Browsing by Issue Date, starting with "2018-08"
Now showing 1 - 10 of 51
Results Per Page
Sort Options
- Modernism and Agrarian UtopiaPublication . MAIA, Maria HelenaThe Iberian Peninsula was mostly rural, poor and archaic until very recently, with only a few cities whose inhabitants lived a substantially different reality from the rest of the population. This provides a background of supposed authenticity of the roots of national architectural identity with direct effects on architectural choices. One of the possible examples to understand this process is the experience of inner colonization, so crucial both in Portugal and in Spain, and the actions taken by the authorities in charge. These parallel experiences provide us with an opportunity to gain a thorough understanding of the relationship between architectural identity and the rural world. In both countries, the 1940s and 1950s were characterized by major infrastructural interventions in the territory. The modernization of Portuguese and Spanish countryside included inner colonization schemes, implementing the “agrarian utopia” purported by both Franco and Salazar. Many modern architects played a part in this process. Rural settlements across the Iberian Peninsula clearly show different points of balance between elements of modernity and references to vernacular architecture. For this reason, they offer an ideal testing ground to question how the local architectural identity was constructed.
- Using a cancer registry to capture signals of adverse events following immune and targeted therapy for melanomaPublication . Aguiar, João P.; Borges, Fábio Cardoso; Murteira, Rodrigo; Ramos, Catarina; Gouveia, Emanuel; Passos, Maria José; Miranda, Ana; Costa, Filipa Alves daBackground Toxicity of oncology treatments in real-life patients is frequently disregarded and hence underreported. Objective To characterize adverse events (AEs) of immunotherapy and targeted therapy reported in patients with locally advanced or metastatic melanoma. Setting District Hospital for Cancer treatment (Instituto Português de Oncologia de Lisboa Francisco Gentil). Method A retrospective cohort of melanoma patients was established, comprising adult patients diagnosed with malignant melanoma treated with immunotherapy or targeted therapy. Exposure was characterized by nature, time and intensity of exposure. To account for different exposure periods, person-time was used as unit of analysis. Main outcomes measure Occurrence of AEs. Results Data from 111 patients included in the cohort indicates the majority received immunotherapy regimens (CTLA-4, anti-PD-1 and combination therapy; (n = 70; 63.1%), among which anti-PD-1 were the predominant treatment. Pembrolizumab was the most frequently prescribed drug (n = 30; 45.7%). Three hundred and seventy-one AEs were extracted. The incidence of AEs was lower in the anti-PD-1 mAc group (54 AEs per 1000 person.months) and the number of AEs/patient was also lower (3.1 ± 2.0). Grade 3 to 4 AEs occurred in 15.3% (n = 17) of the cohort, being more common in the targeted therapy group. Forty-two (11.6%) of the extracted AEs were not described in the Summary of Product Characteristics of the drugs under study. Conclusion This study suggests various known and unknown AEs of immunotherapy and targeted therapy may be identified using the Cancer Registry database. These events should be considered as signals worth further investigation for assessment of causality as the underreporting of AEs in cancer may have potential implications for the patient's quality of life.
- Proliferation of community exercise programs with limited evidence and expertise: safety implicationsPublication . Domingos, Josefa; Dean, John; Melo, Filipe; Godinho, Catarina
- Relationship between childhood trauma and sleep disturbances: the role of perceived stress as a mediatorPublication . Cardoso, Jorge; Almeida, Telma; Ramos, Catarina; Sousa, SaraThe main objective of the current study was to analyze the mediating role of perceived stress on the relationship between childhood trauma and sleep disturbances among the adult population. The sample of this cross-sectional study was composed of 987 Portuguese adults with sleep disturbances, who completed a self-administered questionnaire about childhood trauma, sleep disturbances, and perceived stress. The results of analyses found that in the model that included the variables childhood trauma and perceived stress, both variables were predictors of sleep disturbances; however, perceived stress was the strongest predictor. Regarding the model with the subtypes of maltreatment, only Emotional Abuse predicted sleep problems. Results of the Path Analysis model showed that perceived stress partly mediates the effect of childhood trauma on adult sleep disturbances. This study has clinical implications, supporting the importance of taking into account childhood trauma and perceived stress during the assessment and intervention of sleep disturbances.
- Posttraumatic growth in adult cancer patients: an updated systematic reviewPublication . Ramos, Catarina; Pimenta, Filipa; Patrão, Ivone; Costa, Margarida; Santos, Ana Isabel; Rudnicki, Tânia; Leal, IsabelThe current systematic review is an updated analysis of studies with adult cancer patients, regarding factors associated with posttraumatic growth (PTG), which is defined as perceived positive changes after traumatic event, such as cancer. A systematic review was conducted according to the PRISMA Statement guidelines. Seven electronic databases were searched. Quantitative studies with or without psychosocial group intervention that assessed PTG or similar construct (benefit finding [BF], positive life changes, stress-related growth, growth) as main outcome were included. The initial systematic search yielded 659 papers, published between 2006 and 2015. From those, 81 studies fulfilled the inclusion criteria: 73 studies without intervention and 8 entailing an intervention program. The results suggested that socio-demographic (e.g. age, educational level, household income), clinical (e.g. stage of cancer), cognitive (e.g. intrusiveness, challenge to core beliefs), coping-related (e.g. positive reframing, religious coping) and other psychosocial variables (e.g. social support, optimism, spirituality) are positively associated with PTG. BF is associated with gender, marital status, cancer stage, both cancer and treatment type, positive active coping, positive reappraisal, social support and optimism. Psychosocial group interventions with cancer patients show significant effect on the increase of growth reported (PTG or BF). As conclusion, Growth following a cancer experience is an effect of several variables which might be targeted and promoted in the context of multidisciplinary teams, in hospital and clinical settings. Group interventions are a favorable context to the development of PTG after cancer, but interventions that assess PTG as primary outcome are still needed to evaluate the effect of group on PTG’ facilitation.
- Fatores que influenciam a dádiva de sangue: revisão sistemática de literaturaPublication . Lemos, Bernardo; Ferreira, Cristiana; Zuzarte, Nicole; Nunes, LucíliaContexto: Estudos recentes revelam que em Portugal, apesar das estatísticas divulgadas recentemente apontarem para uma estabilidade nas reservas de sangue, o número de novos dadores e a quantidade de unidades de sangue colhido tem vindo a diminuir consideravelmente. Objetivo: Sintetizar evidências científicas primárias sobre os principais fatores que influenciam a dádiva de sangue através de uma revisão sistemática da literatura. Métodos: Estudo de revisão sistemática da literatura segundo o modelo do Joanna Briggs Institute. Foram utilizadas as bases de dados SciELO®, B-On® e Pubmed® com as palavras- -chave dádiva de sangue, doação de sangue, fatores, blood donation e factors. Foram incluídos artigos em português e inglês publicados entre 2013 e 2017, com texto e referências bibliográficas disponíveis na íntegra, publicados em revistas científicas com peer-review e com relevância para a temática em investigação. De um total de 72.790 artigos encontrados, 6 foram incluídos. Resultados: Os resultados indicam que os fatores que influenciam a dádiva de sangue prendem-se com o medo; campanhas insuficientes e ineficazes; ocultação de informação no momento da triagem; não remuneração; burocracia; necessidade da dádiva a conhecidos; reforço do ganho social; ganho de uma ausência justificada ao serviço; altruísmo; nível cognitivo; estrutura social; idade; sexo; estado civil; historial de dádivas de sangue e comportamentos de risco. Conclusões: Evidenciou-se que existem fatores que influenciam positiva e negativamente a dádiva de sangue, porém, é necessária a realização de novos estudos que analisem os fatores que influenciam a dádiva de sangue em Portugal, de modo a definir estratégias que aumentem a dádiva no nosso país.
- Esophageal and Gastroduodenal Hemorrhagic Necrosis: A Unique Finding in the Setting of Septic Shock and Vasopressor UsePublication . Carvão, Joana; Faria, Maria Gorete; Magno Pereira, Vitor; Sousa Andrade, Carla; Fernandes, Nicodemos; Nóbrega, José Júlio; Jasmins, LuísEsophageal and gastroduodenal necrosis are rare conditions with poor prognosis. We describe a case that was diagnosed with upper endoscopy in the setting of severe septic shock. To our knowledge, this is the first case in which esophageal and gastroduodenal necrosis occurred simultaneously in this setting. We discuss the pathophysiology, diagnostic approach, and treatment options of this rare entity.
- Contributo para otimizar a Gestão dos Recursos Humanos nas Secções de Recursos Logísticos e Financeiros da Guarda Nacional Republicana: a importância da formação emPublication . Lopes, Pedro Manuel Cerqueira; Pereira, Maria Cristina AfonsoO presente Trabalho de Investigação Aplicada está subordinado ao tema: “Contributo para otimizar a Gestão dos Recursos Humanos nas Secções de Recursos Logísticos e Financeiros da Guarda Nacional Republicana; a importância da formação em contratação pública”. Por conseguinte, pretende-se estudar as competências requeridas para a melhoria do desempenho dos recursos humanos no desenvolvimento das funções em contratação pública. Assim sendo, a investigação desenvolveu-se através do método hipotético-dedutivo, permitindo elaborar o estudo de forma a responder à pergunta de partida, às perguntas derivadas e às hipóteses levantadas. No que concerne à metodologia aplicada para a realização do trabalho de investigação, esta foi delimitada segundo os autores, Quivy & Campenhoudt (2017) e Sarmento (2013), assim como a pesquisa bibliográfica, as entrevistas e os inquéritos por questionário foram os procedimentos utilizados para a recolha dos dados. Por conseguinte, o presente trabalho é composto por seis capítulos divididos em três partes, sendo elas, Parte I – Enquadramento Teórico, Parte II – Parte Prática e por último as conclusões e recomendações. Deste modo, a Parte I é definida pelos conceitos teóricos, relativamente à Gestão dos Recursos Humanos, à formação e à contratação pública. No que concerne à Parte II, são apresentados os métodos e procedimentos utilizados, a análise e discussão de resultados. No último capítulo redigem-se as conclusões retiradas dos resultados obtidos e as recomendações futuras. Após toda a investigação, recolha e tratamento dos dados, conclui-se que existe a necessidade de promover formação específica em contratação pública, para os recursos humanos que desempenham funções neste âmbito, nas respetivas Secções de Recursos Logísticos e Financeiros. Neste desiderato, a colocação de um oficial de Administração Militar revela-se uma fator extremamente importante pois possui os conhecimentos teóricos de modo a verificar e controlar os procedimentos aquisitivos desenvolvidos.
- Observation of Complex Time Structures in the Cosmic-Ray Electron and Positron Fluxes with the Alpha Magnetic Spectrometer on the International Space StationPublication . AMS collaboration (252 authors); Arruda, L.; Barao, F.; Orcinha, M.We present high-statistics, precision measurements of the detailed time and energy dependence of the primary cosmic-ray electron flux and positron flux over 79 Bartels rotations from May 2011 to May 2017 in the energy range from 1 to 50 GeV. For the first time, the charge-sign dependent modulation during solar maximum has been investigated in detail by leptons alone. Based on 23.5×106 events, we report the observation of short-term structures on the timescale of months coincident in both the electron flux and the positron flux. These structures are not visible in the e+/e- flux ratio. The precision measurements across the solar polarity reversal show that the ratio exhibits a smooth transition over 830±30 days from one value to another. The midpoint of the transition shows an energy dependent delay relative to the reversal and changes by 260±30 days from 1 to 6 GeV.
- Precision Measurement of Cosmic-Ray Nitrogen and its Primary and Secondary Components with the Alpha Magnetic Spectrometer on the International Space StationPublication . AMS collaboration (243 authors); Arruda, L.; Barao, F.; Orcinha, M.A precision measurement of the nitrogen flux with rigidity (momentum per unit charge) from 2.2 GV to 3.3 TV based on 2.2×106 events is presented. The detailed rigidity dependence of the nitrogen flux spectral index is presented for the first time. The spectral index rapidly hardens at high rigidities and becomes identical to the spectral indices of primary He, C, and O cosmic rays above ∼700 GV. We observed that the nitrogen flux ΦN can be presented as the sum of its primary component ΦNP and secondary component ΦNS, ΦN=ΦNP+ΦNS, and we found ΦN is well described by the weighted sum of the oxygen flux ΦO (primary cosmic rays) and the boron flux ΦB (secondary cosmic rays), with ΦNP=(0.090±0.002)×ΦO and ΦNS=(0.62±0.02)×ΦB over the entire rigidity range. This corresponds to a change of the contribution of the secondary cosmic ray component in the nitrogen flux from 70% at a few GV to <30% above 1 TV.