 136 participantes (M= 74.61 anos de idade; DP = 6.54), sendo 60.3% do sexo feminino; (2) grupo “elevada QV”, com 82 participantes (M = 73.57 anos de idade; DP = 6.26), sendo 50% do sexo feminino. Foram administrados três questionários de autorrelato: Questionário de Avaliação da Qualidade de Vida (WHOQOL-Bref); Questionário de Atitudes face ao Envelhecimento (AAQ-24) e; Escala de Resiliência de Connor-Davidson (CD-RISC). O grupo “elevada QV” demonstra atitudes mais positivas face ao envelhecimento e maior resiliência, exceto na dimensão da espiritualidade. Os idosos do grupo “elevada QV” que estão mais satisfeitos com a sua situação económica ou que estão atualmente doentes, demonstram maior resiliência; e os que estão atualmente doentes ou consideram mais satisfatória a sua qualidade das relações de amizade, têm atitudes mais positivas face ao crescimento psicológico. Os idosos do grupo “baixa/moderada QV” que estão satisfeitos com a sua situação económica são os que demonstram maior resiliência; e os que estão mais satisfeitos com a qualidade das relações familiares ou que não estão atualmente doentes, assumem atitudes mais positivas face às dimensões perdas psicossociais e mudança física, e ao AAQ total. No grupo “elevada QV”, as atitudes face ao envelhecimento são preditas pelas dimensões da resiliência, Competência (β = .71) e Aceitação (β = .28), que explicam 98% da variância dos resultados, enquanto no grupo “baixa/moderada QV” são preditas pela Competência (β = .45), Espiritualidade (β = .24) e Confiança (β = .30), que explicam 96% da variância dos resultados. Este estudo identifica variáveis que interferem na perceção da qualidade de vida dos idosos.

Experimental Zika virus infection in non-human primates results in acute viral load dynamics that can be well-described by mathematical models. The inoculum dose that would be received in a natural infection setting is likely lower than the experimental infections and how this difference affects the viral dynamics and immune response is unclear. Here we study a dataset of experimental infection of non-human primates with a range of doses of Zika virus. We develop new models of infection incorporating both an innate immune response and viral interference with that response. We find that such a model explains the data better than models with no interaction between virus and the immune response. We also find that larger inoculum doses lead to faster dynamics of infection, but approximately the same total amount of viral production.

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Neste trabalho pretendeu-se estudar a diversidade genética e evolução dos genes homC e homD, que codificam para OMPs de H. pylori, num painel de 189 estirpes isoladas de doentes de origem geográfica diferente e com diversas gastropatologias. Foram utilizadas as técnicas de PCR e sequenciação e ferramentas de bioinformática. Posteriormente, pretendeu-se esclarecer o papel destes genes na virulência de H. pylori, através de ensaios in vitro e avaliação da antigenicidade das respectivas proteínas. A reconstrução filogenética do gene homC revelou uma segregação geográfica, com três grupos predominantes, Ocidental, Oriental/Ameríndio e Africano. Foram identificadas oito variantes alélicas, com especificidade geográfica nos alelos mais prevalentes. Os resultados sugerem que estas variantes podem estar envolvidas na adaptação da bactéria ao hospedeiro e constituir marcadores da patologia gástrica e da virulência da estirpe. O gene homD mostrou menor diversidade genómica. No entanto, no terminal-N das proteínas HomD foi observada uma zona variável de repetições de motivos de KP (2-9 KP), tendo-se verificado uma correlação entre um menor número de repetições de motivos KP ( 4 KP) e a UP e o maior número de repetições ( 7 KP) e a gastrite. A análise in silico da proteína HomD mostrou que esta região de repetições exibe um elevado índice de hidrofibicidade e antigenicidade e uma alta probabilidade de exposição à superfície da bactéria. A corroborar estes resultados, demonstrou-se que a proteína HomD é antigénica. Os ensaios in vitro sugerem que o gene homC poderá estar envolvido na resposta inflamatória de H. pylori. Globalmente, os resultados obtidos neste estudo sugerem que o gene homC está implicado na interacção entre H. pylori e o hospedeiro, contribuindo para a virulência desta bactéria. O gene homD parece ser um importante antigénio de H. pylori, e devido à sua elevada conservação a nível mundial, poderá constituir um novo alvo vacinal ou terapêutico.