Health-related quality of life in portuguese SLE patients: an outcome measure independent of disease activity and cumulative damage

PURPOSE: To evaluate quality of life in Portuguese patients with Systemic Lupus Erithematosus (SLE) and its correlation with disease activity and cumulative damage. METHODS: We included consecutive SLE patients, fulfilling the 1997 ACR Classification Criteria for SLE and followed at the Rheumatology Department of the University Hospital of Coimbra, Portugal at time of visit to the outpatient clinic. Quality of life was evaluated using the patient self-assessment questionnaire Medical Outcomes Survey Short Form-36 (SF-36) (validated Portuguese version). The consulting rheumatologist fulfilled the SLE associated indexes for cumulative damage (Systemic Lupus International Collaborating Clinics- Damage Index: SLICC/ACR-DI) and disease activity (Systemic Lupus Erythematosus Disease Activity Index: SLEDAI 2000). Correlation between SLEDAI and SLICC and SF-36 was tested with the Spearman Coefficient. Significant level considered was 0.05. RESULTS: The study included 133 SLE patients (90.2% female, mean age - 40.7 years, mean disease duration - 8.7 years). Most patients presented low disease activity (mean SLEDAI = 4.23) and limited cumulative damage (mean SLICC = 0.76). Despite that, SF-36 mean scores were below 70% in all eight domains of the index. Physical function domains showed lower scores than mental function domains. The QoL in this group of patients is significantly impaired when compared with the reference Portuguese population (p<0.05 in all domains). There was no correlation between clinical activity or cumulative damage and quality of life. CONCLUSION: QoL is significantly compromised in this group of SLE patients, but not related with disease activity or damage. These findings suggest that disease activity, cumulative damage and QoL are independent outcome measures and should all be used to assess the full impact of disease in SLE patients.

Energy requirements for the continuous biohydrogen production from Spirogyra biomass in a sequential batch reactor

The current energy market requires urgent revision for the introduction of renewable, less-polluting and inexpensive energy sources. Biohydrogen (bioH2) is considered to be one of the most appropriate options for this model shift, being easily produced through the anaerobic fermentation of carbohydrate-containing biomass. Ideally, the feedstock should be low-cost, widely available and convertible into a product of interest. Microalgae are considered to possess the referred properties, being also highly valued for their capability to assimilate CO2 [1]. The microalga Spirogyra sp. is able to accumulate high concentrations of intracellular starch, a preferential carbon source for some bioH2 producing bacteria such as Clostridium butyricum [2]. In the present work, Spirogyra biomass was submitted to acid hydrolysis to degrade polymeric components and increase the biomass fermentability. Initial tests of bioH2 production in 120 mL reactors with C. butyricum yielded a maximum volumetric productivity of 141 mL H2/L.h and a H2 production yield of 3.78 mol H2/mol consumed sugars. Subsequently, a sequential batch reactor (SBR) was used for the continuous H2 production from Spirogyra hydrolysate. After 3 consecutive batches, the fermentation achieved a maximum volumetric productivity of 324 mL H2/L.h, higher than most results obtained in similar production systems [3] and a potential H2 production yield of 10.4 L H2/L hydrolysate per day. The H2 yield achieved in the SBR was 2.59 mol H2/mol, a value that is comparable to those attained with several thermophilic microorganisms [3], [4]. In the present work, a detailed energy consumption of the microalgae value-chain is presented and compared with previous results from the literature. The specific energy requirements were determined and the functional unit considered was gH2 and MJH2. It was possible to identify the process stages responsible for the highest energy consumption during bioH2 production from Spirogyra biomass for further optimisation.

História da cultura e das artes: conteúdo musical crúzio conimbricense

O presente trabalho pretende dar um contributo na divulgação do património musical português dos séculos XVI e XVII, partindo da confluência das várias perspectivas musicais que cruzaram o Mosteiro de Santa Cruz de Coimbra durante este período. Apresenta-se desta forma o potencial pedagógico da instituição, bem como os compositores a ela associados no âmbito da História da Música, no que diz respeito ao ensino vocacional. Contém a exploração de algumas obras do reportório cuja observação constituirá, desejavelmente, motivo de reflexão, contribuindo para a sua divulgação, como elemento distintivo e enriquecedor.

Life-cycle assessment of microalgae biodiesel: a review

Microalgae are an attractive way to produce biofuels due to the ability to accumulate lipids and very high photosynthetic yields. This article presents a review of life-cycle assessment studies of microalgae biodiesel production, including an analysis of modeling choices and assumptions. A high variation in GHG emissions (between -0.75 and 2.9 kg CO2eq MJ-1) was found and the main causes were investigated, namely modeling choices (e.g. the approach used to deal with multifunctionality), and a high parameter uncertainty in microalgae cultivation, harvesting and oil extraction processes.

Research Trends in Mechanical Engineering 2016: Conference Proceedings

Professor José Joaquim de Almeida Grácio was a man of many talents. His contribution to the development of physical models to predict the mechanical behaviour of materials for long-term applications in the areas of nanotechnology and forming processes was outstanding and of major international significance. He was a leader not only in his research but also at university administration level. Soon after he received his Ph.D. from the University of Coimbra (Portugal) in 1992, he joined the University of Aveiro with the mission of creating the Department of Mechanical Engineering (DEM). (...)

Perfil y necesidades de alumnos universitarios con altas capacidades en la Universidad de Málaga. Datos iniciales

La investigación sobre la presencia en las Universidad de alumnos con altas capacidades intelectuales es muy escasa, constituyendo un tema de estudio de importante proyección. Apenas hay publicaciones o informes sobre el acceso a los estudios superiores del alumnado con alta capacidad, el perfil personal e intelectual que presenta, las necesidades que tiene durante su trayectoria universitaria, la tasa de abandonos o de éxito en los estudios universitarios que elige, etc. En este trabajo se presentan datos iniciales acerca del perfil y las necesidades de un grupo de estudiantes con altas capacidades intelectuales que accedieron, entre 2011 y 2015, en su etapa preuniversitaria al programa Mentorac UMA y a los que se les hizo seguimiento tras su acceso a nuestra universidad. Los primeros datos que hemos extraído nos describen la edad, perfil y estudios previos desde los que entran en la universidad, el tipo de carrera que eligen, las dificultades que han experimentado, las necesidades que plantean y la satisfacción general con su ingreso en estos estudios.

História da música portuguesa : centros de actividade musical : séculos XVI e XVII (parte II)

Académico - Licenciaturas

História da arte portuguesa medieval : a iluminura românica : o artista no "Scriptorium"

Académico - Licenciaturas

Design of bicycling suitability maps for hilly cities

Post-print version. Pictures and tables separated from main text and presented at the end.

Kinetic studies of alginate gelation

Comunicação oral selecionada

Assessment of Health-Related Quality of Life using the EQ-5D-3L in Individuals with Type 2 Diabetes Mellitus

The daily experience with type 2 diabetes mellitus (T2DM) has significant adverse effects on health-related quality of life (HRQoL). HRQoL assessment is essential for measuring the impact of the disease on the patient and selecting individualized strategies. Generic measures for assessing HRQoL are very useful because, unlike specific measurement instruments, they allow for the comparison with other instruments. The EQ-5D-3L is a generic measure and it describes HRQoL in five dimensions; mobility, self-care, usual activities, pain/discomfort and anxiety/depression, with three levels each. In Portugal, studies using the EQ-5D-3L as a generic measure to assess HRQoL in diabetic patients are scarce. Objective: To assess HRQoL in individuals with T2DM using the Portuguese version of the EQ-5D-3L. Methodology: An accidental sample of patients with T2DM (n=437) was selected at Family Health Units and healthcare centers in Coimbra, Portugal, between January 2013 and January 2014. The EQ-5D-3L was applied in interviews. The EQ-5D-3L score was calculated based on the answers to the five dimensions and the value system for the Portuguese population. Results: In this sample, 100% of the participants answered the EQ-5D-3L. The HRQoL score was 0.6772 in the EQ-5D-3L and 64.85 in the EQ-VAS. The most frequent answers to the five dimensions were no problems or some problems. The mean score of the EQ-5D-3L was significantly associated with age, male gender, high level of education, having an occupation, practicing physical activity, being single and having been diagnosed with T2DM for less time. The Cronbach alpha's value was 0.674, confirming an acceptable internal consistency. Conclusion: HRQoL levels in individuals with T2DM are lower than the national average and vary depending on sociodemographic and clinical characteristics. The EQ-5D-3L is a reliable instrument that can be used to assess the quality of life of diabetic patients and contribute to assess the patients' overall health status, adding data from the subjective dimension of self-care management.

NEW DATA ON THE CHRONOLOGY OF THE VALE DO FORNO SEDIMENTARY SEQUENCE (LOWER TAGUS RIVER TERRACE STAIRCASE) AND ITS RELEVANCE AS FLUVIAL ARCHIVE OF THE MIDDLE PLEISTOCENE IN WESTERN IBERIA

NEW DATA ON THE CHRONOLOGY OF THE VALE DO FORNO SEDIMENTARY SEQUENCE (LOWER TAGUS RIVER TERRACE STAIRCASE) AND ITS RELEVANCE AS FLUVIAL ARCHIVE OF THE MIDDLE PLEISTOCENE IN WESTERN IBERIA Pedro P. Cunha 1, António A. Martins 2, Jan-Pieter Buylaert 3,4, Andrew S. Murray 4, Luis Raposo 5, Paolo Mozzi 6, Martin Stokes 7 1 MARE - Marine and Environmental Sciences Centre, Department of Earth Sciences, University of Coimbra, Portugal: pcunha@dct.uc.pt 2 MARE - Marine and Environmental Sciences Centre, Dep. Geociências, University of Évora, Portugal; aam@uevora.pt 3 Centre for Nuclear Technologies, Technical University of Denmark, Risø Campus, Denmark; jabu@dtu.dk 4 Nordic Laboratory for Luminescence Dating, Aarhus University, Risø DTU, Denmark; anmu@dtu.dk 5 Museu Nacional de Arqueologia, Lisboa, Portugal; 3raposos@sapo.pt 6 Department of Geosciences, University of Padova, Italy; paolo.mozzi@unipd.it 7 School of Geography, Earth and Environmental Sciences, University of Plymouth, UK; m.stokes@plymouth.ac.uk The stratigraphic units that record the evolution of the Tagus River in Portugal (study area between Vila Velha de Ródão and Porto Alto villages; Fig. 1) have different sedimentary characteristics and lithic industries (Cunha et al., 2012): - a culminant sedimentary unit (the ancestral Tagus, before the drainage network entrenchment) – SLD13 (+142 to 262 m above river bed – a.r.b.; with probable age ca. 3,6 to 1,8 Ma), without artefacts; - T1 terrace (+84 to 180 m; ca. 1000? to 900 ka), without artefacts; - T2 terrace (+57 to 150 m; top deposits with a probable age ca. 600 ka), without artefacts; - T3 terrace (+43 to 113 m; ca. 460 to 360? ka), without artefacts; - T4 terrace (+26 to 55 m; ca. 335 a 155 ka), Lower Paleolithic (Acheulian) at basal and middle levels but early Middle Paleolithic at top levels; - T5 terrace (+5 to 34 m; 135 to 73 ka), Middle Paleolithic (Mousterian; Levallois technique); - T6 terrace (+3 to 14 m; 62 to 32 ka), late Middle Paleolithic (late Mousterian); - Carregueira Sands (aeolian sands) and colluvium (+3 a ca. 100 m; 32 to 12 ka), Upper Paleolithic to Epipaleolithic; - alluvial plain (+0 to 8 m; ca. 12 ka to present), Mesolithic and more recent industries. The differences in elevation (a.r.b.) of the several terrace staircases results from differential uplift due to active faults. Longitudinal correlation with the terrace levels indicates that a graded profile ca. 200 km long was achieved during terrace formation periods and a strong control by sea base level was determinant for terrace formation. The Neogene sedimentary units constituted the main source of sediments for the fluvial terraces (Fig. 2). Geomorphological mapping, coupled with lithostratigraphy, sedimentology and luminescence dating (quartz-OSL and K-feldspar post-IRIR290) were used in this study focused on the T4 terrace, which comprises a Lower Gravels (LG) unit and an Upper Sand (US) unit. The thick, coarse and dominantly massive gravels of the LG unit indicate deposition by a coarse bed-load braided river, with strong sediment supply, high gradient and fluvial competence, during conditions of rapidly rising sea level. Luminescence dating only provided minimum ages but it is probable that the LG unit corresponds to the earlier part of the MIS9 (ca. 335 to 325 ka), immediately postdating the incision promoted by the very low sea level (reaching ca. -140 m) during MIS10 (362 to 337 ka), a period of relatively cold climate conditions with weak vegetation cover on slopes and low sea level. Fig. 1. Main Portuguese reaches in which the Tagus River can be divided (Lower Tagus Basin): I – from the Spanish border to Arneiro (a general E–W trend, mainly consisting of polygonal segments); II – from Arneiro to Gavião (NE–SW); III – from Gavião to Arripiado (E–W); IV – from Arripiado to Vila Franca de Xira (NNE-SSW); V – from Vila Franca de Xira to the Atlantic shoreline. The faults considered to be the limit of the referred fluvial sectors are: F1 – Ponsul-Arneiro fault (WSW-ENE); F2 – Gavião fault (NW-SE); F3 – Ortiga fault (NW-SE); F4 – Vila Nova da Barquinha fault (W-E); F5 – Arripiado-Chamusca fault (NNE-SSW). 1 – estuary; 2 – terraces; 3 – faults; 4 – Tagus main channel. The main Iberian drainage basins are also represented (inset). The lower and middle parts of the US unit, comprising an alternation of clayish silts with paleosols and minor sands to the east (flood-plain deposits) and sand deposits to the west (channel belt), have a probable age of ca. 325 to 200 ka. This points to formation during MIS9 to MIS7, under conditions of high to medium sea levels and warm to mild conditions. The upper part of the US unit, dominated by sand facies and with OSL ages of ca. 200 to 154 ka, correlates with the early part of the MIS6. During this period, progradation resulted from climate deterioration and relative depletion of vegetation that promoted enhanced sediment production in the catchment, coupled with initiation of sea-level lowering that increased the longitudinal slope. The Vale do Forno and Vale da Atela archaeological sites (Alpiarça, central Portugal) document the earliest human occupation in the Lower Tagus River, well established in geomorphological and environmental terms, within the Middle Pleistocene. The Lower Palaeolithic sites were found on the T4 terrace (+26 m, a.r.b.). The oldest artefacts previously found in the LG unit, display crude bifacial forms that can be attributed to the Acheulian, with a probable age of ca. 335 to 325 ka. The T4 US unit has archaeological sites stratigraphically documenting successive phases of an evolved Acheulian, that probably date ca. 325 to 300 ka. Notably, these Lower Palaeolithic artisans were able to produce tools with different sophistication levels, simply by applying different strategies: more elaborated reduction sequences in case of bifaces and simple reduction sequences to obtain cleavers. Fig. 2. . Simplified geologic map of the Lower Tagus Cenozoic basin, adapted from the Carta Geológica de Portugal, 1/500000, 1992). The study area (comprising the Vale do Forno and Vale de Atela sites) is located on the more upstream sector of the Lower Tagus River reach IV, between Arripiado and Chamusca villages. 1 – alluvium (Holocene); 2 – terraces (Pleistocene); 3 – sands, silts and gravels (Paleogene to Pliocene); 4 – Sintra Massif (Cretaceous); 5 – limestones, marls, silts and sandstones (Mesozoic); 6 – quartzites (Ordovician); 7 – basement (Proterozoic to Palaeozoic); 8 – main fault. The main Portuguese reaches of the Tagus River are identified (I to V). The VF3 site (Milharós), containing a Final Acheulian industry, with fine and elaborated bifaces) found in a stratigraphic level located between the T4 terrace deposits and a colluvium associated with Late Pleistocene aeolian sands (32 to 12 ka), has an age younger than ca. 154 ka but much older than 32 ka. In the study area, the sedimentary units of the T4 terrace seem to record the river response to sea-level changes and climatically-driven fluctuations in sediment supply. REFERENCES Cunha P. P., Almeida N. A. C., Aubry T., Martins A. A., Murray A. S., Buylaert J.-P., Sohbati R., Raposo L., Rocha L., 2012, Records of human occupation from Pleistocene river terrace and aeolian sediments in the Arneiro depression (Lower Tejo River, central eastern Portugal). Geomorphology, vol. 165-166, pp. 78-90.

A Experiência de dor no doente oncológico com doença avançada

Introdução: O pós-parto abrange o processo de transição para a parentalidade, considerado um dos principais momentos de transição ao longo da vida, responsável por mudanças a vários níveis, nomeadamente individual, conjugal, familiar e social, implicando gestão de novos sentimentos, comportamentos e preocupações com o(a) próprio(a) e com o(s), filho(s) (Kaitz, 2007; Mendes, 2009). Esta revisão integrativa da literatura foca-se nas preocupações da figura materna da díade parental no período pós-parto. Objetivos: Analisar os estudos de investigação acerca da temática das preocupações maternas no pós-parto nas sociedades contemporâneas. Metodologia: Revisão integrativa da literatura centrada na temática “preocupações maternas no pós-parto”. Utilizouse o motor de busca EBSCOhost, com acesso às bases de dados científicos: CINAHL® Complete; MEDLINE Complete; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; e ainda a base de dados SCIELO ”. Obtiveramse 17 publicações científicas com a utilização do Boolean search operators “AND”, para os descritores MeSH pósparto/“ postpartum” e nascimento/“childbirth” e como tema principal “preocupações maternas”/“maternal concerns”, com disponibilidade para aceder ao texto completo, com data de publicação entre o período de Janeiro 2000 e Dezembro 2015. Resultados: Os resultados da revisão integrativa da literatura acerca da temática das preocupações maternas que pretendeu responder à questão - Quais as preocupações maternas durante o pós-parto nas sociedades contemporâneas? - agruparam-se em 5 áreas: preocupações maternas e o cuidar do recém-nascido; preocupações maternas e recuperação funcional; preocupações maternas e transição para a parentalidade; preocupações maternas e relacionamento conjugal; e preocupações maternas intergeracionais. Conclusões: Da revisão dos artigos selecionados verificou-se que as preocupações maternas refletem as necessidades das mães, no período de transição de pós-parto, assim como, as assinaladas alterações no assumir de novos papéis e da redefinição/reorganização nas responsabilidades, no seio da díade parental/família e deste modo, espelham uma área de interesse no âmbito dos cuidados à mulher/casal e família após o nascimento de um filho, de onde as intervenções de enfermagem especializada em saúde materna e obstetrícia são relevantes na avaliação da transição saudável no contexto do pós-parto, quer na vertente materna, quer na díade parental e no cuidar do recém-nascido. Palavras-chave: pós-parto; preocupações maternas; recém-nascido; nascimento Referências bibliográficas: Kaitz, M. (2007). Maternal concerns during early parenthood. Child: Care, Health and Development, 33(6), 720-727. Lugina, H., Christensson, K., Massawe, S., Nystrom, L., & Lindmark, G. (2001). Change in maternal concerns during the 6 weeks postpartum period: A study of primiparous mothers in Dar es Salaam, Tanzania. Journal of Midwifery & Women’s Health, 46(4), 248-257. doi: 10.1016/S1526-9523(01)00133-7 Lugina, H., Nyström, L., Christensson, K., & Lindmark, G. (2004). Assessing mothers’ concerns in the postpartum period: Methodological issues. Journal of Advanced Nursing, 48(3), 279-290. doi: 10.1111/j.1365-2648.2004.03197.x Mendes, I. M. (2009). Ajustamento materno e paterno: Experiências vivenciadas pelos pais no pós-parto. Coimbra, Portugal: Mar da Palavra. * Escola Superior de Enfermagem de Coimbra, Unidade Científico-Pedagógica de Enfermagem de Saúde Materna e Obstetrícia [ana@esenfc.pt] ** Escola Superior de Enfermagem de Coimbra, Enfermagem de Saúde Materna, Obstetrícia e Ginecologia, Professora C

Clínica e cirurgia de equinos

O presente relatório de estágio, elaborado como etapa final do curso de Mestrado Integrado de Medicina Veterinária na Universidade de Évora, refere-se ao estágio curricular realizado na Clínica Equicare – Serviços Médico-Veterinários Lda., em Coimbra, Portugal, no âmbito da clínica e cirurgia de equinos. Este encontra-se dividido em três partes, onde, numa primeira fase se realiza uma descrição da casuística observada durante os seis meses de estágio, inseridas nas áreas de controlo e clínica reprodutiva, medicina preventiva e identificação equina, clínica médica e clínica cirúrgica. De seguida, realiza-se uma monografia sobre a doença degenerativa articular da extremidade distal de equinos e, por fim, uma apresentação de quatro casos clínicos onde se detetava a presença da mesma; EQUINE CLINICS AND SURGERY ABSTRACT: The present report was carried out as the final step of the Master of Science degree in Veterinary Medicine at the University of Évora and refers to the curricular externship held at the Equicare Clinic in Coimbra, Portugal, performed in Equine Clinics and Surgery. The report is divided in three parts, where initially takes place a casuistic analysis of the followed activities and clinical cases during the six month period of the externship, set in the areas of reproductive clinics, preventive medicine and equine identification, internal medicine and surgery. Afterwords a literature review about Degenerative Joint Disease of the distal limb in horses is performed and, finally, four clinical cases, about this same disease, are presented.

Crossing frontiers between tourism and demography. An empirical analysis based on European travellers’ behaviour

This paper aims to establish possible tourism demand scenarios of European travellers to Portugal based on the relationship with changing population structures. A combination of the EUROBAROMETER report 370 (“Attitudes of Europeans towards Tourism in 2013”) and the cohort-component method for population projections will allow the development of different possible tourism demand scenarios. Following the European report, individuals who travelled in 2013 were most likely to live in a household with two or more individuals. Thus, if elderly couples are together till later in their life and in better physiological shape, it is possible that the number of elderly individuals travelling for tourism purposes will increase in the near future. If we can expect tourists from developing countries to be younger due to their demographic dynamics than those from developed countries, where the ageing population is growing fast, we can expect that the percentage of the elderly among tourists will increase. Furthermore, the 2013 European report found that the combination of socio-demographic variables, such as, age, population, gender, household dimension, country of residence and trip purpose explained tourism demand scenarios for Portugal, confirming that seniors and families evidence a paramount sense of importance for the destination. In the literature there is a lack of discussion about the effects of demography in the future and the role of an ageing population in tourism demand choice patterns. We aim to contribute to filling this gap. Consequently, we strongly believe that this paper contributes to the literature by introducing a new field of discussion about the importance of demographic changes in shaping travel trends.