Repositório RCAAP

Study objectives: The stress imposed by the COVID-19 pandemic and ensuing social isolation could adversely affect sleep. As sleep problems may persist and hurt health, it is important to identify which populations have experienced changes in sleeping patterns during the pandemic and their extent. Methods: In Study 1, 3,062 responders from 49 countries accessed the survey website voluntarily between March 26 and April 26, 2020, and 2,562 (84%; age: 45.2 ± 14.5, 68% women) completed the study. In Study 2, 1,022 adult US responders were recruited for pay through Mechanical Turk, and 971 (95%; age 40.4 ± 13.6, 52% women) completed the study. The survey tool included demographics and items adapted from validated sleep questionnaires on sleep duration, quality and timing, and sleeping pills consumption. Results: In Study 1, 58% of the responders were unsatisfied with their sleep. Forty percent of the responders reported a decreased sleep quality vs before COVID-19 crisis. Self-reported sleeping pill consumption increased by 20% (P < .001). Multivariable analysis indicated that female sex, being in quarantine, and 31- to 45-years age group, reduced physical activity and adverse impact on livelihood were independently associated with more severe worsening of sleep quality during the pandemic. The majority of findings were reproduced in the independent cohort of Study 2. Conclusions: Changes imposed due to the pandemic have led to a surge in individuals reporting sleep problems across the globe. The findings raise the need to screen for worsening sleep patterns and use of sleeping aids, especially in more susceptible populations, namely, women and people with insecure livelihoods subjected to social isolation.

Understanding how teacher learning is constituted is an important research area in teacher education with many open questions to be investigated yet. Thereby, in this paper, we present a theoretical model whose main purpose is to enable the design of teacher education programs as well as to guide the understanding of professional learning opportunities for teachers. Based on our research outcomes on teaching and learning algebra and on a literature review, we describe how the model was elaborated and bring some illustrative situations to indicate the model “in action” throughout the teacher education process. The architecture of the program enabled teachers to experience professional learning opportunities linked to mathematical and didactical knowledge regarding patterns and regularities, as well as the opportunity to learn from and with each other, overcoming the isolation caused by daily work in their schools and leading them to explore practices close to their own school reality.

This research describes the evaluation of a teacher education program set up to foster the use of computers as a support for project work. The teachers, who got involved in the program mainly with the motivation of learning how to use computers, recognized changes in their attitudes and pedagogical practices.

This chapter presents a perspective about the exploratory approach as a possible way to enact inquiry based mathematics teaching. In this approach, the teacher, instead of beginning the class by presenting explanations and examples to the students, proposes them to work on tasks that may lead to the construction of new knowledge. We use as illustration the work of a grade 6 class of students solving tasks involving rational numbers. Our aim is to know how students use representations and reasoning processes, seeking to find out how they deal with different representations and how they formulate generalizations and justifications. We follow a qualitative and interpretative approach, with participant observation of a teaching experiment that included five lessons that were integrally videotaped and transcribed. We analyse episodes from the work of the students in two tasks, one involving a complex relationship between fractions and the other involving the use of fractions as operators. The results show that when solving a task that involves rational numbers given as fractions, the students mostly use the decimal representation, with which they feel rather comfortable. In another task, involving rational numbers as operators, most students use fractions, but some of them also use of decimal numbers and pictorial representations. In both cases, the students chose the representation that they considered best suit their needs. In their written work, the students justify their choices by presenting the computations done when solving a task, adding explanations in natural language. Just by themselves, they are able to use counterexamples to refute a statement, and, during whole class discussions, prompted by the teacher, they are able to make generalizations and justifications based on definitions.

Neste capítulo analisa-se o papel dos modelos na aprendizagem dos números racionais.

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.

A investigação acerca das atribuições parentais, relativas ao comportamento desadequado dos filhos, revela a sua importância no entendimento de dificuldades das crianças e dos pais, e no envolvimento destes no processo e no resultado terapêutico da criança, no entanto esta investigação é reduzida, sendo ainda mais escassa na população portuguesa. A presente investigação tem como objetivos o estudo das atribuições parentais acerca do comportamento desadequado dos filhos, bem como compreender a expressão de variáveis que lhe estão associadas, relativas aos pais e aos filhos, no contexto português. Investigou-se um total de 73 pais (17 pais e 56 mães), de nacionalidade portuguesa, com 18 ou mais anos, e com pelo menos um filho(a) entre os 8 e os 12 anos. Os participantes preencheram um questionário sociodemográfico (sexo, profissão e escolaridade dos pais, numero de filhos, e idade sexo dos filhos), bem como 5 questionários de autorrelato para avaliar as atribuições parentais (Parent Cognition Scale), a autoeficácia parental (Perceived Parental Self-Efficacy Scale), o temperamento das crianças (School Age Temperament Inventory), o comportamento das crianças (Strength and Difficulties Questionnaire) e o ajustamento psicológico parental (Brief Symptom Inventory). Os resultados indicam associações significativas negativas entre a autoeficácia parental e as atribuições parentais, e positivas entre a sintomatologia dos pais e as atribuições de causalidade aos pais, e entre o temperamento difícil dos filhos e as atribuições de responsabilidade à criança. Os resultados indicam também que os pais com filhos dos 10-12 anos fazem mais atribuições parentais de responsabilidade à criança, do que os pais com filhos dos 8-9 anos. A autoeficácia parental é o melhor preditor das atribuições parentais. Espera-se contribuir para o aumento do conhecimento sobre as atribuições que os pais fazem quando os filhos apresentam um comportamento desadequado, e para o desenvolvimento de intervenções junto de pais que apresentem atribuições menos adaptativas.

Transseptal puncture emerged 60 years ago and its indications have changed progressively over the decades. Currently, it is a technique performed by multiple disciplines with different objectives and training protocols. Greater accuracy and technological sophistication have replaced the fine art of the classical technique, which was guided solely by fluoroscopy.

Introduction: Currently, the bronchodilator reversibility is not recommended to differentiate asthma from chronic obstructive pulmonary disease (COPD); however, physiopathological specificities of each disease contribute to the differences in response to the drug. Objectives: The objective of this study is to evaluate the differences in bronchodilator response between asthmatic and COPD patients and to determine which of the bronchodilation criteria have the best ability to detect the positive response in these patients. Materials and methods: This was a cross-sectional study. The sample included 104 patients with asthma or COPD who performed lung function tests between January and March 2018. The whole sample was analyzed according to postbronchodilator variation (Δ) of lung function parameters, and the postbronchodilator reversibility was characterized using a multiple bronchodilation criteria. The drug used in reversibility test was salbutamol. Results: In this study, Δ forced-expiratory volume in the 1st s (ΔFEV1) and a Δ Raw was statistically higher in the group with asthma compared with the group with COPD. In the asthma group, the criteria ↓ functional residual capacity (FRC) ≥10%, ↓Raw ≥ 35%, ↑ forced expiratory flow between 25% and 75% of vital capacity (FEF25%–75%) ≥20% and ↑ FEV1 and / or ↑ forced vital capacity ≥12% and 200 mL were those that presented a greater capacity of detecting a positive response to bronchodilator. The criteria ↑ FEF25%–75%≥20% and ↓ FRC ≥ 10% were those that had the greater ability of detecting airway reversibility in COPD group. Conclusion: The analysis of postbronchodilator FEV1 and raw modifications as well as the using of a combination of multiple bronchodilation criteria contribute to a deeper characterization of bronchodilator reversibility in asthma and COPD.

No summary/description provided

Importance: Behavioral disturbances are core features of frontotemporal dementia (FTD); however, symptom progression across the course of disease is not well characterized in genetic FTD. Objective: To investigate behavioral symptom frequency and severity and their evolution and progression in different forms of genetic FTD. Design, setting, and participants: This longitudinal cohort study, the international Genetic FTD Initiative (GENFI), was conducted from January 30, 2012, to May 31, 2019, at 23 multicenter specialist tertiary FTD research clinics in the United Kingdom, the Netherlands, Belgium, France, Spain, Portugal, Italy, Germany, Sweden, Finland, and Canada. Participants included a consecutive sample of 232 symptomatic FTD gene variation carriers comprising 115 with variations in C9orf72, 78 in GRN, and 39 in MAPT. A total of 101 carriers had at least 1 follow-up evaluation (for a total of 400 assessments). Gene variations were included only if considered pathogenetic. Main outcomes and measures: Behavioral and neuropsychiatric symptoms were assessed across disease duration and evaluated from symptom onset. Hierarchical generalized linear mixed models were used to model behavioral and neuropsychiatric measures as a function of disease duration and variation. Results: Of 232 patients with FTD, 115 (49.6%) had a C9orf72 expansion (median [interquartile range (IQR)] age at evaluation, 64.3 [57.5-69.7] years; 72 men [62.6%]; 115 White patients [100%]), 78 (33.6%) had a GRN variant (median [IQR] age, 63.4 [58.3-68.8] years; 40 women [51.3%]; 77 White patients [98.7%]), and 39 (16.8%) had a MAPT variant (median [IQR] age, 56.3 [49.9-62.4] years; 25 men [64.1%]; 37 White patients [94.9%]). All core behavioral symptoms, including disinhibition, apathy, loss of empathy, perseverative behavior, and hyperorality, were highly expressed in all gene variant carriers (>50% patients), with apathy being one of the most common and severe symptoms throughout the disease course (51.7%-100% of patients). Patients with MAPT variants showed the highest frequency and severity of most behavioral symptoms, particularly disinhibition (79.3%-100% of patients) and compulsive behavior (64.3%-100% of patients), compared with C9orf72 carriers (51.7%-95.8% of patients with disinhibition and 34.5%-75.0% with compulsive behavior) and GRN carriers (38.2%-100% with disinhibition and 20.6%-100% with compulsive behavior). Alongside behavioral symptoms, neuropsychiatric symptoms were very frequently reported in patients with genetic FTD: anxiety and depression were most common in GRN carriers (23.8%-100% of patients) and MAPT carriers (26.1%-77.8% of patients); hallucinations, particularly auditory and visual, were most common in C9orf72 carriers (10.3%-54.5% of patients). Most behavioral and neuropsychiatric symptoms increased in the early-intermediate phases and plateaued in the late stages of disease, except for depression, which steadily declined in C9orf72 carriers, and depression and anxiety, which surged only in the late stages in GRN carriers. Conclusions and relevance: This cohort study suggests that behavioral and neuropsychiatric disturbances differ between the common FTD gene variants and have different trajectories throughout the course of disease. These findings have crucial implications for counseling patients and caregivers and for the design of disease-modifying treatment trials in genetic FTD.

The frequency in detection of azole-resistant Aspergillus fumigatus isolates has increased since 2010. In Portugal, the section Fumigati is one of the most frequent, and resistant strains to have been found in clinical and environmental contexts. Although several cryptic species within the Fumigati section show intrinsic resistance to azoles, one factor driving (acquired) resistance is selective pressure deriving from the extensive use of azoles. This is particularly problematic in occupational environments where high fungal loads are expected, and where there is an increased risk of human exposure and infection, with impact on treatment success and disease outcome. The mechanisms of resistance are diverse, but mainly associated with mutations in the cyp51A gene. Despite TR34/L98H being the most frequent mutation described, it has only been detected in clinical specimens in Portugal. Methods: We analyzed 99 A. fumigatus isolates from indoor environments (healthcare facilities, spas, one dairy and one waste sorting unit) collected from January 2018 to February 2019 in different regions of Portugal. Isolates were screened for resistance to itraconazole, voriconazole and posaconazole by culture, and resistance was confirmed by broth microdilution. Sequencing of the cyp51A gene and its promoter was performed to detect mutations associated with resistance. Results: Overall, 8.1% of isolates were able to grow in the presence of at least one azole, and 3% (isolated from the air in a dairy and from filtering respiratory protective devices in a waste sorting industry) were pan-azole-resistant, bearing the TR34/L98H mutation. Conclusion: For the first time in Portugal, we report environmental isolates bearing the TR34/L98H mutation, isolated from occupational environments. Environmental surveillance of the emergence of azole-resistant A. fumigatus sensu stricto strains is needed, to ensure proper and timely implementation of control policies that may have a positive impact on public and occupational health.

Culturing is still the most widely used method for determining fungal growth. Thus, is important to identify the most suitable culture media to assess Aspergillus spp. The aim of this study was to analyze data obtained from previous studies, aiming at identifying the most suitable culture media (malt extract agar (MEA) or dichloran-glycerol agar (DG18) to assess Aspergillus spp. isolation and growth. This study was conducted by using environmental samples (n = 1153). Most of the active sampling methods (air samples) were impacted directly onto both culture media. As for passive sampling methods, fungi were extracted from environmental matrices inoculated onto both media. Overall, total Aspergillus counts were higher in MEA (n = 617, 53.5%) than in DG18 (n = 536, 46.5%). Regarding Aspergillus sections, significant associations were detected with the media (χ2 (7) = 241.118, p < 0.001), the sampling approach (p < 0.001, 95% CI = (0.3 × 10−4), and the indoor environment (p < 0.001, 95% CI = (0.3 × 10−4)). As such, sampling approach and the culture media should be accurately selected when dealing with Aspergillus spp. exposure assessment.

Este trabalho dá conta de actividades e desenvolvidas em Portugal relativamente ao uso de computadores no ensino da Matemática. Analisam-se as principais oportunidades que o computador oferece para utilização educativa e discutem-se as respectivas potencialidades e condições de implementação.

No summary/description provided

Alopecia areata (AA) is a non-scarring alopecia, which often carries a major impact on patients' quality of life. Currently there is no single approved treatment that effectively induces permanent remission. Recently, the JAK-STAT signaling pathway has emerged as a possible therapeutic target leading to increased interest in the use of Janus kinase (JAK) inhibitors (JAKis) in the treatment of this pathology. This review of the literature summarizes information on patients with AA who underwent treatment with JAKis and discusses the current evidence on the efficacy and safety of its use. A literature search was conducted in different databases to identify clinical trials and case reports published in January 2019. Several clinical studies have shown very promising results in the treatment of AA with oral formulas of JAKis. These agents, however, need chronic administration to maintain response. Topical formulations did not show satisfactory responses. The safety profile of these agents appears to be favorable. Current evidence is promising regarding the efficacy and safety of oral JAKis. However, the data obtained are of low quality, originating predominantly from reports of clinical cases. Further studies are needed to confirm these data and to optimize its long-term efficacy and safety.

Notwithstanding the speculations from the literature, the empirical analyses still neglect the convergence between populism and technocracy. The Italian case can be of some interest in this perspective, given the rise of technocratic populism since Silvio Berlusconi’s rise to power in 1994. By analyzing the style of leadership and the processes of ministerial appointment and delegation, we argue that Berlusconi has been a trendsetter, more than a coherent example of technocratic populist leader. On the one hand, he played the role of the entrepreneur in politics, promising to run the state as a firm. Moreover, he adopted an anti-establishment appeal, delegitimizing political opponents and stressing the divide between ‘us’ (hardworking ordinary people) and ‘them’ (incompetent politicians). On the other hand, however, his anti-elite approach was mainly directed towards the ‘post-communist elite.’ Extending the analysis to the following two decades, we introduce a diachronic comparison involving three examples of leadership somehow influenced by Berlusconi. Mario Monti represents the paradox of the impossible hero: A pure technocrat unable to take a genuinely populist semblance. Matteo Renzi represents the attempt to mix a populist party leadership with a technocratic chief executive style. Finally, Salvini represents the pure nativist heir of Berlusconi, as the new leader of the right-wing camp. The latest developments of executive leadership in Italy, and the re-emergence of other residual hints of technocratic populism, will be discussed in the final section of the article, also in the light of the evident impact of the 2020 pandemic outbreak on the practices of government.

The present article opens with a generic plea for the de-imperialization of Lusophone studies. A de-imperial turn should allow researchers to explore more thoroughly the experiences of diaspora and exile that an empire-centered history and its spin-offs have obfuscated; it should also help to de-essentialize depictions of Portuguese heritage and culture shaped by these narratives. Such a turn promises to address the multiple identifications, internal diversities, and racialized inequalities produced by the making and unmaking of empire. My contribution consists of a few ethnographic-historic case studies collected at the intersections of empire, post-empire, and diaspora. These include nineteenthcentury diasporic movements that brought Portuguese subjects to competing empires; past and present celebrations of heritage in diasporic contexts; culture wars around representations; and current directions in post-imperial celebrations and reparations.

Objetivos: Articular, por um lado, o investimento parental nas mães que experienciaram um parto pré-termo e, por outro lado, o sentimento de competência materna e as memórias de infância relativas às figuras parentais. Perceber de que forma as memórias de infância, explicam a variância estatística do sentimento de competência percebido pela mãe de um bebé pré-termo. Amostra: Mães (N = 31) que deram à luz antes do termo da gravidez e cujos filhos têm 0 e 7 anos de idade cronológica. O recrutamento ocorreu na Maternidade Dr. Alfredo da Costa (N = 13) ou foram recrutadas através do enfermeiro de família na USF de Santa Maria em Tomar (n = 18). Instrumentos: Questionário Sociodemográfico e Clínico; Escala de Investimento Parental na Criança (Bradley, Whiteside, Mansell & Brisby, 1997; versão Portuguesa de Gameiro, Martinho, Canavarro & Moura-Ramos, 2008), Parental Bonding Instrument (Parker, Tupling & Brown, 1979; versão Portuguesa de Geada, 2003) e a Escala de Sentimento de Competência Parental (Johnston & Mash, 1989; versão Portuguesa de Ferreira, Veríssimo, Santos & Cardoso, 2011). Hipóteses: Espera-se que as variáveis das memórias de infância e do sentimento de competência materno apresentem contributos significativos para a explicação da variância das variáveis do investimento parental vivido pelas mães. Espera-se, também, que as variáveis das memórias de infância maternas apresentem contributos significativos para a explicação da variância das variáveis do sentimento de competência materno. Resultados: A contribuição significativa das memórias de infância parentais de cuidado e superproteção, em interação com as dimensões do sentimento de competência materno, para a explicação da aceitação do papel parental, foi parcialmente confirmada. A contribuição significativa das memórias infantis de cuidado e superproteção para a explicação do sentimento de competência materno total, foi parcialmente confirmada. Conclusão: De acordo com as nossas hipóteses as memórias de infância e a satisfação com o desempenho do papel parental, são indispensáveis para a compreensão da forma como as mães investem nos seus bebés. Além disso, as memórias de infância das mães contribuem para a compreensão do sentimento de competência materno na relação com o seu bebé pré-termo.

O presente trabalho surge da análise das possibilidades de mudança dos paradigmas da atual ordem social estabelecida, principalmente através dos novos cenários gerados e geradores das novas tecnologias. Serão analisadas, portanto, as perspectivas de conexão entre as pessoas, pelas obras de autores como Fairclough, Bauman, Halliday, Castells e Debord, de modo que as temáticas que envolvem áreas abrangentes como Comunicação & Marketing e Análise do discurso estão intrincados de maneira híbrida, variada e complexa. A análise se debruça sobre os discursos nas mídias sociais em âmbito digital, ou seja, o contexto social é de extrema importância para este trabalho, junto às ferramentas e plataformas disponíveis, com seus limites e possibilidades. Entre estratégias de Marketing e análise do discurso, dois conceitos serão apresentados neste trabalho: OnLife e Discursos Líquidos, de modo a corroborar com o discurso como uma prática social, como um grande contributo para as mudanças sociais, sob os mais variados panoramas.