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O presente trabalho tem como objetivo contribuir para o estudo da perceção que os colaboradores têm sobre o contributo da função dos profissionais de RH dentro das organizações. Com base no modelo de competências dos profissionais de RH de Ulrich et at. (1995) formulou-se a hipótese de que, a perceção do valor da função RH para o negócio da empresa é influenciada positivamente pela perceção que os colaboradores têm das competências dos profissionais da área de RH. Participaram neste estudo, de natureza quantitativa, 547 participantes que responderam a um questionário via on-line, composto por 2 escalas de medida, nomeadamente uma referente aos grupos de competências dos profissionais RH (conhecimento do negócio, expertize, gestão da mudança e relações interpessoais) e a outra á perceção do valor da função RH. Os resultados mostraram uma associação positiva e forte entre as competências incluídas e a perceção de valor. As competências relacionadas com apoio a processos de gestão da mudança organizacional vieram a revelar-se como o melhor preditor do valor da função RH. The propose of this work is to contribute to the study of the perception that employees have about the contribution of the role of HR professionals inside the organizations. Based on the skills model of HR professionals by Ulrich et al. (1995), the hypothesis was formulated that, the perception of the value of the HR function for the company's business is positively influenced by the perception that employees have of the skills of professionals in HR area. In this quantitative study there were 547 participants, who answered a questionnaire via online, consisting of 2 measurement scales, namely one referring to the competence groups of HR professionals (business knowledge, expertize, change management and interpersonal relationships) and the other the perception of the value of the HR function. The results showed a positive and strong association between the skills included and the perception of value. The skills related to supporting organizational change management processes have come to prove to be the best predictor of the value of the HR function.

info:eu-repo/semantics/publishedVersion

Background: Poor institutions management and work organization can cause psychological distress among workers by imposing on them unsustainable pressures and demands. The health sector is particularly exposed to this type of risk, with stress and violence being some of the most important psychosocial risk factors to which these professionals are exposed. This exposure can lead to significant consequences on the individual, in the institution and at a social level and affect directly the physical and mental health of the professionals, impairing their performance and the quality of care provided. Aims: We aimed to determine the presence and characteristics of psychosocial stressors and associated risks, correlating it with sociodemographic variables of workers in a Local Health unit of the Alentejo region, in Portugal. Methods: In this work, the Copenhagen Psychosocial Questionnaire (COPSOQ) was used to evaluate the psychosocial risks of healthcare professionals from a medium-sized healthcare unit in the Alentejo region of Portugal, covering primary and hospital health care. COPSOQ is based on a demand and control model which attempts to explain stress as a consequence of high labor demands and low social support. Results and Conclusions: In this study we found a health risk for medical workers in the dimension “job insecurity”, which reflects fear of losing their job. We also found an intermediate situation for nurses, technical assistants and other workers with higher education. Operational assistants and management workers were the professional categories where the health risk was considered favorable. We also found statistically significant correlations of higher risk for workers in hospital health care in the dimensions work pace (t(124)=2,71), emotional demands (t(124=2,18) and vertical trust (t(116)=2,36); higher risk for male workers in the dimensions cognitive demands (t(136)=2.71), work influence (t(136)=2,32), predictability (t(132)=2,08), transparency of their work role (t(132)=2,74), conflicts at work (t(132)=2,73), meaning of work (t(134)=3.31), work engagement (t(134)=2,44) and offensive behaviors (t(132)=2,16); and a higher risk for female workers in the burnout dimension (t(132)=2,16). These results show that systematic screening for the presence of psychosocial stressors should be implemented on health care units and hospitals. In this way the creation of policies to decrease health professionals risk exposure could be promoted., Introdução: A forma como as organizações são geridas e o modo como é organizado o trabalho e os sistemas de trabalho, pode causar stresse e/ou outra exposição a factores de risco psicossocial nos profissionais. Os Serviços de Saúde são dos sectores de atividade mais expostos, sendo o stresse e a violência alguns dos mais importantes. Estes factores de risco acarretam importantes consequências tanto ao nível individual, como institucional e social, afetando de forma direta a saúde física e mental dos profissionais atingidos e prejudicando o seu desempenho e a qualidade dos cuidados prestados. Objectivos: Caracterizar a presença de factores de risco psicossocial, determinar o risco e correlacioná-lo com variáveis sócio-demográficas em trabalhadores de uma Unidade Local de Saúde do Alentejo. Métodos: Neste trabalho, o Copenhagen Psychosocial Questionnaire, versão II (COPSOQ-II) foi utilizado para avaliar os riscos psicossociais de um universo geral de profissionais de saúde de uma unidade de saúde de média dimensão, na região do Alentejo, que abrange cuidados de saúde primários e hospitalares. O COPSOQ é baseado num modelo de exigência e controlo que tenta explicar o stresse como consequência das elevadas exigências no trabalho e de um baixo apoio social. Resultados e Conclusões: Neste estudo foi encontrado risco elevado para a saúde dos trabalhadores, no sub-grupo dos médicos, na dimensão “insegurança no trabalho”. No caso dos restantes trabalhadores, a estratificação do risco para a saúde resultou numa situação intermédia para enfermeiros, assistentes técnicos e outros técnicos superiores. Os assistentes operacionais e os trabalhadores da gestão foram as categorias onde o risco foi considerado mais favorável. Observaram-se também diferenças estatisticamente significativas, e merecedoras de replicação, o maior risco para a saúde dos trabalhadores dos cuidados hospitalares na dimensão ritmo de trabalho (t(124)=2,71), exigências emocionais (t(124=2,18) e confiança vertical (t(116)=2,36); o maior risco nos trabalhadores do sexo masculino na dimensão exigências cognitivas (t(136)=2,71), influência no trabalho (t(136)=2,32), previsibilidade (t(132)=2,08), transparência t(132)=2,74), conflitos no trabalho (t(132)=2,73), significado do trabalho (t(134)=3,31), compromisso com o trabalho (t(134)=2,44) e comportamentos ofensivos (t(132)=2,16); e o maior risco nas trabalhadoras na dimensão burnout (t(132)=2,16). Estes resultados devem merecer a nossa preocupação se desejamos diminuir a exposição dos trabalhadores desta instituição a estes factores de risco, sendo desejável o seu estudo sistematizado no universo das unidades de saúde do nosso país.

Anthropogenic CO2 release into the atmosphere leads to temperature projections for 2100 only experienced on Earth since many million years. However, those periods are poorly known due to low temporal and spatial data and ill-defined climate forcings. However past warm periods (interglacials), occurring during the Quaternary, under variable boundary conditions (e.g. greenhouse gases concentration, sea level and ice sheets size, insolation and orbital forcing), can provide invaluable information on the dynamics and processes behind natural warm climates. Here we present records for the sea surface temperature based in Uk’37-SST at orbital and millennial-scale over the last 1.25 Ma, with special focus on the past interglacials of two SW Iberian margin sedimentary sequences recovered during IODP Expedition 339, Sites U1385 (37°34.285′N, 10°7.562′W; 2589m) and U1391 (37°21.5322′N, 9°24.6558′W; 991m). We also performed a data-model comparison to explore the dynamics related with the role of obliquity on the Atlantic Meridional Overturning Circulation (AMOC) changes. Our data show that Interglacials are characterized by an interval of maximum warmth followed by a temperature decline punctuated by millennial-scale SST oscillations. In most cases the first stadial marks the beginning of a glacial inception that is characterized by an abrupt SST decrease, followed by high frequency SST oscillations, and large amounts of freshwater input. This suggests a climatic change from interglacial to glacial conditions linked to the start of ice sheets growth (enrichment of d18O) and the AMOC slowdown resulting in an enhanced cooling of the mid-latitudes.

We reconstructed changes in productivity and surface/subsurface and deep-water dynamics in the Western Mediterranean through a multi-proxy study of Ocean Drilling Program Site 975 between late Marine Isotope Stage (MIS) 20 and early interglacial MIS 19. Our high-resolution study (down to similar to 200-year resolution) combines calcareous plankton assemblages (coccolithophores and foraminifera), biomarkers (C-37-alkenones, n-alkanes, n-alcohols) and elemental proxies (total organic carbon, total nitrogen, calcium carbonate). Surface water conditions are derived (i) from high-resolution delta O-18 and delta C-13 records obtained from the planktonic foraminifer Globigerina bulloides, and (ii) from summer and winter, foraminifera-based sea surface temperature reconstructions (SSTJAS-foram, SSTJFM-foram) achieved through transfer function. The integration of the whole dataset makes it possible to identify in the Balearic Sea, and to accurately characterize for the first time, an Organic Rich Layer (ORL) during latest MIS 20-early MIS 19, close to i-cycle 74. Its presence is marked firstly by higher values of total nitrogen (TN) and an increase of total C-37-alkenone and total organic carbon (TOC) preserved in the sediments. The multi-proxy approach reveals that the deglacial phase played a prominent role for ORL formation that was characterized by centennial scale phases. The alcohol preservation index (API) suggests that the shoaling of the circulation, which boosted marine productivity, started in the deglaciation and, in combination with freshening by Atlantic water inflow/riverine input and surface water buoyancy during sea level rising, culminated during the ORL event. At this time calcareous plankton proliferated on subsurface-surface waters, benefiting from ameliorating conditions, which promoted maximum marine productivity and higher organic matter preservation on the seafloor. Geoscience PhD scholarship, University degli Studi di Bari Fundacao para a Ciencia e a TecnologiaPortuguese Foundation for Science and TechnologyEuropean Commission [SFRH/BPD/111433/2015] dell'Universita degli Studi di Bari, Laboratorio per lo Sviluppo Integrato delle Scienze e delle Tecnologie dei Materiali Avanzati e per dispositivi innovativi (SISTEMA) [PONa3_00369] info:eu-repo/semantics/publishedVersion

Marine Isotope Stage (MIS) 13, ∼533–478 ka, has received particular attention due to the unexpected enhancement of monsoon systems under a cool climate characterized by lower atmospheric CO2 and larger ice volume than many other interglacials. Key questions remain about its regional expression (intensity, climate variability, length), and underlying forcing factors, in particular at the mid-latitudes. Here we examine the SW Iberian vegetation, terrestrial climate and sea surface temperature (SST) variability during MIS 13 by combining pollen and biomarker data from IODP Site U1385 with climate-model experiments. We show, for the first time, that despite strong precessional forcing, MIS 13 stands out for its large forest expansions with a reduced Mediterranean character alternating with muted forest contractions, indicating that this stage is marked by a cool-temperate climate regime with high levels of humidity. Results of our data-model comparison reveal that MIS 13 orbitally driven SW Iberian climate and vegetation changes are modulated by the relatively strong ice-sheet forcing. We find that the Northern Hemisphere ice-sheets prescribed at the MIS 13 climate optimum reinforce the insolation effect by increasing the tree fraction and both winter and summer precipitation. We propose that the interactions between ice-sheets and major atmospheric circulation systems may have resulted in the persistent influence of the mid-latitude cells over the SW Iberian region, which led to intensified moisture availability and reduced seasonality, and, in turn, to a pronounced expansion of the temperate forest., Financial support was provided by the Portuguese Foundation for Science and Technology (FCT) through the project CLIMHOL (PTDC/AAC-CLI/100157/2008), ULTImATum (IF/01489/2015), SAICT-45-2017-02 projects (WARM WORLDS: 29897 and HOLMODRIVE: 29029), CCMAR FCT Research Unit - project UIDB/04326/2020, D. Oliveira’s contract (CEECIND/02208/2017), F. Naughton’s contract (IF/01489/2015), T. Rodrigues’s contract (WarmWorld- PTDC/CTA-GEO/29897/2017), Voelker’s contract (IF/01500/2014), and WarmClim, a LEFE-INSU IMAGO project. D. Oliveira acknowledges the fundng provided by the L’Oréal Portugal Medal of Honour for Women in Science 2018 from L’Oréal, FCT and UNESCO. M. Alonso-Garcia acknowledges funding from FCT through the CINNAMOW project (PTDC/MAR-PRO/3396/2014) and the Spanish Ministry of Science through the grant RTI2018-099489-B-I00. Q. Yin is a Research Associate of the Belgian National Fund for Scientific Research (FRS-FNRS). Computational resources have been provided by the supercomputing facilities of the Université catholique de Louvain (CISM/UCL) and the Consortium des Equipements de Calcul Intensif en Fédération Wallonie Bruxelles (CECI) funded by FRS-FNRS. We would like to thank the scientists and technicians of IODP Expedition 339, the Bremen Core Repository, L. Devaux for technical assistance, V. Hanquiez for drawing Fig. 1., and two anonymous reviewers for their constructive comments.

Planktonic foraminifera δ18O and Mg/Ca ratios are widely considered as a powerful proxy to reconstruct past seawater‐column temperature. Due to the complex interpretation of planktonic foraminifera δ18O data in regard to past seawater temperatures, temperature determination based on the foraminifera shell Mg/Ca ratio is believed to be more accurate. Scarce Mg/Ca calibration data exists for coastal upwelling regions, resulting in incoherent results of past seawater reconstructions. The current study along the NW Iberia coastal upwelling system intends to define the best Mg/Ca temperature equation for the most representative species of this region (Neogloboquadrina incompta, Globigerina bulloides, and Globorotalia inflata). Seawater temperature from δ18O and Mg/Ca of these three planktonic foraminifera species was compared with the surface sediments alkenone derived SST and with the in situ temperatures measured at the depths where these foraminifera species currently live and calcify. The equations that better reflect each species calcification depth were selected as our regional equations for δ18O and Mg/Ca temperature reconstructions. The δ18O‐estimated temperatures for surface sediment specimens were comparable with in situ seawater‐column temperature measurements, whereas the Mg/Ca derived temperatures seem to underestimate in situ values, in special for G. bulloides from samples affected by stronger coastal upwelling. The G. bulloides δ18O and Mg/Ca estimated temperatures from samples located offshore, further from coastal upwelling influence, are comparable to surface sediment alkenone derived temperatures. Our study shows that in upwelling areas, regional calibration of planktonic foraminifera Mg/Ca temperature equations is necessary for reliable interpretations of high‐resolution past temperature variability in these important environments

Radiometric dating of glacial terminations over the past 640,000 years suggests pacing by Earth’s climatic precession, with each glacial-interglacial period spanning four or five cycles of ~20,000 years. However, the lack of firm age estimates for older Pleistocene terminations confounds attempts to test the persistence of precession forcing. We combine an Italian speleothem record anchored by a uranium-lead chronology with North Atlantic ocean data to show that the first two deglaciations of the so-called 100,000-year world are separated by two obliquity cycles, with each termination starting at the same high phase of obliquity, but at opposing phases of precession. An assessment of 11 radiometrically dated terminations spanning the past million years suggests that obliquity exerted a persistent influence on not only their initiation but also their duration. We acknowledge financial support from Australian Research Council Discovery Project grants 0664621 (to J.D.W.), 110102185 (to R.N.D., J.D.W., J.C.H., E.W., A.E.F., and S.F.), and 160102969 (to R.N.D., J.D.W., G.Z., E.W., and P.F.). We thank the Gruppo Speleologico Lucchese and the Federazione Speleologica Toscana for logistic and funding support. The SUERC contribution to this study falls within the framework of the Scottish Alliance for Geoscience, Environment and Society (SAGES). P.B. was the recipient of a University of Melbourne International Postgraduate Research Scholarship and Postgraduate Writing-Up Award supported by the Albert Shimmins Fund. J.C.H. was the recipient of an Australian Research Council Future Fellowship (FT130100801). P.F. acknowledges support from the European Union through a Marie-Curie Reintegration grant (PERG-GA-2010-272134 - MILLEVARIABILI). D.H. acknowledges support from the UK Natural Environmental Research Council. E.W. is supported by a Royal Society Professorship. A.H.L.V. and T.R. received financial support from Fundação para a Ciência e a Tecnologia (FCT, Portugal) projects MOWCADYN (PTDC/MAR-PRO/3761/2012), WarmWorld (PTDC/CTA-GEO/29897/2017), and CCMAR (UID/ Multi/04326/2019). Samples from the marine sites were provided by the Integrated Ocean Drilling Program to D.H., A.H.L.V., and T.R. info:eu-repo/semantics/publishedVersion

The South Asian Monsoon (SAM) drives seasonal changes in the atmospheric and ocean circulation of the tropical Indian Ocean, affecting precipitation on land and oceanic primary productivity. This work examined sediments from the International Ocean Discover Program (IODP) Site U1467 (IODP Expedition 359) located in the Maldives Inner Sea (Northern Indian Ocean) at a water depth of 487 m. The Maldives Inner Sea is a perfect location to study past changes in tropical climate and ocean circulation related to monsoon dynamics in the Equatorial Indian Ocean. This study focuses on the similar to 575-175 ka interval, from Marine Isotope Stage (MIS) 14 to 7, an important period for human evolution and dispersal to Eurasia. We reconstructed sea-surface temperature (SST), based on alkenone unsaturation index (U-37(K')), hydrological changes, based on terrestrial input of n-alkanes, and past surface ocean productivity, based on total C-37 alkenones concentration. The U-37(K')-SST record shows a difference of about 1.5 degrees C between glacial and interglacial periods, clearly showing all stages and substages from MIS 14 to 7, and revealing a connection between ice sheets extension and SST at the equatorial region. The n-alkanes concentration and average chain length index indicate vegetation changes at the Indian Peninsula with drier conditions generally associated with glacial periods. Precipitation increases abruptly at the end of terminations, lasting for a variable time interval in each interglacial period, except for MIS 13. However, other mechanisms superimposed to the glacial-interglacial forcing, such as the Indian Ocean Dipole (IOD) mode, have been invoked to explain shorter-scale variability in precipitation over India. The total alkenone concentration record indicates that primary productivity at Site U1467 is strongly associated with orbital changes, probably related to the summer inter-tropical insolation gradient (SITIG, 23N-23S on June 21st). High primary productivity occurred during intervals of low SITIG, which resulted in strong inter-monsoon (April-May and October-November) Indian Ocean Equatorial Westerlies (IEW) and reduced precipitation in the equatorial region. This mechanism may also be related to the IOD, which affects the strength of the IEW. FCTPortuguese Foundation for Science and Technology [UID/Multi/04326/2019, PTDC/CTA-GEO/29897/2017, SFRH/BPD/96960/2013, SFRH/BPD/108600/2015] NSFNational Science Foundation (NSF) [OCE-1326927]

Atualmente, o aproveitamento de excedentes de produção e de subprodutos agro-alimentares é bastante desejável e necessário em termos de sustentabilidade de produção e de consumo. Não obstante, para satisfazer o consumidor, as estratégias de inovação alimentar devem incorporar no seu processo de construção não só as tendências de consumo, mas também a interação direta com o consumidor, percebendo antecipadamente a sua aceitação e potencial comercial. O objetivo principal deste estudo foi desenvolver aplicações gastronómicas com o uso de protótipos de emulsões inversas de origem vegetal, inovadoras, com qualidade sensorial e nutricional, para que se tornem apelativas ao consumidor final. Foram analisadas 5 amostras de emulsões: um creme de barrar de morango, dois cremes de barrar de pimento – pimento amarelo refogado e pimento vermelho assado e dois cremes frutados de mostarda – um de beterraba e framboesa e outro de framboesa e mirtilo. Inicialmente fez-se uma avaliação sensorial, com um painel de provadores e foi utilizada a ferramenta online de Foodpairing®. Após definição do objetivo de cada preparação, desenvolveu-se um receituário com base nos resultados anteriores e também assente no know how gastronómico e culinário da investigadora. Estabeleceu-se um roteiro do menu de degustação e um caderno de prova com parâmetros de aceitação/ intenção de compra/ potencial de comercialização/ utilização. Finalmente realizou-se um teste de aceitação através de um almoço de degustação inserido em restaurante pedagógico, para 40 profissionais do sector alimentar. O painel apreciou positivamente as emulsões mas nenhuma foi apontada como tendo potencial de utilização gastronómica, por si só, mas sim sempre como ingrediente de alguma composição. Obtiveram-se 33 emparelhamentos de ingredientes com a ferramenta de Foodpairing®, que cruzados com a avaliação do painel de provadores conduziram a 34 composições gastronómicas, que foram desenvolvidas em oficina culinária. No almoço de avaliação, foi o creme de pimento amarelo o mais apreciado e o de morango o menos apreciado globalmente. Em relação às iguarias desenvolvidas e apresentadas, todas tiveram apreciação positiva. Na intenção de compra houve um incremento substancial para a maior parte das amostras, após degustação das iguarias confecionadas com os mesmos: a maior parte dos provadores compraria os cremes analisados e vê potencial de comercialização em todas as emulsões. A opinião dos chefs foi bastante importante e útil, mas nem sempre coincidente com os ingredientes propostos pela aplicação de Foodpairing®. A avaliação sensorial e o teste de consumidor demonstraram que o desenvolvimento de aplicações culinárias, após a inovação de produtos é deveras importante, pois pode resultar na aceitação ou não do produto pelo consumidor final, seja ele pertencente ao Food Service ou sendo consumidor doméstico. A inovação global implica aceitação pelo consumidor e educação de aplicação gastronómica, situação evidenciada com o teste de aceitação realizado. Currently, the use of surplus production and agro-food by-products is very desirable and necessary in terms of production and consumption sustainability. Nevertheless, in order to satisfy the consumer, food innovation strategies must incorporate in their construction process not only consumer trends but also direct interaction with the consumer, anticipating their acceptance and commercial potential. The main objective of this study was to develop gastronomic applications with the use of water-in-oil inverse emulsion prototypes, innovative, with sensory and nutritional quality, so that they become appealing to the final consumer. Five samples were analyzed - 3 emulsions of strawberry and pepper (red and yellow) processed differently, with aqueous vegetable phase and 2 mustards with red fruits or beet. Initially a sensory evaluation was carried out with a panel of tasters and the online Foodpairing® tool was used. After defining the purpose of each culinary preparation (entry, main course, dessert, for Food Service or domestic end consumer), a recipe set was developed based on previous results and based on culinary know-how, creative/ aesthetic talent of the researcher. A script of the tasting menu was established, and also a test book with parameters of acceptance/ purchase intention/ marketing/ use potential. Finally, an acceptance test was carried out through a tasting lunch inserted in a pedagogical restaurant for 40 professionals from the food sector. The panel positively evaluated all emulsions but none was pointed out as having potential gastronomic use by itself, to be used alone, but always as an ingredient of some composition. There were 33 combinations of ingredients with the Foodpairing® tool, which, cross-checked with the panel of tasters, led to 34 gastronomic compositions that were developed in a culinary workshop. At the evaluation lunch, the yellow pepper emulsion was the most appreciated and the strawberry was the least appreciated globally. In relation to the delicacies developed and presented, all had positive appreciation. For the intention to buy there was a substantial increase after tasting the delicacies made with them: most tasters would buy the creams analyzed and see commercialization potential in all emulsions. The opinion of the chefs was quite important and useful, but not always coincident with the ingredients proposed by the application of Foodpairing®. Sensory evaluation and consumer testing demonstrated that the development of culinary applications after product innovation is very important because it can result in the acceptance or not of the product by the final consumer, whether it belongs to the Food Service or is a domestic consumer. Global innovation implies acceptance by the consumer and education for the gastronomic application, situation evidenced with the consumer test that was realised.

© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, Health impact assessment (HIA) focuses on minimizing inequities when studying the effects of a policy on the population’s health. Nevertheless, it is seldom simultaneously quantified, multivariate, and visually graphically comprehensible for non-statisticians. This paper aims to address that gap, assessing a policy promoting the quality of Electronic Health Records, linking hospital and primary health care data (Blood Pressure, Cholesterol, Triglycerides, Waist Circumference, Body Mass Index) to mortality outcomes and regional inequities. Acute Myocardial Infarction patients admitted in the hospital are then followed regularly in Portuguese NHS Primary Care. Regional disparities regarding recorded information are observed and different association patterns with mortality identified, ranked, and visualized through adjusted ORs for sex, age, and indicators of severity of hospital admission, complemented with multivariate correspondence analysis. A pathway to handling equity within quantitative HIA shows that complexity in data and methods may generate simplicity and clarity through visual graphical aids. Tackling Big Data with Data Science in HIA may even be at the center of future health reforms, assessing impacts of health promotion and chronic disease policies., This work was partially supported by the CUTEHeart Project – Comparative Use of Technologies for Coronary Heart Disease, funded by FCT, QREN, COMPETE [grant number HMSP-ICT/0013/2011] (http://cuteheart.med.up.pt).

Purpose: To evaluate the degree of psychological distress in family caregivers of people with dementia. Design and Methods: A nonprobabilistic sample of 54 dyads (people with dementia and family caregivers) was recruited. A sociodemographic questionnaire, the Brief Symptom Inventory (BSI), and the Barthel Index were used for data collection. Findings: About half of the caregivers had significant levels of psychological distress. Caregivers showed high scores in some BSI dimensions: somatization, obsessive–compulsion, interpersonal sensitivity, anxiety, and paranoid ideation. Practice Implications: Alleviating the caregivers’ distress is likely to have positive effects on the overall health and capacity to care. Frameworks for providing palliative care to people with advanced dementia and support the caregivers would enhance the quality of care provided and may reduce the distress on the caregiver. info:eu-repo/semantics/publishedVersion

The Iberian Margin is a sensitive area to track high and low latitude processes, and is a key location to understand major past climatic and oceanographic changes. Here we present new biomarker data from IODP Site U1385 ("Shackleton site") (1017-336 ka) that, when combined with existing data from Cores MD01-2443/4 (last 335 ka), allows us to assess the evolution of sea surface temperature (SST) and meltwater influx over the last 1 Ma at the Iberian Margin. Interglacial periods throughout the last 1 Ma show SST close to 20 degrees C, even during the so-called "luke-warm" interglacials that are marked by relatively low atmospheric CO2 concentrations. During glacial periods, extremely cold stadial events are recognized at the Iberian Margin, and are very likely related to meltwater discharges from the European and British-Irish ice sheets into the NE Atlantic, which were transported southwards by the Portugal Current. We subdivided the record into four intervals on the basis of the timing and the magnitude of these extremely cold stadials: 1) from 1017 to similar to 900 ka, only minor sporadic freshwater input occurred during deglaciations; 2) from 900 to 675 ka extreme cold events occur as terminal stadial events at the beginning of the deglaciations, which results in abrupt deglacial SST shifts; 3) from 675 to 450 ka only a few, very short-lived events are recorded and seldom is there freshwater input at the Iberian Margin; 4) during the last 450 ka the extreme cold events occurred under full glacial conditions, with particularly severe events during MIS 6 and 8. We propose these mid -glacial events are associated with a strong discharges of European ice sheet (EIS). The fact that these extreme cold events do not coincide with deglaciations questions the role of European ice sheet discharges in triggering deglaciations. (C) 2017 Elsevier Ltd. All rights reserved. Portuguese Foundation for Science and Technology [PTDC/AAC-CLI/100157/2008, PIDC/AAG-GLO/3737/2012, PTDC/MAR-PRO/ 3396/2014] FCT [SFRH/BPD/66025/2009, SFRH/BPD/108600/2015] MAG post-doctoral grant [SFRH/BPD/96960/2013] CCMAR [UID/Multi/04326/2013] Natural Environmental Research Council [NE/K005804/1, NE/J017922/1] info:eu-repo/semantics/publishedVersion

A inexistência de uma política nacional de emprego tem levado uma série de estados brasileiros a dimensionarem, através de seus órgãos de planejamento e execução, programas e projetos que possibilitem minimizar os efeitos negativos da presença de um elevado contingente populacional em situação de desemprego aberto e subemprego. Não por casualidade mas por determinação de caráter estrutural, essas situações atingem majoritariamente a população de baixa renda que, devido suas características socioeconômicas e culturais, se tornam mais vulneráveis às consequências geradoras e resultantes da defasagem entre oferta e demanda da mão-de-obra no mercado de trabalho. Este tende a apresentar um número limitado de vagas e, paralelamente, a aumentar as exigências com relação aos requisitos a serem preenchidos pela força de trabalho.

Idiographic causal maps are extensively employed in Operational Research to support problem structuring and complex decision making processes. They model means-end or causal discourses as a network of concepts connected by links denoting influence, thus enabling the representation of chains of arguments made by decision-makers. There have been proposals to employ such structures to support the structuring of multicriteria evaluation models, within an additive value measurement framework. However, a drawback of this multi-methodological modelling is the loss of richness of interactions along the means-end chains when evaluating options. This has led to the development of methods that make use of the structure of the map itself to evaluate options, such as the Reasoning Maps method, which employs ordinal scales and ordinal operators for such evaluation. However, despite their potential, Reasoning Maps cannot model explicitly value interactions nor perform a quantitative ranking of options, limiting their applicability and usefulness. In this article we propose extending the Reasoning Maps approach through a multilinear evaluation model structure, built with the MACBETH multicriteria method. The model explicitly captures the value interactions between concepts along the map and employs the MACBETH protocol of questioning to assess the strength of influence for each means-end link. The feasibility of the proposed approach to evaluate options and to deal with multicriteria interactions is tested in a real-world application to support the construction of a population health index.

Purpose: To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration. Materials and methods: Retrospective cohort study involving 951 preterm deliveries (25+0–34+6 weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS (“Complete” n = 441; “Rescue” n = 38; “Incomplete” n = 175; “No ACS” n = 98) and timing of therapy related to delivery (“Before 7 days” n = 260; “After 7 days” n = 181). Results: On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95%CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95%CI 0.069; 1.066) for twins and 0.906 (95%CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95%CI 0.052; 0.642) and singletons of 0.404 (95%CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95%CI 0.053; 0.874) and singletons of 0.404 (95%CI 0.222; 0.727) for incomplete courses. About timing, group “After 7 days” had OR = 2.00 for RDS (95%CI 1.21; 3.30) and 2.32 (95%CI 1.42; 3.78) for MV. Conclusions: ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.

Resumo: A insuficiência cardíaca é uma síndrome com elevada prevalência, morbilidade e mortalidade, sendo, no entanto, pouco reconhecida junto dos cidadãos e decisores políticos. O presente documento foi elaborado por um conjunto de peritos constituído por médicos especialistas em cardiologia, medicina interna e medicina geral e familiar, e pretende expor detalhadamente o problema da insuficiência cardíaca em Portugal a vários níveis: peso da síndrome, diagnóstico, tratamento e acompanhamento dos doentes. Para tal, são identificados e discutidos em detalhe os diferentes aspetos inerentes ao manejo da síndrome durante o processo assistencial, nas várias fases da doença e que incluem doentes hospitalizados e em ambulatório. De modo a otimizar a assistência médica prestada a estes doentes, são apontadas diversas soluções e estratégias a curto, médio e longo prazo com potencial para melhorarem a articulação e utilização dos recursos disponíveis. Pretendeu‐se desta forma destacar estratégias que, não se traduzindo num modelo único de melhoria, poderão ser adaptadas às diferentes especificidades regionais, de modo a aumentar o reconhecimento e a atenção prestada à insuficiência cardíaca em Portugal. Abstract: Heart failure is a syndrome with high prevalence, morbidity and mortality, but awareness of the disease is poor among the general public and policy makers. This document, which was prepared by a group of experts consisting of cardiologists, internists and general practitioners, aims to set out in detail the problem of heart failure in Portugal at several levels: burden of the disease, diagnosis, treatment and monitoring. To this aim, different aspects of the management of the various stages of the disease are identified and discussed in detail, covering both outpatients and hospitalized patients. In order to optimize the medical care provided to these patients, various short‐, medium‐ and long‐term solutions and strategies are put forward that have the potential to improve the integration and use of available resources. The intention is to highlight strategies that are not based on a single model but can be adapted to different regional circumstances, in order to increase awareness and improve management of heart failure in Portugal. Palavras‐chave: Insuficiência cardíaca, Documento de consensos, Prevalência, Tratamento multidisciplinar integrado, Impacto socioeconómico, Keywords: Heart failure, Consensus statement, Prevalence, Integrated multidisciplinary treatment, Socioeconomic impact

© 2019 Published by Elsevier España, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/), Introduction: Cardiovascular (CV) risk is known to be increased in HIV-infected individuals. Our aim was to assess CV risk in HIV-infected adults. Methods: CV risk was estimated for each patient using three different risk algorithms: SCORE, the Framingham risk score (FRS), and DAD. Patients were classified as at low, moderate or high CV risk. Clinical and anthropometric data were collected. Results: We included 571 HIV-infected individuals, mostly male (67.1%; n=383). Patients were divided into two groups according to antiretroviral therapy (ART): naïve (7.5%; n=43) or under ART (92.5%; n=528). The mean time since HIV diagnosis was 6.7±6.5 years in the naive group and 13.3±6.1 years in the ART group. Metabolic syndrome (MS) was identified in 33.9% (n=179) and 16.3% (n=7) of participants in the ART and naïve groups, respectively. MS was associated with ART (OR=2.7; p=0.018). Triglycerides ≥150 mg/dl (OR=13.643, p

Copyright © Ordem dos Médicos 2020, Introduction: Birth weight is a major contributor to neonatal morbidity and mortality and is associated with chronic diseases in adulthood. This study aimed to evaluate the use of Intergrowth 21st instead of the Fenton & Kim 2013 growth charts in the diagnosis of small and large for gestational age in a group of Portuguese newborns. Material and Methods: We conducted an analytical and retrospective study to evaluate birth weight of term and preterm newborns using both growth charts. Groups studied: ‘Term-weeks’ and ‘Term-days’ (term newborns with gestational age in weeks and days, respectively), ‘Preterm-weeks’ and ‘Preterm-days’ (preterm newborns with gestational age in weeks and days, respectively). Results: A total of 14 056 newborns were included, 6% preterm. Using the Intergrowth 21st growth charts, the groups ‘Term-weeks’ (n = 12 081), ‘Term-days’ (n = 1118), ‘Preterm-weeks’ (n = 617) and ‘Preterm-days’ (n = 240), classified as small for gestational age according to the Fenton & Kim 2013 growth charts were adequate for gestational age in 52.8%, 57.8%, 37.7% and 9.3% respectively; and 9.2%, 9.2%, 5.9% and 0.6% of adequate for gestational age newborns were large for gestational age, respectively. In the ‘Pretermdays’ group, 7.9% of adequate for gestational age newborns were small for gestational age and 22.2% of large for gestational age newborns were adequate for gestational age, all with gestational age below 231 days. Discussion: The use of the Intergrowth 21st growth charts in this sample resulted in a lower number of newborns being classified as small for gestational age, except in very preterm newborns. Conclusion: Considering the results obtained, we suggest that Portuguese maternity hospitals use the Intergrowth 21st instead of the Fenton & Kim 2013 growth charts. However, more studies are needed to confirm these results.

Paleoclimate reconstructions suggest that the complex variability within the Greenland stadial 1 (GS-1) over western Europe was governed by coupled ocean and atmospheric changes. However, few works from the North Atlantic mid-latitudes document both the GS-1 onset and its termination, which are often considered as single abrupt transition events. Here, we present a direct comparison between marine (alkenone-based sea surface temperatures) and terrestrial (pollen) data, at very high resolution (28 years mean), from the southwestern Iberian shelf record D13882. Our results reveal a rather complex climatic period with internally changing conditions. The GS-1 onset (GS-1a: 12890-12720 yr BP) is marked by a progressive cooling and drying GS-1b (12720-12390 yr BP) is the coldest and driest phase; GS-1c (12390-12030 yr BP) is marked by a progressive warming and increase in moisture conditions; GS-1 termination (GS-1d: 12030-11770 yr BP) is marked by rapid switches between cool wet, cold dry and cool wet conditions. Although hydroclimate response was very unsteady throughout the GS-1 and in particular during its termination phase, the persistence of an open temperate and Mediterranean forest in southwestern Iberia during the entire episode suggests that at least some moisture was delivered via the Westerlies. We propose coupled ocean and atmospheric mechanisms to reproduce these scenario. Changes in the strength of the Atlantic Meridional Overturning Circulation (AMOC) as well as variations in the North Atlantic sea-ice growth have favoured the displacement of the polar jet stream's latitudinal position and contributed to a complex spatial pattern and strength of the Westerlies across western Europe. (C) 2019 Elsevier Ltd. All rights reserved. FCT - Foundation for Science and TechnologyPortuguese Foundation for Science and Technology [PTDC/AAC-CLI/100157/2008, IF/01489/2015, UID/multi/04326/2016, SAICT-45-2017-02, WARM WORLDS: 29897, HOLMODRIVE: 29029] CCMAR BCC grant [Incentivo/MAR/LA00015/2014] IF grant [F/01489/2015, IF/01047/2014] Sandra Gomes PhD Grant [SFRH/BD/128984/2017, SERH/BPD/108600/2015, SFRH/BPD/111433/2015, IPMA-2017-72-BI]

The MIS 17 interglacial, ~715 675 ka, marks the end of the Mid-Pleistocene Transition as intensified, long and asymmetrical 100-kyr ice age cycles became eminently established. Increasing arrival of moisture to the Northern Hemisphere high latitudes, resulting from the northwestward migration of the Subpolar Front and the intensification of the Norwegian Greenland Seas (NGS) convection, has been put forward to explain the emergence of this quasi-periodic 100-kyr cycle. However, testing this hypothesis is problematic with the available North Atlantic precipitation data. Here we present new pollen-based quantitative seasonal climate reconstructions from the southwestern Iberian margin that track changes in the position and intensity of the westerlies. Our data compared to changes in North Atlantic deep and surface water conditions show that MIS 17 interglacial was marked by three major changes in the direction and strength of the westerlies tightly linked to oceanographic changes. In particular, we report here for the first time a drastic two-steps northward shift of the westerlies centered at ~693 ka that ended up with the sustained precipitation over southern European. This atmospheric reorganization was associated with northwestward migration of the Subpolar Front, strengthening of the NGS deep water formation and cooling of the western North Atlantic region. This finding points to the substantial arrival of moisture to the Northern Hemisphere high latitudes at the time of the decrease in summer energy and insolation contributing to the establishment of strong 100-kyr cycles. © 2019 Elsevier B.V. J.M.P.M. was funded by a Basque Government post-doctoral fellowship ( POS_2015_1_0006 ) and MAG and TR by FCT ( PTDC/MAR-PRO/3396/2014 , UID/Multi/04326/2013 , SFRH/BPD/96960/2013 , SFRH/BPD/108600/2015 ). We acknowledge C. Morales-Molino and D. Oliveira for the reading of the manuscript and V. Hanquiez for drawing Figs. 1 and 9 . We are grateful to Ludovic Devaux for pollen sample preparation. J.M.P.M. was funded by a Basque Government post-doctoral fellowship (POS_2015_1_0006) and MAG and TR by FCT (PTDC/MAR-PRO/3396/2014, UID/Multi/04326/2013, SFRH/BPD/96960/2013, SFRH/BPD/108600/2015). We acknowledge C. Morales-Molino and D. Oliveira for the reading of the manuscript and V. Hanquiez for drawing Figs. 1 and 9. We are grateful to Ludovic Devaux for pollen sample preparation.

Background To identify sensitive periods for the effect of early life growth on childhood bone mass we compared the associations between weight and length/height velocities from birth to age six and bone mineral content (BMC) and areal density (aBMD) at 7 years of age. Methods We analyzed data from 1853 participants from the Generation XXI birth cohort scanned with a whole body dual-energy X-ray absorptiometry system. Velocities of growth in weight and length/height were obtained through linear spline multilevel models on the basis of data collected during routine health examinations. Using linear regression we computed associations of birth weight, birth length, five weight velocities (“early neonatal”: 0–10 days, “early infancy”: 10 days–3 months, “late infancy”: 3–12 months, “early childhood”: 1–3 years, and “later childhood”: 3–6 years) and four length/height velocities (“early infancy”: 0–3 months, “late infancy”: 3–12 months, “early childhood”: 1–3 years, and “later childhood”: 3–6 years) with outcomes BMC, aBMD, height and height-adjusted BMC at age seven. Confounding by maternal and child characteristics was addressed and effects of growth velocities were adjusted to preceding growth. Results Weight and length/height velocities up to the age of six were associated with increased bone mass, areal density and height at 7 years with the strongest associations observed for growth in early childhood. In this age period, after concurrent height and confounder adjustment, one standard deviation (SD) increase in weight velocity was associated with higher BMC z-scores: 0.27 (95%CI: 0.22, 0.32) in girls and 0.24 (95%CI: 0.19, 0.29) in boys. Height velocity was also associated with greater height-adjusted BMC z-score: 0.12 (95%CI: 0.07, 0.17) per SD in girls and 0.11 (95%CI: 0.06, 0.16) in boys. The pattern of associations was similar, albeit attenuated, after adjusting for preceding growth. Conclusion Growth in second and third years of life may represent a sensitive period for the effect of growth on childhood bone mass, partly through their effect on concurrent body size.

This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the Project PTDC/AGR-TEC/5215/2014, the strategic funding of UID/BIO/04469/2019 unit and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte., info:eu-repo/semantics/publishedVersion

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019 Submitted by Sofia Amador (sofiamador@fm.ul.pt) on 2020-05-20T10:21:31Z No. of bitstreams: 1 TeresaAlmeida.pdf: 13719083 bytes, checksum: decdf26bd32f3bae919f1911b4c526e2 (MD5) Made available in DSpace on 2020-05-20T13:02:48Z (GMT). No. of bitstreams: 1 TeresaAlmeida.pdf: 13719083 bytes, checksum: decdf26bd32f3bae919f1911b4c526e2 (MD5) Previous issue date: 2019

Weight management strategies during pregnancy reduce child cardiometabolic risk. However, because maternal weight has an overall positive correlation with offspring bone mass, pregnancy weight management could adversely affect child bone health. We aimed to estimate associations between gestational weight gain (GWG) and bone mineralization in the offspring at 7 years of age, and test early pregnancy body mass index (BMI) as an effect modifier. We analyzed prospective data from 2167 mother-child pairs from the Generation XXI birth cohort who underwent whole-body dual-energy X-ray absorptiometry at 7 years of age. GWG was analyzed as a continuous measure and using the Institute of Medicine categories. In the whole sample and for each early pregnancy BMI category (under/normal weight and overweight/obese), relationships between GWG and offspring bone measures (bone mineral content [BMC], bone areal density [aBMD], size-corrected BMC [scBMC], and height) at 7 years were fitted through local polynomial regression and smoothing splines. The magnitude of associations was estimated through linear regression coefficients (95% CIs), crude and adjusted for maternal age, height, educational level, and child gestational age. In under/normal weight mothers, GWG was associated with slightly increased bone measures at 7 years (per 5 kg of GWG, BMC: 0.07 SD [95% CI, 0.01 to 0.12]; aBMD: 0.10 SD [95% CI, 0.05 to 0.15], scBMC: 0.11SD [95% CI, 0.06 to 0.16], and height: 0.05 SD [95% CI, 0.00 to 0.10]), while in overweight/obese mothers no effect of GWG on bone was observed (BMC: 0.02 SD [95% CI, -0.04 to 0.09]; aBMD: 0.02 SD [95% CI, -0.04 to 0.08], scBMC: 0.01 SD [95% CI, -0.06 to 0.08], and height: 0.02 SD [95% CI, -0.04 to 0.08]). Also, no advantageous effect of gaining weight above the Institute of Medicine recommendations was observed in either early pregnancy BMI group. Our results suggest that adherence to Institute of Medicine recommendations for pregnancy weight gain is unlikely to have a negative repercussion on offspring bone health, particularly in women with excess weight in early pregnancy. © 2018 American Society for Bone and Mineral Research.

This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the Project PTDC/AGR-TEC/5215/2014, the strategic funding of UID/BIO/04469/2019 unit and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte., info:eu-repo/semantics/publishedVersion

The feasibility of storing wastewater samples from pulp and paper industry during more than 5 days (time recommend by ISO 5667-3:2018) for AOX determination was addresses in this study. Samples were collected before and after the aerobic biological treatment of a Portuguese industry. Experimental protocol included AOX measurements at days 4, 5, 6, 8, 11, 13, 15, 18 and 20 after sampling. Results obtained indicate that storage time is not matrix-dependent and it can be extended up to 20 days, which clearly improves management of laboratory activities concerning AOX determination.

This work was supported by Fundacao para a Ciencia e a Tecnologia (FCT, Portugal) in the framework of the Harvard-Portugal. Medical School Program [HMSP-ICT/0020/2010]; Project NORTE-01-0145- FEDER-000008, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020— Operacional Program for Competitiveness and Internationalization (POCI), Portugal 2020; by Portuguese funds through FCT/Ministerio da Ciencia, Tecnologia e Ensino Superior in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER007274); Santa Casa da Misericordia de Lisboa—Premio Neurociencias Mello e Castro (MC-1068- 2015) and the fellowships SFRH/BPD/108738/ 2015 (FCT) to P.M.D.M and Infarmed (FIS-FIS-2015- 01_CCV_20150630-88) to M.T.

Neto, M. D. C., Nascimento, M., Sarmento, P., Ribeiro, S., Rodrigues, T., & Painho, M. (2019). A Dashboard for Security Forces Data Visualization and Storytelling. In I. Ramos, R. Quaresma, P. R. D. Silva, & T. Oliveira (Eds.), Information Systems for Industry 4.0: Proceedings of the 18th Conference of the Portuguese Association for Information Systems (pp. 47-62). (Lecture Notes in Information Systems and Organisation; Vol. 31). Springer International Publishing. https://doi.org/10.1007/978-3-030-14850-8_4 Being security assumed as a basic right of citizens in the current model of democratic rule of law, optimal resources allocation altogether with budgetary constraints are a key component. In fact optimal resources allocation and budgetary constraints oblige an increasingly careful strategic management, adapted to demographic reality. The SIM4SECURITY project aims to build a technological solution to support decision making regarding security, based on the development of a GIS model and in the implementation of demographic scenarios. This model will allow policy makers, leaders and forces of command units and services in the planning and rational affectation of resources adjusted to local dynamics in crime prevention and crime fighting. To communicate the SIM4SECURITY results and support decision making, a data visualization and storytelling approach was adopted by creating dashboards containing the various dimensions and perspectives of the information were elaborated and are presented. The obtained outcomes show that dashboards are an important visual tool in the decision-making process by providing meaningful insights regarding security and in the location-allocation of security forces. authorsversion published

Background: Health inequalities have been consistently reported across and within European countries and continue to pose major challenges to policy-making. The development of scenarios regarding what could affect population health (PH) inequalities across Europe in the future is considered critical. Scenarios can help policy-makers prepare and better cope with fast evolving challenges. Objective: This paper describes the three 2030 time-horizon scenarios developed under the EURO-HEALTHY project, depicting the key factors that may affect the evolution of PH inequalities across European regions. Methods: A three-stage socio-technical approach was applied: i) identification of drivers (key factors expected to affect the evolution of PH inequalities across European regions until 2030) - this stage engaged in a Web-Delphi process a multidisciplinary panel of 51 experts and other stakeholders representing the different perspectives regarding PH inequalities; ii) generation of scenario structures - different drivers' configurations (i.e. their hypotheses for evolution) were organized into coherent scenario structures using the Extreme-World Method; and iii) validation of scenario structures and generation of scenario narratives. Stages ii) and iii) were conducted in two workshops with a strategic group of 13 experts with a wide view about PH inequalities. The scenario narratives were elaborated with the participants' insights from both the Web-Delphi process and the two workshops, together with the use of evidence (both current and future-oriented) on the different areas within the PH domain. Results: Three scenarios were developed for the evolution of PH inequalities in Europe until 2030: 'Failing Europe' (worst-case but plausible picture of the future), 'Sustainable Prosperity' (best-case but plausible picture of the future), and an interim scenario 'Being Stuck' depicting a 'to the best of our knowledge' evolution. These scenarios show the extent to which a combination of Political, Economic, Social, Technological, Legal and Environmental drivers shape future health inequalities, providing information for European policy-makers to reflect upon whether and how to design robust policy solutions to tackle PH inequalities. Conclusions: The EURO-HEALTHY scenarios were designed to inform both policy design and appraisal. They broaden the scope, create awareness and generate insights regarding the evolution of PH inequalities across European regions. This work is part of the EURO-HEALTHY project (Shaping EUROpean policies to promote HEALTH equitY) and it was supported by the European Union’s Horizon 2020 research and innovation programme [Grant Agreement No 643398; 2015-2017].

Laylla Coelho acknowledges the CNPQ-Brazil for her fellowship (IF/00300/2015). Pedro Silva acknowledges the Foundation for Science and Technology (FCT) for his fellowship (SFRD/BD/130247/2017). FCT is also thanked for the Investigator FCT program (PF) and for the grant ref. SFRH/BPD/104712/2014 (IG). This work was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of the UID/BIO/04469/2013 unit and COMPETE 2020 (POCI-01-0145-FEDER-006684) and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 – Programa Operacional Regional do Norte., info:eu-repo/semantics/publishedVersion

Introduction It is unclear whether migrant women experience worse pregnancy outcomes than native women. A better comprehension of obstetric care provision, including controversial interventions such as episiotomy, is important to improve equity of service provision, overall maternal and neonatal health and to support evidence-informed perinatal health policy-making. We aimed to determine if migrant and native women giving birth vaginally have different risks of episiotomy and if the risk differs by migrant sub-groups. Methods This study is based on a cross-sectional survey of foreign-born women with a random sample of native women, implemented in 32 public maternity units in mainland Portugal. We included 3583 women with vaginal delivery. Migrant status was defined by the woman’s country of birth (migrants, born abroad, vs natives, born in Portugal), then as subgroups of migrants from Brasil, Portuguese-speaking African countries (PSAC) and non Portuguese-speaking countries vs natives. The association between migrant status and episiotomy was assessed using multilevel logistic regression models, stratified by delivery mode, and adjusted for main risk factors of episiotomy. Results The overall frequencies of episiotomy were 52.6% and 48.2% among the 1707 natives and the 1876 migrants, respectively (p = 0.01). With spontaneous delivery, migrant women had decreased odds of having an episiotomy (adjusted OR 0.70 [95% CI 0.58-0.83]), especially those from PSAC (aOR 0.57 [0.46-0.71]). However, with instrumental delivery, migrant women had increased odds of episiotomy (aOR 2.47 [95% CI 1.50-4.07]), especially those from Brasil (aOR 3.24 [1.18-8.92]) and non Portuguese-speaking countries (aOR 3.75 [1.82-7.71]). Conclusions These results suggest non-medically justified differential care during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use, in a country with a high frequency of medical intervention during delivery. Key messages Portugal displays a high frequency of medical interventions during delivery, including episiotomy, highlighting the need for developing evidence-based recommendations. Migrant and native women have different risks of episiotomy, suggesting non-medically justified differential care.

A 37-year-old pregnant woman at 39 weeks of gestation, gravida 3, para 2, with a history of uncomplicated spontaneous vaginal deliveries at term, presented to the emergency department with lower abdominal cramps and watery vaginal discharge that started 2 hours before. Vaginal examination

High-resolution quantitative analyses have been carried out in samples from the Ocean Drilling Program (ODP) Site 975 in the Algero-Balearic basin through late Marine Isotope Stage (MIS 20)-Termination IX (800-784 ka). The multi-proxy study combines data of planktonic delta O-18, delta C-13, calcareous plankton (coccolithophores, foraminifera), palynomorphs, alkenone-based sea surface temperature (SST), % alkenone tetraunsatured (% C-37:4), and terrigenous biomarkers (C-23-C-31 n-alkanes, C-22-C-30 n-alkanols) with the aim to reconstruct climate-induced paleoenvironmental changes at orbital-submillennial scale, in a crucial time interval of the Early-Midde Pleistocene transition. The surface water delta O-18(sw) has been reconstructed from delta O-18(G.bulloides) and alkenone-based SST as a proxy for salinity changes. The late MIS 20 has been subdivided in several phases based on evidence of (i) meltwater events of polar origin or from surrounding mountain glaciers, (ii) changes in the production rate of Western Mediterranean Deep Water (WMDW) and in deep water ventilation, (iii) variation in terrestrial input and river discharge, and iv) variations in the strength of the north westerlies, and polar front shift. Following a glacial stadial (lasting ca 3 kyr) marked by the strongest WMDW production, coeval with a boreal summer insolation minimum and a marked low sea level, the latest MIS 20 is characterized by a terminal stadial event (lasting ca 3.5 kyr), which is traced by the occurrence of cold-low salinity water, pointing to meltwater advection at the site location. Short-term warm and cool events occurred through Termination IX during sea level rise and insolation increase, preceding the onset of full MIS 19c, characterized by an organic rich layer (ORL) associated with insolation cycle 74. The succession of these climate and oceanographic events has been compared to evidences from other Mediterranean sites, highlighting similar basin-wide patterns, which recall the climate evolution of Termination I. The comparison of our results with the climate proxies from the Integrated Ocean Drilling Program (IODP) Site U1385 located west of Iberian margin made it possible to point at the connection between Mediterranean oceanographic and atmospheric dynamics and the northern hemisphere ice-sheet instability, providing insight on the relationship with the Atlantic meridional overturning circulation and thermal front migration. (C) 2021 Elsevier Ltd. All rights reserved. Geoscience PhD scholarship, Bari University (Italy); Fondi di Ateneo 2018; FCT

A Insuficiência Cardíaca pode ser causada por qualquer patologia que afete o coração e, consequentemente, condicione a sua função diastólica ou sistólica. Apesar das melhorias que se têm vindo a verificar em termos de prognóstico, os números são ainda preocupantes e a prevalência permanece elevada, sobretudo em idosos. O estado nutricional tem-se revelado intimamente relacionado com o desenvolvimento e prognóstico desta patologia, verificando-se que um grande número de pacientes com Insuficiência Cardíaca avançada apresenta também desnutrição severa (caquexia cardíaca), associada a um aumento da morbilidade e da mortalidade. Por outro lado, a obesidade parece ter um efeito protetor nesta patologia, existindo numerosos estudos que comprovam a relação entre valores de Índice de Massa Corporal elevados e menor risco de mortalidade, quando comparados com indivíduos com valores de Índice de Massa Corporal mais baixos. No entanto, e apesar de ser o método mais utilizado para caracterizar o estado nutricional, o Índice de Massa Corporal não é um bom indicador da composição corporal no que respeita à distribuição de gordura, sendo este um fator fundamental a ser estudado nestes pacientes. Assim, para melhor compreender o papel do tecido adiposo na Insuficiência Cardíaca, é premente determinar o método que melhor se adequa à avaliação do estado nutricional destes pacientes e de que forma este pode influenciar o prognóstico da doença. Heart failure is a cardiovascular disease that may be caused by any condition that affects the heart and, consequently, impairs diastolic or systolic function. Despite the improvements that have been observed in terms of prognosis, the numbers are still alarming and the prevalence remains high, especially in the elderly. Among the many known risk factors, nutritional status has proved to be closely related to the development and prognosis of the pathology, verifying that a large number of patients with advanced heart failure also presents severe malnutrition (cardiac cachexia) associated with an increased morbidity and mortality. Moreover, obesity seems to have a protective effect in this condition, as there are several studies showing the relationship between higher Body Mass Index values and lower risk of mortality when compared to individuals with lower Body Mass Index . However, and despite being the most common method used to characterize the nutritional status, Body Mass Index is not a good indicator of body composition as regards the distribution of body fat, which is a fundamental factor to be studied in these patients. Thus, in order to understand the role of fat in heart failure it is important to determine the best method to assess the nutritional status of these patients and how it may influence the prognosis.

hroughout the twentieth century, Portugal has undergone major social, political, cultural and economic changes. The same happened in healthcare provision issues, even if the most relevant changes in the way Portuguese governments perceived the need and urgency of a real and effective health policy happened in the mid 1970’s. Swiftly Portugal progressed from a narrow understanding of healthcare provision still linked to charitable assistance, to an inclusive approach, based on prevention and on the implementation of other needs, such as the provision of continued care. In the first decades of the last century, the appearance of Ministries of Health throughout Europe was a sign of a full awareness assigned by the central governments to population’s collective health. But in Portugal public health policies do not surpass 60 to 80 years of concerted decision-making, and it is inappropriate to speak of a national health policy before the second half of the century. In this article we will analyse official legislation to describe the pathway of policymaking in the period 1900-2013, concerning the emergence of the Portuguese Welfare State. In methodological terms, we adopted a descriptive and chronological approach, based on the available national studies on the topic, which allow us to identify different health reforms, and each of their main constraints. Our aim is to answer the following questions: Which was the route of health policy in Portugal, and which was the role performed by the State, as the main actor in this field? How did policy options on public health look like in Portugal, and how might they have influenced morbidity and mortality levels? The text is divided in two parts. The first systematises the main stages of the Portuguese health policies in the twentieth century, highlighting the relationship between political stability, resources and the State’s intervention, strongly related to the emergence of the Welfare State. The second part summarises the milestones of

The analysis of the recent demographic development of the Portuguese population reveals a marked change in its age structure, with a distinct aging process, resulting both from decreased levels of fertility and a progressive decrease in mortality levels, in both genders and in all age groups. Additionally, the contribution of migration to population growth and reproduction has substantially decreased, being now insufficient to ensure population growth and to counteract the aging, process. As a consequence, natural increase diminishes (Statistics Portugal, Demographic Indicators) and the population is increasingly aging. Between 1992 and 2011, the number of people aged 65 years and more increased by approximately 42%, accounting for 19.1% of the total population at the end of the period. It is clearly above the EU-27 average (17.5%) and only exceeded by Germany (20.6%), Italy (20.3%) and Greece (19.3%)1. At the same time, the proportion of individuals who complete all higher levels of education rise in both genders and in all age-groups2. Demographic ageing is a major challenge for political decision makers, due to its inevitable impact on social support, health care and the labor market. The population’s ageing changes its pattern of health status.

UID/CPO/04627/2013 The objective of this paper was to produce regional demographic projections for the Portuguese population by sex, age group and level of educational attainment, for the period 2011-2031. We considered fertility, mortality and migration differentials by level of education projected by NUTS II region using the multistate cohort-component method with a block Leslie matrix. Two scenarios were considered: one where educational attainment prior to 2011 remains constant, and another in which educational attainment will follow the trend observed over the last decade, being the trend in the state proportion model using continuation ratio models. The results show an increase in the proportion of individuals who complete higher educational levels in almost all age groups of both sexes although with regional differences. The proportion of people with higher educational levels will continue to rise as the education of younger cohorts seems to evolve positively. Trends in health outcomes also differ. publishersversion published

Quantification of sediment volumes in continental to deep ocean basins is key to understanding processes of sediment distribution in source-to-sink depositional systems. Using our own and published data we present the first quantification of sediment-volume changes in basins along the course of a major southwest European river during the deglaciation. The salient points of this quantitative record in the Tagus and equivalent North Atlantic basins show crucial roles for sea level, climate and land-use in the distribution of sediments. The bypass of sediments starved the Tagus basins, and subsequently sedimentation mainly occurred on the Tagus Abyssal Plain during the sea-level lowstand of the Last Glacial Maximum. The main sediment depocenter rapidly shifted via the continental shelf to the Lower Tagus Valley during sea-level rise in the deglaciation period. Finally, the main sediment depocenter shifted further landward into the Lower Tagus Valley during sea-level high stand in the Holocene. During the high-stand phase (last 7 ky), sediment flux increased up to 2.5 times, due to climate and land-use changes. The average catchment denudation rate during the last 12 ky (0.04–0.1 mm/y) is in agreement with those of other European catchments. Our study clearly demonstrates the added value of detailed knowledge of 3D depocenter distribution, size and chronology. This allowed us to identify an increased sediment flux during the last 7 ky, which was not identified using local observations from boreholes alone. The uniqueness of the Tagus depositional system lies in the combination of a large accommodation space in the bedrock-confined Lower Tagus Valley, the steep lowstand-surface gradient and the narrow continental shelf with canyons indenting the shelf break.

We describe a new pollen and Sea Surface Temperature (SST) record with sub-centennial to centennial resolution from a well-dated sediment core (D13882) obtained from the Atlantic margin of the southwest Iberian Peninsula. The core provides new insights into the dynamics of five ecological pollen-based groups (temperate forests, Mediterranean forests, pinewoods, heathlands and steppe) since the Late Pleistocene (last 13,260 cal yr BP). The record shows that the Early Holocene was marked by an increase of temperate and Mediterranean taxa, accompanied by a reduction of steppic plants, reflecting warm and relatively moist conditions when compared with the previous Younger Dryas episode. The timing of this Temperate and Mediterranean Forest (TMF) maximum which reflects optimum conditions of temperature and precipitation is regionally specific, as detected through a comparison of three marine cores across the Iberian Peninsula. Maximum TMF development occurs between 9760 and 7360 cal yr BP in D13882 whereas at a site to the northwest (MD03-2697), the maximum occurs some centuries earlier, and at a southeast site (MD95-2043), the maximum is evident later. The duration of the forest maximum is also progressively longer from northwest to southwest to southeast. A transition from forested ecosystems to heathland over western Iberia characterises the Middle Holocene, starting from around 7360 cal yr BP in D13882, suggesting reduced seasonality and a more Atlantic climate character with more moisture evenly available through the year. This contrasts with the aridity recorded in southeast Iberian sites and reflects a stable precipitation gradient between the wetter west and drier east of the Iberian Peninsula. Against this backdrop, pinewoods had a continuous presence, albeit with a trend of steady decline through the Holocene. The time-transgressive pattern in the TMF maximum is best explained by a less favourable moisture balance in the drier southeast sector, which was particularly important during the Early Holocene. Despite the relatively short duration of the Holocene interglacial (one half precession cycle), our observations support a key role for orbital forcing in the temporal expression of major vegetation groups, specifically the decline in summer insolation and the precession-related passage of perihelion season from summer to winter.

The Iberian Peninsula, at North Atlantic mid-latitude and the western extreme of the European continent, is a key point for climate reconstructions. This work provides multi-proxy records measured in 8 inner-shelf sediment cores from 5 sites located between South Portugal (Algarve) and Northwest Spain (Galiza) (36 to 41º N) and target a regional reconstruction of climate variability during the Historic period (last 2 ky). The SST records reveal a long-term scale cooling (±1 ºC/2 ky) that ends at the beginning of the 20th century at all latitudes. This cooling is a follow up of the cooling process that started in the early Holocene driven by a decrease in summer insolation in the Northern Hemisphere. Within this long term SST variability multi-decadal/centennial scale variability is detected along Iberia. The different latitudinal SST reconstructions jointly with a determined regional SST stack were compared to on-land precipitation from higher plant n-alkanes and pollen data, to assess the relationship between hydroclimate (drought and/or precipitation) and SST. Regional variability is overall in consonance with NE Spain, and other European and north Hemisphere reconstructions. Warm conditions prevailed throughout 1300 yr, encompassing the Roman Period (RP), the Dark Ages (DA) and the Medieval Warm Period (MWP). The initial cooling at 1300 CE leads to 4 centuries of ±1 ºC colder mean SSTs contemporaneous with the Little Ice Age (LIA). The transition towards the Industrial Era starts by 1800 CE with a rise to pre-LIA SSTs. Climate specificities have been detected in western Iberian margin records and reveal the existence of two distinct phases within the MWP and a two-step SST increase towards the Industrial Era. The intense precipitation/flooding and warm winters but cooler intermediate seasons observed for the early MWP imply the interplay of internal oceanic variability with the three known atmospheric circulation modes, AMO, EA and SCAND in a positive phase. The late MWP, typified by drier and cooler winters and warmer intermediate seasons calls for a change in sign of the SCAND. A stronger mark of oceanic influences on western Iberian Peninsula (IP) starts with the transition to the Industrial Era.

Curcumin (CUR), a natural phytochemical from Curcuma longa, presents a wide range of biological activities such as antioxidant, antimicrobial and antitumoral effects. However, it exhibits very low water solubility and low bioavailability, which limit its food application. To overcome these limitations, nano-scale delivery systems (e.g. nanoemulsions (NE) and solid lipids nanoparticles (SLN)) can be developed to improve its bioavailability and stability. Also, it is essential to assess nanoformulations behaviour and CUR fate in the gastrointestinal (GI) tract. This work aimed at understanding the effect of nanoformulations physical state (NE and SLN) and oil type used in NE (medium chain triglycerides (MCT) and long chain triglycerides (LCT)) on CUR stability, bioaccessibility and effective bioavailability when submitted to an in vitro digestion process. Nanoformulations stability was characterized at each stage of digestion. At the end of digestion, free fatty acids (FFA) release, CUR stability, bioaccessibility and effective bioavailability were determined. Cellular uptake was evaluated using Caco-2 cells. All nanoformulations showed to be stable until gastric phase, from which an increase of particle size was observed. However, SLN showed to be more stable than NE. Regarding FFA release, both NE released higher FFA amount than SLN. Also, NE-MCT released a higher FFA amount than NE-LCT. Although SLN and NE-LCT promoted similar CUR stability, SLN presented the lowest CUR bioaccessibility and effective bioavailability. NE-MCT exhibited lower CUR bioaccessibility but promoted a higher CUR stability and effective bioavailability when compared to NE-LCT. Thus, it was possible to observe that the physical state and oil chain length have a high effect in nanoformulations digestibility and on CUR fate in the GI tract. This work contributed to the progress of the knowledge on the development of different bio-based nanoformulations with improved CUR bioavailability, by collecting essential data on digestion and absorption., FCT for their fellowships (SFRH/BPD/89992/2012 and SFRH/BPD/101181/2014). This study was supported by FCT under the scope of the Project PTDC/AGR-TEC/5215/2014, strategic funding of UID/BIO/04469/2013 unit; COMPETE 2020 (POCI-01-0145-FEDER-006684); BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020-Programa Operacional Regional do Norte, info:eu-repo/semantics/publishedVersion