Projeto de uma instalação de climatização para um edifício hospitalar

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecância

Forças Armadas portuguesas em Missões de Paz: comunicação e reconhecimento: relações públicas e diplomacia

Dissertação apresentada à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Gestão Estratégica das Relações Públicas.

Spanish monarchy and the Portuguese Republic: two routes to democratization

From 1974 to 1986 the Iberian Peninsula was the arena of major political changes. The process then undertaken was characterized by the transition from two Iberian authoritarian regimes to two democracies, which enabled both countries to join the European Economic Community (EEC) on 1 January 1986. However, the political vicissitudes until full membership of what became the European Union (EU) was achieved were very different and were decisively, although not exclusively, influenced by the fact Portugal was a republic and Spain a monarchy. In Portugal the 1974 revolution took place with consequent shift of the head of state while in Spain the engine of change was precisely the head of state: King Juan Carlos I. It is also true that despite the dangers to democracy (terrorism in Spain and some radicalism in Portugal) both societies supported the political parties committed to the democratic process in elections, which helped avoid tensions that could have defeated the process. Likewise, it is possible to argue that in Spain a plan to achieve democracy within the rule of law (an archetypal transition) was designed by the head of state, while in Portugal there was no pre-established plan – the programme of the Armed Forces Movement (Movimento das Forças Armadas [MFA]) was a weak and precarious compromise between different visions of the road to follow, enabling an intense political struggle that almost led to civil war and a dangerous state of crisis.

No grupo de teatro terapêutico: hospital Júlio de Matos

Este trabalho escrito visa relatar a experiência vivenciada com o Grupo de Teatro Terapêutico do Júlio de Matos do Centro Hospitalar Psiquiátrico de Lisboa na preparação de um espectáculo de teatro pelo grupo. Nele vêm-se descritas as actividades referentes ao levantamento do trabalho teatral com um grupo de pessoas com diagnóstico psiquiátrico e ligadas a uma instituição hospitalar, e são referenciadas as práticas e teorias terapêuticas que são associadas à dinamização do grupo. Terminando com a reflexão sobre a componente terapêutica indissociável à natureza do processo artístico.

Mediterranean diet: the impact on cardiovascular risk and metabolic syndrome in HIV patients, in Lisbon, Portugal

Introduction - Metabolic syndrome (MS) is common in HIV-infected individuals and it is associated with higher cardiovascular risk (CVR). Mediterranean diet has been associated with a better metabolic control and lower CVR. Materials and methods - From December 2013 to May 2014, individuals between 18 and 65 years of age, who attended the outpatient HIV Clinic at the University Hospital Santa Maria, Lisbon, were selected. Adherence to Mediterranean diet was evaluated with MedDietScore, a scale from 0 to 55 that punctuates 11 food items according to the frequency of intake. Higher scores represent higher adherence. CVR was assessed using D.A.D tool (classified as low, moderate or high risk). We excluded individuals with opportunistic disease, hospitalized in the past three months or with renal disease diagnosis. All participants gave written informed consent. Results - In the 571 HIV patients included, 67.1% (n=383) were male, 91.6% (n=523) Caucasian, with a mean age of 46.5±8.9 years. Patients were divided in two groups: naïve (7.5%; n=43) or on antiretroviral treatment (ART) (92.5%; n=528). Mean length of HIV diagnosis was 6.7±6.5 years (naïve) and 13.3±6.1 years (ART); TCD4+ counts were above 500 cel/mm3 in 55.8% (n=24) and 67.6% (n=357) of the patients, respectively. MS was present in 33.9% (n=179) of patients in ART group and 16.3% (n=7) in naïve group. Presence of MS was associated with ART group (OR=2.7; p=0.018). MS was also associated with older age in this group (p=0.000). Overall, mean MedDietScore was 27.3±5.5. Higher score was associated with older age (r=0.319; p=0.000). Naïve patients presented a trend to higher adherence to Mediterranean diet (65.1% vs 51.7% in naïve group; p=0.090). No relation between MS and Mediterranean diet was found. Higher CVR was associated with the presence of MS in the ART group (p=0.001). In this group, individuals with moderate CVR presented higher rates of adherence to Mediterranean diet (p=0.036) when compared to low and high CVR score. Conclusions - In this cross-sectional study, naïve individuals presented a trend to higher adherence to Mediterranean diet. On the ART group, higher adherence to Mediterranean diet was found in individuals with moderate CVR score. We think that this might suggest that this group of patients adopt this diet only in the presence of metabolic alterations or perceived CVR. Prospective studies in HIV patients are required to determine the impact of adherence to Mediterranean diet on the reduction of CVR.