Ana Nunes de Almeida

International survey of T2* cardiovascular magnetic resonance in β-thalassemia major

Accumulation of myocardial iron is the cause of heart failure and early death in most transfused thalassemia major patients. T2* cardiovascular magnetic resonance provides calibrated, reproducible measurements of myocardial iron. However, there are few data regarding myocardial iron loading and its relation to outcome across the world. A survey is reported of 3,095 patients in 27 worldwide centers using T2* cardiovascular magnetic resonance. Data on baseline T2* and numbers of patients with symptoms of heart failure at first scan (defined as symptoms and signs of heart failure with objective evidence of left ventricular dysfunction) were requested together with more detailed information about patients who subsequently developed heart failure or died. At first scan, 20.6% had severe myocardial iron (T2*≤10ms), 22.8% had moderate myocardial iron (T2* 10–20ms) and 56.6% of patients had no iron loading (T2*>20ms). There was significant geographical variation in myocardial iron loading (24.8–52.6%; P<0.001). At first scan, 85 (2.9%) of 2,915 patients were reported to have heart failure (81.2% had T2* <10ms; 98.8% had T2* <20ms). During follow up, 108 (3.8%) of 2,830 patients developed new heart failure. Of these, T2* at first scan had been less than 10ms in 96.3% and less than 20ms in 100%. There were 35 (1.1%) cardiac deaths. Of these patients, myocardial T2* at first scan had been less than 10ms in 85.7% and less than 20ms in 97.1%. Therefore, in this worldwide cohort of thalassemia major patients, over 43% had moderate/severe myocardial iron loading with significant geographical differences, and myocardial T2* values less than 10ms were strongly associated with heart failure and death.

Children and digital diversity: from 'unguided rookies' to 'self-reliant cybernauts'

This article discusses the heterogeneity in children’s appropriation and use of the internet that make up contemporary digital divides. Based on a survey of Portuguese children in mandatory education (8- to 17-year-olds), it relies on multivariate statistical procedures to build a topological mapping of internet use patterns. Variations in digital practices and parental mediation are analysed in relation to social backgrounds and demographic traits. Four clusters of users were thus identified: ‘self-reliant cybernauts’, ‘nurtured cybernauts’, ‘nurtured beginners’ and ‘unguided rookies’. This article aims to contribute to deepening the debate on digital divides and digital diversity within the sociology of childhood.

Internet, children and space: Revisiting generational attributes and boundaries:

At the dawn of modernity, in the 18th century, space became a critical category in defining generational attributes and locations. However, borders that previously tightly isolated adults and children are nowadays continuously challenged and modified by a constant and ubiquitous use of new information and communication technologies, namely the Internet, blurring notions of ‘private’ and ‘public’, ‘outdoors’ and ‘indoors’, ‘real’ and ‘virtual’. Giving voice to children, this article explores qualitative empirical data from a research project carried out in Portugal. It focuses on children as subjects and actors of these processes, especially in the way they combine ‘real’ and ‘virtual’ space and place in a geography of their own.

From university to diversity: the making of Portuguese higher education

Contemporary Portuguese higher education differs radically from what distinguished it four short decades back. It has acquired new dimensions and a new public.

Accessing Children’s Digital Practices at Home through Visual Methods: Innovations and Challenges

Abstract Inspired by the debates on participatory methods and drawing from research on “digital childhoods” in Portugal, this chapter aims to address the methodological innovations and challenges in collecting visual and digital data with children at their homes. As one of the stages of a research project on internet use, children were asked to take photos of their favorite objects at home and to collect screenshots of their most used webpages, followed by a conversation with the researcher. The use of photography allowed children greater expression and autonomy and gave researchers access to the children’s own perspectives on their home environment. It also provided unique information about the arrangement of digital objects at home and their different appropriations by girls and boys. Screenshots showed creative uses of the internet by children and gender differences. Ethical concerns were raised, due to the specific nature of working with children and with visual material (anonymization and dissemination). Entering the domestic setting provided a privileged access to children’s private sphere and to the in situ observation of their use of technology. However, the home is not a neutral place for a researcher and crossing the border into the private domain involves risks. These findings, illustrated by empirical examples from the research field, stress the importance of reflecting on and discussing the potentials, limitations, and ethical considerations of different methodologies, as well as their suitability to specific research objects, subjects, and contexts.

Industry, Family, and Class: The Working-Class Community in Barreiro:

Frequently placed on the edges of scientific debate and analyzed in relation to problems or theoretical constructs specific to other social groups, the portrait of the “working-class family” is too often the product of logical deductions and a sort of no-mans land. The research project described by the present article concerns factories, working-class groups, and family strategies in Barreiro, a Portuguese industrial town near Lisbon, the Portuguese capital. Special attention is given to reconstructing the industrial experience at a regional level and to the study of workers in the cork and heavy metallurgical industries of Barreiro. The results suggest the internal diversity of the working-class world and two different kinds of linkeage between family and workplace life—the survival strategy of cork workers in the 1920s, and the promotion strategy of the metal workers in the 1950s.Frequently placed on the edges of scientific debate and analyzed in relation to problems or theoretical constructs specific to other social groups, the portrait of the “working-class family” is too often the product of logical deductions and a sort of no-mans land. The research project described by the present article concerns factories, working-class groups, and family strategies in Barreiro, a Portuguese industrial town near Lisbon, the Portuguese capital. Special attention is given to reconstructing the industrial experience at a regional level and to the study of workers in the cork and heavy metallurgical industries of Barreiro. The results suggest the internal diversity of the working-class world and two different kinds of linkeage between family and workplace life—the survival strategy of cork workers in the 1920s, and the promotion strategy of the metal workers in the 1950s.

Compliance with Static vs. Dynamic Warnings in Workplaces such as Warehouses: A Study Using Virtual Reality

The static nature of traditional warnings cannot always capture the user’s attention. The effectiveness of a warning refers to the way in which it prompts the user to engage in safe behavior. It is known that behavioral compliance is the “golden measure” for evaluating the effectiveness of a warning. Several studies have shown that traditional warnings are not effective in an emergency. Several researches indicate that dynamic safety warnings are more effective than static ones. However, these studies are mostly in critical situations such as emergency evacuations. Literature is not clear about the existence of research on warnings in warehouse operating environments. However, it is known that warehouses are environments where employees often work under pressure and are often involved in accidents. This study objective was to compare the effectiveness of static safety warnings with dynamic ones. This kind of study in real-life is a difficult issue. So, we used an immersive virtual environment for this purpose. Virtual Reality (VR) can be assumed as the most adequate methodology to use in this context, as it overcomes methodological, financial and ethical limitations. Fourteen volunteers participated in the experience. Main results confirmed that dynamic warnings produce greater behavioral compliance even in less dynamic situations such as workplaces such warehouses .

Analysis of contextual variables in the evaluation of child abuse in the pediatric emergency setting

OBJECTIVE This article comprises a sample of abuse modalities observed in a pediatric emergency room of a public hospital in the Lisbon metropolitan area and a multifactorial characterization of physical and sexual violence. The objectives are: (1) to discuss the importance of social and family variables in the configuration of both types of violence; (2) to show how physical and sexual violence have subtypes and internal diversity. METHODS A statistical analysis was carried out in a database (1063 records of child abuse between 2004 and 2013). A form was applied to cases with suspected abuse, containing data on the child, family, abuse episode, abuser, medical history, and clinical observation. A factorial analysis of multiple correspondence was performed to identify patterns of association between social variables and physical and sexual violence, as well as their internal diversity. RESULTS The prevalence of abuse in this pediatric emergency room was 0.6%. Physical violence predominated (69.4%), followed by sexual violence (39.3%). Exploratory profiles of these types of violence were constructed. Regarding physical violence, the gender of the abuser was the first differentiating dimension; the victims gender and age range were the second one. In the case of sexual violence, the age of the abuser and co-residence with him/her comprised the first dimension; the victims age and gender comprised the second dimension. CONCLUSION Patterns of association between victims, family contexts, and abusers were identified. It is necessary to alert clinicians about the importance of social variables in the multiple facets of child abuse.

Children in Disaster Risk Reduction in Portugal: Policies, Education, and (Non) Participation

International agencies and scientific research have been calling for the inclusion of children in disaster preparedness and risk reduction, to hear their voices in order to address their specific needs and vulnerabilities and harness their capabilities in terms of building community resilience. This article assesses the roles ascribed to children in policy and education for disaster risk reduction in Portugal. The approach is based on a scoping methodology that encompasses document analysis and interviews with national and local stakeholders and policymakers in the disaster risk reduction field. The research is carried out within the scope of a European funded project, CUIDAR Cultures of Disaster Resilience among Children and Young People. More specifically, the article provides an overview of the discourses on the roles ascribed to children in urban disaster risk reduction (DRR). The authors maintain that although children are often taken as a target group in urban disaster prevention and management, they are seldom considered in terms of active participation in disaster risk reduction programs in the Portuguese context. Nevertheless, our analysis shows that there is a growing awareness of the relevance of active participation by children in order to create successful DRR.

Virtual Reality Self Induced Cybersickness: An Exploratory Study

Virtual reality (VR) has been used successfully in several studies, namely in the area of safety warnings design. However, regarding cybersickness, this technology it is not innocuous. We report results concerning cybersickness related with awareness of the secondary effects of VR before doing an experiment. Two groups of participant were found. A group that read the consent form (CF) with attention and a group that did not pay attention to the CF and just signed it. The consent contained information about the experiment and also an alert on the secondary effects of VR. In the VR experiment, participants were asked to accomplish a task in a virtual environment (VE) related with other study. Findings suggest that for those who read the consent form carefully, thus, were more aware about VR side effects, there were more symptoms of cybersickness and more withdraws. These reported results rise some practical and also ethical issues related with VR experiments that are discussed in this paper.