Clustering medical tourism in Algarve: setting the first steps for the the health authority

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Smart metering consumer behavior study in the Republic of Ireland: Further analyses on the consumers’ electricity consumptions and usage perceptions

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

A green future for European electricity? :Energy sources, policies and further determinants of the household price of electricity

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics

Production of ellagitannins concentrate by UF-NF from tropical highland blackberries

Dissertation presented to Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa for obtaining the master degree in Membrane Engineering

Enhancing physical activity coaching through personalized motivational strategies and self-adaptive goal-setting: development of self-adaptive processes in a monitoring and coaching smartphone application

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica

Investigation of the regulation mechanisms for bioplastics production from industrial residues

Dissertação para obtenção do Grau de Mestre em Biotecnologia

Further evidence of spontaneous cure in human Chagas disease

An acute case of Chagas disease was studied in 1944, with clinical and laboratory follow-up until 2007, in Bambuí, Minas Gerais, Brazil. A five-year-old girl living in a rural hut that was highly infested with Triatoma infestans presented a febrile clinical condition compatible with the acute form of trypanosomiasis. She presented a positive thick blood smear, but never again showed serological and/or parasitological evidence of Trypanosoma cruzi infection, on several occasions. This patient never received any specific treatment and, to this day, she remains completely asymptomatic, with normal findings from clinical, electrocardiographic, X-ray and echocardiographic examinations.

Intervenção educativa junto de um grupo de enfermeiros de um serviço de medicina : impacto na prática da terapêutica inalatória

RESUMO: O presente estudo, enquadra-se, no domínio do exercício profissional dos enfermeiros e na formação em serviço destes profissionais e teve por objectivo avaliar, num grupo de enfermeiros de um serviço de medicina, o impacto de uma intervenção educativa na melhoria dos procedimentos a executar na prática da terapêutica inalatória. A amostra do estudo (amostra por conveniência) foi constituída por oito enfermeiros do serviço de medicina do Hospital Curry Cabral (idades compreendidas entre os 24 a 43 anos de idade), sem anterior formação específica na área da terapêutica inalatória, mas com experiencia profissional prévia com doentes respiratórios. O estudo decorreu em dois momentos de avaliação: avaliação 0 (antes da intervenção educativa) e avaliação 1 (após a intervenção educativa). Entre estes dois momentos, foi ministrada, a todos os enfermeiros, uma acção de formação sobre terapêutica inalatória, com componente teórico-prática. Antes e depois da intervenção educativa foram aplicados dois instrumentos: para avaliação dos conhecimentos teóricos, construi-se e aplicou-se, um questionário de auto-avaliação de conhecimentos sobre terapêutica inalatória ao grupo dos enfermeiros, e para avaliação dos conhecimentos práticos e execução de procedimentos, uma grelha de observação da demonstração da técnica de inalação com três dispositivos inalatórios: MDI, MDI com câmara expansora ACE e DPI turbohaler®. Os resultados do estudo mostraram que o grupo dos enfermeiros da nossa amostra detinha já alguns conhecimentos de carácter teórico, de âmbito geral, sobre a terapêutica inalatória, mas conhecimentos pouco sólidos, nomeadamente no que concerne aos fármacos utilizados por via inalatória. Verificou-se, ainda, um deficiente domínio de conteúdos de carácter mais específico e prático sobre terapêutica inalatória, por exemplo a importância de determinados procedimentos - agitação do inalador, tempo de pausa entre cada inalação, cuidados de manutenção da câmara expansora, higienização da cavidade bucal após a inalação dos corticosteróides. Quanto à observação da técnica de inalação, o grupo dos enfermeiros revelou algumas lacunas, quer relativamente à técnica de inalação com MDI, quer do MDI com câmara expansora, observando-se a execução de passos incorrectos e mesmo omissão de passos por parte dos enfermeiros, antes da intervenção educativa.Não nos foi possível realizar a observação da técnica de inalação com dispositivo de pó seco turbohaler®, dado que nenhum dos enfermeiros da nossa amostra se sentiu capaz de manusear de forma correcta este dispositivo, antes e após a formação. Em termos globais, achamos que a formação dada sobre terapêutica inalatória, mostrou melhorar os conhecimentos teóricos e práticos dos enfermeiros neste âmbito. Esta melhoria ficou claramente demonstrada no aumento do número de respostas correctas dadas pelos enfermeiros no questionário efectuado, após a formação. Do mesmo modo, após a formação, registou-se uma melhoria considerável dos conhecimentos específicos e práticos, no que concerne à importância de determinados procedimentos na prática da terapêutica inalatória - agitação do inalador, tempo de pausa entre cada inalação, cuidados de manutenção da câmara expansora, higienização da cavidade bucal após a inalação dos corticosteróides - observando-se, um maior número de respostas correctas assinaladas no questionário. Em contrapartida, os conhecimentos sobre fármacos administrados por via inalatória, ficaram um pouco aquém das expectativas, pois o número de respostas correctas dadas pelos enfermeiros após a formação não foi significativo. Poderemos mesmo dizer que, a acção de formação com maior grau de especificidade sobre fármacos não se revelou eficaz e gerou até alguma ―confusão‖ neste grupo de enfermeiros, parecendo que os conhecimentos anteriores sobre fármacos por via inalatória não estariam consolidados antes da formação. De igual modo, após a formação, registou-se no grupo dos enfermeiros do estudo uma melhoria na performance da técnica de inalação com o MDI e MDI com a câmara expansora. Os enfermeiros do estudo, não só corrigiram os passos ou itens de avaliação da técnica inalatória, anteriormente executados incorrectamente, mas também, mostraram um melhor conhecimento dos passos ou itens de avaliação da técnica de inalação, com menor número de passos ou itens de avaliação omissos, após a formação. Em contrapartida, a acção de formação, no que diz respeito ao dispositivo de pó seco turbohaler®, não cumpriu o seu objectivo, dado que nenhum dos enfermeiros da amostra foi capaz de demonstrar a técnica de inalação com este dispositivo, antes e após a formação. Poderemos dizer que, não sendo um dispositivo da sua prática clínica, os enfermeiros não sentiram necessidade de adquirir estes conhecimentos. Em síntese, podemos concluir que na sua globalidade, a formação dada (com informação actualizada sobre as orientações mais adequadas neste domínio) e o treino formal dos enfermeiros neste âmbito, foi bastante proveitoso, uma vez que, mostrou melhorar os conhecimentos teóricos e práticos na prática da terapêutica inalatória do grupo de enfermeiros doserviço de medicina. Realça-se, no entanto, a importância de uma formação adequada, sentida como útil pelos enfermeiros, faseada, ligada à prática dos profissionais e alternando com momentos de exercício profissional. Os conhecimentos e os procedimentos dos enfermeiros deverão ainda ser monitorizados e avaliados ao longo do tempo, para a detecção de eventuais desvios que a rotina pode introduzir e para levantamento de novas necessidades de formação.-------------------ABSTRACT: This study fits in the domain of in-service training of professional nurses. It was aimed to assess the impact of an educational intervention and the consequent improvement of the practice of inhalation therapy in a group of nurses from a medical service The study sample (convenience sample) was consituted by eight nurses from the medical service, Hospital Curry Cabral (aged 24-43 years) without previous special training in the field of inhalation therapy, but with prior experience with patients with respiratory diseases. The study ran in two moments of evaluation: evaluation 0 (before the educational intervention) and evaluation 1 (post-intervention). Between these two moments, a training program about therapeutic inhalation was administered to all nurses, with a double component of theory and practice. Before and after the educational intervention two evaluation tools were applied: for the assessment of theoretical knowledge, the nurses had to fill a self-assessment questionnaire and in order to evaluate their knowledge related to procedural skills as well as their performance, they were observed (and their behaviour recorded on a check-list) during a demonstration of three inhalation techniques with devices: metered dose inhaler, metered dose inhaler with a spacer device ACE® and device turbohaler® The study results showed that the group of nurses in our sample had already some knowledge of theoretical nature (general scope of the inhalation therapy) but little solid knowledge, particularly in regard to drugs used in inhalation. In fact, a relatively weaker knowledge was registerd in what concerns specific and practical knowledge about inhalation therapy, for example, the importance of certain procedures - shaking the inhaler, pause between each inhalation, maintenance care of spacer device, mouth cavity hygiene after inhalation of corticosteroids. As for the observation of the inhaler technique, it was found that the group of nurses had a poor inhalation technique, in what concerns inhalation technique with MDI or MDI with spacer device, with a performance with several incorrect steps, or even omission of steps by nurses before the educational intervention. Finally, as the observation technique of the dry powder device turbohaler ®, we were unable to analyze the observation concerning this device, since none of the nurses in our sample, wast able to handlle it correctly, before and after training.In general terms, we found that the training given on inhalation therapy had a positive impact either in the theorical or the pratical knowledge on inhalation therapy (higher number of correct answers after training). Similarly, after training, there was the considerable improvement of specific and practical skills, namely the importance of certain procedures in the practice of inhalation therapy - shaking the inhaler, pause time between each inhalation, maintenance care of spacer device, sanitizing the buccal cavity after inhalation of corticosteroids. In contrast, knowledge about drugs administered by inhalation, were slightly below expectations, showing a lower number of correct answers given by the nurses after training. The training seemed to be a factor of "confusion" for this group of nurses, whose prior knowledge in this domais was not probably very solid to begin with. After training, the group of nurses in the study improved the performance of inhalation technique with MDI and MDI with spacer device. They not only correcty performed the steps or itens for the assessment of inhalation technique, previously performed incorrectly, but also showed a better understanding of the steps or itens for assessing the inhalation technique, with fewer steps missing (after training). In contrast, training with regard to the device turbohaler ® dry powder, was also below expectations, given that none of the nurses in the sample was able to demonstrate inhaler technique with this device before and after training. This was probably due to the fact that, the nurses did not feel the need to acquire this knowledge and the related practice. In summary, we can say that, overall, the training (with updated information on the appropriate policies in this field) showed an improvement in knowledge and performance in the practice of inhalation therapy. It is however crucial to underline the importance of in-service adequate training programmes, perceived as useful by the nurses, developped in different phases, linked to the nurses’ practice and combining with professional practices. The nurses’ knowledge and skills should also be further monitorized and evaluated in order to detect deviations introduced by the rotinization of procedures and to identify new training needs.

Long-term follow-up of a patient since the acute phase of Chagas disease (South American trypanosomiasis): further treatment and cure of the infection

ABSTRACTA woman had been followed since 1957 for acute phase Chagas disease. Parasitological and serological tests were positive, and treatment included benznidazole in 1974. Following treatment, parasitological test results were negative and conventional serology remained positive until 1994, with subsequent discordant results (1995-1997). The results became consistently negative since 1999. She had an indeterminate chronic form until 1974. Only two minor and transitory nonspecific alterations on electrocardiogram were noted, with the last nine records normal until June 2014. This case confirms the possibility of curing chronic disease and suggests the benefit of specific treatments for preventing long-term morbidity.

Study of in vivo interactions between penicillin-binding proteins of Staphylococcus aureus

Staphylococcus aureus (S. aureus) is a major human pathogen that has acquired resistance to practically all classes of β-lactam antibiotics, being responsible of Multidrug resistant S. aureus (MRSA) associated infections both in healthcare (HA-MRSA) and community settings (CA-MRSA). The emergence of laboratory strains with high-resistance (VRSA) to the last resort antibiotic, vancomycin, is a warning of what is to come in clinical strains. Penicillin binding proteins (PBPs) target β-lactams and are responsible for catalyzing the last steps of synthesis of the main component of cell wall, peptidoglycan. As in Escherichia coli, it is suggested that S. aureus uses a multi-protein complex that carries out cell wall synthesis. In the presence of β-lactams, PBP2A and PBP2 perform a joint action to build the cell wall and allow cell survival. Likewise, PBP2 cooperates with PBP4 in cell wall cross-linking. However, an actual interaction between PBP2 and PBP4 and the location of such interaction has not yet been determined. Therefore, investigation of the existence of a PBP2-PBP4 interaction and its location(s) in vivo is of great interest, as it should provide new insights into the function of the cell wall synthesis machinery in S. aureus. The aim of this work was to develop Split-GFPP7 system to determine interactions between PBP2 and PBP4. GFPP7 was split in a strategic site and fused to proteins of interest. When each GFPP7 fragment, fused to proteins, was expressed alone in staphylococcal cells, no fluorescence was detectable. When GFPP7 fragments fused to different peptidoglycan synthesis (PBP2 and PBP4) or cell division (FtsZ and EzrA) proteins were co-expressed together, fluorescent fusions were localized to the septum. However, further analysis revealed that this positive result is mediated by GFPP7 self-association. We then interpret the results in light of such event and provide insights into ways of improving this system.

Why further investigation of brazilian Strychnos?

During the past fifteen years, African Strychnos species have been pharmacologically and chemically screened by some European Universities, sometimes with the collaboration of some African Institutes. Strychnos usambarensis will be discussed here because of our interest in it, after the discovery of its use in the preparation arrow poison with curarizing activity.The European studies have show thah the African species of Strychnoschemically are very similar to certain South-American species. Indeed, the occurrence in the African species of curarizing quaternary bases, and in the American species of tetanizing tertiary bases, such as akagerine, emphasizes the unity of genus Strychnos in terms of it alkaloids. Many biological activities (antmicrobial, hypotensive, smasmolytic, amoebicial...) have been detected.Finally, the antimitotic properties of some alkaloids will be presented. Besides know antitumor drugs, e.g. alstonine and ellipticine, African species possess new antimitotic products, e.g. strychnopentamine present in Strychnos usambarensis.Because of these findings, the main reasons why further investigate Brazilian Strychnos species are the lack of knowledge about:- the distribution on the species in the southern part of the great Amazon Basin.Accordin to Krukoff, it is possible that new species may be found there.- the distribution of alkaloids in many of know species. Indeed, there is little information on the variation in compposition of the alkaloidal mixtures in the different parts of the plants.- the biological of alkaloids. In the past, interest has been focused too narrowly on possible curarizing properties.Why should Brazilian species not cantain alkaloids with properties similar to those found in the African species?

Cooperations in the nonprofit sector

Many Nonprofit Organizations are pursuing mergers and alliances with the purpose of become more sustainable, better use their resources, and generate a higher impact. This report wants to bring further concrete evidences to the contents highlighted by the researchers. Firstly, a theoretical framework is derived from the literature analysis. Based on that a case study is developed, which see the NOVA SBE and the IES – SBS planning a strategic alliance to constitute a new Social Entrepreneurship Center. A first analysis of the strategic alliance plan showed a wide potential in terms of impact generated and sustainability, only the future steps will be able to demonstrate the successful implementation.

Effects of residues on the degradation of PHA produced from mixed microbial cultures and processed in extrusion

Thermal degradation upon melting is one of the major drawbacks reported for polyhydroxyalkanoates (PHA). However, the role of residues originating from the fermentation and the extraction steps on the thermal stability of this class of biopolymers still needs to be clarified. In the particular case of PHA produced from mixed microbial cultures (MMC), this topic is even less documented in the literature. Here, two polyhydroxy(butyrate-co-valerate) (PHBV) produced from MMC enriched in PHA accumulating organisms and fed with cheese whey were studied. A micro extrusion line is used to produce filaments and assess the processability and the degradation of processed PHBV. The prototype micro extrusion line allows for studying grams of materials. The two PHBV contain 18 mol% HV. PHBV was recovered with 11 wt% residues, and further submitted to a purification procedure resulting in a second biopolyester containing less than 2 wt% impurities. The thermorheological characterization of the two PHBV is first presented, together with their semicrystalline properties. Then the processing windows of the two biopolyesters are presented. Finally, the properties of extruded filaments are reported and the thermomechanical degradation of PHBV is extensively studied. The structure was assessed by wide angle X-ray diffraction, mechanical and rheological properties are reported, thermal properties are studied with differential scanning calorimetry and thermogravimetric analysis, whereas Fourier Transform Infrared spectroscopy was used to assess the impact of the extrusion on PHBV chemical structure. All results obtained with the two PHBV are compared to assess the effects of residues on both PHBV processability and degradation.