Celiac disease in children from Madeira island and its prevalence in first degree relatives

Context - It is well recognized that celiac disease is an immune-mediated systemic disorder highly prevalent among relatives of celiac patients. Objectives - The aim of this study is to determine the prevalence of celiac disease in a group of first degree relatives of celiac children, and to access the frequency of human leukocyte antigen HLA-DQ2 and DQ8 in celiac disease patients and their affected relatives. Methods - A survey was conducted of 39 children with celiac disease with follow-up in the Pediatric outpatient’s clinic of Dr. Nélio Mendonça Hospital, in Madeira Island, Portugal. Were invited 110 first degree relatives to undergo serological screen for celiac disease with IgA antibody to human recombinant tissue transglutaminase (IgA-TGG) quantification. In all seropositive relatives, small intestinal biopsy and HLA typing was recommended. Results - HLA- typing was performed in 38 celiac patients, 28/74% DQ2 positive, 1/2% DQ8 positive and 9/24% incomplete DQ2. Positive IgA-TGG was found in five out of the 95 relatives, and CD was diagnosed in three of them. Three relatives had the presence of HLA-DQ2, two were DQ2 incomplete (DQB1*02). Conclusion - The prevalence of celiac disease among first degree celiac patients´ relatives was 3.1%, 4.5 times higher than the general Portuguese population (0,7%) witch reinforces the need of extensive diagnostic screening in this specific group. HLA-DQ2 typing may be a tool in the diagnostic approach.

Leadership of portuguese community schools in the East Coast of the United States and the public policies of education: a multiple case studies

The Portuguese community schools of the United States located in the areas of larger Portuguese population concentration are social organizations that come materializing throughout decades the designs of the educative policies of the Portuguese government in relation to the expansion and preservation of the language, the culture and the history of Portugal. These designs of the educative policies are enrolled in the Constitution of the Republic (1976), in the Basic Law of Educative System (1986) and, over all, in the successive legislative norms (Decree-laws and ordinances) of the successive governments. Portuguese community schools in the United States are structuralized in analogous way to schools of the Portuguese geographic space. For this qualitative study (multiple case), four directors of Portuguese schools of the East Coast of the United States were interviewed; two schools are in the state of Rhode Island and the other two are in the state of Massachusetts. Also, it was administered the questionnaire on practices of leadership “Leadership Practices Inventory” (LPI) of Kouzes and Posner (2002) to collect additional data about practices of leadership on the directors of the schools. The LPI evaluates practices of leadership classifying them in five domains: (a) Model the way; (b) Inspire a shared vision; (c) Challenge the process; (d) Enable others to act; and, (e) Encourage the heart. Results of this qualitative research indicate that the Portuguese Government has not had an educative policy stimulant, coherent and consistent of support, incentive, maintenance and diffusion of the Portuguese language and culture and the directors of the studied schools they have a proactive and serving leadership style in conducting the management of Portuguese community schools. The five practices of leadership are highly practiced by the directors of the studied schools above all the practices “Enable others to act” and “Encourage the heart”.