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Introdução: O estatuto social diminuto que o idoso tem na sociedade portuguesa, pela perda de autoridade no processo de envelhecimento e maior vulnerabilidade, associada ao grau de dependência, isolamento social e fragilidade económica, contribuem de forma imperativa para um maior risco de incidência de maus tratos. Segundo a Organização Mundial de Saúde, Portugal é um dos principais países onde esta problemática se verifica. De acordo, com um estudo realizado em Portugal, 39,4% das mulheres idosas inquiridas afirmavam ser vítimas de maus tratos. Os maus tratos físicos, sexuais ou psicológicos constituem problemas importantes de saúde pública. Objetivo: Rever os métodos de rastreio de maus tratos em idosos disponíveis. Métodos: Foi realizada uma pesquisa nas bases de dados: Medline e Uptodate e revistas médicas: Postgraduate Medicine, PacientCare e Geriatrics. Resultados: Foram encontradas cerca de duas dezenas de escalas de rastreio de maus tratos em idosos, com diferentes critérios de aplicação e seleção. Discussão: Através do rastreio e identificação dos casos de maus tratos, bem como pela consciencialização da existência de fatores de risco e sinais de alarme o médico de família tem um papel fundamental na prevenção e proteção dos seus doentes idosos vulneráveis. No entanto será importante mais investigação neste campo, no sentido de simplificar a seleção da escala mais adequada a utilizar na prática clínica diária.

Introduction: The elderly's diminished social status in Portuguese society, the loss of authority during the aging process and the increased vulnerability associated with dependence, social isolation and economic frailty, contribute imperatively to a higher risk of abuse. According to the World Health Organization, Portugal is one of the main countries where this problem occurs. According to a study conducted in Portugal, 39.4% of elderly women surveyed claimed to be victims of abuse. Physical, sexual or psychological abuse are major public health problems. Aim: To review the available screening methods for elder abuse. Methods: A search was conducted in the databases: Medline and Uptodate and medical journals: Postgraduate Medicine, PacientCare and Geriatrics. Results: About two dozen screening scales for elder abuse were found, with different application and selection criteria. Discussion: Through screening and identification of cases of maltreatment, as well as awareness of the existence of risk factors and alarm signs, the family doctor has a key role in the prevention and protection of their vulnerable elderly patients. However, further research in this field is important to simplify the selection of the most appropriate scale to be used in daily clinical practice.

The work developed and described in this dissertation is part of the Ambiosensing project, developed under the Portugal 2020 program. This project aims to design and develop a tool for the energy management of buildings, considering low implementation costs, adaptability, versatility, and easy maintenance in line with the premises of Industry 4.0. One of the main requirements of the project is related to the intelligent supervision of equipment, adaptability and optimization of energy efficiency and quality of comfort ofthe occupants of buildings.In this way, the problem that this dissertation addresses is related to the comfort of the occupants within a service building. For that purpose,an application for mobile devices was designed and developed complementing the Intelligent Supervision system developed in the project. This application makes it possibleto view the values of the registered environmental variables and allows the users of the spaces to leave their feedback regarding their feeling considering the presented values, in order to improve the performance of the supervision system. In addition toallowing the connection between the user and the system improving not only the system's performance, but the application also improves the user's experience inside the building. O trabalho desenvolvido e descrito nesta dissertação está integrado no projeto Ambiosensing, desenvolvido no âmbito do programa Portugal 2020. Este projeto tem como objectivo a concepção e desenvolvimento de uma ferramenta para a gestão energética de edifícios, considerando baixos custos de implementação, adaptabilidade, versatilidade e fácil manutenção alinhado com as premissas da Indústria 4.0. Um dos principais requisitos do projecto está relacionado com a supervisão inteligente dos equipamentos, adaptabilidade e optimização de eficiência energética e qualidade de conforto dos ocupantes dos edifícios. Desta forma, o problema que esta dissertação aborda está relacionado com o conforto dos ocupantes dentro de um edifício de serviços e para tal foi desenhada e desenvolvida uma aplicação para dispositivos moveis que serve de complemento ao sistema de Supervisão Inteligente desenvolvido no projecto. Esta aplicação possibilita a visualização dos valores das variáveis ambientais registados permite que os utilizadores dos espaços deixem o seu feedback em relação à sua sensibilidade sobre os valores apresentados, com o intuito de melhorar a performance do sistema de supervisão.Além de permitir a ligação entre o utilizador e o sistema melhorando,não só a performance do mesmo, a aplicação permite também melhorar a experiência do utilizador no interior do edifício.

Purpose: Heart failure (HF) disproportionately impacts African Americans. We evaluated existing quality improvement (QI) initiatives and patient and provider perceptions of barriers to HF care to develop equity-centered QI recommendations. Methods: We performed a literature review, interviewed providers and patients (N=11), and conducted a root cause analysis at a safety net hospital in San Francisco, California. Results: We have identified four elements to foster a more equitable HF care model: screening for social determinants of health, technological innovation, optimization of space, and implicit bias training. Conclusion: QI initiatives for HF should integrate health equity elements in their design and implementation.

Background Focal dermal hypoplasia (FDH) is rare X-linked dominant disease characterized by atrophy and linear pigmentation of the skin, split hand/foot deformities and ocular anomalies. FDH is caused by mutations of the Porcupine (PORCN) gene, which encodes an enzyme that catalyzes the palmitoylation of Wnt ligands required for their secretion. High resolution melting analysis (HRM) is a technique that allows rapid, labor-efficient, low-cost detection of genomic variants. In the present study, we report the successful implementation of HRM in the molecular diagnosis of FDH. Methods Polymerase chain reaction and HRM assays were designed and optimized for each of the coding exons of the PORCN gene, processing genomic DNA samples form a non-affected control and a patient complying with the FDH diagnostic criteria. The causal mutation was characterized by Sanger sequencing from an amplicon showing a HRM trace suggesting heterozygous variation and was validated using an amplification-refractory mutation system (ARMS) assay. Results The melting profiles suggested the presence of a variant in the patient within exon 1. Sanger sequencing revealed a previously unknown C to T transition replacing a glutamine codon for a premature stop codon at position 28, which was validated using ARMS. Conclusions Next-generation sequencing facilitates the molecular diagnosis of monogenic disorders; however, its cost-benefit ratio is not optimal when a single, small or medium size causal gene is already identified and the clinical diagnostic presumption is strong. Under those conditions, as it is the case for FDH, HRM represents a cost- and labor-effective approach.

Statements about building walls, deportation and denying services to undocumented immigrants made during President Trump's presidential campaign and presidency may induce fear in Latino populations and create barriers to their health care access. To assess how these statements relate to undocumented Latino immigrants' (UDLI) and Latino legal residents/citizens' (LLRC) perceptions of safety and their presentations for emergency care, we conducted surveys of adult patients at three county emergency departments (EDs) in California from June 2017 to December 2018. Of 1,684 patients approached, 1,337 (79.4%) agreed to participate: 34.3% UDLI, 36.9% LLRC, and 29.8% non-Latino legal residents/citizens (NLRC). The vast majority of UDLI (95%), LLRC (94%) and NLRC (85%) had heard statements about immigrants. Most UDLI (89%), LLRC (88%) and NLRC (87%) either thought that these measures were being enacted now or will be enacted in the future. Most UDLI and half of LLRC reported that these statements made them feel unsafe living in the US, 75% (95% CI 70-80%) and 51% (95% CI 47-56%), respectively. More UDLI reported that these statements made them afraid to come to the ED (24%, 95% CI 20-28%) vs LLRC (4.4%, 95% CI 3-7%) and NLRC (3.5%, 95% CI 2-6%); 55% of UDLI with this fear stated it caused them to delay coming to the ED (median delay 2-3 days). The vast majority of patients in our California EDs have heard statements during the 2016 presidential campaign or from President Trump about measures against undocumented immigrants, which have induced worry and safety concerns in both UDLI and LLRC patients. Exposure to these statements was also associated with fear of accessing emergency care in some UDLIs. Given California's sanctuary state status, these safety concerns and ED access fears may be greater in a nationwide population of Latinos.

Dissertação de Mestrado, Ciências da Comunicação, 3 de Junho de 2015, Universidade dos Açores. Presença assídua na imprensa madeirense, Horácio Bento de Gouveia reúne um vasto espólio de textos jornalísticos cujo tema central é a ilha da Madeira. Ao longo de mais de seis décadas de colaboração periodística, o autor elaborou uma análise à Madeira do século XX, abordou algumas vivências, rituais e objetos característicos da ilha, comparou-os com os demais povos, realçando assim algumas das características identitárias da ilha. Pela sua linguagem, regularidade, forma e conteúdo, os escritos bentianos são maioritariamente inseridos no género jornalístico "crónica", um tipo de texto opinativo que se propõe desenvolver os mais variados assuntos e que está introduzido na fronteira ténue e dual entre os universos da literatura e do jornalismo, o que despoletou a necessidade de uma breve análise e definição da noção de crónica jornalística. Entendida como uma intervenção de natureza livre, a crónica, nos jornais, dá predominância à subjetividade de quem escreve, como se comprova através dos textos de Horácio Bento, em que, em muitos momentos, o cronista madeirense expressa o seu parecer e a sua faceta regionalista, nomeadamente quando exalta alguns dos costumes arcaicos que ainda se podem encontrar em determinadas zonas da Madeira e quando revela traços inerentes à sua ilha. Embora ainda não esteja teoricamente consolidada, a identidade madeirense é hoje em dia um tema em debate. Desde a sua descoberta, no século XV, a ilha absorveu um conjunto de usos, costumes e tradições dos primeiros colonizadores e, com o passar dos anos, estas formas de ser e de agir moldaram-se à realidade madeirense e assumiram-se como características identitárias daquele espaço e daquele povo. Ainda que seja um território insular e tenha, por isso, maior facilidade em preservar os traços caracteriológicos primitivos, a identidade madeirense, pela vertente turística da ilha, foi também sucessivamente sendo modificada com base em influências exteriores. ABSTRACT: Horácio Bento de Gouveia, a constant presence in Madeira press, has a wide collection of journalistic chronicles about Madeira island. Over six decades, the columnist analysed Madeira island during the 20th century, approached some experiences, rituals and characteristic objects of the island, comparing them with other people and highlighting some of Madeira's cultural identity characteristics. For his language, regularity, form and content, the most part of the Bento Gouveia's texts are classified as "chronicles". This is a journalistic genre that is a kind of opinion text that proposes to develop several subjects and that is situated on the dual and tenuous border between literature and journalism. This situation took me for a brief analysis and definition of the concept of journalistic chronicle. Understood as a free intervention, the chronicle, in the newspapers, gives predominance to the writer's subjectivity, as we can see through Horácio Bento’s texts. In several moments, the chronicler expresses his opinion and its regionalist point of view particularly when he exalts some archaic traditions that can still be found in certain areas of Madeira and when he reveals traits inherent to his island. Madeira's cultural identity is today a topic of debate but still it is not a consolidated theoretical concept. Since its discovery, in the fifteenth century, the island has absorbed a set of traditions of the early settlers and, over the years, these ways of being and acting molded Madeira's reality and became part of the identity of that space an of that people. Although it is an insular territory and therefore it is easier to preserve the primitive traits, Madeira's cultural identity, by the effect of tourism, has also been successively modified by external influences.

The forensic value of Y-STR markers in Guine-Bissau was accessed by typing of 215 males. Allele and haplotype frequencies, determined for loci DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439 and the duplicated locus DYS385, are within the limits of variation found in other populations south of the Sahara. The level of discrimination achieved is Guineans is higher than for European or other African populations with comparable data. The haplotype diversity of 0.9995 is reduced to 0.9981 when the minimal haplotype is considered thus revealing the importance of increasing the number of typed loci.

Background The geographic and ethnolinguistic differentiation of many African Y-chromosomal lineages provides an opportunity to evaluate human migration episodes and admixture processes, in a pan-continental context. The analysis of the paternal genetic structure of Equatorial West Africans carried out to date leaves their origins and relationships unclear, and raises questions about the existence of major demographic phenomena analogous to the large-scale Bantu expansions. To address this, we have analysed the variation of 31 binary and 11 microsatellite markers on the non-recombining portion of the Y chromosome in Guinea-Bissau samples of diverse ethnic affiliations, some not studied before. Results The Guinea-Bissau Y chromosome pool is characterized by low haplogroup diversity (D = 0.470, sd 0.033), with the predominant haplogroup E3a*-M2 shared among the ethnic clusters and reaching a maximum of 82.2% in the Mandenka people. The Felupe-Djola and Papel groups exhibit the highest diversity of lineages and harbor the deep-rooting haplogroups A-M91, E2-M75 and E3*-PN2, typical of Sahel's more central and eastern areas. Their genetic distinction from other groups is statistically significant (P = 0.01) though not attributable to linguistic, geographic or religious criteria. Non sub-Saharan influences were associated with the presence of haplogroup R1b-P25 and particular lineages of E3b1-M78. Conclusion The predominance and high diversity of haplogroup E3a*-M2 suggests a demographic expansion in the equatorial western fringe, possibly supported by a local agricultural center. The paternal pool of the Mandenka and Balanta displays evidence of a particularly marked population growth among the Guineans, possibly reflecting the demographic effects of the agriculturalist lifestyle and their putative relationship to the people that introduced early cultivation practices into West Africa. The paternal background of the Felupe-Djola and Papel ethnic groups suggests a better conserved ancestral pool deriving from East Africa, from where they have supposedly migrated in recent times. Despite the overall homogeneity in a multiethnic sample, which contrasts with their social structure, minor clusters suggest the imprints of multiple peoples at different timescales: traces of ancestral inhabitants in haplogroups A-M91 and B-M60, today typical of hunter-gatherers; North African influence in E3b1-M78 Y chromosomes, probably due to trans-Saharan contacts; and R1b-P25 lineages reflecting European admixture via the North Atlantic slave trade.