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As dermo-hipodermites bacterianas agudas não necrotizantes são processos infeciosos que incluem a erisipela e a celulite infeciosa, e são geralmente causadas por estreptococos β–hemolíticos do grupo A. Em mais de 80% dos casos situam-se nos membros inferiores e são fatores predisponentes a existência de solução de continuidade na pele, o linfedema crónico e a obesidade. O seu diagnóstico é essencialmente clínico e o quadro típico baseia-se na presença de placa inflamatória associada a febre, linfangite, adenopatia e leucocitose. Os exames bacteriológicos têm baixa sensibilidade ou positividade tardia. Nos casos atípicos é importante o diagnóstico diferencial com a fasceíte necrotizante e a trombose venosa profunda. A flucloxacilina ou a cefradina são os fármacos de primeira linha. A recidiva constitui a complicação mais frequente, sendo fundamental o correto tratamento dos fatores de risco.

Palmoplantar pustulosis (PPP) is a rare, chronic, recurrent inflammatory disease that affects the palms and/or the soles with sterile, erupting pustules, which are debilitating and usually resistant to treatment. It has genetic, histopathologic and clinical features that are not present in psoriasis; thus, it can be classified as a variant of psoriasis or as a separate entity. Smoking and upper respiratory infections have been suggested as main triggers of PPP. PPP is a challenging disease to manage, and the treatment approach involves both topical and systemic therapies, as well as phototherapy and targeted molecules. No gold standard therapy has yet been identified, and none of the treatments are curative. In patients with mild disease, control may be achieved with on-demand occlusion of topical agents. In patients with moderate-to-severe PPP, phototherapy or a classical systemic agent (acitretin being the best treatment option, especially in combination with PUVA) may be effective. Refractory patients or those with contraindications to use these therapies may be good candidates for apremilast or biologic therapy, particularly anti-IL-17A and anti-IL-23 agents. Recent PPP trials are focusing on blockage of IL-36 or IL-1 pathways, which play an important role in innate immunity. Indeed, IL-36 isoforms have been strongly implicated in the pathogenesis of psoriasis. Therefore, blockage of the IL-36 pathway has become a new treatment target in PPP, and three studies are currently evaluating the use of monoclonal antibodies that block the IL-36 receptor in PPP: ANB019 and spesolimab (BI 655130). In this review, we explore the diagnosis, screening and treatment of patients with PPP.

Rapid urban growth and high population density have become a problem for urban water resources, especially in developing countries. In general, the pollution of rivers and degradation of ecosystems are the result of both management failures and lack of sewage treatment. River restoration appears as a solution to improve this scenario, but it is common for there to be an absence of a systemic vision in these projects. Thus, this work analysed one of these projects as an initial approach to create coherent (qualitative) shared perspectives on the same problem. This project was developed in a Brazilian university territory in response to a Public Civil Action. Rivers within the university surroundings are degraded due to sewage disposal and wastewater pollution from external and internal sources within the university, but the programme actions contemplate only interventions within the perimeter of the university while excluding the other parts of its watershed. We analyse this problem under a Systems Thinking approach by using causal loop diagrams, being clear that ecosystems cannot be reduced to territorial limits only. The systemic map shows many actions that contribute to the water quality degradation, with emphasis on illegal dumping of wastewater (sewage) and land use change in the upstream areas prior to the university. Point measures are palliative and do not guarantee the quality of river water. Regulation of impervious surfaces and correct disposal of wastewater can improve the current panorama, but greater integration between stakeholders and other key actors is required.

Objetivo: Analizar los niveles preliminares de estrés, Burnout y depresión entre los auxiliares y técnicos de enfermería que trabajan en las unidades de cuidados intensivos de algunos servicios hospitalarios privados.Método: Estudio de enfoque cuantitativo-analítico y transversal, en 3 servicios hospitalarios privados y en 4 unidades de terapia intensiva. El instrumento de recolección de datos se compuso de 5 cuestionarios validados: perfil socioeconómico y demográfico, sintomatología del estrés en Bacarro, Escala de Estrés en el Trabajo, Cuestionario de JBeili, versión brasileña inspirada en el Maslach Burnout Inventory (versión HSS - Human Services Survey) el Inventario de Depresión de Beck, todos los datos fueron tratados a través de la estadística analítica.Resultados: Fueron abordados 72 auxiliares y técnicos de enfermería, donde la mayoría era del sexo femenino (52,8%), técnicos en enfermería (95,8%), entre 31 a 35 años (27,8%), casados (54,2%) y con 2 o más vínculos de trabajo (62,5%). En la fase inicial del síndrome de Burnout (68,1%) y con cuadro disfórico-depresivo (45,4%) en Bacarro, con estrés leve (66,7%) en la escala de estrés en el trabajo, en la fase inicial del síndrome de Burnout (68,1%) y con cuadro disfórico-depresivo (45,8%).Conclusión: Las unidades de cuidados intensivos son ambientes insalubres, potencialmente tensiogénicos y con elevada tasa de absentismo. Los participantes del estudio mantienen doble jornada de trabajo, en su mayoría mujeres y con hijos, presentando escores preocupantes de estrés, Burnout y depresión. Objective: To analyze the preliminary levels of stress, Burnout and depression among nursing assistants and technicians working at intensive care units of some private hospital services.Method: A quantitative-analytical and cross-sectional study in three private hospital services and in four intensive care units. The data collection instrument consisted of five validated questionnaires: socioeconomic and demographic profile, stress symptomatology in Bacarro, Work Stress Scale, JBeili Questionnaire, Brazilian version inspired by the Maslach Burnout Inventory (HSS - Human Services Survey) and the Beck Depression Inventory, all data were treated using analytical statistics.Results: The study included 72 nursing assistants and technicians, the majority was female (52.8%), nursing technician (95.8%), aged 31-35 years old (27.8%), married (54,2%) and with two or more employments (62.5%). They were classified with moderate stress (70.8%) in Bacarro, with mild stress (66.7%) on the work stress scale, in initial phase of Burnout syndrome (68.1%) and with dysphoric-depressive symptoms (45,8%).Conclusion: Intensive care units are potentially tensiogenic unhealthy environments and with high absenteeism rates. The study participants keep double working hours, mostly women and with children, presenting high scores of stress, Burnout and depression. Objetivo: Analisar os níveis preliminares de estresse, Burnout e depressão entre os auxiliares e técnicos de enfermagem que trabalham nas unidades de terapia intensiva de alguns serviços hospitalares privados.Método: Estudo de abordagem quantitativo-analítica e transversal, em 3 serviços hospitalares privados e em 4 unidades de terapia intensiva. O instrumento de coleta dos dados foi composto de 5 questionários validados: perfil socioeconômico e demográfico, sintomatologia do estresse em Bacarro, Escala de Estresse no Trabalho, Questionário de JBeili, versão brasileira inspirada no Maslach Burnout Inventory (versão HSS - Human Services Survey) e o Inventário de Depressão de Beck, todos dados foram tratados através da estatística analítica. Resultados: Foram abordados 72 auxiliares e técnicos de enfermagem, onde a maioria era do sexo feminino (52,8%), técnicos em enfermagem (95,8%), entre 31 a 35 anos (27,8%), casados (54,2%) e com 2 ou mais vínculos empregatícios (62,5%). Classificados com estresse moderado (70,8%) em Bacarro, com estresse leve (66,7%) na escala de estresse no trabalho, na fase inicial da síndrome de Burnout (68,1%) e com quadro disfórico-depressivo (45,8%).Conclusão: As unidades de terapia intensiva são ambientes insalubres, potencialmente tensiogênicos e com elevada taxa de absenteísmo. Os participantes do estudo mantêm dupla jornada de trabalho, em sua maioria mulheres e com filhos, apresentando escores elevados de estresse, Burnout e depressão.

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Lesional skin of AD contains elevated levels of Th2, Th17, Th22 and Th1-citokines. With a growing movement toward use of targeted therapies, parallel to psoriasis, JAK inhibitors are an important focus of therapeutic research for AD.Methods: We review current evidence on the efficacy and safety of oral and topical JAK inhibitors for the treatment of AD.Results: Several JAK inhibitors are in phase II and III clinical trials as oral therapies for moderate-to-severe AD or as topical treatments for mild-to-moderate AD. Results thus far are encouraging, with the majority of the patients achieving the primary outcome of their trial as well as a favorable safety profile.Discussion: JAK inhibitors will most certainly be the first oral targeted option when topical therapy fails. With good oral bioavailability and lack of immunogenicity, they address some of the limitations of biologics. Yet to be defined is whether selective JAK 1 inhibitors or nonselective JAK inhibitors will provide the best equilibrium of efficacy versus side effects. Less clear is the position in the therapeutic ladder for topical JAK inhibitors; although, an unmeet need exists in the topical treatment of AD.

Background & aims As far as we know, no screening questionnaire has been developed and validated for identification of adverse food reactions in Portuguese-speaking adults, as an initial approach towards the investigation of cases of possible food allergy. Thus, the objective of this study was to develop and validate a screening questionnaire of food allergy in adult Portuguese-speaking patients. Methods This was a multicentre, cross-sectional study using a simple random sample of 186 adults between 18 and 82 years old from various parts of the centre of Portugal. Intelligibility of the questionnaire was first assessed in 24 patients with confirmed IgE- or non-IgE-mediated food allergy, and in 24 volunteers without food allergies. The 17-item questionnaire was subsequently applied by phone to 78 food allergic patients (66 IgE-mediated and 12 non-IgE mediated) and to 60 non-food allergic volunteers, with subsequent reassessment (re-test). Face and content validity, intelligibility, construct validity, and test-retest reliability (temporal stability) were analysed. Results Face and content validity allowed item reduction from 30 to 17 items with adequate content validity index >0.78. Construct validity was confirmed in the 66 confirmed IgE-mediated food allergic patients, 12 non-IgE-mediated food allergic patients, and 60 non-allergic patients. Test-Retest Reliability (general temporal stability) of the test had a Spearman correlation coefficient value of 0.845 for the retest. Cohen's Kappa values for the relevant questions were greater than 0.890 for almost all items. No differences were found when sex, age, and volunteers' recruitment origin were analysed. An inverse relationship was found between reliability and retest time interval. Conclusions Due to the quick and easy implementation, confirmation of face, content and construct validity as well as high temporal reproducibility, this screening questionnaire may be a useful study tool for an initial approach to detection of food allergies in adults.

Submitted by Biblioteca SESARAM (repositorio@sesaram.pt) on 2022-01-30T00:26:47Z No. of bitstreams: 1 2020 - Isaacs syndrome in pediatric patient and voltage-gated potassiu....pdf: 2593852 bytes, checksum: b49611c6e6a0e4adf8f5d710b6b5b358 (MD5) Made available in DSpace on 2022-01-30T00:26:48Z (GMT). No. of bitstreams: 1 2020 - Isaacs syndrome in pediatric patient and voltage-gated potassiu....pdf: 2593852 bytes, checksum: b49611c6e6a0e4adf8f5d710b6b5b358 (MD5) Previous issue date: 2020-08-26 info:eu-repo/semantics/acceptedVersion

Background & aims The objective of the present study was to determine, for the first time, the prevalence and clinical features of food allergy in Portuguese adolescents. Methods Cross-sectional study performed in various secondary schools in central Portugal. Randomly selected adolescents replied to a validated food allergy questionnaire. Those who reported an adverse food reaction were seen at participating hospitals, where clinical history was taken, skin prick (SPT) and prick-prick skin (SPPT) tests were performed, and food allergen-specific IgE levels (sIgE) were determined. An open oral challenge was performed in selected cases. Cases of positive clinical history of immediate (up to 2 h after ingestion) reaction in association with positive food sIgE levels and/or SPT were classified as IgE-associated probable food allergy and as confirmed IgE-mediated food allergy if food challenges were positive. Cases of positive clinical history of delayed (more than 2 h after ingestion) and negative food sIgE levels independently of positive SPT or SPPT results, were classified as non-IgE associated probable food allergy. Results The prevalence of probable food allergy in Portuguese adolescents was 1.41% (95% CI: 0.90–2.03%), with fresh fruits, shellfish, nuts, and peanut as the most frequently implicated foods. IgE-mediated probable food allergy occurred in 1.23% (95% CI: 0.67–1.72%) of cases, with fresh fruits, shellfish, and nuts mainly involved. Cutaneous symptoms were most frequently reported. Conclusions The prevalence of probable food allergies in Portuguese adolescents is low, is mostly related to fresh fruits, shellfish, nuts, and peanut, and most frequently involves cutaneous symptoms.

Purpose The purpose of this paper is to demonstrate the relevance of developing literary tourism in Coimbra. Design/methodology/approach This exploratory qualitative research identifies existent resources and development potential of literary tourism. The instruments of data collection were bibliographic research, questionnaires, interviews and participant observation. Findings There are few literary tourism products in Coimbra, which contrasts with the number of literary places identified, namely, on the left bank of the River Mondego. Tourism development stakeholders in Coimbra have not paid enough attention to the emergence of literary tourism and the opportunities for the development of new sustainable cultural products related with it. Research limitations/implications This study is limited by the size and continual renewal of the corpus, which implies a constant updating of data regarding authors and texts. Practical implications This study will lead to the production of a database of Coimbra’s literary resources and a digital literary map, allowing any citizen or entity to design and implement literary tourism products. Originality/value To the best of authors’ knowledge, this is the first study reviewing the potential of Coimbra as a literary tourism destination. Moreover, it discusses literary heritage as a source of products and experiences to foster more balanced tourist flows throughout the city.

Although cultural tourists increasingly seek to experience cultural events actively and to directly engage in creative activities, empirical knowledge about the creative tourist remains limited. This study aims to characterize the motivations and profile of creative tourists. The data was collected through a survey of participants in creative tourism activities in Portugal developed by 40 pilot institutions of the CREATOUR project during 2017 and 2018, with 814 usable questionnaires collected and validated. The questionnaire had 30 questions and marked the first time this kind of research was conducted in Portugal. The questionnaire included questions on: the composition of their travel companions, their previous participation in a creative tourism experience, reasons for visiting the destination, their characterization of the creative tourism experience, an evaluation of their creative tourism experience, and their socio-demographic profile. Using a cluster analysis to analyse the data, three clusters were found: Novelty-Seekers, Knowledge and Skills Learners, and Leisure Creative-Seekers., Highlights • This study aims to characterize the motivations and profile of creative tourists. • Three clusters of participants in creative tourism activities were identified. • This is the first major study at the national and international levels to investigate and segment the creative tourism market for activities in small and medium-sized cities and rural areas.

Stormwater management (SWM) includes a wide range of services aimed at environmental protection, enhancement of water resources and flood control. Local governments are responsible for managing all these aspects within their jurisdiction, but they often present limitations in generating revenues. Thus, many municipalities have been seeking a dedicated funding source for these programs and practices. This publication provides a brief overview of current legal issues associated with stormwater funding focusing on the most used method: fees. It is a successful mechanism to fund legal obligations of municipalities; however, it must have a significant value to motivate the reduction of runoff. Through literature, we found stormwater fees in Australia, Brazil, Canada, Ecuador, France, Germany, Poland, South Africa and the United States (USA). France had the highest average monthly fee, but this financing experience was suspended in 2014. Brazil has the lowest fee by m², comparable to the US fee. While in Brazil overall SWM represents low priority investments, the USA represents one of the most evolved countries in stormwater funding practices. It was noticed by reviewing the international experience that charging stormwater fees is a successful mechanism to fund the legal obligations and environmental protection.

Introdução: A presença de hipofosfatemia é fortemente relacionada à ocorrência de síndrome de realimentação em pacientes críticos, na qual um dos principais grupos de risco é a população idosa. Objetivos: Avaliar a prevalência de hipofosfatemia e o risco de síndrome de realimentação em idosos internados em uma unidade de terapia intensiva. Métodos: Estudo observacional prospectivo, realizado numa unidade de terapia intensiva com pacientes idosos de ambos os sexos e em uso de terapia nutricional enteral. Foram coletados dados demográficos, clínicos e exames bioquímicos, e realizadas triagem e avaliação nutricional. As necessidades nutricionais foram calculadas e adotou-se o ponto de corte de 90% para estabelecer a adequação da oferta calórica. Para avaliar o risco e a ocorrência de síndrome de realimentação, foram utilizados os critérios propostos pelo grupo NICE. A análise estatística foi realizada com o auxílio do programa SPSS 13.0, com um intervalo de confiança (IC) de 95%. Resultados: Foram estudados 44 pacientes, dos quais 34,1% estavam em magreza; 86,4% dos pacientes iniciaram a terapia nutricional enteral em até 48 horas, com 43,2% de adequação calórica em até 72 horas. A hipofosfatemia foi encontrada em 9,1% dos pacientes na admissão e em 29,5% após o início da dieta. Com isso, 88,6% dos pacientes apresentaram algum risco para desenvolver síndrome de realimentação e 40,9% deles manifestaram a síndrome. Conclusão: Foi identificada elevada prevalência de hipofosfatemia após o início da terapia nutricional. Além disso, o risco de desenvolver síndrome de realimentação foi elevado e sua manifestação se assemelha aos dados encontrados na literatura.

No mundo, o câncer colorretal é considerado o mais fatal e a segunda principal causa de morte por câncer. Fatores como envelhecimento da população e hábitos de vida possuem relação com a prevalência deste câncer. Este artigo de revisão tem por objetivo expor por meio da análise de artigos científicos a importância do diagnóstico precoce em pacientes com fatores de risco para o câncer colorretal. Trata-se de uma revisão bibliográfica de caráter qualitativo sistemático realizado entre os anos de 2018 a 2021 nos idiomas português, inglês e espanhol. Dados epidemiológicos reforçam a importância do rastreamento do câncer, principalmente devido ao aumento de casos de CCR nos últimos 30 anos. Esta realidade é atribuída a fatores ambientais, principalmente relacionados ao estilo de vida (sedentarismo, desnutrição, obesidade, tabagismo) e envelhecimento da população. Portanto, a triagem é baseada nos fatores de risco. O rastreio deve iniciar aos 45 anos, pois a detecção precoce do CCR pode reduzir significativamente as taxas de mortalidade. O câncer colorretal é considerado uma das neoplasias mais prevalentes do mundo. Anteriormente era mais comum em pacientes com idade acima de 50 anos, mas essa realidade tem mudado devido ao estilo de vida da população. Infelizmente não há um rastreio desse tipo de câncer que seja oferecido pelo Sistema Único de Saúde (SUS) e por isso o diagnóstico precoce não ocorre com a frequência esperada. É necessário que sejam desenvolvidas formas de rastreio deste câncer, assim como as realizadas no câncer de mama e de próstata, visto que o câncer colorretal é agressivo e possui altas taxas de mortalidade.

A síndrome hemolítico-urêmica atípica (SHUa) é caracterizada por uma tríade de trombocitopenia, anemia hemolítica micro angiopática e insuficiência renal aguda. A patogênese da SHU corresponde à micro angiopatia trombótica (MAT). O trabalho tem por objetivo expor através da análise de artigos científicos as principais manifestações clínicas e os desafios no diagnóstico da Síndrome Hemolítico-Urêmica Atípica. Trata-se de uma revisão bibliográfica de caráter qualitativo que se baseia na produção científica a partir de estudos já publicados entre os anos de 2018 a 2021. Embora a síndrome hemolítico-urêmica atípica seja rara, está relacionada a complicações e sequelas importantes secundárias a alterações da função renal; 42% das crianças e 27% dos adultos podem apresentar trombocitopenia grave (

Introduction Atopic dermatitis (AD) is a common chronic, pruritic inflammatory dermatosis. The inflammatory response is characterized by a T helper 2 (Th2) immune response phenotype. Evidence acquisition To assess current available data on dupilumab, the writers of this article did a comprehensive search in different databases, including Medline, EMBASE, SCOPUS, and clinical trial registries. All relevant articles identified were then manually reviewed. Information regarding dupilumab mechanism of action, pharmacokinetics, clinical efficacy, safety, and future trends was then summarized. Evidence synthesis Topical therapy is the main treatment in mild-to-moderate AD, but many cases of moderate-to-severe require systemic treatments. Dupilumab is the first biologic approved for the treatment of adults with moderate-to-severe AD. It inhibits IL-4 and IL-13 signaling pathways and reduces Th2 response. Clinical trials have demonstrated significantly improved clinical and patient-reported outcomes. The addition of application of topical corticosteroids results in a more significant improvement in signs and symptoms of AD than with use of dupilumab in monotherapy. The vast majority of patients improves under dupilumab, and almost 40% of patients achieve clear or nearly clear skin. In addition to its effectiveness, dupilumab also has a favorable safety profile. Frequent adverse events reported in the clinical trials were mostly mild-to-moderate and included nasopharyngitis, upper respiratory tract infection, injection site reactions, and conjunctivitis. Conclusions In general, rates of adverse events occurred with similar frequency between the treatment and placebo groups. Conjunctivitis seems to be a dupilumab-specific side effect and so far has only been observed in atopic dermatitis patients (not in asthma or nasal polyposis). There were no major serious safety concerns identified in phase III clinical trials. Trials in the pediatric population are ongoing and are highly awaited.

What can people express about their places through the objects that they valorise and link to their territory? Can objects create narratives about a place's identity and collect significant cultural information that locate people in their places? Can such cultural mapping be a useful tool in the design of creative tourist offers? The Project CREATOUR held a series of Idea Laboratories with several entities that provide creative tourism experiences, approaching cultural mapping through objects as a tool for regional actors to discover what is 'so special' about their places, a way to link tourism offers with the community where they take place. These exercise lead participants to remark on the importance and idiosyncrasy of their regions and evidenced the importance of cultural mapping to a more sustainable offer and the overall marketing of destinations. Mapping intangibilities through tangible objects helped to capture what gives meaning to particular places. Fundação para a Ciência e Tecnologia CREATOUR - 16437 COMPETE2020, POR Lisboa info:eu-repo/semantics/publishedVersion

In the present context, it is frequent for urban and national road networks to be highly congested, resulting in increased travel times and delays. At the same time, due to toll charging, some high-quality highway networks, particularly in Portugal, are underused. Dynamic charging on highway networks can contribute towards the optimization of the network performance and understanding the behavior of logistic operators as one of the main users of the network is of great importance for the development of any dynamic charging toll model. Within this context, one of the pilot cases of the H2020 project OPTIMUM includes the development of such a forecasting and dynamic (toll) charging model with the key objective of transferring heavy traffic from the urban and national roads to highways. The first run of pilot occurred between March 09th, 2017 and April 07th, 2017, performance indicators (KPI) were highly positive in terms of freight traffic shift from the national roads to the highways and, consequently, an increase in toll revenues and freight operations efficiency was registered.

Submitted by Biblioteca SESARAM (repositorio@sesaram.pt) on 2020-10-13T16:26:50Z No. of bitstreams: 1 B3.2. Vulvar lichen sclerosus in a prepubertal girl.pdf: 120857 bytes, checksum: 2ba85c8834af0a6d319fafe0a500028a (MD5) Made available in DSpace on 2020-10-13T16:26:50Z (GMT). No. of bitstreams: 1 B3.2. Vulvar lichen sclerosus in a prepubertal girl.pdf: 120857 bytes, checksum: 2ba85c8834af0a6d319fafe0a500028a (MD5) Previous issue date: 2018 info:eu-repo/semantics/publishedVersion

Rapid growth and high population density concentrated in small areas became inadequate urban water resources, especially in the developing countries. The pollution of rivers and degradation of ecosystems are the result. Rivers restoration appears as a solution to improve this panorama. In this way, this paper analysed one of these projects. It was developed by a Brazilian university in response to a Public Civil Action. The actions described in the program are still insufficient and they can be summarized as monitoring of the current situation. These streams are degraded due to sewage and wastewater pollution from external and internal sources of the university, which has been proven by studies on water quality. Despite of this, the program actions contemplate only interventions within the territory of the university. From a holistic view it is believed that these actions are insufficient to recover the water quality of the rivers.

International audience; Challenges posed by demographic changes and population aging are key priorities for the Horizon 2020 Program of the European Commission. Aligned with the vision of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), the development, exchange, and large-scale adoption of innovative good practices is a key element of the responses required to ensure all European citizens remain as active and healthy as possible as they age. Urged by the need of developing scalable disruptive innovation across Europe, the European Commission and the EIP on AHA created the Reference Sites; local coalition of partners that develop good practices to support AHA. Ageing@Coimbra is an example of how this can be achieved at a regional level. The consortium comprises over 70 institutions that develop innovative practices to support AHA in Portugal. Ageing@Coimbra partners support a regional network of stakeholders that build a holistic ecosystem in health and social care, taking into consideration the specificities of the territories, living environments and cultural resources (2,243,934 inhabitants, 530,423 aged 65 or plus live in the Centre Region of Portugal). Good practices in reducing the burden of brain diseases that affect cognition and memory impairment in older people and tackling social isolation in urban and rural areas are among the top priorities of Ageing@Coimbra. Profiting from the collaborative work of academia, business companies, civil society, and authorities, the quadruple helix of Ageing@Coimbra supports: early diagnosis of frailty and disease; care and cure; and active, assisted, and independent living. This paper describes, as a Community Case Study, the creation of a Reference Site of the EIP on AHA, Ageing@Coimbra, and its impact in Portugal. This Reference Site can motivate other regions to develop innovative formulas to federate stakeholders and networks, building consortia at regional level. This growing movement, across Europe, is inspired by the quadruple helix concept and by the replication of innovative good practices; creating new Reference Sites for the benefit of Citizens.

nducible laryngeal obstruction (ILO) is a complex entity and its exact mechanisms are still unclear. It is characterised by transiente and reversible narrowing of the larynx in response to external triggers, resulting in symptoms such as cough, dyspnoea and noisy breathing. The prevalence of this condition in adult or paediatric populations is uncertain. Management of ILO starts by establishing an accurate diagnosis, and treatment includes control of trigger factors, breathing and relaxation techniques, and speech and respiratory therapy. The aim of this article is to summarise current understanding and provide a review of the literature of ILO in the paediatric population. info:eu-repo/semantics/publishedVersion

The Mobile Five Senses Augmented Reality System for Museums (M5SAR) project aims to development an Augmented Reality mobile system for museums. Museums are amazing places, where it is important to sensorial augment as much as possible the visits, permitting to see, ear, touch, smell, and taste all the interesting objects there exist. Also fundamental is that visitors with different profiles (child, adult, expert, etc.) can have different experiences when visiting the same object. In the M5SAR system, the visitor uses its smartphone to select the object(s) to explore, and the user interface adapts on-the-fly to the object(s) and user's profile. Simultaneously, when integrated, a paired hardware device allows the extension of the augmented reality system to the human five senses, complementing the visual and auditory information about the objects. This chapter presents the initial framework to develop a five senses mobile adaptive museum system.

The search for materials with suitable thermoelectric properties that are environmentally friendly and abundant led us to investigate p- and n-type hydrogenated nanocrystalline silicon (nc-Si:H) thin films, produced by plasma-enhanced chemical vapor deposition. The Seebeck coefficient and power factor were measured at room temperature showing optimized values of 512 µV K−1 and 3.6 × 10−5 W m−1 K−2, for p-type, and −188 µV K−1 and 2.2 × 10−4 W m−1 K−2, for n-type thin films. The thermoelectric output power of one nc-Si:H pair of both n- and p-type materials is ~91 µW per material cm3, for a thermal gradient of 8 K. The output voltage and current values show a linear dependence with the number of pairs interconnected in series and/or parallel and show good integration performance.

The combination of high transparency and good thermoelectric properties of SnO 2 can open new field of applications for the thin film thermoelectric materials. Here we report on SnO 2 thin films with transmittance above 90%, resistivity bellow 10 -3 Ωm and a Power Factor around 10 -4 W/m.K 2 , for a Seebeck of -255 μV/K, at room temperature. The effect of film thickness and post-deposition annealing on the thermoelectric properties were analysed. The performances of a single layer thermoelectric device are also presented.

Background: Preeclampsia has been associated with several risk factors and events. However, it still deserves further investigation, considering the multitude of related factors that affect different populations. Objective: To evaluate the maternal factors and adverse perinatal outcomes in a cohort of pregnant women with preeclampsia receiving care in the public health network of the city of Maceió. Methods: Prospective cohort study carried out in 2014 in the public health network of the city with a sample of pregnant women calculated based on a prevalence of preeclampsia of 17%, confidence level of 90%, power of 80%, and ratio of 1:1. We applied a questionnaire to collect socioeconomic, personal, and anthropometric data, and retrieved perinatal variables from medical records and certificates of live birth. The analysis was performed with Poisson regression and chi-square test considering p values < 0.05 as significant. Results: We evaluated 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP). A previous history of preeclampsia (prevalence ratio [PR] = 1.57, 95% confidence interval [95% CI] 1.47 - 1.67, p = 0.000) and black skin color (PR = 1.15, 95% CI 1.00 - 1.33, p = 0.040) were associated with the occurrence of preeclampsia. Among the newborns of PWP and PWoP, respectively, 12.5% and 13.1% (p = 0.907) were small for gestational age and 25.0% and 23.2% (p = 0.994) were large for gestational age. There was a predominance of cesarean delivery. Conclusion: Personal history of preeclampsia and black skin color were associated with the occurrence of preeclampsia. There was a high frequency of birth weight deviations and cesarean deliveries. Resumo Fundamento: A pré-eclâmpsia tem sido associada a vários fatores de risco e eventos. No entanto, esta doença é merecedora de mais investigações, tendo em vista a multiplicidade de fatores relacionados que acometem diferentes populações. Objetivo: Avaliar os fatores maternos e os resultados perinatais adversos em uma coorte de gestantes com pré-eclâmpsia da rede pública de saúde de Maceió. Métodos: Estudo de coorte prospectivo realizado em 2014 na rede pública de saúde do município com uma amostra de gestantes calculada com base na prevalência de pré-eclâmpsia de 17%, nível de confiança de 90%, poder de 80% e razão de 1:1. Foi aplicado um questionário para coleta de dados socioeconômicos, pessoais e antropométricos, e obtidas variáveis perinatais de prontuário e da declaração de nascido vivo. Análise realizada com regressão de Poisson e teste do qui-quadrado, considerando p < 0,05 como significativo. Resultados: Foram estudadas 90 gestantes com pré-eclâmpsia (GCP) e 90 gestantes sem pré-eclâmpsia (GSP). História prévia de pré-eclâmpsia (razão de prevalência [RP] = 1,57, intervalo de confiança de 95% [IC 95%] 1,47-1,67, p = 0,000) e cor da pele negra (RP = 1,15, IC 95% 1,00-1,33, p = 0,040) estiveram associadas à ocorrência de pré-eclâmpsia. Entre os recém-nascidos das GCP e GSP, 12,5% e 13,1%, respectivamente, eram pequenos para a idade gestacional (p = 0,907) e 25,0% e 23,2%, respectivamente, eram grandes para a idade gestacional (p = 0,994). Houve predomínio da via de parto cesariana. Conclusão: História pessoal de pré-eclâmpsia e cor da pele negra estiveram associadas à ocorrência de pré-eclâmpsia. Houve elevadas frequências de desvios de peso ao nascer e da via de parto cesariana.

Semi-trailers with load boxes are the most important mode of grain transport by land in the world. Load boxes can be produced with different materials such as: wood, steel, and synthetic material. They are responsible for effectiveness retention and quality of grains during the transport. Among the main aspects to be considered and valued when selecting materials for load boxes are the final mass of the semi-trailer, loss of grains, and mechanical properties. Environmental performance is another important aspect to be taken into account for developing and selecting new materials in this kind of application. This study presents a comparative environmental evaluation of load boxes built from two different materials (a wood panel and a three-layer synthetic (TLS) panel). Mass balance and life cycle assessment (LCA) were used in this study. The TLS panel is made of polyvinyl chloride, metal, and wood sheets. The wood panel is composed of a marine plywood, protected with latex paint. Each semi-trailer is 7.1 m long and has two load boxes. Mass balance allowed the evaluation of the productive process itself, considering the different materials used, water and energy consumption and solid waste generation. LCA was applied to evaluate the environmental impacts associated with the production, use, and end-of-life (EOL) processes for the two different types of load box panels. LCA followed the ISO 14040 standard and was performed with the SimaPro 7.0 software. The functional unit of the load boxes is defined as: to allow and to protect the transportation of 40 tons per journey of dry grains, for 10 years, traveling 120,000 km per year. The databases selected for this study were local ones produced by different authors that presented Brazilian inventories (petroleum, PVC, wood, electrical energy, steel, and natural gas). When local databases were not available, inventories from Buwal and Ecoinvent were used. Impact evaluation was performed with the Eco-indicator 95 method. The mass of materials necessary to build wood panel load boxes is four times higher than the mass of material required to build the TLS panel load boxes. Furthermore, solid waste generation is ten times higher for the wood panels (on a mass basis). Water consumption is also higher for the production of the wood panel load boxes. However, the mass balance analysis showed that energy consumption during production is higher for a TLS panel load box than for the wood panel load box. The results of the LCA showed that the TLS panel load boxes provide superior environmental performance compared with wood panel load boxes. However, the wood boxes panel scored only 10.7% more impact points than the TLS panel load boxes in the LCA, considering all phases, including production, use, and end-of-life processes. The use phase is responsible for more than 96% of the total impact points for the wood panel load boxes. Impact points for the TLS load boxes are 33% higher than for the wood panel boxes during the production phase. The TLS load boxes offer greater durability than wood panel load boxes, resulting in a smaller number of replacement TLS load boxes to fulfill the same functional unit. However, even considering the smaller number of replacement boxes, the difference in terms of impact points between the two types of load boxes was small. This result may seem counter-intuitive, since wood panel load box production employs more raw materials, generates more waste, and consumes more water than the TLs panel load box production. Non-standardization of the boundaries of the databases employed in the LCA is believed to be a major reason that only a small difference was found between material types in the LCA. This is particularly true with respect to the databases for disposal of residual materials, as these databases do not exist in Brazilian inventories or are not satisfactory available in other databases. Improvement of these datasets for Brazilian circumstances should be a priority. The TLS panel load boxes provided better overall environmental performance compared with the wood panel load boxes, considering both the mass balance analysis and LCA results. The quality of the databases employed in the analysis is a critical factor with respect to the adequacy of the LCA. Additional effort is necessary to create adequate datasets for use in Brazilian LCA, particularly with respect to waste disposal.

Introduction and Objective: Oxidative stress appears to play a critical role in the pathogenesis of preeclampsia. Evidence suggests that adequate intake of antioxidants can modulate this condition. The objective of this study was to assess the intake of antioxidant nutrients and coefficients of variation in pregnant women with preeclampsia. Methods: In a cross-sectional study in the public health network of the city of Maceió, Brazil, a dietary survey was performed consisting of 24-hour food recalls, with subsequent adjustment of nutrients using the estimated average requirement as the cutoff point, and a questionnaire on frequency of consumption of antioxidants. Results: We studied 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP) with mean ages of 25.8±6.7 years and 24.1±6.2 years (p=0.519), respectively. A low mean intake of antioxidants (vitamin A, selenium, zinc and copper) was observed in both PWP and PWoP, although intakes of vitamin A (p=0.045) and selenium (p=0.008) were higher in PWoP. In addition, we observed high coefficients of variation in nutrient intakes in both groups, which were higher for vitamin C (p

On July 16, 2000, about 4000 m3 of crude oil were spilled in a pipeline accident at the REPAR Refinery in Brazil, reaching part of the refinery area and the banks of the Barigui and Iguaçu rivers. An Oil Recovery and Cleanup Action Plan was conducted as a cooperative action between PETROBRAS and the Federal and State environmental agencies. One of the areas which suffered the most impact was Ponto Zero, right behind the pipeline failure site, where there was a lot of time for infiltration. Thus, a large amount of oil infiltrated and a free phase was formed for the oil. An estimate of the free phase volume from fluid levels in monitoring wells was conducted using the method of Lenhard and Parker (1990), on two occasions during the recovery action plan, the first in October 2000 right after the oil spill with a value of 43m3, the second in August 2001, after constructing the hydraulic structures to recover the infiltrated crude oil, at a value of 5.5 m3. The recovery system consisted mainly of closed trenches with well-sorted gravel to control the groundwater level and conduct the oil and water collected to a separator system. This recovery system was very efficient (about 87% in one year of operation), at a relatively low implementation and operation cost.

9 páginas.-- 5 figuras.-- 3 tablas.-- 36 referencias, Biodeterioration of stained-glass windows by fungi was studied using historically accurate glass production methods. Glass reproductions were made according to the chemical composition determined by micro energy dispersive X-Ray Fluorescence of two historical glass windows belonging to King Ferdinand II's collection dating from the 15th and 17th centuries. Three distinct glasses compositions with different colours were selected and reproduced: i) a mixed-alkali colourless glass: ii) a purple potash-glass with manganese as chromophore, and iii) a brown potash-glass coloured by iron ions. The reproduced glass samples, with two initial surface morphologies (corroded and non-corroded), were inoculated with fungi previously isolated and identified on the original stained-glass windows as species of the genera Penicillium and Cladosporium. Physical and chemical glass surface alterations were analysed by means of optical microscopy, Raman microscopy, micro Infrared spectroscopy, and scanning electron microscopy with energy dispersive spectroscopy analysis. Results showed that fungi produced clear damage on all glass surfaces, present as spots and stains, fingerprints, biopiting, leaching and deposition of elements, and formation of biogenic crystals. Therefore, the inoculated fungi were able to biodeteriorate glasses with distinct compositions. Regarding the biodeterioration degree, there were no differences between the initial non-corroded and corroded glass surfaces., This work was supported by The Portuguese Science Foundation (projects PEst-OE/EAT/UI0729/2011 and PTDC /EPH-PAT/3579/2012), and was partially financed through a postdoctoral grant to AZM (SFRH/BPD/63836/2009) and a doctoral grant to AJR (SFRH/BD/84675/2012).

Background : Family violence (FV) is a common, yet often invisible, cause of violence. To date, most literature on risk factors for family, interpersonal and sexual violence is from high-income countries and might not apply to Mozambique. Aims : To determine the individual risk factors for FV in a cohort of patients seeking care for injuries at three health centers in Maputo, Mozambique. Setting and Design : A prospective multi-center study of patients presenting to the emergency department for injuries from violence inflicted by a direct family member in Maputo, Mozambique, was carried out. Materials and Methods : Patients who agreed to participate and signed the informed consent were verbally administered a pilot-tested blank-item questionnaire to ascertain demographic information, perpetrator of the violence, historical information regarding prior abuse, and information on who accompanied the victim and where they received their initial evaluation. De-identified data were entered into SPSS 13.0 (SPSS, version 13.0) and analyzed for frequencies. Results : During the 8-week study period, 1206 assault victims presented for care, of whom 216 disclosed the relationship of the assailant, including 92 being victims of FV (42.6%). The majority of FV victims were women (63.0%) of age group 15-34 years (76.1%) and were less educated (84%) compared to national averages. Of the patients who reported assault on a single occasion, most were single (58.8%), while patients with multiple assaults were mostly married (63.2%). Most commonly, the spouse was the aggressor (50%) and a relative accompanied the victim seeking care (54.3%). Women most commonly sought police intervention prior to care (63.2%) in comparison to men (35.3%). Conclusion : In Mozambique, FV affects all ages, sexes and cultures, but victims seeking care for FV were more commonly women who were less educated and poorer.

A doença oncológica reveste-se de um carácter estigmatizante, sentida pelo utente e sua família que, associada a incertezas de prognóstico, provocam sofrimento, levantando questões ao nível da Qualidade de Vida (QV) dos indivíduos. Com a finalidade de compreender qual o impacto da gastrectomia em utentes com carcinoma gástrico (nutrição versus QV), a sua influência na satisfação do autocuidado e o papel do enfermeiro, ao longo do processo de transição saúde-doença efectuou-se uma Revisão Sistemática de Literatura (RSL), sem meta-síntese e sem metanálise. Foi seguida a metodologia PI[C]OD - Participantes; Intervenções; [Comparações]; Outcomes; Desenho do estudo - para a elaboração da pergunta de investigação e definição dos critérios de inclusão e exclusão dos estudos recolhidos, sendo que, doze constituíram a amostra: foram analisados, interpretados e sintetizados. Dessa análise pode concluir-se que a nutrição se traduz num benefício quando iniciada precocemente traduzindo-se numa melhoria da QV. O enfermeiro funciona como elemento facilitador no processo, promovendo a autonomia e independência necessárias para satisfazer as necessidades, expressas ou sentidas, de autocuidado. Em Portugal, surge a necessidade de reconhecer a importância da variável nutrição na minimização do impacto da cirurgia por carcinoma gástrico e desenvolver estudos neste âmbito transpondo os resultados para a prática. Cancer has a stigmatizing nature felt by the sufferer and his familie, associated with the uncertainty of prognosis, causing suffering, and raising issues of the Quality of Life (QOL) of individuals. In order to understand the impact on those having gastrectomy for gastric carcinoma (nutrition versus QOL), its influence on satisfaction with self-care and the nurse’s role during the health-disease transition process, a Systematic Literature Review (RSL) was conducted, without meta-synthesis and without meta-analysis. The PI[C]OD methodology - Participants; Interventions; [Comparisons]; Outcomes, Study design - was used to develop the research question and to define the criteria for inclusion and exclusion of studies identified, with twelve forming the sample; analysis, interpretation and summary were conducted. From this analysis it can be concluded that nutrition is beneficial when started early, leading to improvement in QOL. The nurse acts as a facilitator in the process, promoting autonomy and independence, to satisfy the needs, expressed or perceived, for self-care. In Portugal, there is a need to recognize the importance of nutrition in minimizing the impact of surgery for gastric carcinoma and to carry out studies in this area to transfer the results into practice. La enfermedad oncológica está impregnada de un carácter estigmatizante sentida por el usuario y su familia que, asociado a incertidumbres de pronóstico, provoca sufrimiento, planteando interrogantes respecto a la Calidad de Vida (QV) de los individuos. Con el fin de comprender cuál es el impacto de la gastrectomía en usuarios con carcinoma gástrico (nutrición versus calidad de vida), su influencia en la satisfacción del autocuidado y el papel del enfermero a lo largo del proceso de transición salud-enfermedad se efectuó una Revisión Sistemática de la Literatura (RSL), sin meta-síntesis y sin metanálisis. Se siguió la metodología PI[C]OD - Participantes; Intervenciones; [Comparaciones]; Resultados; Diseño del estudio - para la elaboración de la pregunta de investigación y definición de los criterios de inclusión y exclusión de los estudios recogidos siendo que, los doce que constituyeron la muestra fueron analizados, interpretados y sintetizados. De ese análisis pudo concluirse que la nutrición se traduce en un beneficio cuando es iniciada precozmente y que conlleva a una mejora de la Calidad de Vida. El enfermero funciona como elemento facilitador en el proceso, promoviendo la autonomía e independencia necesarias para satisfacer las necesidades, exprimidas o sentidas, de autocuidado. En Portugal, ha surgido la necesidad de reconocer la importancia de la variable nutrición en la minimización del impacto de la cirugía por carcinoma gástrico y de desarrollar estudios en este ámbito, transponiendo los resultados a la práctica.