Barriers to research in family medicine-interviews with Portuguese family physician researchers.

BACKGROUND: There is a need for a deeper understanding of the barriers to research in family medicine (FM) and to consider the perceptions and perspectives of professionals. Our study aims to provide a strategic view for research capacity building in FM. We included the perspective of family physician researchers (FPR) on the existing barriers to investigation in this context. OBJECTIVES: To understand and characterize the barriers to research in FM (personal and structural), from the perspective of Portuguese family physicians who are researchers. METHODS: A qualitative study, of phenomenological nature, was performed, through the conduction of semi-structured interviews with FPR, from 2019 to 2022. Data analysis and thematic coding were done on MAxQDA®, with inductive and deductive approaches, until data saturation was reached. RESULTS: A total of 12 family physicians/researchers were interviewed. Seven main themes were identified as barriers to research: time, professional valorization, funding, ethics committees, infrastructure, management/institutions, and participants. Each theme is divided into subthemes that make it possible to assess how a barrier can affect researchers in performing research activities. CONCLUSION: Our study highlights the identification of 7 main barriers. Structuring them into sub-themes not only improved the organization of our results but also provided robust support for the next phase, namely the application of a survey with the aim of gaining a deeper insight into the repercussions that these barriers to FPR have at a national level. This research is crucial to laying the foundations for a policy document that offers well-defined and tailored recommendations to address the barriers we have uncovered.

Sensors Network as an Added Value for the Characterization of Spatial and Temporal Air Quality Patterns at the Urban Scale.

Within the scope of the Aveiro STEAM City project, an air quality monitoring network was installed in the city of Aveiro (Portugal), to evaluate the potential of sensors to characterize spatial and temporal patterns of air quality in the city. The network consists of nine sensors stations with air quality sensors (PM10, PM2.5, NO2, O3 and CO) and two meteorological stations, distributed within selected locations in the city of Aveiro. The analysis of the data was done for a one-year measurement period, from June 2020 to May 2021, using temporal profiles, statistical comparisons with reference stations and Air Quality Indexes (AQI). The analysis of sensors data indicated that air quality variability exists for all pollutants and stations. The majority of the study area is characterized by good air quality, but specific areas-associated with hotspot traffic zones-exhibit medium, poor and bad air quality more frequently. The daily patterns registered are significantly different between the affected and non-affected road traffic sites, mainly for PM and NO2 pollutants. The weekly profile, significative deltas are found between week and weekend: NO2 is reduced on the weekends at traffic sites, but PM10 is higher in specific areas during winter weekends, which is explained by residential combustion sources.

Spatial Distribution of Heterochromatin Bodies in the Nuclei of Triatoma infestans (Klug).

Constitutive heterochromatin typically exhibits low gene density and is commonly found adjacent or close to the nuclear periphery, in contrast to transcriptionally active genes concentrated in the innermost nuclear region. In Triatoma infestans cells, conspicuous constitutive heterochromatin forms deeply stained structures named chromocenters. However, to the best of our knowledge, no information exists regarding whether these chromocenters acquire a precise topology in the cell nuclei or whether their 18S rDNA, which is important for ribosome function, faces the nuclear center preferentially. In this work, the spatial distribution of fluorescent Feulgen-stained chromocenters and the distribution of their 18S rDNA was analyzed in Malpighian tubule cells of T. infestans using confocal microscopy. The chromocenters were shown to be spatially positioned relatively close to the nuclear periphery, though not adjacent to it. The variable distance between the chromocenters and the nuclear periphery suggests mobility of these bodies within the cell nuclei. The distribution of 18S rDNA at the edge of the chromocenters was not found to face the nuclear interior exclusively. Because the genome regions containing 18S rDNA in the chromocenters also face the nuclear periphery, the proximity of the chromocenters to this nuclear region is not assumed to be associated with overall gene silencing.

Genetic characterization of residual Triatoma infestans populations from Brazil by microsatellite.

In spite of long-term efforts to eliminate Triatoma infestans (Klug 1834) from Brazil, residual foci still persist in the states of Bahia and Rio Grande do Sul. Data on the genetic variability and structuring of these populations are however lacking. Using nine microsatellite loci, we characterized one residual T. infestans population from Bahia and four from Rio Grande do Sul, and compared them with bugs originally from an older focus in São Paulo; 224 bugs were genotyped. The number of alleles per locus ranged from 5 to 11. Observed and expected heterozygosities per locus ranged, respectively, from 0 to 0.786 and from 0 to 0.764. Significant departures from Hardy-Weinberg equilibrium, mainly due to heterozygote deficits, were detected in all loci and in most populations. Global indices estimated by AMOVA were: Fis was 0.37; Fst was 0.28; and Fit was 0.55; overall indices with p = 0.00 indicated substantial differentiation. Inter-population Fst ranged from 0.118 to 0.562, suggesting strong genetic structuring and little to no gene flow among populations. Intra-population Fis ranged from 0.301 to 0.307. Inbreeding was apparent in all populations except that from Bahia-which might be either linked by gene flow to nearby unsampled populations or part of a relatively large local population. The overall pattern of strong genetic structuring among pyrethroid-susceptible residual T. infestans populations suggests that their persistence is probably due to operational control failures. Detection and elimination of such residual foci is technically feasible and must become a public health priority in Brazil.

Strategies for the Promotion of Primary Health Care Research in Portugal: A Qualitative Study.

INTRODUCTION: There are several barriers discouraging clinicians from undertaking research, including insufficient funding, lack of time, organizational issues and lack of support. The strengthening of research capacity is perceived from three levels: characteristics of the researcher, the environment, and organizational issues. To date, Portugal is lacking studies on this subject. The aim of this study was to identify the best practices to promote research in Portuguese Primary Health Care. METHODS: We conducted a qualitative study using semi-structured interviews with family doctors with broadly recognized research work and other stakeholders. We selected a sample by convenience and snowball sampling. From a total of 14 doctors invited by email, 12 responded positively, and we subsequently included two other stakeholders. We conducted the interviews in digital or face-to-face formats. Two team members handled the coding of interviews independently. We kept all recordings and transcripts confidential, only accessible to researchers. RESULTS: We identified 16 strategies: 1) increasing institutional support; 2) creating support structures; 3) redefining the residency program; 4) investing in research training; 5) redefining curriculum evaluation; 6) establishing dedicated time for research; 7) increasing funding; 8) improving access to research data; 9) being a research driver; 10) establishing a research culture; 11) working in collaboration; 12) creating formally organized research groups; 13) creating autonomous research centers; 14) improving the definition of the research subjects and study designs; 15) reviewing procedures for ethics' committees; and 16) reviewing the current selection of articles for publication. CONCLUSION: Overall, a greater proportion of interviewees identified the following as the most relevant strategies for research promotion: institutional support, including technical and scientific support from public institutions, private entities and academic centers; the reorganization of working hours with protected time for research; increased funding directed towards research and breaking isolation in research, promoting teamwork with clinicians within the same area or from different professional backgrounds.

Characterization of antioxidant olive oil biophenols by spectroscopic methods.

BACKGROUND: Olive oil contains numerous phenolic components with well-recognized health-beneficial activity. The major phenolic compounds present in olives and virgin olive oil-hydroxytyrosol, oleuropein and the oleuropein aglycones 3,4-DHPEA-EA and 3,4-DHPEA-EDA-as well as some of their metabolites were studied in the present work, regarding their main structural preferences. Vibrational spectroscopy (Raman) coupled to theoretical methods were used, aiming at fully characterizing the systems and therefore enabling their quick and reliable identification in food samples. RESULTS: The raman data, assisted by the theoretical simulations, allowed us to obtain the main geometrical and spectroscopic features of the olive oil constituents under study, which determine their known antioxidant and chemoprotective properties. In fact, it was verified that the spectra comprise distinctive bands for each compound, allowing their ready detection and differentiation. CONCLUSION: This is the first reported study on the structural behaviour of olive oil phenolic compounds, and it established Raman spectroscopy as a rapid, non-destructive and reliable analytical technique for identifying these bioactive components in dietary extracts. It can surpass other analytical methods currently used, once it allows the concomitant identification of several olive oil components in a particular sample.

Effects of sodium valproate on the chromatin of Triatoma infestans (Klug, 1834) (Hemiptera, Reduviidae) under in vitro culture conditions.

Sodium valproate (VPA) is a classic anticonvulsive, a histone deacetylase inhibitor, and a chromatin remodeling inducer. When injected into specimens of Triatoma infestans, a vector of Chagas disease, VPA affects the chromatin supraorganization of chromocenter heterochromatin in only a few cells of the Malpighian tubules. To test whether this result was explained by the inaccessibility of all of the organ's cells to the drug, we investigated the nuclear phenotypes and global acetylation of lysine 9 in histone H3 (H3K9ac) in Malpighian tubules cultivated in vitro for 1-24 h in the presence of 0.05 mM-1 mM VPA. The present results revealed that the chromatin decondensation event in the chromocenter body, which was detected only under low VPA concentrations up to a 4-h treatment, was not frequent during organ culture, similar to the results for injected insects. Cultivation of T. infestans Malpighian tubules in vitro for 24 h revealed inadequate for cell preservation even in the absence of the drug. Immunofluorescence signals for H3K9ac following VPA treatment showed a slightly increased intensity in the euchromatin, but were never detected in the chromocenter bodies, except with great intensity at their periphery, where the 18S rDNA is located. In conclusion, when VPA affects the chromocenter heterochromatin in this animal cell model, it occurs through a pathway that excludes a classic global H3K9ac mark. Investigation of nonhistone proteins associated with histone methylation marks is still required to further explain the differential response of T. infestans chromatin to VPA.

Impact of harbour activities on local air quality: A review.

Several harbour activities cause negative environmental impacts in the harbours' surrounding areas, namely the degradation of air quality. This paper intends to comprehensively review the status of the air quality measured in harbour areas. The published studies show a limited number of available air quality monitoring data in harbours areas, mostly located in Europe (71%). Measured concentrations of the main air pollutants were compiled and intercompared, for different countries worldwide allowing a large spatial representativeness. The higher NO2 and PM10 concentrations were found in Europe - ranging between 12 and 107 µg/m3 and 2-50 µg/m3, respectively, while the higher concentrations of PM2.5 were found in Asia (25-70 µg/m3). In addition, the lower levels of SO2 monitored in recent years suggest that current mitigation strategies adopted across Europe were very efficient in promoting the reduction of SO2 concentrations. Part of the reviewed studies also estimated the contributions from ship emissions to PM concentration through the application of source apportionment methods, with an average of 5-15%. In some specific harbour areas in Asia, ships can contribute up to 7-26% to the local fine particulate matter concentrations. This review confirms that emissions from the maritime transport sector should be considered as a significant source of particulate matter in harbour areas, since this pollutant concentrations are frequently exceeding the established standard legal limit values. Therefore, the results from this review boost the implementation of mitigation measures, aiming to reduce, in particular, particulate matter emissions.

Assessment of source contribution to air quality in an urban area close to a harbor: Case-study in Porto, Portugal.

Several harbors, like the Port of Leixões (Porto, Portugal), are located near urban and industrial areas, places where residential urban areas, highways and the refinery industry coexist. The need for assessing the contribution of the port to the air quality in its vicinity around the port is the motivation for the present study. This contribution was investigated using a numerical modelling approach based on the web-based research screening tool C-PORT. The impact of the meteorological conditions (namely atmospheric stability and wind direction) was first evaluated, and the most critical conditions for pollutants dispersion were identified. The dominant wind direction, from WSW, was responsible for the transport of pollutants over the surrounding urban area, which was potentiated by the diurnal sea breeze circulation. Multiple scenario runs were then performed to quantify the contribution of each emission sector/activity (namely maritime emissions; port activities; road traffic and refinery) to the ambient air quality. The multiple scenario runs indicated that land-based emission sources at the Port (including trucks, railways, cargo handling equipment and bulk material stored) were the major contributors (approximately 80%) for the levels of surface PM10 concentrations over the study area. Whereas, the main drivers of NOX concentrations were docked ships, responsible for 55-73% of the total NOX concentrations.

Rendu-Osler-Weber Syndrome: case report and literature review.

Hereditary Hemorrhagic Telangiectasia or Rendu-Osler-Weber Disease is a rare fibrovascular dysplasia that makes vascular walls vulnerable to trauma and rupture, causing skin and mucosa bleeding. It is of dominant autosomal inheritance, characterized by recurrent epistaxis and telangiectasia on the face, hands and oral cavity; visceral arteriovenous malformations and positive family history. Epistaxis is often the first and foremost manifestation. It's associated to arteriovenous malformations in several organs. There are possible hematologic, neurologic, pulmonary, dermatologic and gastrointestinal complications. Treatment is supportive and helps prevent complications. This study is a case report of a patient with this syndrome who came to the ENT Outpatient Ward of the Faculdade de Medicina de Marília; and we have done a bibliographic review of the disease's etiopathogenesis, clinical manifestations and clinical-surgical treatment options.

Histone acetylation and methylation marks in chromatin of Panstrongylus megistus (Hemiptera, Reduviidae).

Panstrongylus megistus, a potential vector of Chagas disease, currently occupies a wider geographic distribution in Brazil than Triatoma infestans, another member of the hemipteran Reduviidae family and a vector of the same disease. A small heterochromatic body (chromocenter) formed by the Y chromosome is evident in the somatic cells of P. megistus, differing in size and chromosome type contribution from the well-studied chromocenters present in T. infestans. While the overall distribution of histone epigenetic marks differ when comparing the heterochromatin and euchromatin territories in T. infestans, no similar data have been established for other hemipteran reduviids, including P. megistus. In the present work, histone acetylation and methylation marks were investigated in cells of Malpighian tubules of P. megistus 5th instar nymphs using immunocytochemical assays and compared to previously published data for T. infestans. Although similarities between these species were found regarding absence of acetylated H3K9, H4K8 and H4K16, and H3K9me and H3K9me2 in the chromocenter, presence of these marks in euchromatin, and presence of H3K9me3 in the chromocenter, no intimate association of acetylated H4K8 and 18S rDNA was revealed in the chromocenter of P. megistus. The elevated abundance of H3K9me2 marks at the nuclear periphery in P. megistus cells, differing from data for T. infestans, is suggested to reflect differences in the interaction of lamina-associated chromatin domains with the nuclear lamina, methyl-transferase modulation and/or association with the last DNA endoreplication step in 5th instar nymphs, which is a matter for further investigation.

[Triatoma tibiamaculata (Pinto, 1926): life table for nymphs, duration of adult forms and oviposition of females]. / Triatoma tibiamaculata (Pinto, 1926): Tábua de vida das ninfas, duração das formas adultas e postura das fêmeas (Hemiptera - Reduviidae).

Under laboratory conditions, the authors analyzed the survival rate of nymphs, the minimum and maximum duration of each stage, the length of life of the winged forms and oviposition of the females. Two groups of 100 eggs each were monitored. In batch A, the specimens were reared in a single glass receptacle. In batch B, the specimens were kept apart, one by one, and when they reached the winged stage, they formed twenty couples, which made it possible to watch over the oviposition of the females and the length of life of each specimen. The egg eclosion rate was 96%; the proportion still alive at the end of the nymph phase was 69.5% in batch A and 78.4% in batch B. The most frequent length of time observed between oviposition and eclosion of first-stage nymphs was 28 days. The nymph phase lasted four to eight months and the adult phase five months. The mean total oviposition in batch B was 181.6 eggs per female.

[Infestation by triatomines in rural settlement and resettlement areas the Region of Pontal do Paranapanema, State of São Paulo]. / Infestação por triatomíneos em assentamentos e reassentamentos rurais na Região do Pontal do Paranapanema, Estado de São Paulo.

This study had the aim of assessing the characteristics of triatomine infestation in human dwellings in rural settlement and resettlement areas with regard to the time when infestation began. We analyzed data relating to 48 triatomine surveys carried out in 105 settlement areas and six resettlement areas in the region of Pontal do Paranapanema between January 1984 and June 2005. Among the 16 surveys in settlement areas, seven (43.8%) had positive findings, all of them in communities established eight or more years previously. Among the 32 surveys in resettlement areas, 23 (71.9%) had positive findings, all of them in communities established for periods shorter than eight years. Since the inhabitants of such communities frequently move, the need for constant vigilance to detect any cases of infestation by vector triatomines in new settlements cannot be overemphasized.

Use of noninvasive 'bug-eggs' to enable comparative inferences on genetic mating system with and without parental information: A study in a cattle egret colony.

Colonial waterbirds such as herons, egrets and spoonbills exhibit ecological characteristics that could have promoted the evolution of conspecific brood parasitism and extra-pair copulation. However, an adequate characterization of the genetic mating systems of this avian group has been hindered by the lack of samples of elusive candidate parents which precluded conducting conventional parentage allocation tests. Here, we investigate the genetic mating system of the invasive cattle egret using hematophagous insects contained in fake eggs to collect blood from incubating adults in a wild breeding colony. We tested a protocol with a previously unused Neotropical Triatominae, Panstrongylus megistus, obtained blood samples from males and females in 31 nests built on trees, drew blood from 89 nestlings at those nests, and genotyped all samples at 14 microsatellite loci, including six new species-specific loci. We comparatively addressed the performance of parentage allocation versus kinship classification of nestlings to infer the genetic mating system of cattle egrets. In line with previous behavioral observations, we found evidence in support of a non-monogamous genetic mating system, including extra-pair paternity (EPP) and conspecific brood parasitism (CBP). Parentage allocation tests detected a higher percentage of nests with alternative reproductive tactics (EPP: 61.7%; CBP: 64.5%) than the kinship classification method (EPP: 50.0%; CBP: 43.3%). Overall, these results indicate that rates of alternative reproductive tactics inferred in the absence of parental genetic information could be underestimated and should be interpreted with caution. This study highlights the importance of incorporating samples from candidate parents to adequately determine the genetic mating system of a species. We expand knowledge on the reproductive tactics of colonial waterbirds, contributing novel data on the genetic mating system of the cattle egret, valuable for the design of management strategies for this invasive bird.

[Chagas' disease: triatomines notification of the São Paulo State during the 1990s]. / Doença de Chagas: notificação de triatomíneos no Estado de São Paulo na década de 1990.

The objective of this study was to analyze the surveillance of Chagas' disease in São Paulo State through notifications registered from 1990 to 1999. The information originated when notification of triatomines was announced by inhabitants and the established control program was followed. 20,563 triatomine notifications were received, showing a decrease over the years, with more accentuated decreases in the area of greatest frequency of Panstrongylus megistus. Each notification corresponded to an average of 1.3 examples of captured triatomines (median = 1), predominantly in the intradomicile area, while during attendance, the mean number of collected insects was 3.6 (median = 2), mostly present in the peridomicile area. The notification distribution permitted the demarcation of three different areas in the state: area 1, comprising the areas of São José do Rio Preto, Araçatuba and part of Presidente Prudente; area 2, São Vicente and Sorocaba; area 3, municipalities located to the northeast of the Campinas region. Analysis showed that entomological surveillance through triatomine notification, despite the fall in the same, has not detected intradomiciliary colonies associated with Trypanosoma cruzi which could give rise to vectorial transmission of Chagas' disease.

Histone epigenetic marks in heterochromatin and euchromatin of the Chagas' disease vector, Triatoma infestans.

Triatoma infestans, a vector of Chagas' disease, shows several particular cell biology characteristics, including the presence of conspicuous heterochromatic bodies (chromocenters) where DNA methylation has not been previously detected. Whether histone modifications contribute to the condensed state of these bodies has not yet been studied. Here, we investigated epigenetic modifications of histones H3 and H4 and presence of the non-histone heterochromatin protein (HP1-α) in the chromocenters and euchromatin of T. infestans cell nuclei, using immunocytochemistry. The effect of different concentrations of the histone deacetylase inhibitors valproic acid (VPA) and sodium butyrate (NaBt) on chromocenter condensation was visually examined; in VPA-treated specimens, this effect was also analyzed by image analysis. Trimethylated H3K9 signals, which were revealed in chromocenter and non-chromocenter areas, were strongest in chromocenters, whereas selected acetylated histone marks and mono- and dimethylated H3K9 and H4K20 signals were detected only in euchromatin. Weak trimethylated H4K20 signals and variable distribution of HP1-α were detected in chromocenters of part of the cellular population analyzed. Although specific VPA and NaBt treatment conditions affected the heterochromatin condensation pattern, they did not induce a decrease in survival and molting rates of the T. infestans nymphs. The VPA-induced chromatin remodeling was not accompanied by induction of H3K9 acetylation in chromocenters. Present findings regarding histone modifications and effects following VPA or NaBt treatments did not yet solve the question of which factors are responsible for maintenance of the condensed state of chromocenters in T. infestans. A possibility requiring further investigation remains on histone methylation marks and/or non-histone proteins.

[Triatoma rubrovaria (Blanchard 1843): life table of nymphs, duration of the forms and posture of the females]. / Triatoma rubrovaria (Blanchard 1843): tábua de vida das ninfas, duração das formas e oviposição das fêmeas.

The authors followed the development of 150 eggs of Triatoma rubrovaria to enable the construction of a life table for the nymphs. The winged form was reached by 94.64% of the individuals, of which 79 were males and 65 females. The mean lifetime of the males was 115 days and 99 days for the females. Part of this group was divided into 30 couples and kept separated to facilitate the count of egg laying by each female. Another lot was also formed of 30 males and 30 females but these were housed together in a glass crystallizer that allowed the observation of a larger number of eggs laid (7,832 eggs) in relationship to that of the females with only one male (total 5,167 eggs). The good development of the individuals and reproduction of the species in the experimental conditions demonstrated the capacity to maintain colonies of Triatoma rubrovaria in laboratory conditions.

[Broadening the scope of triatomine research in the attendance of notifications of Triatoma sordida (Stål, 1859) in the State of São Paulo]. / Ampliação de raio de pesquisa de triatomíneos na atividade de atendimento às notificações em área de Triatoma sordida (Stål, 1859) no Estado de São Paulo.

The objective of this study was to broaden the inspection of home units to a radius of 200 meters from the residence of each notified case. The notifications received by the regional Services of SUCEN of São José do Rio Preto, Araçatuba and Presidente Prudente were evaluated in August, September and October of 2002. There was a total of 263 notifications of triatomines, of which 79 were positive. Broadening the scope meant another 610 domestic units were included in the investigation and in 14.5% of these triatomines were found. It was observed that 24.7% of the domestic units neighboring the house of the notified case presented positive results in the triatomines investigation. When a notified domestic unit presented a positive result, broadening the scope showed positivity in 42.5% of neighboring domestic units (Odds ratio 2.252 (1.25

Supercritical extraction of essential oil from aniseed (Pimpinella anisum L) using CO2: solubility, kinetics, and composition data.

Supercritical fluid extraction (SFE) from aniseed using carbon dioxide was performed at 30 degrees C and pressures of 80-180 bar. The chemical composition of the SFE extract was determined by GC-MS; the quantitative analysis was done by GC-FID and TLC. The total amount of extractable substances or global yield (mass of extract/mass of feed) for the SFE process varied from 3.13 to 10.67% (mass). The solubilities of the anise essential oil in CO(2) were 0.0110, 0.0277, 0.0143, and 0.0182 kg of solute/kg of CO(2) at 80, 100, 140, and 180 bar, respectively. The major compounds identified and quantified in the extracts were anethole ( approximately 90%), gamma-himachalene (2-4%), p-anisaldehyde (<1%), methylchavicol (0.9-1.5%), cis-pseudoisoeugenyl 2-methylbutyrate ( approximately 3%), and trans-pseudoisoeugenyl 2-methylbutyrate ( approximately 1.3%). The Sovová model described quite well the experimental overall extraction curves.

[Triatomine: ovicidal action of some pyretroids]. / Triatomíneos: ação ovicida de alguns piretróides.

The insecticidal action on eggs of triatomine have been little considered in the control activitys of Chagas' disease. With objective [corrected] of to compare the potential of three synthetic pyrethroids (deltamethrin,alphacypermethrin and lambdacyhalothrin) on eggs, the authors realized laboratory tests. The pyretroid lambdacialotrin is more efficient. The following species were used in this experiment: Panstrongylus megistus and Triatoma sordida. The specie Triatoma sordida is more susceptible with the pyrethroids utilized.