Contrast sensitivity evaluation with filter contact lenses in patients with retinitis pigmentosa: a pilot study

Purpose: the aim of this pilot study was to test whether retinitis pigmentosa patients would benefit from filter contact lenses as an effective optical aid against glare and photophobia. Methods: fifteen subjects with retinitis pigmentosa were enrolled in this study. All of them were evaluated with filter soft contact lenses (MaxSight), filter glasses (CPF 527) and without filters (control). All patients were assessed for the three aid conditions by means of best corrected visual acuity (BCVA), contrast sensitivity (without glare and with central and peripheral glare)(CSV-1000) and a specific subjective questionnaire about quality of vision. Results: BCVA was slightly better with filters than without filter but the differences were not statistically significant. Contrast sensitivity without glare improved significantly with the contact lenses (p<0.05). The central glare had significant differences for the frequencies of 3 cpd and 18 cpd between the contact lens filter and the control group (p=0.021 and p=0.044, respectively). For the peripheral glare contrast sensitivity improved with contact lens versus control group for highest frequencies, 12 and 18 cpd (p<0.001 and p=0.045, respectively). According to the questionnaire the contact lens filter gave them more visual comfort than the glasses filter under the scenarios of indoors glare, outdoors activities and indoors comfort. Conclusion: the filter contact lenses seem to be a good option to improve the quality of vision of patients with retinitis pigmentosa.

Mujer Pagana/ Mujer Cristiana en Ad uxorem de Tertuliano

Desde los primeros años del cristianismo la figura de la mujer no ha pasado desapercibida para los distintos autores. Nos parece muy interesante la figura de Tertuliano, autor africano de los siglos II-III d. C. Pagano de formación y atraído por el mensaje y las vivencias de la nueva religión, pero confundido por la radicalidad que surgieron en las sectas del cristianismo. Es el primer escritor cristiano del norte de África que se ocupó ampliamente de la mujer virgen, viuda y casada. Siente una especial predilección por las cristianas de Cartago, porque ejercieron una gran labor en el desarrollo del cristianismo primitivo, por su tarea como evangelizadoras. Estaba muy preocupado por la conducta que iban adquiriendo, pues se hallaban inmersas en una cultura pagana. Hemos elegido la obra Ad uxorem, una especie de testamento espiritual que Tertuliano le escribe a su mujer en caso de morir antes que ella. A partir de la lectura y análisis de esta obra y de la comparación entre la mujer pagana y la mujer cristiana se aprecia la influencia notable de la cultura pagana. Pero no debemos caer en el error de pensar que hablamos de dos mundos diferentes. No olvidemos que el cristianismo llegó a una Roma imbuida de una religión y de unos dioses paganos. Por lo tanto, no podemos estudiar ambos mundos como contrarios y distintos, sino que un mundo surge dentro del otro y se complementan. Tertuliano va a presentar una evolución en su pensamiento que sólo se podrá entender a través del estudio de diversos aspectos que se han considerado importantes. Para ello, hemos estructurado el trabajo en cuatro capítulos. Destacamos cómo se desenvolvía la mujer en el mundo mediterráneo antiguo, tanto en Roma como en el Norte de África. Igualmente, el contexto social y eclesial que envolvía a Tertuliano en estos siglos II-III d.C., junto con su vida y su obra, han sido claves para entender cómo inciden ambos contextos en el pensamiento del autor. También se analiza la obra Ad uxorem para mostrar algunos datos interesantes relativos a la época de composición del tratado, estudio de la estructura retórica del mismo, público al que va dirigido y la intención del autor. Por último, se ha realizado un examen más en profundidad de la obra mediante la observación de aquellos términos y textos que emplea Tertuliano para retratar a la mujer. Todo ello nos ha ayudado a extraer las diferentes características de dichas mujeres teniendo en cuenta los espacios en los que se movían, los proyectos que tenían, su relación con Dios, con el hombre y con la sociedad. El estudio del mundo pagano y cristiano presentes en la obra de Tertuliano se ha llevado a cabo a partir de un modelo al que hemos llamado “escenario”, a través del método socio-antropológico, que ha contribuido a completar todos los escenarios que envuelven tanto al autor como a la mujer en general. Este método se ha visto reforzado por el método analítico, para describir dichos factores y analizarnos en profundidad y, también, por el método comparativo, que nos ha llevado a completar nuestro objetivo último: las características de las mujeres paganas y cristianas en la obra Ad uxorem de Tertuliano. Tras la realización del análisis de la obra descubrimos la importancia que tienen los términos que emplea Tertuliano para referirse a las mujeres, expresando la familiaridad propia del cristianismo. Igualmente, su adhesión al montanismo hace que su opinión sobre las mujeres se endurezca. Así mismo, en el análisis de los textos se muestran las diversas virtudes que Tertuliano destaca en las cristianas: estas aparecen como univirae, pudorosas, castas, sumisas, continentes, perseverantes, sobrias y silenciosas, mientras que las paganas en su crítica resultan ser mujeres de varios esposos, impúdicas, desvergonzadas, desobedientes, orgullosas, avariciosas, ambiciosas y charlatanas, invitando siempre a las cristianas a alejarse del ejemplo de estas últimas. Sin embargo, nuestro estudio nos ha llevado mucho más lejos; hemos descubierto cuáles eran las conductas exigidas para la cristiana, y qué mujer era aquella por la que Tertuliano sentía una especial predilección. En conclusión, Tertuliano anhelaba aquella mujer casta, que consagraba su virginidad a Dios, mujer soltera y sin hijos, es decir, la virgen, pues su objetivo era la salvación de las cristianas y ésta era la mejor forma de conseguirla. No obstante, esto no quita que Tertuliano sea consciente del valor tan inmenso que adquiere el matrimonio dentro del cristianismo, lo que explicaría en la conclusión de su tratado esa bellísima alabanza del matrimonio cristiano. -Selección bibliográfica: -ALFARO BECH V. (2012), “Importancia y colaboración de las cristianas cartaginesas en la difusión del cristianismo y la evangelización en el Norte de África”, en F. RIVAS REBAQUE (ED.), Iguales y diferentes. Interrelación entre mujeres y varones cristianos a lo largo de la historia, San Pablo, Madrid, pp. 75-128. -BLAISE A. (1954), Dictionnaire latin-français des auteurs chrétiens, Brepols, Leuven. -BRAUN R. (1985), “Tertullien et le Montanisme: Église institutionnelle et église spirituelle”, Rivista di Storia e Letteratura religiosa XXI, pp. 245-257. _______ (1992), “Tertullien et la philosophie païenne. Essai de mise au point”, en ID., Approches de Tertullien. Vingt-six études sur l’auteur et sur l’œuvre (1955-1990), Brepols (Collection d’Études Augustiniennes, 134), Paris, pp. 21-41. -CANTARELLA E. (1991b), La mujer romana, Universidad de Santiago, Santiago de Compostela. -DUNN G. D. (2004), Tertulllian. The Early Church Fathers, Routledge, Londres–Nueva York. -ESTÉVEZ E. (2012), Las mujeres en los orígenes del cristianismo, Verbo Divino, Estella (Navarra). -FREDOUILLE J.–C. (1972), Tertullien et la conversion de la culture Antique, Études Augustiniennes, Paris. -HAMMAN A. G. (2000), “Tertuliano, A su esposa”, en Matrimonio y virginidad en la Iglesia antigua, Desclée de Brouwer, Bilbao, pp. 49-81. -HENNE P. (2011), Tertullien l’Africain, Ed. du Cerf, Paris. -LÓPEZ CÁNDIDA A.–POCIÑA A. (1990), La mujer en el mundo mediterráneo antiguo, Universidad de Granada, Granada. -MACDONALD M. (2004), Las mujeres en el cristianismo primitivo y la opinión pagana. El poder de la mujer histérica, Verbo Divino, Estella (Navarra). -MESNAGE J. (1914), Le Christianisme en Afrique. Origines, développments, extensión, Adolphe Jourdan, Alger. -OSIEK C.–MACDONALD M.–TULLOCH J. (2007), El lugar de la mujer en la Iglesia primitiva, Sígueme, Salamanca. -Oxford Latin dictionary (2005), P.G.W. GLARE (ED.), Oxford University Press, New York. -RIVAS REBAQUE F. (2008), “La mujer cristiana en el Norte de África latina”, en ID., Desterradas hijas de Eva. Protagonismo y marginación de la mujer en el cristianismo primitivo, Universidad Pontificia Comillas–San Pablo, Madrid, pp. 57-110.

Proposta de método para avaliação do desempenho térmico de residências unifamiliares em clima quente e úmido

Nowadays, evaluation methods to measure thermal performance of buildings have been developed in order to improve thermal comfort in buildings and reduce the use of energy with active cooling and heating systems. However, in developed countries, the criteria used in rating systems to asses the thermal and energy performance of buildings have demonstrated some limitations when applied to naturally ventilated building in tropical climates. The present research has as its main objective to propose a method to evaluate the thermal performance of low-rise residential buildings in warm humid climates, through computational simulation. The method was developed in order to conceive a suitable rating system for the athermal performance assessment of such buildings using as criteria the indoor air temperature and a thermal comfort adaptive model. The research made use of the software VisualDOE 4.1 in two simulations runs of a base case modeled for two basic types of occupancies: living room and bedroom. In the first simulation run, sensitive analyses were made to identify the variables with the higher impact over the cases´ thermal performance. Besides that, the results also allowed the formulation of design recommendations to warm humid climates toward an improvement on the thermal performance of residential building in similar situations. The results of the second simulation run was used to identify the named Thermal Performance Spectrum (TPS) of both occupancies types, which reflect the variations on the thermal performance considering the local climate, building typology, chosen construction material and studied occupancies. This analysis generates an index named IDTR Thermal Performance Resultant Index, which was configured as a thermal performance rating system. It correlates the thermal performance with the number of hours that the indoor air temperature was on each of the six thermal comfort bands pre-defined that received weights to measure the discomfort intensity. The use of this rating system showed to be appropriated when used in one of the simulated cases, presenting advantages in relation to other evaluation methods and becoming a tool for the understanding of building thermal behavior

Estágio realizado no Programa Comunitário PLE²NO

A OA é a doença reumática mais comum no ser humano e uma doença crónica com impacto elevado na sociedade. Tem repercussões na saúde, ao nível da funcionalidade, comprometendo a realização das atividades da vida diária e a qualidade de vida dos indivíduos. Uma das articulações mais afetada pela OA é a articulação do joelho. O tratamento eficaz requer a combinação de tratamentos farmacológicos e não farmacológicos. Os tratamentos não farmacológicos, principalmente o exercício e a educação do doente têm vindo a ganhar importância, no que se refere ao controlo dos sintomas. A realização do estágio curricular surge no programa comunitário PLE²NO. O programa é considerado uma opção não farmacológica no tratamento e controlo dos sintomas da Osteoartrose (OA) no joelho. Os principais objetivos do estágio no PLE²NO consistiram: aquisição de conhecimentos teóricos relacionados com OA e práticos com vista ao aperfeiçoamento da prescrição do exercício; aquisição de competências essenciais à ótima liderança e comunicação com as pessoas e instituições envolvidas; prescrição de exercício a indivíduos com OA no joelho; cativar e motivar as pessoas para a prática de exercício; e determinar a eficácia de um programa de 3 meses de educação e exercício nos sintomas, aptidão física e qualidade de vida dos idosos com OA no joelho. Na aptidão física verificaram-se diferenças significativas na capacidade aeróbia, flexibilidade e velocidade da marcha. Nos indicadores de saúde houve melhoria em praticamente todos os parâmetros avaliados: mobilidade, cuidados pessoais, dor/mal-estar e sintomas de ansiedade/depressão. Assim, esta intervenção revelou-se ser uma mais-valia para o tratamento não farmacológico da osteoartrose do joelho a médio prazo.

Management of the clinical issue of constipation with abdominal complaints in adults: a national survey of Primary Care physicians and gastroenterologists

Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort) with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care). Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation) and a response rate potentially biased by professional motivation.

Clinical Practice Guideline: irritable bowel syndrome with constipation and functional constipation in the adult

In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

Influência das áreas verdes no microclima local: um estudo do conjunto habitacional Ponta Negra, Natal/RN

Owing to na intense process of urban development, urban uneasiness and discomfort in the daily life of populations have nowadays, especially in the big cities, become increasingly ordinary issues. Population density, degeneration of central areas and pollution are some of the environmental stressors the urban man is subjected to. The existence of open areas in the urban network contributes to a better movement of the air and transforms salubrity conditions. Yet, it has been noticed that parks and squares are disappearing from the heart of the city districts. In their place there are either unused plots of land where garbage has been dumped or nearly all-paved squares with meager or no vegetation at all. Such areas, when handled properly, play an important role in the city because in addition to being zones for rendering a mild climate they perform social, cultural and hygienic functions. Aiming at demonstrating that proper handling of green areas can favorably influence the local microclimate, we have attempted to develop analysis from the point of view of bioclimatizing attributes of urban form and their relationship to the local microclimate found in the eight open areas located in the Ponta Negra Housing Complex in the city of Natal/RN

Subjective comparison of consumer television technologies for 3D visualization

This paper presents a comparison among different consumer 3D display technologies by means of a subjective assessment test. Therefore, four 55-in displays have been considered: one autostereoscopic display, one stereoscopic with polarized passive glasses, and two with active shutter glasses. In addition, a high-quality 3D video database has been used to show diverse material with both views in high definition. To carry out the test, standard recommendations have been followed considering also some modifications looking for a test environment more similar to real home viewing conditions, with the objective of obtaining more representative conclusions. Moreover, several perceptual factors have been considered to study the performance of the displays, such as picture quality, depth perception, and visual discomfort. The obtained results show interesting issues, like the performance improvement of active shutter glasses technology, the high performance of the polarized glasses technology in terms of quality and comfort, and the need of improvement of the autostereoscopic displays to complement the visual comfort to reach a global high-quality visual experience.

Efeitos secundários da quimioterapia antineoplásica e seu impacto na qualidade de vida em cães e gatos com doença oncológica

Mestrado Integrado em Medicina Veterinária

Design inclusivo no espaço urbano

Dissertação de Mestrado para obtenção do grau de Mestre em Design de Produto, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.

Fachada flexível para casa padronizada em condomínios

The employment of flexibility in the design of façades makes them adaptable to adverse weather conditions, resulting in both minimization of environmental discomfort and improvement of energy efficiency. The present study highlights the potential of flexible façades as a resource to reduce rigidity and form repetition, which are usually employed in condominiums of standardized houses; as such, the work presented herein contributes to field of study of architectural projects strategies for adapting and integrating buildings within the local climate context. Two façade options were designed using as reference the bionics and the kinetics, as well as their applications to architectural constructions. This resulted in two lightweight and dynamic structures, which cater to constraints of comfort through combinations of movements, which control the impact of solar radiation and of cooling in the environment. The efficacy and technical functionality of the façades were tested with comfort analysis and graphic computation software, as well as with physical models. Thus, the current research contributes to the improvement of architectural solutions aimed at using passive energy strategies in order to offer both better quality for the users and for the sustainability of the planet

Sexual dysfunction in breast cancer survivors: cross-cultural adaptation of the Sexual Activity Questionnaire for use in Portugal

"Introduction: The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of the disease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led to the development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. Material and Methods: The questionnaire was translated and back-translated, refined following face-to-face interviews with seven breast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. Results: Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then tested with 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfort scales, all yielding good internal consistency (Cronbach’s α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist was good (Spearman’s r > 0.65; p-value < 0.001) and reliability acceptable (Cohen’s k > 0.444). The Sexual Activity Questionnaire allowed the identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not having a partner. Discussion: Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previously abandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overall population to enable generalizability of the findings. Conclusion: The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors in Portugal."

Síndrome Irlen, uso de transparencias de color y mejoras de la lectura en escolares urbanos de Cuenca.

Objetivo: Determinar si el uso de transparencias de color ayuda a mejorar la lectura, eliminando distorsiones visuales perceptuales, malestares físicos al leer, sintomatología del síndrome Irlen. Materiales y Métodos: Estudio cuasi-experimental sobre efectos del Método Irlen® - uso del color - en sesenta y un estudiantes del cuarto grado de las escuelas urbanas de Cuenca, identificados como severos en el rango de Irlen, en un estudio anterior de prevalencia. Los participantes fueron evaluados a través de nuevas observaciones, entrevistas y cuatro pruebas de la Escala Perceptual de Lectura Irlen. Medidas de tendencia central y porcentajes fueron utilizadas para el análisis de datos. Resultados: Las mejoras atribuidas al uso del color en rango considerable fueron: 1) 59% comodidad; 2) 37.7% menos borroso; 3) 41% menos tensión y fatiga; 4) 45.9% más seguridad y fluidez al leer; 5) 34.4% menos movimientos en la página; 6) 31.2% eliminación de distorsiones; 7) 13.1% menos errores al leer; 8) 9.8% mejora del espacio limitado; 9) 8.2% en atención limitada; y 10) 1.6% mejora en comprensión lectora. Conclusión: El uso de las transparencias de color ayuda parcialmente a eliminar algunas distorsiones visuales perceptuales y malestares físicos al leer lo que facilita la lectura

Los orígenes de las reivindicaciones autonomistas catalanas y sardas a través de la prensa periódica del siglo XIX (1840-1890)

The purpose of the thesis for obtaining this PhD diploma is a comparative research between the origin of the Catalonian national movement and the Sardinian national one through the analysis of the 19th century periodicals as well as through a bibliography obtained by extracting them from consulted newspapers and magazines. Not only are both realities compared because of the Aragonese-Catalan influence over the Sardinian culture during its conquer but also because both movements had their origin during the 1840s and developed concurrently along that century presenting some differences, though. The political and cultural scene in Sardinia in those years was characterized by the spread of a discomfort feeling among the population after the acceptance of the “ Fusione perfetta” in 1848 and the following rollout of the “Statuto Albertino” in the island, representing this last regulation an attempt to unify the different Italian provinces in an administrative and legislative way, together with the previous “Feliciano” code from 1827. Therefore, this is how it began to be defined the set of political, economic, and cultural theme that forms the central point of the “questione sarda” (this term and its whole connotation were used for the first time in 1867 in an article published in the Cagliaritano weekly-publication La Cronaca). The singularity of this Sardinian nationalistic movement is related to the origin of the first regional demands expressed during those same years in some European regions and, more specifically, in Catalonia. Actually in this region, in those same years, we find the origin of a cultural movement called RenaixenÇa whose initial claim was the linguistic and cultural Catalonian renaissance and which adopted a more political meaning along the 19th century...

Bioadhesive drug delivery system of diltiazem hydrochloride for improved bioavailability in cardiac therapy

Purpose: To prepare and evaluate bioadhesive buccal films of diltiazem hydrochloride (a L-type calcium channel blocker) for overcoming the limitations of frequent dosing, low bioavailability and gastrointestinal discomfort of oral delivery. Methods: Buccal films were prepared by solvent casting technique using sodium carboxymethylcellulose, polyvinyl pyrrolidone K-30 and polyvinyl alcohol. The films were evaluated for weight, thickness, surface pH, swelling index, in vitro residence time, folding endurance, in vitro release, ex-vivo permeation (across porcine buccal mucosa) and drug content uniformity. Results: The drug content of the formulations was uniform with a range of 18.94 ± 0.066 (F2) to 20.08 ± 0.07 mg per unit film (F1). The films exhibited controlled release ranging from 58.76 ± 1.62 to 91.45 ± 1.02 % over a period > 6 h. The films containing 20 mg diltiazem hydrochloride, polyvinyl alcohol (10 %) and polyvinyl pyrrolidone (1 % w/v) i.e. formulation F5, showed moderate swelling, convenient residence time and promising drug release, and thus can be selected for further development of a buccal film for potential therapeutic uses. Conclusion: The developed formulation is a potential bioadhesive buccal system for delivering diltiazem directly to systemic circulation, circumventing first-pass metabolism, avoiding gastric discomfort and improving bioavailability at a minimal dose.