bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of an aquatic exercise program on balance in patients with ankylosing spondylitis
Authors: Ferreira Margarida , Mesquita Cristina , Santos Paula , Borges João , Graça Maria , Henriques Ana , Lopes Sofia
Published: August 2021

Background

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that leads to a limitation of mobility, which can cause postural deficits and progressive loss of balance. Aquatic exercise improves this health condition. The objetive is to verify the influence of an aquatic exercise program, on balance and functionality, in individuals with AS.

Methods

Pre-experimental study carried out on 6 individuals with AS. All individuals were assessed at baseline (M0) and 12 weeks after the intervention (M1) using the Bath indices (BASMI, BASFI and BASDAI) and the balance assessment protocol (‘Body Sway’) by the Physiosensing Platform. Data were analyzed using the Statistical Program Statistical Package for the Social Sciences (SPSS), version 26. Were used descriptive statistics and Wilcoxon test to compare M0 and M1. The significance value was 0.05.

Results

We verify improvements in BASMI (P = 0.046), BASFI (P = 0.042) and BASDAI (P = 0.027) scores. Through the analysis of the center of pressure variables, there were no statistically significant differences, between moments, in the protocol. However, when assessing balance, in the anteroposterior mean distance in both the protocol (eyes open) and in the protocol (eyes closed), in the root mean square in both protocols and in mediolateral mean velocity, only in the protocol (eyes open), there was a slight decrease in the median value.

Conclusions

The present study suggests that the specific aquatic exercise program, may influence balance and improve functionality in a population with AS. Therefore, the Bath indices translate improvements in the symptoms and functionalities of these participants.
COVID-19 and their outcomes: how personality, place, and sex of people play a role in the psychology of COVID-19 beliefs
Authors: Brito-Costa Sonia , Jonason Peter K , Tosi Michele , Antunes Rui , Silva Sofia , Castro Florêncio
Published: August 2021

Background

There is considerable variation in people’s attitudes towards the COVID-19 pandemic. One way to understand why people differ in their attitudes is to examine how personality traits predict the degree to which people hold different attitudes.

Methods

We collected data (N = 1420) from Portugal and Spain using Facebook advertising. We measured the Dark Triad and Big Five traits, and negative affect, along with ad hoc items for religiousness, and attitudes towards and fear of COVID.

Results

Neuroticism and Negative affect was linked to various domains of insecurity or fear and provides insights into how personality predicts concerns and behaviors related to the COVID-19 pandemic. Religious people were less trusting in science, thought prayer was answer, and attributed the existence of the virus to an act of God. Women reported more fear of COVID-19 than men did, and this was enabled by women’s greater tendency to have Negative Affect and higher Neuroticism than men.

Conclusions

Neurotic people and those with more Negative Affect appear to be more fearful, more trusting in others and systems likely to protect them (e.g., scientists), and less likely to trust in systems shown to not help them (e.g., prayer). We found other effects for the Dark Triad traits and the Big Five traits. In total, we highlight some of the reasons that people may be in such disagreements about what to do about the virus at the individual and institutional levels. Personality, place, and participant’s sex all appear to play a role in the psychology of COVID-19 beliefs.
Portuguese European spoken cross-cultural adaptation and validation of the patient perception of patient-centredness (PPPC)
Authors: Santiago Luiz Miguel , Coelho Beatriz
Published: August 2021

Background

There is growing evidence supporting the relevance of practicing Person-Centered Medicine (PCM). An English language tools exists to evaluate it from the person’s perspective.

The aim of this study was to culturally adapt and validate for the European spoken Portuguese the Patient Perception of Patient-Centeredness (PPPC), a 9-item questionnaire 4 grade answering, created by Moira Stewart with an internal consistency of 0.80, Cronbach's alpha.

Methods

PPPC translation to Portuguese (PPPC-Pt), medical experts analisys, back-translation and degree of readability measurement were performed. Cross-sectional multicentric observational studies in convenience samples of persons having attended medical appointments and applying the PPPC-Pt and gender, age and academic training epidemiologic questioning were performed. Internal consistence by Cronbach’s alpha and descriptive and inferential statistical analysis were made for P < 0.01 level for difference.

Results

PPPC-Pt internal consistency of Cronbach’s alpha = 0.724, range 0.691 to 0.720, item-total correlations between 0.324–0.652, F-test of F = 32 343.086, P < 0.001, reliability of ρ = 0.960; P < 0.001, and Flesh Index of ‘easy’ were found. In n = 570, 36.8% women, 17.0% under 35 and 36.3% above 65 years, 48.9% at 6th level and 16.3% high educational level, a mean ± SD of 32.7 ± 3.7, median 33, minimum 13 maximum 36 points no differences were found for gender P = 0.732, age P = 0.572 and educational level P = 0.436 for the mean score of the PPPC-Pt.

Conclusions

The PPPC-Pt was cross-culturally adapted and is reliable and a valid measure of the measure of person perception of a PCM for the Portuguese population, even though with slight internal consistency (0.724 Pt and 0.800 Eng)
Heart rate variability—study in futsal athletes
Authors: Pereira Joaquim , Santos Ana , Pereira Telmo
Published: August 2021

Background

The practice of high perfomance sports leads to alterations of the autonomic nervous system (ANS). The study of heart rate variability (HRV) resorting to the electrocardiogram (ECG) is a practical, efficient and non invasive tool that allows the monitorization of the cardiac-autonomic function in high perfomance athletes, exposing the physiological adaptations to repeated and intense physical exercise. To evaluate the resting heart rate variability of futsal players resorting to the electrocardiogram during the pre-season and competitive season.

Methods

The sample used in this study was composed of fifteen male futsal athletes, subjected to a resting electrocardiogram in supine position with the duration of 6 minutes, at two different moments.

Results

From the first to the second record heart rate variability, it was observed a significant decrease in heart rate from 66.53 ± 10.39 bpm to 61.50 ± 11.14 bpm (P < 0.05) and the indexes related to the activity of the parasympathetic nervous system (PNS), RMSSD, pNN50, HFnu did not present statistical significance (P > 0.05) despite the verified increased of absolute values from the first to the second evaluation.

Conclusions

We were able to observe a decrease in heart rate (HR), as well as, a tendency for elevated parasympathetic indexes and a vagal predominance from the first to the second moment of evaluation. The monitorization of heart rate variability can be useful to identify adaptations to competitive loads and, thus, planning adequate training loads for each athlete, avoiding the occurrence of lesions and fatigue and allowing an improvement in performance.
The institutionality of the policy agenda against SARS-CoV-2 pandemic: a comparative study between Brazil and Portugal
Authors: Ximenes Ana Carênina Albuquerque , Macedo Ana Angélica Mathias , Joaquim João José , Pinto Marta Vasconcelos , Mendes Fernando
Published: August 2021

Background

The SARS-CoV-2 pandemic imposed challenges to researchers and governments in proposing political strategies to contain the transmission chain. Despite being an issue of global impact, the public policy strategies in fighting this pandemic depend on each country. This scenario demands studies to describe and explore these policies' institutionality. In this context, a question raises on how the biggest economies of the Portuguese language, Brazil and Portugal, have conducted the public policy agenda against the pandemic.

Methods

A comparative, qualitative, and descriptive study of the public policy agenda setting in Brazil and Portugal to fight against the pandemic was conducted through bibliographic and document research. The theoretical axis adopted was the Institutional Economy and the elaborations and management of public policy, mainly Douglas North, Geoffrey M. Hodgson, and Amatya Sen’s studies.

Results

The combat against the SARS-CoV-2 pandemic was translated in a search for urgency analytical theories, elaboration, implementation, and evaluation of public policies in Brazil and Portugal. In both countries, social restriction strategies were adopted such as closing public places, stores, and schools. Also, some economic actions were established to mitigate these restrictions’ impacts, more limited in Brazil as a neoliberal picture of the current government.

Conclusions

The results pointed to differences and similarities in Portuguese and Brazilian agendas, especially with the virus transmission mitigating strategies and the social and economic assistance, being Brazil suffering from the negationism culture that promoted contagion and mortality acceleration.
Effects of the first quarantine in health care services on the Portuguese population
Authors: Cavaleiro Alexandre , Marouvo Joel , Saraiva Marina , Brito António , Castro Maria
Published: August 2021

Background

With the COVID-19 pandemic, the lack of information about this new virus, and its high transmissibility in humans, quarantine was declared to avoid spread. During early times of confinement, several health services closed or limited the patients' access. This study aims to analyze the impact of the first quarantine in health care services on the Portuguese population.

Methods

An online survey, approved by the IPC ethics committee, inquired about the health care services people attended before and during the quarantine period. 536 Portuguese with mean age 42.2 years (14.8) full-field the survey. The responses were gathered from the 18th of March till the 30th of April 2020. Differences between paired samples were established using the Wilcoxon test (P-value < 0.05), due to an abnormal sample distribution (t = 0.0515, P < 0.0001).

Results

The table shows the number of appointments that people attended before and after the quarantine and the statistics analysis (P) between the two moments.

Conclusions

There was a reduction in the number of appointments or treatments among all health care services. The total number of appointments decreased from 118 to 7 (P < 0.001).
Psychosocial risk factors and work capacity in health professionals
Authors: Pocinho Margarida , Santos Cristina , Saraiva António
Published: August 2021

Background

Modern societies put enormous pressure on workers by putting their health at risk. Psychosocial risks are considered those related to the conception, organization and management of work, social and environmental factors, which can cause psychological, social or physical damage to the worker and the work capacity expresses the generic evaluation of a worker's productive capacities, worker's health, and their psychological resources. Important factor for maintaining a working life. The aim of this study was to evaluate the relationship between work ability and exposure to psychosocial risk factors in health professionals.

Methods

The sample consisted of 309 primary health care professionals, and validated instruments were applied to assess the Work Ability Index (WAI) and psychosocial risks in the work contexts (COPSOQ).

Results

It was found that female professionals are more exposed to psychosocial risk factors: Offensive Behaviors and Quantitative Requirements (P < 0.05). Mental and physical demands influence work ability (P < 0.05). There was a correlation between psychosocial risk factors and work ability in 11 COPSOQ subscales.

Conclusions

Thus, it is pertinent to evaluate and manage psychosocial risks and to take measures that enable a positive combination between psychosocial characteristics and individual resources, in order to minimize psychosocial risks and situations of vulnerability in health professionals.
Occupational exposure to particles and air pollutants in a car paint workshop
Authors: Ferreira Ana , Loureiro António , Seco Silvia , Figueiredo João Paulo , Paixão Susana , Costa Lucia Simões , Oliveira Gonçalo
Published: August 2021

Background

In auto paint workshops there are several chemical, physical and biological agents that are harmful to health, making it essential to guarantee the well-being and safety of workers. In this sense, the assessment of the Indoor Air Quality (IAQ) of these places, in an associated context of occupational health, proves to be important.

Methods

The present study had as main objective to evaluate the occupational exposure of workers in an automobile painting workshop to particles and air pollutants. The data collection consisted of the evaluation of air quality, using for this purpose, the assessment of atmospheric pollutants carbon monoxide (CO), carbon dioxide (CO2), Volatile Organic Compounds (VOC), formaldehyde (CH2O), carbon dioxide sulfur (SO2), nitrogen dioxide (NO2), hydrogen sulfide (H2S) and particulate matter (PM2.5, PM10, breathable and inhalable particles) and the meteorological variables temperature and relative humidity. The collected data was processed using the statistical software IBM SPSS version 27.0. The interpretation of the statistical tests was performed with a 95% confidence level for a maximum random error up to 5%.

Results

We found that the concentrations of inhalable particles recorded in some workstations exceeded the legally established exposure limit value.

Conclusions

IAQ should be a priority concern for the government and for all professionals working in the area of Occupational Health and Safety having in mind the implementation of measures that promote the continuous improvement of the IAQ of the facilities, thus guaranteeing a good assessment and monitoring of workstations, preventing atmospheric pollutants from reaching concentrations that could put workers' health at risk.
The influence of the use of earphones in the of young people’s hearing
Authors: Tavares Juelma , Nazaré Cristina
Published: August 2021

Background

Listening music is extremely important in our day life, but studies indicate that young people who use earphones for long periods tend to develop hearing problems. The aim of this study was to evaluate the hearing of young people who use earphones to listen to music very often and occasionally, and observe if there are differences between them.

Methods

The sample was composed by 2 groups (n = 15 in each) of young people, students in higher education (18–24 years) who use earphones to listen music every week, with Group 1 using earphones occasionally and Group 2 very often. Otoscopy, pure tone audiogram (PTA: 0.125–8 kHz), high frequencies (HF: 9–12.5 kHz) and distortion product otoacoustic emissions (DPOAEs: 2–10 kHz) was performed.

Results

There were statistically significant differences between groups in PTA (0.125 and 0.5 kHz in right ear - RE) and DPOAEs (7.5, 8.3, 9.1 and 10 kHz in RE and 6.2, 7.5, 10 kHz in left ear), being the means of hearing thresholds (PTA and HF) higher and the means of the DPOAE’s amplitudes lower in Group 2, in most frequencies. Despite all individuals had normal hearing thresholds in PTA, in HF at 11.2 KHz in RE, the mean of threshold in Group 2 was over 20 dBHL.

Conclusions

The differences found between groups can be a warning sign for future hearing loss in young people who use earphones very often to listen to music, so it is important to raise awareness among young people for the prevention of hearing loss and change behaviours.
Aging and auditory temporal ordering
Authors: Reis Cláudia , Gaspar Cláudia , Nazaré Cristina
Published: August 2021

Background

The aging process is characterized by a gradual impairment of several capacities, such as hearing, memory and communication, which implies changes at various levels and, consequently, changes in both hearing and auditory skills, of which the auditory temporal ordering is an example.

Methods

The sample consisted of 23 elderly individuals, aged between 70 and 96 years (average of 83.09 years) and with mild to severe type I sensorineural hearing loss. For the collection of information, the pure tone audiogram, the frequency and duration pattern tests, the verbal and non-verbal sequential memory tests were used.

Results

The results revealed that between age and the auditory temporal order tests there was a negative correlation (except in the duration pattern test in the left ear) and between the auditory threshold and the auditory temporal order tests there was negative correlation (except in the duration pattern test in the right ear).

Conclusions

It is concluded that in this sample the ability of auditory temporal ordering was influenced by aging and hearing loss, which shows that as the age of the elderly progresses and the degree of hearing loss increases the difficulties in temporal auditory processing become larger. This leads us to consider that these elderly have several difficulties in temporal auditory processing and that an intervention as auditory training may be advantageous for the elderly, as it could improve their central auditory processing and, consequently, their hearing, memory and quality of life.
Characterization of neuronal precursors obtained from human adipose-derived mesenchymal stem cells
Authors: Oliveira N B , Irioda A C , Stricker P E F , Mogharbel B F , Rosa N N , Perussolo M C , Carvalho K A T
Published: August 2021

Background

Mesenchymal stem cells (MSCs) can be isolated from any tissue derived from the mesoderm and have as main characteristics: high plasticity, the ability to originate mesodermal and non-mesodermal tissues, acting in the modulation of the inflammatory response, and the tissue repair. When grown in microenvironments with elasticity comparable to the human brain, these cells can differentiate efficiently in neural cells due to the mechanism related to the YAP protein, which can mediate responses to substrate stiffness in mesenchymal stem cells.

Methods

Human adipose-derived MSCs were isolated*, then it was done the trilineage test into adipocytes, osteocytes and, chondrocytes. Besides that, differentiation to neural precursor cells was through neurospheres after seeding the cells over a natural biopolymer matrix as NFBX. Those cells were analyzed using flow cytometry for the surface markers CD13, CD34, CD45, CD73, CD90, CD105, HLA-DR, HLA-ABC, immunocytochemistry for the proteins Nestina, ß-tubulin III, YAP and AMOT and RT-PCR for the NEFM and TUBB3 genes.

Results

Isolated cells demonstrated characteristics of MSCs. Those cells were differentiated in neural precursors, expressing the proteins Nestina and ß-tubulin III on immunocytochemistry and, the NEFM and TUBB3 genes in RT-PCR. Regarding the YAP and AMOT proteins, it was possible to observe the translocation of the YAP protein in response to the regulation of AMOT out of the cell nucleus, proving neurodifferentiation.

Conclusions

Human adipose-derived MSCs seeded in a natural biopolymer matrix were able to differentiate into neural precursors expressing characteristic neural markers without adding any neural growth factors or genetic induction.
Biodegradable nanoparticles loaded with levodopa and/or curcumin for treatment of Parkinson’s disease
Authors: Cardoso Marco André , Mogharbel Bassam Felipe , Irioda Ana Carolina , Stricker Priscila Elias Ferreira , Slompo Robson Camilotti , Perussolo Maiara Carolina , Travelet Christophe , Halila Sami , Borsali Redouane , de Carvalho Katherine Athayde Teixeira
Published: August 2021

Background

Parkinson’s disease (PD) is the second most common age-related neurodegenerative disorder. Levodopa (L-DOPA) remains the standard gold drug available for the treatment of PD. Curcumin has a wide range of pharmacological activities, including antioxidant, anti-inflammatory, antimicrobial, anti-amyloid, antitumor properties. Copolymers composed of poly(ethylene oxide) (PEO) and biodegradable polyesters like poly(ε-caprolactone) (PCL) that can self-assemble into nanoparticles (NP). This study describes the development of NH2-PEO-PCL diblock copolymer positively charged and modified by the addition of glutathione (GSH) on the outer surface, resulting in a synergistic delivery of L-DOPA and curcumin that would be able to pass the blood-brain barrier.

Methods

The NH2-PEO-PCL nanoparticles suspensions were prepared using a nanoprecipitation and solvent displacement method and were coated with GSH. NP was submitted to various characterizations assays, and to ensure the bioavailability, Vero and PC12 cells were treated with various concentrations of the loaded and unloaded NP to observe cytotoxicity.

Results

NP has successfully loaded L-DOPA and curcumin was stable after freeze-drying, capable of advancing into in vitro toxicity testing. After being treated up to 72 hours of various concentrations of L-DOPA and curcumin loaded NP Vero and PC12 cells, the viability of the treated cells maintained a high percentage indicating that the NPs are biocompatible.

Conclusions

NP consisting of NH2-PEO-PCL have been characterized as potential formulations for brain delivery of L-DOPA and curcumin, and obtained results also indicate that the developed biodegradable nanomicelles were blood compatible, presented low cytotoxicity even in longer exposure times.
Digital pathology in the immunohistochemical evaluation of biomarkers in breast cancer
Authors: Lopes J , Silva S , Monteiro J , Pinto I M , Silva R A
Published: August 2021

Background

Currently, the evaluation of biomarkers HER-2 and ER is critical for targeting therapy for breast cancer and is performed by experienced pathologists, which takes time and causes a certain interobserver variability. The use of histological slide scanners coupled with the application of software for immunoexpression quantification can be profitable in pathological laboratories routine. This study aims to compare the quantification of HER-2 and ER immunoexpression employing automatic algorithms, using as standard the evaluation performed by a pathologist.

Methods

From the archive since 2016 to 2018 were retrieved 75 immunostained slides for HER-2 and 76 immunostained slides for ER with invasive breast carcinoma diagnosis. The slides were scanned in Aperio CS2 and the immunostaining signal was quantified in Aperio Imagescope using a membrane and nuclear algorithm, respectively. The concordance between the scores obtained and the previous assessment was calculated by Cohen’s Kappa coefficient as well as the sensitivity and specificity for each algorithm.

Results

Both algorithms showed an almost perfect concordance with the conventional method (k = 0.94 for HER-2; k = 0.92 for ER). Digital evaluations presented a sensitivity of 100% for both biomarkers, and a specificity of 100% for HER-2 and 80% for ER.

Conclusions

This assay showed that applying signal quantification software for HER-2 and ER in digitized slides is accurate, as these tools have potential to be implemented in laboratory routine. However, it will be necessary to increase the sample to obtain more reliable values and extend this study to the PR and Ki67 biomarkers since both carry prognostic and predictive information as well.
Evaluation of radiation dose in pediatric radiological exams
Authors: Vosiak Paula , Schelin Hugo Reuters , Bunick Ana Paula , Yagui Akemi , Legnani Adriano
Published: August 2021

Background

Pediatric patients are in a phase of high anatomical and physiological development, whose characteristics make them more radiosensitive to certain radiation exposures. Exposure to doses of radiation can lead to the occurrence of biological effects, including cancer.

Objectives

To analyze radiation exposures resulting from pediatric radiological examinations and to perform an optimization process, with the purpose to adequate use of the principles of radiological protection.

Methods

The analysis of radiation doses was performed using the technical parameters of the tests (voltage, current, exposure time and focus-skin distance), the patient's parameters (age, weight and thickness), the calculation of the radiation dose, using the output of the X-ray tube, all recorded at the time of the examination. The results were classified into 4 age groups and 5 weight groups.

Results

The results were classified according to the patient's age and weight, taking into account the radiation dose received. The data were also separated by gender, as the analysis showed that female patients are slightly smaller than male patients, and as a consequence, the doses received by this gender were lower. Examinations of the chest, abdomen, pelvis, skull and sinuses were analyzed and some groups received higher doses compared to other studies and international dose reference levels (DRL).

Conclusions

An optimization study must be carried out to verify the possible cause of such values, readjusting the values of the technical parameters and performing a new radiation dose analysis.
Preterm infants comfort before and after capillary blood sampling procedure
Authors: Balciunaite Karolina , Vaskelyte Alina
Published: August 2021

Background

Because of the immaturity and severe condition preterm infants undergoes a lot of painful and stressful procedures during their care that can cause short-term and long-term negative consequences. Maintenance of optimal comfort is essential for good clinical practice. To assess the comfort of preterm infants before and after the capillary blood sampling procedure.

Methods

The quantitative observational study was conducted in May 2019—February 2020 in the University hospital NICU. The research instrument was a neonatal comfort scale COMFORTneo, which total scores ranged 6–30. Higher scores indicated higher discomfort. Preterm infant comfort was assessed before the capillary blood sampling procedure and 30 min. after applying non-pharmacological pain relief and comfort assurance methods and implementing the procedure. The research was conducted in accordance with ethical principles.

Results

Comfort was assessed in 157 preterm newborns with a gestational age of 30 ± 3.3 weeks and a postnatal age of 6.0 ± 5.7 days. The mean value of neonatal comfort before the capillary blood sampling procedure was 10.0 ± 3.2 points, after the procedure 9.1 ± 2.4 points. A statistically significant inverse relationship was found between pre-procedure and post-procedure comfort (Z = -5.374; P < 0.001). A statistically significant weak inverse relationship was found between gestational age and comfort scores before the procedure (r = -0.204; P = 0.01) and after the procedure (r = -0.321; P = 0.008).

Conclusions

In most cases, preterm infants were feeling moderate discomfort before and after the capillary blood sampling procedure. Newborns had more discomfort before the procedure than 30 min. after the completion of the procedure. Lower gestational age newborns were feeling greater discomfort.
Assessment of utilization and willingness to use it devices to support heath management
Authors: Espírito-Santo Margarida , Moura Maria Margarida Madeira , Lapão Nelson , Peixoto Stefany
Published: August 2021

Background

Amongst the technological solutions that aim to facilitate daily tasks, the potential contributions of mhealth is significant, mainly within the crescent elderly population presenting chronic diseases and using medication. Thus, this study aimed to assess the utilization and willingness to use IT devices to support health management, such as medication management.

Methods

A cross-sectional study was held, including the application (face-to-face and online) of an electronic questionnaire, with 164 participants. Data were processed using SPSS v27.

Results

Study participants had a mean age of 37.6 ± 20.0 years old, 23.8% were ≥ 60 years old, 73.2% female, 28% declared to suffer a chronic disease, with 27.4% using chronic medication and mostly managed by oneself (71.1%). Most of the participants owned and used a mobile phone (respectively 93.9% and 59.8%), a tablet (48.8% and 44.5%), and a computer (73.8% and 17.1%). Only about half of the participants aged ≥ 60 years declared to use their mobile devices to internet access (mobile phones 51.3%, tablet 35.9% and computers 41%). In this group, only 2% mentioned using applications in the health area. Overall, 85.4% considered these tools could be useful, although fewer would be willing to buy them (33.6% for < 60 years and 66.7% for ≥ 60 years).

Conclusions

The use of IT devices is less widespread in the older population, the age groups with greatest need for tools to support health management. Future development of this area must pay special attention to target audience characteristics and their limitations in the use of technology.
Family influence on perinatal depression
Authors: Saraiva Ana , Rosendo Inês , Miguel Susana , Duarte Joana , Marques Tiago , Baptista Sylvie
Published: August 2021

Background

The perinatal period is of big changes and adaptations for pregnant woman, making them more susceptible to depression. Perinatal depression can have huge negative consequences for the pregnant woman, child, family and society. Thus, the objective of this work is to understand the family influence in the appearance of this pathology.

Methods

This is a cross-sectional observational study of a sample of pregnant women included for convenience, who answered a questionnaire with sociodemographic questions, pathological and physiological background and 4 scales: ERAP, EADS-21, FACES IV and ESSS. A descriptive analysis was carried out and then an inferential statistical analysis between the levels of depression, stress and anxiety and different variables.

Results

The sample includes 41 pregnant women who agreed to participate in the study. It was found that only the family variables related to ‘Satisfaction with the family’ (P = 0.024) and ‘Intimacy’ (P = 0.006) seem to have significant relationship with the levels of perinatal depression. As possible confounding variables influencing these levels, we have the fact that pregnancy is planned (P = 0.049), ‘Satisfaction with friends’ (P = 0.001) and ‘Social activities’ (P≤0.001).

Conclusions

It was proven that high levels of satisfaction with family and intimacy are protective factors for the development of perinatal depression. These family-related risk factors can be easily addressed in the context of family’s doctor appointments and help to detect pregnant women at risk of perinatal depression. Deepening this knowledge will make it possible to prevent and intervene earlier in these cases and, consequently, reduce the harmful effects of this pathology.
In vitro characterization of Pseudomonas aeruginosa recovered in Portugal from low respiratory tract infections in ICU patients (STEP Study)
Authors: Hernández-García Marta , García-Fernández Sergio , García-Castillo María , Pássaro Leonor , Cantón Rafael ,   STEP study group, Melo-Cristino José , Pinto Margarida F , Marcelo Cristina , Peres Helena , Lourenço Isabel , Peres Isabel , Marques João , Chantre Odete , Pina Teresa , Microbiologia Laboratório de , Clínica Serviço de Patologia , Gonçalves Elsa , Toscano Cristina , Alves Valquíria , Microbiologia Serviço de , Ribeiro Manuela , Costa Eliana , Vieira Ana Raquel , Clínica Serviço Patologia , Ferreira Sónia , Diaz Raquel , Ramalheira Elmano , Clínica Serviço Patologia , Schäfer Sandra , Tancredo Luísa , Sancho Luísa , Clínica Serviço de Patologia , Rodrigues Ana , Diogo José , Microbiologia Serviço de , Ferreira Rui , Ramos Helena , Silva Tânia , Silva Daniela , Microbiologia Serviço de , Chaves Catarina , Queiroz Carolina , Nabiev Altair , Microbiologia Serviço de , Pássaro Leonor , Paixao Laura , Romano João , Moura Carolina , Castillo María García del , García-Fernández Sergio , Hernández-García Marta , Cantón Rafael
Published: August 2021

Purpose: to characterize the distribution and mechanisms involved in ceftolozane/tazobactam (C/T) resistance in Pseudomonas aeruginosa isolates recovered from intensive care units (ICUs) in Portugal as part of the STEP surveillance study. Materials and methods: a total of 226 P. aeruginosa isolates were collected from patients with low respiratory tract infections (LRTI) admitted to ICUs between June 2017 and July 2018. Susceptibility to antimicrobials including the recent C/T combination was determined by EUCAST-criteria. Whole genome sequencing (WGS) was performed in a subset of 17 isolates. Results: multidrug resistant (MDR) and extremely drug resistant (XDR) phenotypes accounted for 20.4% and 25.7% of cases, respectively. C/T showed the highest susceptibility rate in both MDR (100%) and XDR (93.1%) isolates, followed by amikacin (97.8% MDR and 79.3% XDR). blaKPC-3 (n = 2) and blaGES-13 (n = 1) carbapenemase genes were detected in 3 of the 17 sequenced isolates, but only the GES-13-producing isolate displayed resistance to C/T. Additionally, the C/T-resistant phenotype was also found in two non-carbapenemase producers that carried known ceftolozane/tazobactam resistance-associated mutations in the PBP3 gene. Conclusions: C/T was highly active against MDR/XDR-P. aeruginosa isolates causing LRTI in ICUs. Moreover, beyond carbapenemase-encoding genes, mutations in chromosomal PBP-encoding genes might also be involved in ceftolozane/tazobactam resistance in Portugal.
The Evolution of Comparative Phylogeography: Putting the Geography (and More) into Comparative Population Genomics
Authors: Edwards Scott V , Robin V V , Ferrand Nuno , Moritz Craig
Published: August 2021

Comparative population genomics is an ascendant field using genomic comparisons between species to draw inferences about forces regulating genetic variation. Comparative phylogeography, by contrast, focuses on the shared lineage histories of species codistributed geographically and is decidedly organismal in perspective. Comparative phylogeography is approximately 35 years old, and, by some metrics, is showing signs of reduced growth. Here, we contrast the goals and methods of comparative population genomics and comparative phylogeography and argue that comparative phylogeography offers an important perspective on evolutionary history that succeeds in integrating genomics with landscape evolution in ways that complement the suprageographic perspective of comparative population genomics. Focusing primarily on terrestrial vertebrates, we review the history of comparative phylogeography, its milestones and ongoing conceptual innovations, its increasingly global focus, and its status as a bridge between landscape genomics and the process of speciation. We also argue that, as a science with a strong “sense of place,” comparative phylogeography offers abundant “place-based” educational opportunities with its focus on geography and natural history, as well as opportunities for collaboration with local communities and indigenous peoples. Although comparative phylogeography does not yet require whole-genome sequencing for many of its goals, we conclude that it nonetheless plays an important role in grounding our interpretation of genetic variation in the fundamentals of geography and Earth history.
3. Hate Speech and Freedom of Expression
Authors: Abel William , Kahn Elizabeth , Parr Tom , Walton Andrew
Published: August 2021

This chapter assesses when, if ever, a state should restrict hate speech. Political disputes about this topic are part of broader disagreements about the limits of freedom of expression. The chapter makes a case for restricting hate speech when, and on the grounds that, it incites or makes more likely harm to particular members of society. It considers whether some familiar justifications for freedom of expression provide a persuasive case against this view, exploring arguments that appeal to autonomy, individual interests in expression, and the dangers of granting the state regulatory power. None of these justifications supports the protection of hate speech. The chapter then sketches the kinds of hate speech legislation that these arguments justify.
9. Minority Exemptions and Multiculturalism
Authors: Abel William , Kahn Elizabeth , Parr Tom , Walton Andrew
Published: August 2021

This chapter argues that there is a narrow range of cases in which the state should grant members of minority groups exemptions from laws and policies that apply to others. Social and economic institutions tend to favour the preferences of those who share the majority culture, with the result that a member of a minority group often faces additional burdens in complying simultaneously with the law and the demands of their culture or religion. The chapter draws on this to propose an initial case for minority exemptions. The justification for these exemptions sees them as part of a political programme of multiculturalism, which aims to treat members of minority groups fairly when designing and applying laws and policies. The chapter then looks at the limits of this argument to shed light on the range of cases in which the state should grant such exemptions.
12. War and law in the twenty-first century
Authors: Scicluna Nicole
Published: August 2021

This chapter explicates the various ways in which contemporary warfare challenges post-1945 international law on the use of force and the conduct of war. It begins by exploring the rules governing the use of force against non-state actors. This is one of the most pressing issues of the war on terror, much of which has involved military operations against terrorist groups operating from the territory of states that cannot or will not suppress their activities. In particular, campaigns by the US and several other states against ISIS in Syria have seriously undermined the international law framework governing self-defence and the right of states to have their sovereignty and territorial integrity respected. The chapter then looks at another trademark policy of the war on terror: the use of targeted killings, often carried out by unmanned drones, to eliminate suspected terrorists. It also considers a new type of warfare altogether: the emerging phenomenon of cyber warfare, which, too, has implications for both jus ad bellum and jus in bello.
7. Economic and Monetary Union
Authors: Hodson Dermot
Published: August 2021

This chapter examines the role of the economic and monetary union (EMU) in the European Union’s macroeconomic policy-making. As of 2015, nineteen members of the euro area have exchanged national currencies for the euro and delegated responsibility for monetary policy and financial supervision to the European Central Bank (ECB). EMU is a high-stakes experiment in new modes of EU policy-making insofar as the governance of the euro area relies on alternatives to the traditional Community method, including policy coordination, intensive transgovernmentalism, and delegation to de novo bodies. The chapter first provides an overview of the origins of the EMU before discussing the launch of the single currency, the sovereign debt crisis, and economic responses to Covid-19. It also considers variations on the Community method, taking into account the ECB and the European Stability Mechanism.
20. The Stability of EU Policy-Making in a Turbulent World
Authors: Pollack Mark A. , Roederer-Rynning Christilla , Young Alasdair R.
Published: August 2021

This chapter examines trends in European Union policy-making during times of multiple, overlapping challenges. It first considers the main trends in EU policy-making that emerge from policy case studies, including experimentation with new modes of policy-making, often in conjunction with more established modes, leading to hybridization; renegotiation of the role of the member states (and their domestic institutions) in the EU policy process; and erosion of traditional boundaries between internal and external policies. The chapter proceeds by discussing the issue of national governance as well as the interaction between European and global governance. Finally, it explores how the EU has responded to the challenges of Brexit, the politicization of the Union, geopolitical upheaval, and the shock of the Covid-19 pandemic.
5. Democracy and the EU
Authors: Raunio Tapio
Published: August 2021

This chapter examines the relationship between European integration and democracy. The continuous transfer of policy-making powers from European Union (EU) member states to the European level has raised serious concerns about democratic legitimacy. The chapter assesses the claims that European integration undermines national democracy, and that decision-making at the EU level is not sufficiently democratic. It argues that while significant challenges remain, European integration has definitely become more democratic over the years. But there is perhaps a trade-off, with stronger input legitimacy potentially an obstacle to efficient European-level decision-making. It also underlines the multilevel nature of the EU polity and the importance of public debates about European integration.
9. Parliaments
Authors: Martin Shane
Published: August 2021

Parliaments are the cornerstone of representative democracy. This chapter examines the role and performance of national parliaments in European democracies. The chapter begins with a review of how parliaments are designed, including the number of chambers and the power of parliamentary committees. It discusses parliaments’ roles and functions, including law-making, government formation, oversight, and political representation, and assesses whether parliaments reflect the make-up of the citizenry at large. The chapter then discusses the possibility of strong parties and dominant executives within the legislative arena leading to weak parliaments, as well as recent attempts to strengthen the capacity of national parliaments.
10. Constitutions and Courts
Authors: Garoupa Nuno , Magalhães Pedro C.
Published: August 2021

This chapter focuses on the constitutions of European countries as well as on the mechanisms in place to interpret and enforce them. It starts by defining ‘constitution’. It then proceeds to a discussion about the role of courts and constitutional review of legislation. Focusing in particular on centralized constitutional review, it describes the variety of powers enjoyed by contemporary constitutional courts. Existing mechanisms for litigation and judicial appointment are also considered. Finally, it addresses the existing empirical evidence about both judicial behaviour in such courts and their political impact. The chapter concludes with an examination of current trends in the direction of supranational constitutionalism and constitutional review.
Introduction
Authors: Costello Rory
Published: August 2021

This chapter begins by describing the scope and main themes of the book, and explaining the rationale for the countries selected for inclusion. It discusses the prevalence of democracy in Europe, and provides an overview of some of the main similarities and differences between European democracies. A number of recent developments that have challenged the political status quo across the continent are highlighted. The chapter also outlines the general approach taken throughout the book, and discusses the importance of comparison in political research. It concludes with an outline of the book and a brief summary of its three main sections.
11. Poststructuralism
Authors: Campbell David , Bleiker Roland
Published: August 2021

This chapter examines how and why poststructuralism engaged International Relations (IR) from the 1980s to today. It begins by analysing the interdisciplinary context of social and political theory from which poststructuralism emerged, along with the misconceptions evident in the reception of the poststructuralist approach among mainstream theorists. It then considers what the critical attitude of poststructuralism means for social and political inquiry and draws on the work of Michel Foucault to highlight the importance of discourse, identity, subjectivity, and power to the poststructuralist approach. It also discusses the methodological features employed by poststructuralists in their readings of, and interventions in, international politics. The chapter concludes with a case study of images of famines and other kinds of humanitarian crises that illustrates the poststructural approach.
13. Normative International Relations Theory
Authors: Erskine Toni
Published: August 2021

This chapter deals with normative international relations theory, a field of study that relies on a variety of approaches and theories to explore moral expectations, decisions, and dilemmas in world politics. Normative IR theory has adopted—and adapted—conceptual categories such as communitarianism and cosmopolitanism from political theory. It also borrows from moral philosophy to designate different types of ethical reasoning, such as deontology and consequentialism. The chapter begins with an overview of the history, influences, and some of the categories that normative IR theory brings to the study of international relations. It then examines the ways in which normative IR theory engages with the hidden ethical assumptions of a range of IR approaches. The case study considers the ethics of war in the Iraq war.
14. Green Theory
Authors: Eckersley Robyn
Published: August 2021

This chapter examines how environmental concerns have influenced International Relations theory. It first provides a brief overview of the ecological crisis and the emergence of green theorizing in the social sciences and humanities in general, along with the status and impact of environmental issues and green thinking in IR theory. It then investigates green theory’s transnational turn and how it has become more global, while critical IR theory has become increasingly green. It also considers the different ways in which environmental issues have influenced the evolution of traditional IR theory. It concludes with a case study of climate change to illustrate the diversity of theoretical approaches, including the distinctiveness of green theories.
4. Parliament
Authors: Blick Andrew
Published: August 2021

This chapter looks specifically at the UK Parliament as this is the central institution of the UK political system. It describes the people in Parliament, its internal makeup, and the way in which it is changing. The chapter examines the roles of members of the House of Commons and House of Lords. It considers the four basic functions of Parliament: providing a basis of government, holding government to account, producing legislation, and interacting with the wider public. The chapter describes three practical examples to help illustrate some of its themes. These are the following: the 2010–15 coalition government’s attempts to reform the House of Lords; the 2009 Wright Committee proposals for parliamentary reform and their implementation; and the practice of pre-appointed hearings conducted by parliamentary committees.
5. The legal system and human rights
Authors: Blick Andrew
Published: August 2021

This chapter focuses on the legal system in the UK and looks at how the legal system and human rights relate to the political system. The chapter starts by defining both the legal system and human rights and shows how they are important in politics and in our democratic society and how they work in practice. These are closely connected issues, as the UK legal system is supposed to operate within human rights principles. The chapter introduces a series of theoretical concepts that aid to the understanding of the legal system. Central to this is the concept of the rule of law. The chapter presents some practical examples to show how various goals are realized. The first example given in the provision of legal aid to those who cannot afford their own legal advice. The second example relates to how policy makers attempt to deal with threats of terrorism. The third example is the key legal basis for the upholding of human rights via the Human Rights Act 1998. The chapter finishes with a debate on the political role of courts and looks at the implications of Brexit for the legal system and human rights.