Ingestão de plásticos por aves marinhas na Costa Norte de Portugal

Dissertação de mestrado em Ecologia

Patients' and physicians' preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a discrete choice experiment.

OBJECTIVE To assess Spanish and Portuguese patients' and physicians' preferences regarding type 2 diabetes mellitus (T2DM) treatments and the monthly willingness to pay (WTP) to gain benefits or avoid side effects. METHODS An observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model. RESULTS Three-hundred and thirty (n=330) patients (49.7% female; mean age 62.4 [SD: 10.3] years, mean T2DM duration 13.9 [8.2] years, mean body mass index 32.5 [6.8] kg/m(2), 41.8% received oral + injected medication, 40.3% received oral, and 17.6% injected treatments) and 221 physicians from Spain and Portugal (62% female; mean age 41.9 [SD: 10.5] years, 33.5% endocrinologists, 66.5% primary-care doctors) participated. Patients valued avoiding a gain in bodyweight of 3 kg/6 months (WTP: €68.14 [95% confidence interval: 54.55-85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54.80 [23.29-82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: €287.18 [95% confidence interval: 160.31-1,387.21]) the most, followed by avoiding a 3 kg/6 months gain in bodyweight and decreasing cardiovascular risk (WTP: €166.87 [88.63-843.09] and €154.30 [98.13-434.19], respectively). Physicians and patients were willing to pay €125.92 (73.30-622.75) and €24.28 (18.41-30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143.30 (73.39-543.62) and €42.74 (23.89-61.77) to avoid nausea. CONCLUSION Both patients and physicians in Spain and Portugal are willing to pay for the health benefits associated with improved diabetes treatment, the most important being to avoid hypoglycemia and gaining weight. Decreased cardiovascular risk and weight reduction became the third most valued attributes for physicians and patients, respectively.

Caracterização das chuvas erosivas em Urussanga, SC, com relação ao padrão de distribuição temporal

O estudo da distribuição temporal de chuvas é realizado com objetivo de caracterizar o padrão de chuva mais frequente. O conhecimento das características físicas das chuvas com relação aos padrões de precipitação permite realizar modelagem matemática de eventos hidrológicos em condições mais próximas às condições reais. O objetivo deste trabalho foi caracterizar as chuvas erosivas em Urussanga, SC, com relação aos padrões hidrológicos de distribuição temporal. Foram usados os pluviogramas da estação meteorológica de Urussanga (latitude 28,31º S, longitude 49,19º W e altitude de 49 m) relativos ao período de outubro de 1980 a março de 2012. As chuvas erosivas foram classificadas em padrões avançado, intermediário e atrasado, se a maior intensidade ocorre no terço de duração inicial, intermediário e final, respectivamente. Foram determinadas as características de altura pluvial, duração da chuva, energia cinética, intensidade máxima em 30 min, erosividade e frequência de chuvas mensais de cada padrão de chuva. Verificou-se a ocorrência de 1.221 chuvas erosivas, das quais 651 com perfil avançado; 416, intermediário; e 154, atrasado. A duração média das chuvas erosivas é de 14,4 h. A média total de intensidade média para as chuvas erosivas foi de 17,4 mm h-1. A maior concentração de chuvas (32,9 %) foi observada no intervalo de duração de 6 a 12 h. Para duração inferior a 18 h, ocorre maior frequência de chuvas do padrão avançado; já para acima de 18 h, as frequências de chuvas do padrão avançado e intermediário são semelhantes.

Prevalence and determinants of obesity in children in public schools of Sintra, Portugal

OBJECTIVE: To assess the prevalence of and the factors related to overweight and obesity in a sample of children from the region of Sintra, Portugal. METHODS AND PROCEDURES: Cross-sectional study, stratified for freguesia with random selection of schools. Height, weight, triceps skinfold, upper arm and waist circumferences were measured, and overweight/obesity defined according to international criteria. Breast-feeding, number of daily meals and parents' height and weight data were also collected. RESULTS: One thousand two hundred and twenty-five children aged 6-10 years were assessed. Overall prevalence of overweight and obesity was 35.6% (23% overweight and 12.6% obesity). Overweight or obese children had higher triceps skinfold, upper arm circumference, arm muscle area, and waist circumference than their normal weight counterparts (P < 0.001). On multivariate analysis, relatively to a child without obese progenitors, a child with one obese progenitor had an obesity risk multiplied by 2.78 (95% confidence interval (CI): 1.76-4.38), while a child with two obese progenitors had a risk multiplied by 6.47 (95% CI: 5.59-16.19). Conversely, being picky was significantly related with a smaller risk of obesity: for boys, odds ratio (OR) = 0.15 (95% CI: 0.04-0.63); for girls, OR = 0.19 (95% CI: 0.06-0.64). Finally, no relationships were found between obesity, birth weight, birth height or breast-feeding. DISCUSSION: Prevalence of overweight and obesity are elevated among children of the Sintra region in Portugal compared to most other regions of Europe. The relationship with the parents' nutritional state stresses the need to target families for preventing obesity.

Prevalence and management of cardiovascular risk factors in Portuguese living in Portugal and Portuguese who migrated to Switzerland.

BACKGROUND: Information regarding the health status of migrants compared to subjects who remain in the country of origin is scarce. We compared the levels and management of the main cardiovascular risk factors between Portuguese living in Porto (Portugal) and Portuguese migrants living in Lausanne (Switzerland). METHODS: Cross-sectional studies conducted in Porto (EPIPorto, 1999 to 2003, n = 1150) and Lausanne (CoLaus, 2003 to 2006, n = 388) among subjects aged 35-65 years. Educational level, medical history and time since migration were collected using structured questionnaires. Body mass index, blood pressure, cholesterol and glucose levels were measured using standardized procedures. RESULTS: Portuguese living in Lausanne were younger, more frequently male and had lower education than Portuguese living in Porto. After multivariate adjustment using Poisson regression, no differences were found between Portuguese living in Porto or in Lausanne: prevalence rate ratio (PRR) and (95% confidence interval) for Portuguese living in Lausanne relative to Portuguese living in Porto: 0.92 (0.71 - 1.18) for current smoking; 0.78 (0.59 - 1.04) for obesity; 0.81 (0.62 - 1.05) for abdominal obesity; 0.82 (0.64 - 1.06) for hypertension; 0.88 (0.75 - 1.04) for hypercholesterolemia and 0.92 (0.49 - 1.73) for diabetes. Treatment and control rates for hypercholesterolemia were higher among Portuguese living in Lausanne: PRR = 1.91 (1.15 - 3.19) and 3.98 (1.59 - 9.99) for treatment and control, respectively. Conversely, no differences were found regarding hypertension treatment and control rates: PRR = 0.98 (0.66 - 1.46) and 0.97 (0.49 - 1.91), respectively, and for treatment rates of diabetes: PRR = 1.51 (0.70 - 3.25). CONCLUSIONS: Portuguese living in Lausanne, Switzerland, present a similar cardiovascular risk profile but tend to be better managed regarding hypercholesterolemia than Portuguese living in Porto, Portugal.

La cantata humana para voz solista en la Península Ibérica a finales del siglo XVII y inicios del XVIII : estudio y edición musical de parte del códice 82 de la Colección Pombalinas de la Biblioteca Nacional de Portugal

La cantata humana per a veu solista a la Península Ibèrica a finals del segle XVII i inicis del XVIII. Estudi i edició musical d'una part del còdex 82 de la Colección Pombalinas de la Biblioteca Nacional de Portugal.

Alguns aspectos epidemiológicos da mancha bacteriana (Xanthomonas spp.) do tomateiro na região de Caçador/SC

Objetivando explorar alguns aspectos da epidemiologia da de orvalho e um período médio de 13 horas continuas de umidade mancha bacteriana do tomateiro, incitada por Xanthomonas spp., relativa e"90%. A população bacteriana epifítica oscilou nas 10 em Caçador/SC, um ensaio a campo foi conduzido com plantas semanas após o plantio, conforme as condições climáticas, no inoculadas antes do transplantio. A cada sete dias e durante 19 entanto após o inicio dos sintomas manteve-se estável. O semanas foi monitorada a população bacteriana epifítica, as progresso da doença foi representado pelo modelo logístico y = condições climáticas e a severidade na planta. Constatou-se que o 0.99964/(1+exp(10.35989-0.69762*x)) e devido a pratica de inicio da epidemia teve concomitância com início da maturação apenas 1 colheita semanal, a severidade em frutos foi alta, fisiológica dos frutos do primeiro cacho, sendo que 77 dias antes atingindo 30,22% com produtividade total de117,88 ton.ha-1. Este do início da colheita não houve sintomas nas folhas. Observou-se, estudo epidemiológico servirá de um indicativo para determinação que mesmo em condição de estiagem, houve acréscimo da doença do inicio da epidemia e será usado na validação de um sistema de devido ao constante molhamento foliar decorrente da formação previsão para a mancha bacteriana do tomateiro.

Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

PURPOSE: It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. METHODS: Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. RESULTS: The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). CONCLUSION: It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

Lettres pastorales, l'une du chapitre de l'église d'Elvas ; l'autre du collège de la Sainte église de Lisbonne, en exécution de la lettre royale du 19 janvier 1759, pour détruire & anéantir les erreurs impies & séditieuses que les jésuites ont voulu semer dans ses royaumes...

[Acte. 1759-02-12]