A Conjugalidade de famílias em transição para a parentalidade / The conjugality of families in transition to parenthood

Enquadramento: A enfermagem familiar tem sido reconhecida através das políticas de saúde, sendo a família integrada nos cuidados de forma a promover e manter a sua saúde. As respostas humanas às transições são alvo dos cuidados da Enfermagem de Saúde Familiar, devendo promover-se intervenções promotoras de capacitação. A transição para a parentalidade é descrita como a que causa mais impacto no ciclo vital familiar. Objetivos: Descrever criticamente as atividades clínicas desenvolvidas para alcançar as competências comuns do Enfermeiro Especialista e as competências específicas do Enfermeiro Especialista em Enfermagem de Saúde Familiar; e realizar um estudo de investigação intitulado ?A Conjugalidade de famílias em transição para a parentalidade?, com os objetivos de descrever a perceção de casais em transição para a parentalidade sobre a sua conjugalidade, e sobre os recursos que a influenciam. Metodologia: Na componente clínica, realizou-se avaliação e intervenção familiar e estudos de família. Na componente de investigação, realizou-se um estudo qualitativo, descritivo, exploratório e transversal. Participaram 20 cônjuges, que cumpriram os critérios de inclusão, tendo respondido a um guião de entrevista semiestruturada. Resultados: A avaliação e intervenção familiar foi sedimentada pela mobilização do Modelo Dinâmico de Avaliação e Intervenção Familiar, implementando cuidados integrais às famílias. No estudo verificou-se que a conjugalidade é afetada ao nível da relação dinâmica, comunicação, interação sexual e coping familiar. Quanto ao enfermeiro de família, os casais reconhecem que pode apoiá-los na conjugalidade, mas revelam ausência deste foco na sua prática e desconhecimento das suas reais competências. Conclusão: A componente clínica proporcionou o desenvolvimento dos dois tipos de competências referidas acima. A componente de investigação permitiu conhecer o fenómeno da vivência da conjugalidade de casais em transição para a parentalidade, e o contributo do enfermeiro ao longo deste processo. Assim, o estudo poderá contribuir para a melhoria das práticas de enfermagem, prevendo cuidados antecipatórios, bem como evidenciar o papel do enfermeiro especialista desta área.

From Testicle to Brain: A Case of Disseminated Tuberculosis.

Tuberculosis remains a major cause of death by infection in the world. Disseminated tuberculosis occurs most frequently in the context of reactivation of a previously latent infection and is invariably lethal if untreated. Age, late presentation, and serious underlying disease are strong death predictors. We report the case of a 72-year-old male patient who presented to the emergency room with sudden onset hemiparesis and aphasia, with no acute lesions on contrast CT. Two months prior to the current event, the patient had undergone surgery for a testicular abscess in a different hospital. Since the surgery, he had progressive and unexplained weight loss and dysphagia. The medical team reviewed patient records from this hospital and the one where the surgery took place and concluded that the histopathology results from the surgery were not reviewed in the post-surgery follow-up consult and that the diagnosis of genitourinary tuberculosis was never made. This disease, untreated, evolved into disseminated tuberculosis with central nervous system involvement, causing the neurological deficits the patient presented and leading to his death. Surveillance and notification systems exist for individual and public health safeguarding. In the present case, failure to review the pathology report after surgery, coupled with the absence of notification from the laboratory, delayed the diagnosis and led to patient death. This report suggests a need for continuous system improvement, with integrated healthcare records and interinstitutional communication channels, in order to minimize information loss, diagnostic delays, and public health risks.

Assessing the Impact and Suitability of Dense Carbon Dioxide as a Green Solvent for the Treatment of PMMA of Historical Value.

Surface cleaning of plastic materials of historical value can be challenging due to the high risk of inducing detrimental effects and visual alterations. As a result, recent studies have focused on researching new approaches that might reduce the associated hazards and, at the same time, minimize the environmental impact by employing biodegradable and green materials. In this context, the present work investigates the effects and potential suitability of dense carbon dioxide (CO2) as an alternative and green solvent for cleaning plastic materials of historical value. The results of extensive trials with CO2 in different phases (supercritical, liquid, and vapor) and under various conditions (pressure, temperature, exposure, and depressurization time) are reported for new, transparent, thick poly(methyl methacrylate) (PMMA) samples. The impact of CO2 on the weight, the appearance of the samples (dimensions, color, gloss, and surface texture), and modifications to their physicochemical and mechanical properties were monitored via a multi-analytical approach that included optical microscopy, Raman and attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopies, and micro-indentation (Vickers hardness). Results showed that CO2 induced undesirable and irreversible changes in PMMA samples (i.e., formation of fractures and stress-induced cracking, drastic decrease in the surface hardness of the samples), independent of the conditions used (i.e., temperature, pressure, CO2 phase, and exposure time).

A robot localization proposal for the RobotAtFactory 4.0: A novel robotics competition within the Industry 4.0 concept.

Robotic competitions are an excellent way to promote innovative solutions for the current industries' challenges and entrepreneurial spirit, acquire technical and transversal skills through active teaching, and promote this area to the public. In other words, since robotics is a multidisciplinary field, its competitions address several knowledge topics, especially in the STEM (Science, Technology, Engineering, and Mathematics) category, that are shared among the students and researchers, driving further technology and science. A new competition encompassed in the Portuguese Robotics Open was created according to the Industry 4.0 concept in the production chain. In this competition, RobotAtFactory 4.0, a shop floor, is used to mimic a fully automated industrial logistics warehouse and the challenges it brings. Autonomous Mobile Robots (AMRs) must be used to operate without supervision and perform the tasks that the warehouse requests. There are different types of boxes which dictate their partial and definitive destinations. In this reasoning, AMRs should identify each and transport them to their destinations. This paper describes an approach to the indoor localization system for the competition based on the Extended Kalman Filter (EKF) and ArUco markers. Different innovation methods for the obtained observations were tested and compared in the EKF. A real robot was designed and assembled to act as a test bed for the localization system's validation. Thus, the approach was validated in the real scenario using a factory floor with the official specifications provided by the competition organization.

Programming Robots by Demonstration Using Augmented Reality.

The world is living the fourth industrial revolution, marked by the increasing intelligence and automation of manufacturing systems. Nevertheless, there are types of tasks that are too complex or too expensive to be fully automated, it would be more efficient if the machines were able to work with the human, not only by sharing the same workspace but also as useful collaborators. A possible solution to that problem is on human-robot interaction systems, understanding the applications where they can be helpful to implement and what are the challenges they face. This work proposes the development of an industrial prototype of a human-machine interaction system through Augmented Reality, in which the objective is to enable an industrial operator without any programming experience to program a robot. The system itself is divided into two different parts: the tracking system, which records the operator's hand movement, and the translator system, which writes the program to be sent to the robot that will execute the task. To demonstrate the concept, the user drew geometric figures, and the robot was able to replicate the operator's path recorded.

Application of Infrared Reflectance Spectroscopy on Plastics in Cultural Heritage Collections: A Comparative Assessment of Two Portable Mid-Fourier Transform Infrared Reflection Devices.

Plastics have been increasingly used to create modern and contemporary art and design, and nowadays, museum collections hold numerous objects completely or partially made of plastics. However, the preservation of these materials is still a challenging task in heritage conservation, especially because some plastics show signs of degradation shortly after their production. In addition, different degradation mechanisms can often take place depending on the plastic composition and appropriate environmental and packaging conditions should be adopted. Therefore, methods for in situ and rapid characterization of plastic artifacts' composition are greatly needed to outline proper conservation strategies. Infrared (IR) spectroscopy, such as attenuated total reflection Fourier transform infrared spectroscopy (ATR FT-IR), is a well-established method for polymeric material analysis. However, ATR FT-IR requires an intimate contact with the object, which makes its application less appropriate for the in situ investigation of fragile or brittle degraded plastic objects. Mid-FT-IR reflectance spectroscopy may represent a valid alternative as it allows in situ measurements with minimum or even no contact, and IR data can be acquired rapidly. On the other hand, spectral interpretation of reflectance spectra is usually difficult as IR bands may appear distorted with significant changes in band maximum, shape, and relative intensity, depending on the optical properties and surface texture of the material analyzed. Presently, mid-FT-IR reflection devices working in external reflection (ER FT-IR) and diffuse reflection infrared Fourier transform spectroscopy (DRIFTS) modes have been used in cultural heritage research studies. As the collected vibrational information depends on the optical layout of the measuring system, differences between ER FT-IR and DRIFT spectra are thus expected when the same polymer is analyzed. So far, ER FT-IR and DRIFT spectroscopy have been individually explored for the identification of plastic objects, but comparative studies between the application of two reflectance FT-IR modes have not been presented yet. In this work, the use of two portable FT-IR spectrometers equipped with ER FT-IR and DRIFTS modes were compared for plastics identification purposes for the first time. Both references of polymeric materials and historical plastic objects (from a Portuguese private collection) were studied and the differences between ER FT-IR and DRIFT spectra were discussed. The spectra features were examined considering the two different optical geometries and analytes' properties. This new insight can support a better understanding of both vibrational information acquired and practical aspects in the application of the ER FT-IR and DRIFTS in plastic analysis.

A first approach into the characterisation of historical plastic objects by in situ diffuse reflection infrared Fourier transform (DRIFT) spectroscopy.

This research explores the potential of a portable instrumentation of diffuse reflection infrared Fourier transform (DRIFT) spectroscopy for the in situ characterisation of plastics cultural objects. As sampling has been increasingly questioned in the conservation field, the development of portable devices has been sought. Among them, infrared (IR) spectroscopy in reflection mode has been gaining a powerful position in conservation research. Attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) has been widely used for plastics, yet the strong contact required by the technique can make it inappropriate for flexible and/or fragile historic objects. Therefore, in this study, the potential of in situ DRIFT spectroscopy is assessed on both references and historical objects made of the same polymers - polyethylene (PE), polypropylene (PP) and polystyrene (PS). Plastic samples showing different characteristics such as refractive and absorption indexes and topography are also included. These different polymers and surface qualities are discussed as factors influencing the final spectra. In situ DRIFT proved to be very versatile as it could be applied in a variety of plastics and objects' shapes, does not require sampling nor an intimate contact as ATR. Moreover, specific bands and spectral profiles were identified as DRIFT markers of the polymers under study. The acquisition conditions for the in situ analysis were optimized and a pilot spectral database using different IR modes (transmission, ATR and DR) was created. Important information was collected, which allowed the polymer identification of the majority of the historical objects produced between the 1940s and 1980s, from a Portuguese private collection.

A survey to assess the availability, implementation rate and remuneration of pharmacist-led cognitive services throughout Europe.

BACKGROUND: Pharmacist-led cognitive services (PLCS) are increasingly necessary in primary care as a response to patient-centered care. However, the implementation rate and remuneration models of PLCS are either absent or superficially described in the literature. OBJECTIVE: The aim of this study is to review the implementation of PLCS in primary care across Europe and explore the associated third-party paid remuneration models. METHODS: A cross-sectional study was conducted using an online survey sent to representatives of 44 European countries. The survey listed 21 PLCS and asked respondents to report the availability of the service, the rate of implementation and the existence of remuneration. To ensure credible data, data triangulation was sought using three representatives per country, representing backgrounds of community pharmacy, pharmacy practice research and health policy. Subsequently, data was validated, and consensus sought. RESULTS: Data were collected between November 2016 and October 2017 from 34 different countries across Europe (79%). Provision of medicines' information (94.1%), generic substitution (85.3%), provision of emergency oral contraception (70.6%) and point-of-care testing (67.7%) were the services reported as the most widely disseminated in European primary care. Medication review was the most disseminated among advanced services (55.9%). Medication review, adherence support and monitoring, prescription renewal, opioid substitution and travel medicine had the highest implementation rates reported. Half of the participating countries mentioned models of remuneration, predominantly based on a fee-for-service, with less frequent reports of pay-for-performance or mixed models of remuneration. CONCLUSIONS: The availability of PLCS is increasing and varying in scope across Europe. There is wide variation in the implementation level of services across Europe and a lack of valid data. Remuneration of PLCS is also spreading but no clear pattern was found that relates service provision to payment.

Community pharmacist-led medication review procedures across Europe: Characterization, implementation and remuneration.

BACKGROUND: Pharmaceutical Care Network Europe (PCNE) proposed a definition and classification system (type 1, 2a, 2b, 3) for medication review in 2016. However, to date, a description of the implementation and remuneration of such procedures across Europe is lacking. OBJECTIVE: The aim of this study was to describe the medication review procedures and the level of implementation and remuneration in community pharmacies across Europe. METHODS: An online survey was developed to characterize medication review procedures (PCNE classification), level of implementation (considering regional or national) and remuneration by a third party. This survey was sent to a purposive sample of three individuals per country, with a working background in community pharmacy, pharmacy practice research, or health policy to ensure reliable data. Data triangulation was used and consensus sought between the responses. RESULTS: Data were received from 34 out of 44 targeted European countries (November 2016-October 2017) [response rate = 77%]. Overall, 55.9% of the countries provided at least one type of medication review as an implemented service or project. Type 1 medication review (based on the medication history) was provided in 13 countries, type 2a (medication history + patient interview) in 14, type 2b (medication history + clinical data) in two, and type 3 medication review (medication history + patient interview + clinical data) in four countries. Ten of the mentioned services or projects were remunerated by a third-party. CONCLUSION: Substantial heterogeneity was observed across Europe in various aspects, including the procedures, implementation level and remuneration obtained. Type 1 and 2a medication review services seem to be more feasible to implement in the community pharmacy than type 2b and 3. A large number of medication review projects were ongoing in community pharmacies, which suggests that new medication review services could become implemented in the coming years.

Resveratrol-Loaded Lipid Nanocarriers Are Internalized By Endocytosis in Yeast.

Different positive pharmacological effects have been attributed to the natural product resveratrol (RSV), including antioxidant, antiaging, and cancer chemopreventive properties. However, its low bioavailability and rapid metabolic degradation has led to the suspicion that many of the biological activities of this compound observed in vitro may not be attainable in humans. To improve its bioavailability and pharmacokinetic profile, attempts have been made to encapsulate RSV into lipid-based nanocarrier systems. Here, the dioctadecyldimethylammonium bromide (DODAB):monoolein (MO) liposomal system (1:2) loaded with RSV revealed appropriate characteristics for drug release purposes: reduced size for cellular uptake (157 ± 23 nm), stability up to 80 days, positive surface charge (ζ ≈ +40 mV), and a controlled biphasic release of RSV from the lipid nanocarriers over a period of almost 50 h at pH 5.0 and 7.4. Moreover, the encapsulation efficiency of the nanocarrier ranged from 70% to 92% and its RSV loading capacity from 9% to 14%, when [RSV] was between 100 and 200 µM. The partition coefficient ( Kp) of RSV between lipid and aqueous phase was log Kp = 3.37 ± 0.10, suggesting moderate to high lipophilicity of this natural compound and reinforcing the lipid nanocarriers' suitability for RSV incorporation. The thermodynamic parameters of RSV partitioning in the lipid nanocarriers at 37 °C (Δ H = 43.76 ± 5.68 kJ mol-1; Δ S = 0.20 ± 0.005 kJ mol-1; and Δ G = -18.46 ± 3.48 kJ mol-1) reflected the spontaneity of the process and the establishment of hydrophobic interactions. The cellular uptake mechanism of the RSV-loaded nanocarriers labeled with the lipophilic fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH) was studied in the eukaryotic model system Saccharomyces cerevisiae. Thirty minutes after incubation, yeast cells readily internalized nanocarriers and the spots of blue fluorescence of DPH clustered around the central vacuole in lipid droplets colocalized with the green fluorescence of the lipophilic endocytosis probe FM1-43. Subsequent studies with the endocytosis defective yeast deletion mutant ( end3Δ) and with the endocytosis inhibitor methyl-ß-cyclodextrin supported the involvement of an endocytic pathway. This novel nanotechnology approach opens good perspectives for medical applications.

Trends in anecdotal fox sightings in Tasmania accounted for by psychological factors.

There has been little evaluation of anecdotal sightings as a means to confirm new incursions of invasive species. This paper explores the potential for equivocal information communicated by the media to account for patterns of anecdotal reports. In 2001, it was widely reported that red foxes (Vulpes vulpes) had been deliberately released in the island state of Tasmania (Australia), although this claim was later revealed to be baseless. Regardless, by 2013 a total of 3153 anecdotal fox sightings had been reported by members of the public, which implied their distribution was wide. For each month in 2001-2003, we defined a monthly media index (MMI) of fox-related media coverage, an index of their relative seasonal abundance (abundance), and a factor denoting claims of fox evidence (claimed evidence) regardless of its evidentiary quality. We fitted a generalized linear model with Poisson error for monthly totals of anecdotal sightings with factors of year and claimed evidence and covariates of MMI, abundance, and hours of darkness. The collective effect of psychological factors (MMI, claimed evidence, and year) relative to biophysical factors (photoperiod and abundance) was highly significant (χ2 = 122.1, df = 6, p < 0.0001), whereas anticipated changes in abundance had no significant influence on reported sightings (p = 0.15). An annual index of fox media from 2001 to 2010 was strongly associated with the yearly tally of anecdotal sightings (p = 0.018). The odds ratio of sightings ranked as reliable by the fox eradication program in any year decreased exponentially at a rate of 0.00643 as the total number of sightings increased (p < 0.0001) and was indicative of an observer-expectancy bias. Our results suggest anecdotal sightings are highly susceptible to cognitive biases and when used to qualify and quantify species presence can contribute to flawed risk assessments.

DivStat: a user-friendly tool for single nucleotide polymorphism analysis of genomic diversity.

Recent developments have led to an enormous increase of publicly available large genomic data, including complete genomes. The 1000 Genomes Project was a major contributor, releasing the results of sequencing a large number of individual genomes, and allowing for a myriad of large scale studies on human genetic variation. However, the tools currently available are insufficient when the goal concerns some analyses of data sets encompassing more than hundreds of base pairs and when considering haplotype sequences of single nucleotide polymorphisms (SNPs). Here, we present a new and potent tool to deal with large data sets allowing the computation of a variety of summary statistics of population genetic data, increasing the speed of data analysis.

Sequence comparison alignment-free approach based on suffix tree and L-words frequency.

The vast majority of methods available for sequence comparison rely on a first sequence alignment step, which requires a number of assumptions on evolutionary history and is sometimes very difficult or impossible to perform due to the abundance of gaps (insertions/deletions). In such cases, an alternative alignment-free method would prove valuable. Our method starts by a computation of a generalized suffix tree of all sequences, which is completed in linear time. Using this tree, the frequency of all possible words with a preset length L-L-words--in each sequence is rapidly calculated. Based on the L-words frequency profile of each sequence, a pairwise standard Euclidean distance is then computed producing a symmetric genetic distance matrix, which can be used to generate a neighbor joining dendrogram or a multidimensional scaling graph. We present an improvement to word counting alignment-free approaches for sequence comparison, by determining a single optimal word length and combining suffix tree structures to the word counting tasks. Our approach is, thus, a fast and simple application that proved to be efficient and powerful when applied to mitochondrial genomes. The algorithm was implemented in Python language and is freely available on the web.

mtDNAoffice: a software to assign human mtDNA macro haplogroups through automated analysis of the protein coding region.

We describe a fast, automated process to determine distances between mtDNA sequences allowing their subsequent clustering and haplogroup assignment that may increase the speed of data analysis and avoid human errors. In order to avoid complexities/ambiguities resulting from recurrence and insertion/deletion phenomena and thus improving evolutionary signal-to-noise ratio, protein coding sequences were compared using a vectorial representation method, and the corresponding genetic distance matrix was used for the construction of a neighbor-joining/UPGMA tree or an MDS graphic, which generally agrees with the consensus mtDNA phylogeny. mtDNAoffice software, detailed instructions and example files are freely available on the web at http://www.portugene.com/SupMat/setupmtDNAoffice.rar.

Establishment of a constructed wetland in extreme dryland.

BACKGROUND, AIM, AND SCOPE: The project was set to construct an extensive wetland in the southernmost region of Israel at Kibbutz Neot Smadar (30 degree 02'45" N and 35 degree 01'19" E). The results of the first period of monitoring, summary, and perspectives are presented. The constructed wetland (CW) was built and the subsequent monitoring performed in the framework of the Southern Arava Sustainable Waste Management Plan, funded by the EU LIFE Fund. The specific aims were: (1) To end current sewage disposal and pollution of the ground, the aquifer, and the dry river bed (wadi) paths by biologically treating the sewage as part of the creation of a sustainable wetland ecosystem. (2) Serve as an example of CW in the Negev highlands and the Arava Valley climates for neighboring communities and as a test ground for plants and building methods appropriate to hyper arid climate. (3) Serve as an educational resource and tourist attraction for groups to learn about water reuse, recycling, local wildlife and migrating birds, including serving the heart of a planned Ecological-Educational Bird Park. This report is intended to allow others who are planning similar systems in hyper arid climates to learn from our experience. MATERIALS AND METHODS: The project is located in an extreme arid desert with less than 40 mm of rain annually and temperature ranges of -5 degree C to +42 degree C. The site receives 165-185 m3 of municipal and agricultural wastes daily, including cowshed and goat wastes and winery outflow. RESULTS: The CW establishment at Neot Smadar was completed in October 2006. For 8 months, clean water flowed through the system while the plants were taking root. In June 2007, the wetland was connected to the oxidation pond and full operation began. Because of seepage and evaporation, during the first several months, the water level was not high enough to allow free flow from one bed to the next. To bed A, the water was pumped periodically from the oxidation pond (Fig. 1) and from there flowed by gravitation through the rest of the system. The initial results of the monitoring are promising. In nearly all measurements, the system succeeded as expected to reduce levels of contaminants at least to the level acceptable for irrigating fruit trees and often to the level of unlimited irrigation. The introduction of the plants in the system and their physiological performance were evaluated and were found to correlate well to the quality of water in the various beds. DISCUSSION: It should be said at the outset that evaluation of the performance of a CW system is a long-term process. Thus, the main aim of this report is to present the problems, difficulties, preliminary results, and concepts concerned with the first stage of establishment of CW in an extremely dry region. CONCLUSIONS: The CW system was designed to dispose of municipal and agricultural wastes in a way that not merely reduces pollution, but adds to environmental quality by creating accessible parkland for local residents and tourists. Several factors affected the performance of the system at the initial stages of operation: ecological balance between microbes and plants, big seasonal variations, seepage and evaporation reduced the flow in the initial operation of the system. Despite the initial difficulties, the quality of water coming out the system is acceptable for irrigation. RECOMMENDATIONS AND PERSPECTIVES: The CW can function well under extreme dryland conditions. The oxidation pond was the major source of evaporation and bad odors. Therefore, alternatives to the oxidation pond are needed. Cost effectiveness of the system still has to be evaluated systematically.