Abstract Constant growth in the concrete floor sector claims new techniques to improve concrete performance and avoid undesirable issues. In this way, materials used in concrete floors are essential, and it is critical to investigate them. Therefore, this study evaluated the influence of surface hardeners on the surface hardness determined by the rebound hammer test of concrete floors prepared with distinct water/cement ratios, curing ages, and cement types. The control parameters of the concrete’s production, including the compressive strength, flexural tensile strength, and bleeding tests were analyzed. In addition, data were assessed by multifactorial analysis of variance (ANOVA). Thus, hardeners increased the surface resistance of the composites, therefore reducing the chances of pathological manifestations occurring. Taken together, we demonstrated that hardeners improved the concrete surface prepared with all mixture proportions, but it was more significant when using the cementitious hardener and higher w/c content (0.6).

Abstract Introduction and Objectives: Tocology knowledge is crucial in obstetrician's decisions and actions. The aim of this research is to assess the experience of Portuguese Gynecology and Obstetrics residents in performing operative vaginal delivery. Study design, population and methodology: Observational and transversal study with collecting an anonymous online survey with 47 questions, performed to 2nd to 6th year residents of Gynecology and Obstetrics. Results: 82 responses to the survey were obtained. The mean age of the sample was 29.3±0.248 years and 92.7% (n=76) of the participants were female. About half of the participants (53.7%, n=44) were working in a central hospital. The vacuum was the instrument most frequently used by the residents (95.1%). When asked about their level of confidence in performing an instrumented delivery, 6th-year residents (n=20) gave, on average, on a 1 to 9 scale, a score of 4.25±0.56 for the use of forceps and 8.05 ±0.22 for the use of vacuum (p<0.001). In this sample, 90.2% of the residents had the opportunity to undergo practical training in instrumented deliveries during the residency. Regarding maternal morbidity, the main concern using forceps are obstetric anal sphincter injuries (74.4%) and using vacuum are vaginal lacerations (32.9%). Conclusions: This survey allowed to characterize and to assess the residents experience, as well as their limitations, on performing operative vaginal deliveries. The knowledge acquired is essential to adapt and homogenize training plans, whenever needed.

Resumo Objetivos: Esclarecer o papel da metformina na prevenção da diabetes gestacional (DG) na grávida obesa não diabética. Fontes de dados: Bases de dados The Cochrane Library, Canadian Medical Association Infobase, Database of Abstracts of Reviews of Effects, NICE Guidelines Finder, National Guideline Clearinghouse, BMJ Clinical Evidence, PubMed e Índex de Revistas Médicas Portuguesas. Métodos: Em junho de 2020 foram pesquisadas meta-análises, revisões sistemáticas, ensaios clínicos controlados e randomizados e diretrizes clínicas publicados entre maio de 2010 e maio de 2020, nas línguas portuguesa e inglesa. Foram utilizados os termos MeSH Pregnancy, Obesity, Metformin, Diabetes Gestational e os termos Descritores em Ciências da Saúde “Gravidez”, “Obesidade”, “Metformina”, “Diabetes gestacional”. Para atribuição dos níveis de evidência e força de recomendação utilizou-se a escala Strength Of Recommendation Taxonomy (SORT), da American Family Physician. Resultados: Foram encontrados 152 artigos, dos quais três cumpriam os critérios de inclusão e foram selecionados. A revisão da Cochrane de 2018, baseada em três ensaios clínicos aleatorizados e randomizados (ECAC), com um total de 1.099 grávidas, não encontrou diferenças significativas na taxa de DG nos grupos metformina vs. placebo (nível de evidência 1). A meta-análise de Chatzakis et al., que avaliou quatro ECAC, incluindo 624 mulheres, concluiu que a metformina não diminui o risco de desenvolver DG (nível de evidência 1). O ECAC de Sales et al. incluiu 164 grávidas (82 metformina vs 82 controlo) e concluiu que o uso de metformina não é eficaz na prevenção de DG (nível de evidência 2). Conclusão: Não há evidência disponível para recomendar o uso de metformina na prevenção da DG em mulheres grávidas obesas (força de recomendação A).

Abstract Objectives: To clarify the role of metformin in the prevention of gestational diabetes in obese non-diabetic pregnant women. Data sources: The Cochrane Library, Canadian Medical Association Infobase, Database of Abstracts of Reviews of Effects, NICE Guidelines Finder, National Guideline Clearinghouse, BMJ Clinical Evidence, PubMed, and Portuguese Medical Journals Index. Review methods: In June 2020, we searched for meta-analysis, systematic reviews, controlled and randomized clinical trials and clinical guidelines published between May 2010 and May 2020, in Portuguese and English. The searched MeSH terms were: Pregnancy, Obesity, Metformin, Diabetes Gestational and the terms Health Sciences Descriptors ‘Gravidez’, ‘Obesidade’, ‘Metformina’, ‘Diabetes gestacional’. We used the American Family Physician's Strength Of Recommendation Taxonomy (SORT) scale to classify the evidence. Results: The search provided 152 articles, of which three met the inclusion criteria and were selected. A 2018 Cochrane review, based on three randomized and randomized controlled trials (ECAC) with a total of 1,099 pregnant women, found no differences in the rate of gestational diabetes in the metformin vs. placebo groups (level of evidence 1). A meta-analysis by Chatzakis et al. evaluated four ECAC, including 624 women, and concluded that metformin does not diminish the risk of developing gestational diabetes (level of evidence 1). Sales et al. included 164 pregnant women (82 metformin vs 82 control) and concluded that the use of metformin is not effective in preventing gestational diabetes (level of evidence 2). Conclusions: There is no available evidence to recommend metformin use for GD prevention in obese pregnant women (strength of recommendation A).

Resumo Este estudo tem como objetivo comparar a eficácia de dois programas de intervenção de escrita inventada, um com instrução explícita de correspondências grafo-fonéticas e outro baseado no questionamento e reflexão sobre as correspondências grafo-fonéticas (designadas como instruções implícitas). Noventa crianças em idade pré-escolar, cujas escritas inventadas não mobilizavam letras convencionais para representar os sons, foram distribuídas por três grupos, dois experimentais e um de controlo. Todos os grupos eram equivalentes na idade, inteligência, conhecimento de letras e consciência fonológica. Manipulámos o tipo de instruções (implícitas vs. explícitas) entre os pré e pós-testes nos dois grupos experimentais onde as crianças participaram num programa de intervenção de escrita inventada. As crianças que participaram no programa de intervenção implícita mostraram uma melhoria significativa no número de letras mobilizadas corretamente nas suas produções escritas e na consciência fonémica em comparação com as crianças dos grupos de controlo e com instrução explícita. As crianças do grupo de instrução explícita mostraram melhorias significativas relativamente às crianças do grupo de controlo. Estes resultados sugerem que o questionamento e a reflexão aplicados aos programas de escrita inventada parecem potenciar um conhecimento mais significativo sobre as relações entre o código oral e o escrito.

Abstract This study aims to compare the effectiveness of two invented spelling intervention programs, one with explicit instruction of graph-phonetics matches and another based on questioning and reflection on the graph-phonetic correspondences (implicit instructions). Ninety pre-school children, whose invented spellings use conventional letters unconventionally to represent sounds, were allocated to three groups, two experimental and one control. All groups were equivalent in age, intelligence, letter knowledge, and phonological awareness. We manipulated the type of instructions (implicit vs. explicit) between the pre- and post-tests in two experimental groups where children participated in an intervention programme of invented spelling. Children who participated in the implicit intervention programme showed a significant improvement in the number of correct letters mobilized in their spelling and phonemic awareness compared with children of control and explicit instruction group. Children from explicit instruction group showed significant more improvements than the children from the control group. These results suggest that questioning and reflection applied to invented spelling programmes seems to enhance a more significant knowledge about the relations between the oral and written code.

Abstract Introduction: Ulipristal acetate (UPA) was introduced in clinical practice for the treatment of uterine fibroids in February 2012. During the post-marketing exposure, there were reports of liver injury and the European Medicine Agency recommended monitoring of liver enzymes for safety reasons. Objectives: The aim of this survey was to gather information about Portuguese gynaecologists’ experience with UPA regarding liver function and other complications related to UPA use. Material and methods: The study consisted of a cross-section survey among members of the Portuguese Society of Gynaecology between April and May 2018. The responders used an online platform to answer a survey that focused on safety and specific alterations in laboratory analyses of liver function considering treatment with UPA since January 2018. Results: In the period considered in this survey, 199 women were treated with UPA by the responders. Monitoring of liver function was performed in 93 women and alterations in liver function laboratory tests were reported in five cases (2.5%). In two of these cases, the past medical history was associated with liver diseases, namely alcoholic, infectious and autoimmune. The clinical course was favourable in all cases. Conclusions: Despite temporary UPA temporary suspension, this survey reinforced the need of clinical database for UPA safety monitoring, particularly regarding the possible application in selected clinical cases.

Abstract Estetrol (E4) is a native fetal estrogen with a distinct pharmacological profile, acting preferentially on alpha estrogen receptors. Estetrol (15 mg) in combination with drospirenone (3 mg) has been recently approved for contraception. The advantage of hormonal combined contraception with estetrol is demonstrated by neutral impact on hemostatic factors, decreased modulation on lipidic parameters which creates a unique safety profile that emphasizes the utility of E4 in clinical practice. Besides, the E4 use for the treatment of menopause related symptoms and for breast and prostate cancer control has been extensively studied.

Resumo: Este trabalho é um delineamento das produções e ações do Grupo de Pesquisa Humanidades e Sociedade Contemporânea, do IFMT, com o objetivo de identificar discursos emancipados e também opressores acerca do bullying. Adotou-se a metodologia qualitativa e a coleta de dados foi realizada por meio de um questionário com perguntas objetivas e subjetivas, o qual foi aplicado de forma on-line. Para este estudo, foi feita análise das respostas de uma (01) instituição de ensino em que os alunos responderam: Você tem uma sugestão para acabar com o bullying? Os dados coletados foram analisados por meio da Análise de Discurso Crítica (ADC), evidenciando a que a linguagem é um componente essencial do cotidiano e se conecta dialeticamente a outros elementos sociais. Utilizou-se como aporte teórico as contribuições sobre a banalidade do mal, de Hannah Arendt, para compreender a dinâmica da perpetuação da violência como um ato de despolitização do homem. Como resultados, as respostas dos estudantes traduzem os discursos simbólicos encontrados no contexto escolar, com respostas que sugerem uma visão crítica sobre a ocorrência do bullying em seu cotidiano, mas também com respostas reprodutoras de violência e opressão das vítimas e também dos agressores. Corroborando com o senso crítico da ADC, o conceito da banalidade do mal, de Arendt, complementou a análise do discurso de ódio dos estudantes diante de situações de bullying e oportunizou reflexões no sentido de fomentar diálogos emancipatórios por meio da consciência das mazelas da sociedade.

Abstract: This work is an outline of the productions and actions of the Humanities and Contemporary Society Research Group of IFMT, with the objective of identifying emancipated as well as oppressed speeches about bullying. The qualitative methodology was adopted and the data collection was carried out through a questionnaire with objective and subjective questions, the same was applied online through the use of google forms, it is composed of 13 questions (11 objective and 2 subjective). For this study, an analysis was made of the responses of 01 educational institution, which had the participation of 73 high school students, of this number only 40 students answered the question: Do you have a suggestion to end bullying? The collected data were analyzed through Critical Discourse Analysis (ADC), showing the identification of language as an essential component of everyday life that dialectically connects to other social elements. Hannah Arendt's contributions on the banality of evil were used as a theoretical contribution to understand the dynamics of the perpetuation of violence as an act of depoliticization of man. As a result, the students' responses translate the symbolic discourses found in the school context, with responses that suggest a critical view on the occurrence of bullying in their daily lives, but also with responses that reproduce violence and oppression of victims as well as aggressors. Corroborating with the critical sense of ADC, Arendt's concept of the banality of evil complemented the analysis of students' hate speech in the face of bullying situations and provided opportunities for reflections in order to foster emancipatory dialogues through the awareness of society's problems.

ABSTRACT Mobile phones (MPs) have become an important work tool around the world including in hospitals. We evaluated whether SARS-CoV-2 can remain on the surface of MPs of first-line healthcare workers (HCW) and also the knowledge of HCWs about SARS-CoV-2 cross-transmission and conceptions on the virus survival on the MPs of HCWs. A cross-sectional study was conducted in the COVID-19 Intensive Care Unit of a teaching hospital. An educational campaign was carried out on cross-transmission of SARS-CoV-2, and its permanence in fomites, in addition to the proper use and disinfection of MPs. Herewith an electronic questionnaire was applied including queried conceptions about hand hygiene and care with MP before and after the pandemic. The MPs were swabbed with a nylon FLOQ Swab™, in an attempt to increase the recovery of SARS-CoV-2. All MP swab samples were subjected to SARS-CoV-2 RT-PCR; RT-PCR positive samples were subjected to viral culture in Vero cells (ATCC® CCL-81™). Fifty-one MPs were swabbed and a questionnaire on hand hygiene and the use and disinfection of MP was applied after an educational campaign. Most HCWs increased adherence to hand hygiene and MP disinfection during the pandemic. Fifty-one MP swabs were collected and two were positive by RT-PCR (4%), with Cycle threshold (Ct ) values of 34-36, however, the cultures of these samples were negative. Although most HCWs believed in the importance of cross-transmission and increased adherence to hand hygiene and disinfection of MP during the pandemic, SARS-CoV-2 RNA was detected in MPs. Our results suggest the need for a universal policy in infection control guidelines on how to care for electronic devices in hospital settings.

Resumo Introdução: A investigação clínica (IC) é essencial para a formação médica, além de requisito obrigatório do currículo de Ginecologia e Obstetrícia (GO). Contudo, a literatura acerca da atitude dos internos portugueses relativamente à IC é escassa. O objetivo deste estudo foi avaliar obstáculos e incentivos à IC no internato de GO em Portugal. Materiais e Métodos: Estudo transversal, com realização de um questionário, anónimo, aos internos portugueses de GO, avaliando dados demográficos, experiência e perceções acerca dos obstáculos e incentivos à IC. Resultados: Dos 65 (25,5%) internos que responderam ao questionário, 90,8% eram mulheres. Destes, 58,5% provinham de hospital central e 41,5% de periférico. Todas as regiões do país e anos de internato estiveram representados. A maioria respondeu que: o seu hospital não disponibilizava centro de bioestatística de apoio (66,2%), mas que esta medida seria importante (96,9%), e não oferecia formação em bioestatística (93,8%). A maioria dos centros (81,5%) tem uma reunião científica semanal e 9,2% referiu ter mais que duas. Na análise da perspetiva relativamente à IC, 80% considerava uma experiência positiva, contudo que o ambiente do seu serviço não a promovia (60%). Os obstáculos à investigação mais apontados foram: tempo disponível insuficiente, falta de apoio em bioestatística e dificuldade no acesso aos registos clínicos. A formação num hospital central associou-se significativamente a disponibilização de apoio em bioestatística (p=0,03), maior número de artigos publicados (p=0,001) e de reuniões científicas (p=0,006). Discussão e Conclusão: O conhecimento dos fatores que influenciam a motivação dos internos relativamente à investigação é fulcral para a implementação de medidas de otimização da produção científica.

Overview and aims: Several risk factors for fetal growth restriction (FGR) have been described, however the impact of maternal working conditions is still poorly understood. To evaluate the impact of type of transport used, travel time, weekly hours of work, shift work, posture, environmental conditions, physical load and occupational stress on fetal weight. Study design and population: A case-control study was conducted. All professionally active pregnant woman that attended during 3rd trimester a pregnancy surveillance consultation at two Portuguese public hospitals during 4 months were included. The population was divided in two groups: FGR group - fetuses with estimated fetal weight (EFW) below the 10th percentile at 3rd trimester ultrasound; control group - fetuses with EFW equal to or higher than 10th percentile at 3rd trimester ultrasound. Methods: Data about working conditions, anthropometric and sociodemographic characteristics were collected using a questionnaire and the occupational stress questionnaire-general version (QSO-VG). Data on obstetric characteristics was acquired from clinical records. Data analysis was performed using SPSS ®, version 22.0. Results: There were 50 pregnant women in the FGR group and 295 in the control group. A predictive model of FGR was developed including 5 variables - sitting for at least 3 hours, high occupational stress levels, work by shifts, shifts with daytime and night rotation and load or lift weights greater than or equal to 25 Kg - with high specificity (98,5%), a positive predictive value of 85.7% and a negative predictive value of 74.2%, but with a low sensitivity (20.7%). Conclusions: This study showed that maternal working conditions can be important predictors of FGR.