Classificação Internacional de Funcionalidade, Incapacidade e Saúde : uma dimensão do neurodesenvolvimento

RESUMO: Objetivo Principal • Determinar a consistência da utilização dos instrumentos de avaliação da capacidade intelectual – escalas de Griffiths e WISC III – no enquadramento dos domínios e dos qualificadores da CIF-CJ, restrita às funções mentais do corpo. Objetivo secundário: • Estudar a efetividade e concordância inter-observador da aplicação da CIF, com base na leitura dos dados obtidos em avaliação efetuada com os instrumentos referidos, por duas observadoras independentes, em contexto de articulação saúde, respetivamente educação e segurança social Métodos • Estudo observacional, descritivo, transversal e prospetivo. • Foi estudada uma amostra de conveniência 355 crianças, num período de três anos (Maio de 2010 a 30 de Abril de 2013), com patologia da área da pediatria do neurodesenvolvimento (total de 4000 consultas) no Centro de Desenvolvimento (CD) do Hospital de Dona Estefânia (HDE), Centro Hospitalar de Lisboa Central, EPE (CHLC, EPE). • Critérios de inclusão: crianças de ambos os sexos, observadas no CD do HDE, CHLC (primeiras consultas e consultas de reavaliação) com idade ≥12 meses e ≤17 anos e incapacidade intelectual definida de acordo com os critérios da DSM-IV-TR, DSM 5 e CID-10. • Critérios de exclusão: crianças com autismo, perturbações específicas da linguagem, hiperatividade, défice de atenção e concentração, défices sensoriais congénitos (baixa visão e ou audição), ou com outros diagnósticos de perturbações de neurodesenvolvimento. • O estudo teve duas fases: na primeira, a investigadora principal colheu ou atualizou a história clínica, observou clinicamente as crianças solicitando os exames complementares considerados necessários e foi efetuada avaliação psicológica com os instrumentos adiante descritos, pela mesma psicóloga clínica, devidamente credenciada, e com larga experiência nas escalas referidas. Com base nos dados colhidos, quer por observação direta, quer através dos resultados das escalas Griffiths e WISC – III, a investigadora aplicou a CIF-CJ, circunscrita aos domínios e funções (variáveis): 1. FUNÇÕESMENTAIS GLOBAIS (b110- Funções da consciência, b114- Funções da orientação no espaço e no tempo, b117 – Funções intelectuais, b122- Funções psicossociais globais, b125- Funções intrapessoais, b126- Funções do temperamento e da personalidade); 2.FUNÇÕES MENTAIS ESPECÌFICAS (b140- funções da atenção, b147- Funções psicomotoras, b152- Funções emocionais, b156- Funções da perceção, b163- Funções cognitivas básicas, b164- Funções cognitivas de nível superior, b167- Funções mentais da linguagem 3. FUNÇÕES DA VOZ E DA FALA (b320- Funções da articulação, b330- Funções da fluência e do ritmo da fala). Numa segunda fase, foi solicitada a colaboração de duas co-investigadoras, com formação específica nas escalas utilizadas e na CIF-CJ, a aplicação da CIF nos mesmos domínios e funções. Estas observadoras não efetuaram observações diretas das crianças envolvidas. • Para efetuar a análise estatística e analisar a relação entre os qualificadores (0 a 4) das variáveis da CIF em estudo (b117, b122, b147, b163, b164, b167, b320 e b330) e os instrumentos psicométricos (escalas de Griffiths e WISC III), que constitui a primeira parte do estudo, recorreu-se à técnica estatística não paramétrica do coeficiente de correlação de Spearman, que quantifica a intensidade e sinal da eventual correlação existente entre as variáveis em estudo. • Para determinar as correlações referentes à segunda parte do estudo, foram utilizados os programas SPSS®, (IBM SPSS Statistics) e Statistica® (StatSoft, Inc., 2011). STATISTICA (data analysis software system, version 10. www.statsoft.com.), tendo-se dado preferência aos gráficos deste último. Resultados 1. Observou-se um predomínio do sexo masculino (relação de 1:1,9); relativamente à idade no momento de avaliação, 242 crianças (68,1%) tinham entre zero e seis anos e, dentro destas, a maioria (189) situava-se entre os três e os seis anos. 2. De acordo com a DSM-IV e DSM-5, 261 (73,4%) crianças apresentavam incapacidade intelectual ligeira. 3. A avaliação da competência intelectual pelas escalas de Ruth Griffiths e WISC III (QI), revelaram correlação negativa predominantemente forte e muito forte (índice de Spearman) com os qualificadores das funções do corpo estudadas (funções mentais, mentais específicas e da voz). Os resultados obtidos pela co-investigadora A foram sobreponíveis aos da investigadora principal. Os resultados obtidos pela co-investigadora B revelaram correlação negativa moderada e forte, correlação inferior à da investigadora principal; Conclusões Os resultados permitem inferir que as escalas de Ruth Griffiths e WISC-III são instrumentos adequados para caracterizar a incapacidade intelectual na CIF-CJ; a concordância inter-observador, moderada, nos qualificadores atribuídos nas funções em análise pela investigadora e co-investigadoras, permite concluir que as escalas de Ruth Griffiths e WISC IIIl são bons instrumentos para caracterizar os qualificadores nos domínios e funções estudados, por diferentes grupos de profissionais ligados à infância. Subsistem dificuldades na diferenciação entre qualificadores, designadamente entre os qualificadores 1 e 2, o que tem necessariamente implicações na elegibilidade das crianças para os apoios preconizados pelo DL 3/2008. ------------------------ ABSTRACT: Main objective • To determine the consistency of the use of assessment tools for intellectual ability - Griffiths and WISC III scales - in the context of domains and qualifiers for the ICF-CY, restricted to the mental functions of the body. Secondary objective • Studying the effectiveness and inter-observer concordance concerning the application of the ICF, based on the data recovered from the assessment made with the mentioned instruments, carried out by two independent observers including their perspective on health, education and social security. Methods • Observational, descriptive, cross-sectional and prospective study. • A convenience sample of 355 children was studied over a period of three years (May 2010 to April 2013), with a pathology in the area of pediatric neurodevelopment – intellectual disability (total of 4000 consultations, including first consultations and revaluations) were observed in the Development Centre (CD) in Hospital de Dona Estefânia (HDE), Centro Hospitalar de Lisboa Central, EPE (CHLC). • Inclusion criteria: children of both sexes aged ≥12 months and years ≤17 and intellectual disability defined according to the criteria in the DSM-IV-TR, DSM 5 and ICD-10. • Exclusion criteria: children with autism; specific language impairment, hyperactivity; attention deficit disorder; severe birth sensory deficits (eg, impaired vision and hearing); amongst other diagnoses for neurodevelopmental disorders. • The study was conducted in two phases: in the first phase the principal investigator collected or updated medical history, clinically observed children requesting additional investigations if she deemed necessary. Psychological evaluation was performed by a single, duly licensed clinical psychologist with extensive experience in the referred scales using the instruments described below. Based on data collected, either by direct observation or through the results of Griffiths scales and WISC - III, the researcher applied the ICF-CY confined to the following fields and functions (variables): 1. GLOBAL MENTAL FUNCTIONS (b110- functions of consciousness, b114- Functions referring to space and time orientation , b117 - intellectual functions, b122- global psychosocial functions, b125- intrapersonal functions, b126- functions related to temperament and personality); 2. SPECIFIC MENTAL FUNCTIONS ( b140- attention functions, b147-psychomotor functions, b152- Emotional functions, b156- perception functions, b163- basic cognitive functions and cognitive functions b164- top level b167- language related mental functions. ) 3. VOICE AND SPEECH FUNCTIONS (b320-articulation functions, b330- fluency and rhythm of speech functions). • In the second phase, two co-investigators, with specific training on the scales used and the ICF-CY have applied the ICF in the domains and functions mentioned above, based on the scales results. These co-investigators did not make any direct observation of the studied children. • To perform the statistical analysis and analyze the relationship between the qualifiers (0-4) of the variables in the ICF study (b117, b122, b147, B163, B164, b167, b320 and B330) and psychometric instruments (Griffiths scale and WISC III), which is the first part of the study, the statistical technique of non-parametric Spearman correlation coefficient was used, which quantifies the strength and sign of the possible correlation between the variables under study. • For submission of correlations related to the second part of the study, SPSS (IBM SPSS) and Statistica (StatSoft, Inc., 2011) programs were used. STATISTICA (data analysis software system, version 10 www.statsoft.com.). Preference was given to graphs computed in Statistica. Results • Male predominated (ratio of 1: 1.9). 242 children (68.1% of the sample) were aged between zero and six years and, among these, the majority (189) was aged largest number between three and six years. • According to the DSM-IV and DSM-5, 261 (73.4%) children had mild intellectual disability. The correlation between the assessment of intellectual competence by Ruth Griffiths scales and WISC III (QI), was predominantly negative strong and very strong correlation with the qualifiers of body functions studied (specific mental functions, mental and voice functions using Spearman index). The levels of correlation obtained by the co-investigatores were in agreeance with the results from the principal investigator. The results obtained by co-investigator B showed moderate to strong negative correlation, levels that were lower to the those registered by the principal investigator; Conclusions These results indicate that Ruth Griffiths and WISC-III scales are adequate tools to characterize intellectual disability in the ICF-CY; moderate inter-observer agreement in the qualifiers assigned the functions under analysis by the researcher and co-researchers, shows that the scales are also good tools to measure CIF qualifyers by diferent technicians with different professional orientations, related to children. However, there are still difficulties in differentiating qualifiers, namely between qualifiers 1/2 and 3/4, which necessarily has implications for the eligibility of children for the state support advocated by the Portuguese Decret Law 3/2008.

Derecho administrativo comunitario

The globalization and the need for countries to unite under regional organizations fostered the emergency of a Communitary law. This isa law made bysupranational institutions capable of submitting States toa single legal order. Thistransforms administrative law on international administrative law that overflows the national legal system. This phenomenon was felt on Colombia given the current development of the Andean Integration System

A caracterização do trabalho análogo ao escravo na jurisprudência dos tribunais brasileiros

Based on bibliographical research and the analysis of court rulings, this study investigates the characterization of slave-like labor by Brazilian courts. After the alteration of article 149 of the Brazilian Penal Code, introduced by Law nº 10.803/2003, which typifies the practice of contemporary slavery in Brazil, divergent characterizations of this practice remain. The courts currently employ the broadest concept of contemporary slave labor, in which the crime is characterized by the engagement in one of the following conducts established as a criminal offense: labor with the restriction of freedom, submission to exhaustive working conditions, degrading working conditions, and debt bondage. The engagement in one of the above is therefore enough to constitute a crime. Contemporary slave labor in Brazil is not characterized only by the restriction of the worker’s freedom, as in the case of forced labor or debt bondage, but also through the submission of the workers to situations that offend their human dignity. Individual freedom and the dignity of the human person, fundamental tenets of the Brazilian Federal Constitution, are juridical resources safeguarded by law. Contemporary slavery is not limited to the mere infringement of labor laws, but represents a severe violation of the human rights of the workers involved.

Construção de uma responsabilidade europeia além-fronteiras

The suppression of internal border controls has led the European Union to establish a mechanism for determining the Member State responsible for examining each asylum application, with the main intention of deterring asylum seekers from lodging multiple applications and guaranteeing that it will be assessed by one of the States – the Dublin System. Even though it holds on a variety of criteria, the most commonly used is the country of first entrance in the EU. The growing migrating flows coming mainly from Northern Africa have thus resulted in an incommensurable burden over the border countries. Gradually, countries like Greece, Bulgaria and Italy have lost capability of providing adequate relief to all asylum seekers and the records of fundamental rights violations related to the provision of housing and basic needs or inhuman detention conditions started piling up. To prevent asylum seekers who had already displaced themselves to other Member States from being transferred back to countries where their human dignity is questionable, the European Court of Human Rights and the Court of Justice have developed a solid jurisprudence determining that when there is a risk of serious breach of fundamental rights all transfers to that country must halt, especially when it is identified with systemic deficiencies in the asylum system and procedures. This reflexion will go through the jurisprudence that influenced very recent legislative amendments, in order to identify which elements form part of the obligation not to transfer under the Dublin System. At last, we will critically analyze the new rising obligation, that has clearly proven insufficient in light of the international fundamental rights framework that the Member States and the EU are bound to respect, proposing substantial amendments with a view to reach a future marked by high solidarity and global responsibility from the European Union.

Períodos de Fidelização

This dissertation aims to study the loyalty clauses present in most of the long lasting service contracts. We introduce its main features and the consequences that arise from breaching of contract. We analyze the presence of loyalty periods in the Portuguese legislation. In this sense, we discuss Decree-Law 446/85, Law 24/96, Decree-Law 57/2008 and Decree-Law 56/2010. The loyalty period is the minimum period of time for which the contract should be maintained. In most cases, when this obligation is not fulfilled a penalty clause is set, intending to push the weaker party to comply with the contract or sanction it when the party fails to do so. We conclude that the contractual relationship where there is a loyalty period is usually an unbalanced relationship because it only protects the interest of one party. The penalty clause should not be admitted between parties with unequal bargaining powers. The contractual imbalance is not limited to consumer contracts.

A proposta de regulamento relativo a um direito europeu comum da compra e venda e as suas implicações no direito português

We have witnessed in recent years, an obvious effort by the competent European institutions, towards the harmonization of general law applicable to all Member States (MS's). Many developments have been registered in several areas of law, a europeanization process that aims to add value to cross-border transactions and, consequently, the internal market and european trade. This trend manifests itself in general to the private law level, and particularly in contract law. The extension of the field in which market participants - whether professionals or consumers - can act, must imperatively be articulated with a consequent wider protection. After all, the consumer is also a leading European purposes and its level should not be called into question for the sake of promoting trade. The link between the positions of two opposing parties, professionals and consumers, requires commitment and work reinforced by the institutions but only on that basis is consistent legislative production. The proposed Regulation on a Common European Sales Law of the sale, the European Commission, set focus to European contract law and raises questions about the relevance and necessity of such uniformity. An instrument for purposes of harmonization of European contract law, that can be applied to all cross-border consumer contracts, similar in all MS's certainly bring many benefits. However, its applicability and usefulness would depend on the level of protection that would provide, compared to the existing national rights. Would an optional instrument ensure the designs of a common law? Moreover, would a binding instrument be the best alternative in that sense? Keywords:

O espaço das informações no combate ao terrorismo

The management of terrorism presents an added importance because of the ignorance and uncertainty that this threat to peace launches in societies. From the globalization process has resulted a capacity of mobility and communication which allowed the spread of terrorism globally and hence the ability to be in the international agenda. Thus it became necessary a synergy between the main international organizations and states, in the common interest of managing terrorism to acceptable levels. This thesis aims to assess how much space is reserved for intelligence on combating terrorism. To this end, it carried out a literature review related to intelligence, security and terrorism, such as legislation and official documents, national and international. These allowed realize the strategies for combating terrorism of major international organizations and the Portuguese, the institutions that are in charge of fighting terrorism and related crimes, highlighting the intelligence institutions within the European Union and Portugal. Intelligence should enter on this panel by the need to meet the threat and its contours. On the one hand lies to understand the framework which establishes terrorism, tracing relevant scenarios to reduce uncertainty in decision-making and, on the other hand, also be responsible for disseminating information to other stakeholders on security, allowing its commands to use the means efficiently.

As forças de tipo gendarmerie e as operações/missões de gestão de crises da União Europeia

The European Union has taken in recent years an increasingly important role in ensuring peace and stability in the international community, and the security and defence policy of the Union has become synonymous with crisis management. The Union has addressed the issue of crisis management through two sources: the military side and the civilian side, which consists in carrying out numerous crisis management operations and missions. This study discusses the role of the European Union in conducting crisis management operations and missions and how the gendarmerie forces contribute to the success of the same. It will discuss the evolution of the European Union's security policy and the concept of crisis management, and seek to demonstrate the added value of the commitment of gendarmerie forces in operations and missions of crisis management, particularly with regard to employment of the European Gendarmerie Force. On the other hand, it will study the planning process for crisis management of the European Union, featuring the entities and agencies involved in it, and presenting the products that result from this same process. The use of Gendarmerie forces in crisis management operations and missions has significant advantages. Its use is recommended to post - conflict scenarios, in complementarity with the armed forces, in order to overcome the "security gap" that mediates the transition from the state of conflict for the period of peace and reconstruction. Gendarmerie forces can also be engaged both in military crisis management operations and civilian crisis management missions.

O sigilo bancário e a fraude fiscal

Tax evasion and fraud threaten the economic and social objectives of modern tax systems, precluding the state funding for the satisfaction of collective needs and the fair distribution of wealth, being a violation of basic principles and values of our society. In tax law, to give tax administration the necessary powers to supervise and control the information provided by taxpayers and combat tax evasion and fraud, over the last years the grounds for a derogation of bank secrecy without judicial authorization have been extended, which raises some constitutional compatibility issues. Similarly, this tendency of making this legal regime more flexible and increasing automatic exchange of information has been followed by the European Union and the international community. Banking secrecy, as a professional secrecy, is an instrument to protect the right to privacy but also appears as an anti-abuse and repressive mechanism of evasive and fraudulent behaviors. Because of the conflict of interests will always be necessary to make a practical agreement between them, ensuring the legality and the due guarantees of the taxpayers but also an effective way to combat tax evasion and fraud. Bank secrecy cannot be one method to, behind the right to privacy, taxpayers practice illegal activities. But the practice of these irregular conducts also does not justify a total annihilation of the right to banking secrecy, uncovering all documents and bank information’s. Although considering the legislative changes, the administrative derogation of bank secrecy will always be what the tax administration does of it.