Desigualdades sociais em saúde nos idosos : um retrato para Portugal

RESUMO - Contexto: As desigualdades sociais em saúde são uma questão central de justiça social. No contexto de forte envelhecimento populacional em Portugal, as desigualdades nos idosos representam um desafio crucial para o futuro, sobre as quais existe pouca evidência. Este estudo pretende investigar a existência de desigualdades socioeconómicas em saúde nos idosos, em Portugal. Metodologia: Foram utilizados os dados para Portugal, da quarta vaga do Survey of Health, Ageing and Retirement in Europe. O estudo engloba 2017 indivíduos com 50 ou mais anos. Foram utilizados quatro indicadores de saúde: problemas de saúde, saúde auto-reportada, doenças de longa duração e atividade limitada. Foi utilizado o nível de educação como indicador socioeconómico. As desigualdades socioeconómicas foram avaliadas através de regressões logísticas multivariadas. Resultados: Existem desigualdades socioeconómicas em saúde nos idosos favoráveis aos mais educados. Os indivíduos com menor educação estão em maior risco de reportar má saúde (OR=5,5); maior risco em ter problemas de saúde, existindo um gradiente social na Hipertensão Arterial (OR=2,4) e na Artrite (OR=7,0); maior risco de doenças de longa duração (OR=1,6) e maior risco de limitação nas atividades diárias (OR=5,1). As desigualdades socioeconómicas diminuem com a idade. Conclusão: De forma a melhorar a saúde e reduzir as desigualdades socioeconómicas em saúde nos idosos, os resultados apontam para a necessidade de implementar medidas no âmbito dos problemas de saúde em que existe um gradiente social, melhorar o nível de educação da população geral e implementar medidas de educação para a saúde, aumentando a literacia em saúde nos idosos mais jovens.

Bioproduction of succinic acid from renewable feedstocks by Actinobacillus succinogenes 130Z

Succinic acid (SA) is a highly versatile building block that is used in a wide range of industrial applications. The biological production of succinic acid has emerged in the last years as an efficient alternative to the chemical production based on fossil fuels. However, in order to fully replace the competing petro-based chemical process from which it has been produced so far, some challenges remain to be surpassed. In particular, one main obstacle would be to reduce its production costs, mostly associated to the use of refined sugars. The present work is focused on the development of a sustainable and cost-e↵ective microbial production process based on cheap and renewable resources, such as agroindustrial wastes. Hence, glycerol and carob pods were identified as promising feedstocks and used as inexpensive carbon sources for the bioproduction of succinic acid by Actinobacillus succinogenes 130Z, one of the best naturally producing strains. Even though glycerol is a highly available carbon source, as by-product of biodiesel production, its consumption by A. succinogenes is impaired due to a redox imbalance during cell growth. However, the use of an external electron acceptor such as dimethylsulfoxide (DMSO) may improve glycerol metabolism and succinic acid production by this strain. As such, DMSO was tested as a co-substrate for glycerol consumption and concentrations of DMSO between 1 and 4% (v/v) greatly promoted glycerol consumption and SA production by this biocatalyst. Aiming at obtaining higher succinic acid yield and production rate, batch and fed-batch experiments were performed under controlled cultivation conditions. Batch experiments resulted in a succinic acid yield on glycerol of 0.95 g SA/g GLY and a production rate of 2.13 g/L.h, with residual production of acetic and formic acids. In fed-batch experiment, the SA production rate reached 2.31 g/L.h, the highest value reported in the literature for A. succinogenes using glycerol as carbon source. DMSO dramatically improved the conversion of glycerol by A. succinogenes and may be used as a co-substrate, opening new perspectives for the use of glycerol by this biocatalyst. Carob pods, highly available in Portugal as a residue from the locust bean gum industry, contain a significant amount of fermentable sugars such as sucrose, glucose and fructose and were also used as substrate for succinic acid production. Sugar extraction from raw and roasted carobs was optimized varying solid/water ratio and extraction time, maximizing sugar recovery while minimizing the extraction of polyphenols. Kinetic studies of glucose, fructose and sucrose consumption by A. succinogenes as individual carbon sources till 30 g/L were first determined to assess possible metabolic diferences. Results showed no significant diferences related to sugar consumption and SA production between the diferent sugars. Carob pods water extracts were then used as carbon source during controlled batch cultivations. (...)

Avaliação da exposição a aditivos alimentares em crianças dos 0 aos 3 anos: estudo exploratório

RESUMO - O aumento dos produtos processados na alimentação diária, em especial das crianças, tem repercussões no consumo aumentado de aditivos, cujas consequências são ainda ambíguas. Associado ao aumento do consumo deste tipo de alimentos encontra-se a prevalência de excesso de peso e obesidade infantil. O presente estudo exploratório pretendeu avaliar a exposição a aditivos alimentares em crianças dos 0 aos 3 anos, com base nos Limites Máximos de Utilização e nas Doses Diárias Admissíveis, e estudar a sua associação com variáveis como a idade, sexo, percentil de Índice de Massa Corporal e nível de escolaridade dos Pais. Pretendeu-se também identificar as categorias de alimentos consumidas que mais contribuíram para a exposição aos aditivos alimentares em estudo. Com base numa amostra de dados reportados em diários alimentares, foram selecionados 12 aditivos. Observaram-se ingestões estimadas superiores às DDA, para o dióxido de enxofre (E220), o ácido fumárico (E297) e o nitrito de sódio (E250). As categorias de alimentos “Açúcar, confeitaria e sobremesas açucaradas”, “Leite e produtos lácteos”, “Cereais e derivados” e “Pratos compostos”, foram as que mais contribuíram para a exposição dos aditivos selecionados. O presente trabalho permitiu inferir o perfil de exposição a aditivos alimentares em crianças, lançar resultados preliminares para justificar a necessidade de estudos mais pormenorizados, e a criação do sistema de monitorização nacional da ingestão de aditivos. Estudos sobre consumos de aditivos alimentares podem servir de base para elaboração de estratégias de saúde pública, com a finalidade de reduzir o consumo destas substâncias e promover hábitos alimentares mais saudáveis.

A consagração dos naturais

“One cannot analyse a legal concept outside the economic and socio-cultural context in which it was applied” – such is the longstanding thesis of António Manuel Hespanha. I argue that Hespanha’s line of argument relative to legal concepts is also applicable, mutatis mutandis, to legal agents: the magistrates, advocates, notaries, solicitors and clerks who lived and exercised their professions in a given time and place. The question, then, is how to understand the actions of these individuals in particular contexts – more specifically in late 18th century and 19th century Goa. The main goal of the present thesis was to comprehend how westernized and Catholic Goan elite of Brahman and Chardó origin who provided the majority of Goan legal agents used Portuguese law to their own advantage. It can be divided into five key points. The first one is the importance of the Constitutional liberalism regime (with all the juridical, judicial, administrative and political changes that it has brought, namely the parliamentary representation) and its relations with the perismo – a local political and ideological tendency nurtured by Goan native Catholic elite. It was explored in the chapter 2 of this thesis. The second key point is the repeated attempts made by Goan native Catholic elite to implement the jury system in local courts. It was studied in the chapter 3. Chapter 4 aims to understand the participation of the native Catholic elite in the codification process of the uses and traditions of the indigenous peoples in New Conquests territory. The fourth key point is the involvement of those elites not only in the conflict of civil and ecclesiastical jurisdictions but also in the succession of the Royal House of Sunda. It was analyzed in the chapter 5. The functions of an advocate could be delegated to someone who, though lacking a law degree, possessed sufficient knowledge to perform this role satisfactorily. Those who held a special licence to practice law were known as provisionários (from provisão, or licence, as opposed to the letrados, or lettered). In the Goa of the second half of the 18th century and the 19th century, such provisionários were abundant, the vast majority coming from the native Catholic elite. The characteristics of those provisionários, the role played by the Portuguese letrados in Goa and the difficult relations between both groups were studied in the chapter 6.

Serviços públicos em diferentes contextos territoriais: (re)organização das redes e relações com os sistemas urbanos

A presença de serviços públicos nos aglomerados populacionais suscita diferentes arti-culações e rearranjos socioterritoriais e promove a sua dinamização e especialização, fomenta a economia local e contribui, direta e indiretamente, para a coesão, o desen-volvimento, a atratividade, a competitividade e a resiliência dos territórios. Nas últimas décadas, as lógicas da oferta e da procura dos serviços públicos têm evoluído rapida-mente, passando de um modelo de gestão fechado e burocrático, para um modelo mais aberto, diversificado, simplificado e participativo. Com elas, surgiram (novos) de-safios na sua gestão, que vão desde a sua sustentabilidade económica até aos impac-tos sociais e territoriais resultantes da modernização, sem esquecer a maior (e cres-cente) exigência do cidadão. Estas mutações têm repercussões na filosofia da sua or-ganização e no modus operandi, com uma crescente orientação para as necessidades da procura e a satisfação do utente, procurando, em simultâneo, reduzir os custos e aumentar a produtividade e a qualidade dos serviços prestados, com base em políticas de inovação e em parcerias e governação em rede. Na prática, estas alterações condu-zem a processos diferenciados, que têm passado pela fusão, reconversão ou mesmo encerramento de serviços públicos. Num contexto de crise económico-financeira, como o que se vive em Portugal, e aten-dendo às mutações ocorridas na oferta e na procura de serviços públicos de educação, saúde, eventos de vida, defesa e segurança e justiça, importa refletir sobre os concei-tos inerentes a estes serviços e sintetizar as principais dinâmicas nesse período de tempo, tendo como pressupostos que, por um lado, o território é um elemento dife-renciador na prestação e na utilização de serviços e que, por outro lado, estes serviços, pela sua natureza estratégica para a sociedade e para a economia, exigem a definição de políticas e de estratégias territoriais consentâneas e inclusivas. Esta investigação centra a sua análise em dois âmbitos geográficos. Numa primeira fa-se, à escala de Portugal continental, onde se obtém um retrato atual da espacialização dos serviços públicos referidos acima. Em seguida, após a criação de uma metodologia inovadora baseada em análises e modelação de informação geográfica para a tipifica-ção dos diferentes tipos de territórios, são identificados três casos de estudo regionais, com características distintas. Assim, são estudados territórios metropolita-nos/densamente urbanizados (constituídos pelos concelhos de Lisboa, Almada, Seixal, Palmela, Sesimbra e Setúbal), eixo urbano-rural (Évora, Portel, Viana do Alentejo, Vidi-gueira, Cuba e Beja) e territórios profundamente rurais (Barrancos, Moura, Serpa e Mértola), para os quais foi realizado um inquérito à população, com o objetivo de compreender a utilização que fazem dos serviços públicos e quais as suas expetativas em relação aos mesmos. Os resultados obtidos para as análises nacional e regionais são acompanhados por uma reflexão sobre a territorialização das políticas de serviços públicos, as quais incidem em matérias relacionadas com o seu planeamento e, sobre-tudo, com a sua gestão.

Al-doped ZnO ceramic sputtering targets based on nanocrystalline powders produced by emulsion detonation synthesis – deposition and application as a transparent conductive oxide material

Transparent conducting oxides (TCOs) have been largely used in the optoelectronic industry due to their singular combination of low electrical resistivity and high optical transmittance. They are usually deposited by magnetron sputtering systems being applied in several devices, specifically thin film solar cells (TFSCs). Sputtering targets are crucial components of the sputtering process, with many of the sputtered films properties dependent on the targets characteristics. The present thesis focuses on the development of high quality conductive Al-doped ZnO (AZO) ceramic sputtering targets based on nanostructured powders produced by emulsion detonation synthesis method (EDSM), and their application as a TCO. In this sense, the influence of several processing parameters was investigated from the targets raw-materials synthesis to the application of sputtered films in optoelectronic devices. The optimized manufactured AZO targets present a final density above 99 % with controlled grain size, an homogeneous microstructure with a well dispersed ZnAl2O4 spinel phase, and electrical resistivities of ~4 × 10-4 Ωcm independently on the Al-doping level among 0.5 and 2.0 wt. % Al2O3. Sintering conditions proved to have a great influence on the properties of the targets and their performance as a sputtering target. It was demonstrated that both deposition process and final properties of the films are related with the targets characteristics, which in turn depends on the initial powder properties. In parallel, the influence of several deposition parameters in the film´s properties sputtered from these targets was investigated. The sputtered AZO TCOs showed electrical properties at room temperature that are superior to simple oxides and comparable to a reference TCO – indium tin oxide (ITO), namely low electrical resistivity of 5.45 × 10-4 Ωcm, high carrier mobility (29.4 cm2V-1s-1), and high charge carrier concentration (3.97 × 1020 cm-3), and also average transmittance in the visible region > 80 %. These superior properties allowed their successful application in different optoelectronic devices.

Measuring the effects of price movements on private consumption

This paper studies how shocks in the prices of Food, Energy and Financial Assets affect private consumption using a VAR Model. Then, the total effects are broken into direct and indirect effects, using the coefficients taken from the previous model. We use quarterly data for the Portuguese economy from the last 20 years. We found that energy prices and financial assets have a strong connection with consumption, suggesting that the economy may be too exposed to shocks in these markets.

US fiscal dynamics in political perspective

Given the importance of fiscal balance for ensuring a sustainable fiscal policy, we conduct an empirical examination of fiscal dynamics in the United States in response to unsustainable budget deviations. We concentrate on the role of political factors, namely the Republican - Democrat presidential divide, in determining the fiscal response to budget disequilibria. Making use of an asymmetric cointegration framework, we explore politically motivated fiscal asymmetries in the US, from Eisenhower to Obama. We conclude that political factors such as the government’s political quadrant and the timing of elections are important determinants of the fiscal response to unsustainable budget deviations.

As apostas desportivas online associadas à combinação de resultados

The present dissertation is aimed at finding out whether the existing criminal protection of the sports ethics value is sufficient, regarding the dangers arising from the global online sports betting market and its characteristics. In the first chapter, the main issue will be introduced: the association between online sports bets and competition manipulations from a criminal point of view. In the second chapter, online sports bets will be defined, the characteristics of the referred global market explained and the danger said features bear to the manipulation of sports competitions exposed – also analysing the participants in this phenomenon. In chapter 3, it will be shown that the protection of sports ethics is a matter of public interest and that this interest is carried out by the sports federations as well. In the fourth chapter, the focus will be the criminal protection of sports ethics: its necessity based on the penal dignity of this system of sport associated values; the need to re-evaluate the existing protection due to the recognition of the existence of the online sports betting market; the existing criminal norms regarding the manipulation of sports competitions. Finally, in chapter 5, the intent will be to propose solutions to the identified problems concerning the sufficiency of the existing criminal legislation.

The effect of energy and traffic light labeling on parents purchasing decisions of cereals for their children

Objective: Nutritional labeling systems are considered a tool to fight obesity since they aim to contribute for more informed food choices as well as assist consumers to make healthier nutrition options and in this manner, contribute to a decrease in the obesity rate. This study intends to analyze the effect of different types of labeling systems on parents’ purchasing decisions for their children on a specific product: breakfast cereals. More precisely, how labels affect parents’ perception of healthiness regarding cereals and if the nutritional information has an effect on intended purchases for their children. Participants and methods: We conducted a study with 135 Portuguese parents of children aged 4 to12 years. Parents answered a questionnaire with one of three hypothetical cereals menus. Menus only differed in their nutritional labeling technique: no labels (control group), reference intake labels or traffic light labels. In addition, we conducted 20 face-to-face interviews to a different group of parents in order to perform a recall task. Findings: This paper provides no evidence to suggest that energy labeling or traffic light labeling systems alone were successful in helping parents making healthy purchases of cereals for their children. Therefore, there is the need to promote supplementary policies to encourage the consumption of healthier food and help fight obesity.

Progressivity in the Portuguese personal income tax system

This Work Project analyzes the evolution of the Portuguese personal income tax system’s progressivity over the period of 2005 through 2013. It presents the first computation of cardinal progressivity measures using administrative tax data for Portugal. We compute several progressivity indices and find that progressivity has had very modest variations from 2005 to 2012, whilst from 2012 to 2013 there has been a relatively stronger decrease, excluding the impact of the income tax surcharge of the years 2012 and 2013. When this latter is included, progressivity of 2012 and 2013 decreases considerably. Analyzing the effective average tax rates of the top income percentiles in the income scale, we find that these rates have increased over the period 2010–2013, suggesting that an analysis of effective tax rates is insufficient to assess progressivity in the whole tax scheme.

Molecular tools in the diagnostic and epidemiology of infections caused by members of Mycobacterium avium Complex

Mycobacterium avium Complex (MAC) comprises microorganisms that affect a wide range of animals including humans. The most relevant are Mycobacterium avium subspecies hominissuis (Mah) with a high impact on public health affecting mainly immunocompromised individuals and Mycobacterium avium subspecies paratuberculosis (Map) causing paratuberculosis in animals with a high economic impact worldwide. In this work, we characterized 28 human and 67 porcine Mah isolates and evaluated the relationship among them by Multiple-Locus Variable number tandem repeat Analysis (MLVA). We concluded that Mah population presented a high genetic diversity and no correlations were inferred based on geographical origin, host or biological sample. For the first time in Portugal Map strains, from asymptomatic bovine faecal samples were isolated highlighting the need of more reliable and rapid diagnostic methods for Map direct detection. Therefore, we developed an IS900 nested real time PCR with high sensitivity and specificity associated with optimized DNA extraction methodologies for faecal and milk samples. We detected 83% of 155 faecal samples from goats, cattle and sheep, and 26% of 98 milk samples from cattle, positive for Map IS900 nested real time PCR. A novel SNPs (single nucleotide polymorphisms) assay to Map characterization based on a Whole Genome Sequencing analysis was developed to elucidate the genetic relationship between strains. Based on sequential detection of 14 SNPs and on a decision tree we were able to differentiate 14 phylogenetic groups with a higher discriminatory power compared to other typing methods. A pigmented Map strain was isolated and characterized evidencing for the first time to our knowledge the existence of pigmented Type C strains. With this work, we intended to improve the ante mortem direct molecular detection of Map, to conscientiously aware for the existence of Map animal infections widespread in Portugal and to contribute to the improvement of Map and Mah epidemiological studies.

A+ grandparents at school

Facing an aging society, where there is a large gap between generations and where the elderly are neglected, the Portuguese Red Cross – Delegation of Vila Nova de Gaia – created the project A+: grandparents at school, which encourages intergenerational work. After observing the positive results of the pilot project, the A+ team decided that the project has the potential to be scaled at a national level to enable it to contribute to the integration of the older people in the society, as well as for positive changes of individuals with regard to the elderly. This work project proposes a method to determine whether A+ can be scaled and what is the most efficient way to do it, establishing a process of scale that can be used by every non-profit organization