Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

A tutela preventiva da responsabilidade civil

The contemporary society is characterized by high risks. Today, the prevention of damages is as important as compensation. This is due to the fact that the potentiality of several damages is not in line with compensation, because often compensation proves to be impossible. Civil law should be at the service of the citizens, which explains that the heart of the institution of non-contractual liability has gradually moved towards the victim's protection. It is requested from Tort law an active attitude that seeks to avoid damages, reducing its dimension and frequency. The imputation by risk proves to be necessary and useful in the present context as it demonstrates the ability to model behaviors, functioning as a warning for agents engaged in hazardous activities. Economically, it seeks to prevent socially inefficient behaviors. Strict liability assumes notorious importance as a deterrent and in the dispersion of damage by society. The paradigm of the imputation founded on fault has proved insufficient for the effective protection of the interests of the citizens, particularly if based in an anachronistic vision of the concept of fault. Prevention arises in several areas, especially in environmental liability, producer liability and liability based on infringement of copyright and rights relating to the personality. To overcome the damage as the gauge for compensation does not inevitably mean the recognition of the punitive approach. Prevention should not be confused with reactive/punitive objectives. The deterrence of unlawful conduct is not subordinated to punishment.

Indicadores de qualidade na emergência médica pré-hospitalar : painel operacional para o INEM, I.P.

RESUMO - A Emergência Médica Pré-Hospitalar é uma parte importante na cadeia de cuidados de saúde, quer pela gravidade das situações a que atende, quer por funcionar como gatekeeper. O estudo é dedicado a instrumentos de medição e em simultâneo a medições de qualidade como processo de melhoria contínua da qualidade na EMPH. Existem projetos a nível internacional para implementação de painéis de indicadores, alguns atribuem significativa relevância aos processos assistenciais. O European Emergency Data Project (EDD) foi selecionado para servir como painel de indicadores a explorar neste trabalho. Porque a nível científico está bem desenhado, as definições e variáveis estão bem explicitadas e interessa ao INEM, I.P. utilizar um painel que lhe permita um benchmarking. Criou-se um dashboard para os indicadores selecionados e com ele analisaram-se os dados para aferir a qualidade do SEM. Não foi possível, pela sua inexistência, coletar dados para dois dos indicadores propostos. Foram apresentadas propostas de melhoria no sistema de captação de dados do INEM, I.P. para que a instituição possa monitorizar periodicamente os indicadores selecionados. A existência de dados e a sua fiabilidade para utilizar na medição por indicadores é algo que se explorou neste trabalho de campo, e as fraquezas encontradas foram matéria para oportunidades, recomendações, e caminho para discussão e o fortalecimento da instituição.

Involvement and interactions of different immune cells and their cytokines in human visceral leishmaniasis

Visceral leishmaniasis (VL) or kala-azar, a disseminated infection of the lymphoreticular system of the body, is marked by severe defect in immune system of the host. Successful cure of VL depends on the immune status of the host in combination with the effects of the antileishmanial drugs. The rationale approach towards eradication of this disease would be to potentiate the immune functioning of the host in addition to parasite killing. This review deals with different aspects of adaptive and innate immune responses and explores their role in protection or pathogenesis of VL. IL-10 has emerged as the principal cytokine responsible for disease pathogenesis, although evidences regarding its source during active VL remain inconclusive. On the other hand, IFNγ, under the influence of IL-12, is mostly correlated with healing of the disease. Chemokines are important in mounting cell-mediated immune response as they can prevent parasite invasion in association with cytokines. Different types of T cells like CD4, CD8 and NK T cells also contribute to the immunology of this disease. In spite of conflicting reports, the role of regulatory T cells in VL pathogenesis is important. Recently discovered Th17 subset and its different members have been reported to perform diverse functions in the course of VL and leishmaniasis as a whole. Innate immune responses, depending on the cell types, are essential in early parasite detection and subsequent development of an efficient NK cell response. Immunotherapy targeting IL-10 could be looked upon as an interesting option for the treatment of VL.

The impact of talent management practices on employee retention: The moderator effect of leader-member exchange and role modeling

Organizations are undergoing serious difficulties to retain talent. Authors argue that Talent Management (TM) practices create beneficial outcomes for individuals and organizations. However, there is no research on the leaders’ role in the functioning of these practices. This study examines how LMX and role modeling influence the impact that TM practices have on employees’ trust in their organizations and retention. The analysis of two questionnaires (Nt1=175; Nt2=107) indicated that TM only reduced turnover intentions, via an increase in trust in the organization, when role modeling was high and not when it was low. Therefore, we can say that leaders are crucial in the TM context, and in sustaining a competitive advantage for organizations.

Portuguese commercial banking: An assessment of competition in the 1960-2013 period

Strong consolidation is one of the most evident developments of banking markets around the world in recent decades. This change is raising questions on how and to what an extent competition is affected by the expansion of the largest banks. The aim of the present study is to measure the degree of competition in the Portuguese commercial banking market in the long-run, during the period ranging from1960 to 2013, by using the non-structural model developed by Panzar and Rosse. The main findings are that the Portuguese banking system, despite the legal restrictions in place, operated mostly in a market with some degree of competition and, at some points in time, presented some interesting competitive features. More recently, it has evolved into functioning as a cartel.

Competition policy costs to firms

The existence of competition policy forces companies to adjust their behaviour. This is also costly. Using a database from a company on contracts, I will try to estimate if a specific competition policy disposition, supply contracts cannot be longer than 60 months, has costs for the coffee suppliers operating in the Portuguese “on-trade” coffee market. The estimation method used in this paper will be OLS. The results suggest that limiting the duration of exclusivity contracts to 60 months can be harmful to the coffee suppliers and it can even seriously affect the market functioning. Key

Analysis and treatment of a nineteenth century portrait, study of Artsorb® and a proposal for a microclimate frame

The present work is divided in two parts: Part 1 is focused on the analysis and treatment of a 19th century portrait of Domingos Affonso, which belongs to the Ecomuseu Municipal do Seixal; and Part 2, which is entitled “The Microclimate Frame Project” is focused on the study of Artsorb® and on the planning of a microclimate frame for the painting. In Part 1, a study of the painting’s materials was performed using complementary analytical techniques and the painting’s condition was carefully evaluated. The painting exhibited signs of mould growth, and a more detailed investigation was made of this topic to understand if the fungal community was active and if it represented a real danger to the painting. A treatment was proposed, appropriate to the painting’s condition. A description of the treatment carried out, comprising the treatment options, is also present in this section. Within the study of the microclimate frame, in Part 2, the study of the potential corrosiveness of Artsorb® was a central subject. Artsorb® sheets are one of the most widely used materials for buffering relative humidity fluctuations in microclimate frames and its reported excellent performance is enhanced by its availability in lightweight sheets that can be easily placed inside microclimate frames. However, concerns have arisen regarding the presence of the corrosive salt lithium chloride in the composition of this buffer. Consequently, the present work also aimed to understand the potential risks of using Artsorb® and the possibility of avoiding exposure of lithium chloride to the artworks through the use of Tyvek®. Results from the preliminary tests seem to indicate that Artsorb® releases lithium chloride into air. This study also showed that a Tyvek® cover over Artsorb® reduces but does not eliminate evidence of chlorine contamination, and it significantly reduces the effectiveness of the buffering material. Considering that Artsorb® appears to be unsuitable due to the release of the corrosive salt, that Tyvek® was not efficient as a barrier for lithium chloride or as a permeable material to enable the proper functioning of Artsorb®, the buffering material proposed for the use in the microclimate frames is silica gel without indicator. Based on the choice of buffering material, as a result of this study, a microclimate frame is proposed.

Relatório de estágio no departamento central de investigação e acção penal

The means of obtaining evidence, the amount of evidence obtained, the number of defendants related to each criminal case and the gravity of the crimes for which the magistrates of the Department are holders of penal action, define its real importance to the Rule of Law. I have deeply studied the subject of the institution of hierarchical intervention required by the assistant and the application of an opening statement by the defendant, starting from a hypothetical case, provided when the query of an investigation with the subject of the crime of active corruption, where this institution was called as a reaction to the archiving dispatch delivered by the Public Ministry. I have study about the implementation of the institution of provisional suspension of the process, specifically in the scope of fiscal criminality, analyzing the effective satisfaction of the purposes of the sentences in two slopes: general prevention and special prevention. I went for my first time to a Central Court of Criminal Instruction, where I attended the measures of inquiry and instructive debate of a process that culminated with the prosecution and pronunciation of the defendants. In addition to this criminal experience, I have deepened and consolidated the academic knowledge with the study of various criminal cases from various fields in the scope of criminality investigated by the Department. I could therefore check the basis of procedural delays, regarding to our legal system, especially in this type of crime, raising issues that I analyzed and discussed, always in a critical and academic way. I had the opportunity to attend and witness a seminar in the Lisbon Directorate of Finance as well of entering the Centre for Judicial Studies to attend a conference on the International Anti-Corruption Day. Focus on the investigatory importance of the international judicial cooperation, through the various organs, with special interest to EUROJUST. I comprehended the organization and functioning of these communitarian organs and means of communication of procedural acts, in particular, the rogatory letters and european arrest warrants. This involvement is motivated by the moratorium factor of the investigations where rogatory letters are necessary for the acquisition of evidence or information relevant to the good continuation of the process. For this reason the judicial cooperation through the relevant communitarian organs, translates a streamlined response between the competent judicial authorities of the Member States, through the National Member that integrates EUROJUST. This report aims to highlight some of the difficulties and procedural issues that Public Prosecutors of DCIAP and criminal police bodies that assist them, face in combating violent and organized crime, of national and transnational nature, of particular complexity, according to the specifics of criminal types.

O abuso de informação privilegiada (insider trading)

In the stock market, information takes on special relevance, due to the market’s permanent updating and the great fluidity of information existent therein. Just as in any other negotiations, the party with the better information has a bargaining advantage, as it is able to make more advantageous business decisions. However, unlike most other markets, the proper functioning of the stock market is greatly dependent on investors’ trust in the market itself. As such, if there are investors who, due to any condition they possess or office they hold, have access to relevant information which is not accessible to the general public, distrust is bred within the market and, consequently, investment is lessened. Thus, there is a need to prevent those who hold privileged information from using it in abusive ways. In Portugal, abuse of privileged information is set out and punished criminally in Article 378. of the Portuguese Securities Code (‘Código dos Valores Mobiliários’). In this dissertation, I have set out, firstly, to analyze the inherent conditions for there to be a crime of abuse of privileged information; secondly, to analyze two well-known cases, which took place and were decided in other jurisdictions, and attempt to understand how these cases would fall under Article 378. of the Portuguese Securities Code. Whereas the first case, Chiarella v. United States, was scrutinize under Article 378 of the Portuguese Securities Code, in the second, Lafonta v. AMF, the conclusion arrived at was that the crime taken place was different. This analysis allowed, on one hand, the application to a particular case of prerequisites and concepts which were explained, at a first approach, from a more theoretical perspective; on the other hand, it also allowed the further development of specific aspects of the regime, namely the difference between an insider and a tipee, as well as to more clearly set out the limits to the precise character of the information at hand.

The impact of credit conditions on market liquidity – a case for European stock markets

The recent financial crisis has drawn the attention of researchers and regulators to the importance of liquidity for stock market stability and efficiency. The ability of market-makers and investors to provide liquidity is constrained by the willingness of financial institutions to supply funding capital. This paper sheds light on the liquidity linkages between the Central Bank, Monetary Financial Institutions and market-makers as crucial elements to the well-functioning of markets. Results suggest the existence of causality between credit conditions and stock market liquidity for the Eurozone between 2003 and 2015. Similar evidence is found for the UK during the post-crisis period. Keywords: stock

Relatório de estágio curricular Federação Portuguesa de Futebol

This report aims to present the work that has been developed throughout the internship in the Portuguese Football Federation. First it is presented a characterization of the host institution, not only on its legal framework, but also on how it works. Then it´s revealed the work done during the internship, which consisted mainly in the preparation of a study about the opened / litigated cases in season 2012/2013 in what football concerns, that is to say, those cases where the Portuguese Football Federation Disciplinary Board, which is always the decision-making body, had direct intervention. The study is separated into two sections (one regards the professional football and the other the non-professional football) because each one have their own competence, and the processes obey to different formalities in the two sections. Within each section are defined all process forms, and it’s made an evaluation about their decisions and the timing of each procedural stage. What is expected with this work is that it can clarify and promote some aspects of the functioning of the sports justice in what football concerns.

Terminologia em uso na Direcção Nacional de Desenvolvimento Tecnológico e Inovação: a variação nos termos complexos

Inserido no âmbito do Projecto “Terminologia da Administração Pública – TERMAP”, o presente trabalho constitui uma análise descritiva de elementos discursivos que nos permitem dar conta da terminologia produzida na Direcção Nacional de Desenvolvimento Tecnológico e Inovação, do Ministério da Ciência e Tecnologia. Temos como objectivo a organização da terminologia da área, tendo em vista a fixação dos termos, permitindo assim uma melhor comunicação e transferência de conhecimento, quer a nível intra-institucional quer a nível interinstitucional, bem como a nível externo. Neste trabalho, partimos de uma abordagem semasiológica, e procuramos sempre ter em foco as especificidades discursivas, não pondo de parte, quando necessário, uma perspectiva mais onomasiológica. A abordagem proposta desenvolve-se em torno de cinco capítulos: a) o primeiro traz em revisão aspectos da organização e funcionamento da Administração Pública Central em Angola, na qual se insere o domínio de análise; b) o segundo consiste na análise dos aspectos relativos à constituição do corpus textual; c) os pressupostos teóricos apresentados no terceiro capítulo dizem respeito à formação dos termos complexos e aos fenómenos de variação em terminologia; d) no quarto capítulo, a análise volta ao corpus textual, mais propriamente ao seu tratamento. Neste capítulo apresentam-se os processos relativos à extracção e selecção dos candidatos a termos, e o levantamento dos casos de variação; e) o quinto capítulo é reservado à apresentação e análise dos dados. Fazemos uma proposta de um modelo de base de dados terminológica multilingue. Esta proposta surge na sequência da necessidade de fixar os termos, com vista à transferência de conhecimento.

A multi-criteria decision support system for a routing problem in waste collection

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General and mental health of poor and multiproblematic families

The main feature of the so called multiproblem families is the persistence along time of a set of problems in various areas of the individual’s functioning in several family members.This research study aims: a) To identify and characterise the major health problems faced by the members of these families; b) To explore the perceived relevance of these problems; c) To explore the perceived effectiveness of health care interventions received by respondents; d) To explore the level of control perceived over these problems.