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- ABC traffic light: a health education toolPublication . Dias, Maria do Rosário; Correia, Paula Grade; Correia, Patrícia RodriguesIt is during the childhood period of one’s life trajectory that the exponential increase of vocabulary acquisition occurs. In Portugal, language disorders are the most frequently seen child development impairments, affecting 3 to 15 per cent of children under six years. Because delays in the acquisition of basic vocabulary can compromise inter-peer relational communication, a timely therapeutic assessment and intervention becomes all the more crucial. A speech therapy ludic-pedagogic intervention tool—the ABC Traffic Light—was created so as to aid in promoting basic vocabulary acquisition in children aged between three and six years. It consists in a traffic light with three built-in pouches, each of which containing cards suggestive of activities of varying difficulty levels. The empirical range of the proposed tool in the context of speech therapy assessment and intervention sessions should be highlighted.
- Abcesso epidural – uma complicação anestésicaPublication . Carvalho, Inês; Tomé, Sara; Neto, Miguel; Dinis, Isabel"Os abcessos epidurais são infeções muito graves do Sistema Nervoso Central. Constituem lesões focais confinadas ao crânio ou coluna vertebral que exercem compressão cerebra lou medular causando sintomas severos e complicações permanentes. Este caso clínico constitui a descrição de uma complicação pós-operatória após uma artroplastia total do joelho.Embora seja uma entidade rara, tem-se vindo a verificar um aumento de incidência nos últimos 30 anos que se deve, não só aos avanços tecnológicos no campo da imagiologia,mas também ao envelhecimento progressivo da população e ao acréscimo do número de anestesias regionais. A chave para o tratamento desta complicação é o seu reconhecimento precoce, pelo que a hipótese diagnóstica deverá ser colocada, especialmente em casos de doentes imunocomprometidos submetidos a técnicas anestésicas regionais, sob pena de comprometer a cura completa e levar ao desenvolvimento de sequelas graves."
- About the effect of eye blinking on drug release from pHEMA-based hydrogels: an in vitro studyPublication . Galante, Raquel; Paradiso, Patrizia; Moutinho, Maria Guilhermina; Fernandes, Ana Isabel; Mata, José; Matos, António; Colaço, Rogério; Saramago, Benilde; Serro, Ana Paula"The development of new ophthalmic drug delivery systems capable of increasing the residence time of drugs in the eye and improve its bioavailability relatively to eyedrops has been object of intense research in recent years. Several studies have shown that drug loaded therapeutic soft contact lenses (SCLs) constitute a promising approach, with several potential advantages as compared with collyria. The main objective of this work is to study the effect of repetitive load and friction cycles caused by the eye blinking, on the drug release from hydrogels used in SCLs which, as far as we know, was never investigated before. Two poly-2-hydroxyethylmethacrylate based hydrogels, pHEMA-T and pHEMA-UV, were used as model materials. Levofloxaxin was chosen as model drug. The hydrogels were fully characterized in what concerns structural and physicochemical properties. PHEMA-UV revealed some superficial porosity and a lower short range order than PHEMA-T. We observe that the load and friction cycles enhanced the drug release from pHEMAUV hydrogels. The application of a simple mathematical model, which takes into account the drug dilution caused by the tear flow, showed that the enhancement of the drug release caused by blinking on this hydrogel may be relevant in in vivo conditions. Conversely, the more sustained drug release from pHEMA-T is not affected by load and friction cycles. The conclusion is that, depending on the physicochemical and microstructural characteristics of the hydrogels, blinking is a factor that may affect the amount of drug delivered to the eye by SCLs and should thus be considered."
- About the sterilization of chitosan hydrogel nanoparticlesPublication . Galante, Raquel; Rediguieri, Carolina F.; Kikuchi, Irene Satiko; Vasquez, Pablo A. S.; Colaço, Rogério; Serro, Ana Paula; Pinto, Terezinha J. A.In the last years, nanostructured biomaterials have raised a great interest as platforms for delivery of drugs, genes, imaging agents and for tissue engineering applications. In particular, hydrogel nanoparticles (HNP) associate the distinctive features of hydrogels (high water uptake capacity, biocompatibility) with the advantages of being possible to tailor its physicochemical properties at nano-scale to increase solubility, immunocompatibility and cellular uptake. In order to be safe, HNP for biomedical applications, such as injectable or ophthalmic formulations, must be sterile. Literature is very scarce with respect to sterilization effects on nanostructured systems, and even more in what concerns HNP. This work aims to evaluate the effect and effectiveness of different sterilization methods on chitosan (CS) hydrogel nanoparticles. In addition to conventional methods (steam autoclave and gamma irradiation), a recent ozone-based method of sterilization was also tested. A model chitosan-tripolyphosphate (TPP) hydrogel nanoparticles (CS-HNP), with a broad spectrum of possible applications was produced and sterilized in the absence and in the presence of protective sugars (glucose and mannitol). Properties like size, zeta potential, absorbance, morphology, chemical structure and cytotoxicity were evaluated. It was found that the CS-HNP degrade by autoclaving and that sugars have no protective effect. Concerning gamma irradiation, the formation of agglomerates was observed, compromising the suspension stability. However, the nanoparticles resistance increases considerably in the presence of the sugars. Ozone sterilization did not lead to significant physical adverse effects, however, slight toxicity signs were observed, contrarily to gamma irradiation where no detectable changes on cells were found. Ozonation in the presence of sugars avoided cytotoxicity. Nevertheless, some chemical alterations were observed in the nanoparticles.
- Accidental father-to-son HIV-1 transmission during the seroconversion periodPublication . Ezeonwumelu, Ifeanyi; Bártolo, Inês; Martin, Francisco; Abecasis, Ana; Campos, Teresa; Romero-Severson, Ethan O.; Leitner, Thomas; Taveira, NunoA 4-year-old child born to an HIV-1 seronegative mother was diagnosed with HIV-1, the main risk factor being transmission from the child's father who was seroconverting at the time of the child's birth. In the context of a forensic investigation, we aimed to identify the source of infection of the child and date of the transmission event. Samples were collected from the father and child at two time points about 4 years after the child's birth. Partial segments of three HIV-1 genes (gag, pol, and env) were sequenced and maximum likelihood (ML) and Bayesian methods were used to determine direction and estimate date of transmission. Neutralizing antibodies were determined using a single cycle assay. Bayesian trees displayed a paraphyletic–monophyletic topology in all three genomic regions, with the father's host label at the root, which is consistent with father-to-son transmission. ML trees found similar topologies in gag and pol and a monophyletic–monophyletic topology in env. Analysis of the time of the most recent common ancestor of each HIV-1 gene population indicated that the child was infected shortly after the father. Consistent with the infection history, both father and son developed broad and potent HIV-specific neutralizing antibody responses. In conclusion, the direction of transmission implicated the father as the source of transmission. Transmission occurred during the seroconversion period when the father was unaware of the infection and was likely accidental. This case shows how genetic, phylogenetic, and serological data can contribute for the forensic investigation of HIV transmission.
- Adaptação do questionário de suporte parental (QSP-6) - versão reduzida para adolescentesPublication . Gouveia, Patrícia; Leal, Isabel; Cardoso, Jorge"A família tem grande poder de influência e de transformação na vida de crianças e adolescentes. Os estudos recentes referem que o suporte familiar parece influenciar o desenvolvimento de comportamentos agressivos. Afirmam ainda a existência de uma relação entre o comportamento de bullying e o suporte que os jovens recebem das suas famílias. Assim, partindo da hipótese de que na fase da adolescência dos filhos, o suporte social dos pais poderá estar na origem de diferentes tipos de comportamentos agressivos/vitimizantes, o objetivo deste estudo é o de explorar as propriedades psicométricas do Questionário de Suporte Parental (QSP-6) – versão reduzida para Adolescentes (Clouse, 2007). Deste modo, apresentamos os resultados obtidos a partir de uma amostra de 728 adolescentes e jovens (372 do sexo feminino e 356 do sexo masculino) com idades compreendidas entre os 12 e os 21 anos. A estrutura relacional dos 18 itens foi avaliada por uma Análise Fatorial Exploratória (AFE) sobre a matriz de correlações, com extração dos fatores pelo método das componentes principais, seguido de rotação varimax. Os estudos psicométricos do QSP-6 revelam, de forma global, bons índices de fiabilidade e validade do instrumento."
- Adaptação e validação do instrumento Children Care Quality at Hospital para o PortuguêsPublication . Loureiro, Fernanda; Araújo, Beatriz; Charepe, ZaidaObjetivo: adaptar e validar o instrumento Children Care Quality at Hospital (CCQH) de avaliação da qualidade dos cuidados de enfermagem à criança hospitalizada para o idioma português de Portugal.
- Addressing ageism : be active in aging: study protocolPublication . Fernandes, Júlio Belo; Ramos, Catarina; Domingos, Josefa; Castro, Cidália; Simões, Aida; Bernardes, Catarina; Fonseca, Jorge; Proença, Luís; Grunho, Miguel; Moleirinho-Alves, Paula; Simões, Sérgio; Sousa-Catita, Diogo; Vareta, Diana Alves; Godinho, CatarinaAgeism refers to stereotyping (how we think), prejudice (how we feel), and discrimination (how we act) against people based on their age. It is a serious public health issue that can negatively impact older people’s health and quality of life. The present protocol has several goals: (1) adapt the Ambivalent Ageism Scale for the general Portuguese population and healthcare professionals; (2) assess the factorial invariance of the questionnaire between general population vs. healthcare professionals; (3) evaluate the level of ageism and its predictors in the general population and evaluate the level of ageism and its predictors in healthcare professionals; (4) compare the levels of ageism between groups and the invariance between groups regarding the explanatory model of predictors of ageism. This quantitative, cross-sectional, descriptive, observational study will be developed in partnership with several Healthcare Professional Boards/Associations, National Geriatrics and Gerontology Associations, and the Universities of the Third Age Network Association. The web-based survey will be conducted on a convenience sample recruited via various social media and institutional channels. The survey consists of three questionnaires: (1) Demographic data; (2) Ambivalent Ageism Scale; (3) Palmore-Neri and Cachioni questionnaire. The methodology of this study will include translation, pilot testing, semantic adjustment, exploratory and confirmatory factor analysis, and multigroup analysis of the Ambivalent Ageism Scale. Data will be treated using International Business Machines Corporation (IBM®) Statistical Package for the Social Sciences (SPSS) software and Analysis of Moment Structures (AMOS). Descriptive analysis will be conducted to assess the level of ageism in the study sample. The ageism levels between the two groups will be compared using the t-student test, and two Structural Equation Modeling will be developed to evaluate the predictors of ageism. Assessing ageism is necessary to allow healthcare professionals and policymakers to design and implement strategies to solve or reduce this issue. Findings from this study will generate knowledge relevant to healthcare and medical courses along with anti-ageism education for the Portuguese population.
- Adolescent hope in the context of nursing care : A scoping reviewPublication . Paramos, Ana; Ferreira, Cláudia; Loureiro, Fernanda; Charepe, ZaidaProblem: Hope is a multidimensional concept with a multidisciplinary approach in different areas of health intervention. From the perspective of the discipline of nursing, the concept of hope in the adolescent has been defined. However, its characterization is not consensually established but is necessary for nurses to be able to plan interventions aimed at its promotion. This scoping review aims at mapping the existing knowledge about adolescent's hope in the context of nursing care and contributing to the improvement of nursing interventions.
- Age estimation of unaccompanied minors: A portuguese overviewPublication . Pereira, Cristiana Palmela; Escobar, Catarina Pereira; Santos, Jorge Costa"In the past decade there has been a considerable increase in the number of unaccompanied asylum seeking children, many of whom appeared to be older than their given age. Dental age assessment has been included as part of the asylum seeking process in Portugal since the Law n. º 27/2008 dated 30 June (the “Asylum Law”). The legal framework of the forensic examination is based in biomedical ethics. The aim is to find the frequency of unaccompanied asylum seeking children with dental evidence of being older 18 years during the period between 2009 and 2013. In this period age estimations have been performed on 82 unaccompanied asylum seeking children whose given ages were queried by the Aliens and Bored Service – SEF, to the South Branch of National Institute of Legal Medicine and Forensic Sciences from Portugal. The dental development was studied on ortopantomograpic radiographs and the developing teeth staged from the tables according to Liversidge (2008), Mincer et al. (1993), Kullmanet al. (1992) and Haavikko (1970). If the dental development was complete, the dental age was estimated from Kvaal et al. (1995). The majority of the unaccompanied asylum seeking children clamed to came from Guinea Conakry, Nigeria, Guinea Bissau, Syria, Congo, Morocco and other African countries and non-African countries. There was no statistical significant difference between sexes. The majority gave the age as being 14 or 15 years (70%). Forty percent were found to be 18 years or older by the dental methods. Fifty percent were in need of dental treatment."