Poderá ser a criminalização do assédio moral e/ou mobbing, rectius no trabalho, respeitadora dos princípios constitucionais da necessidade, adequação, proporcionalidade e intervenção mínima penais? - A lesão dos direitos fundamentais constitucionais dos trabalhadores: o caso português1

Resumo: O direito constitucional português ao trabalho: introdução § Algumas ideias sobre o assédio moral ou psicológico: as principais vítimas, as diferenças do bullying (e/ou intimidação ou tiranizar), os fundamentos, o seu estudo § O contexto do ordenamento jurídico português: algumas consequências do assédio moral § O direito geral à personalidade § A distinção entre o assédio moral e outras figuras § O assédio sexual faz parte do assédio moral em sentido amplo § Dentro do problema do “assédio moral”, da “liberdade moral” e, nomeadamente, dos crimes contra a liberdade sexual e autodeterminação sexual, algumas notas, de Direito penal, sobre a “coação sexual”: responsabilidade penal § O assédio moral no ordenamento jurídico português e, designadamente, no contexto do Direito do trabalho § O assédio moral como doença profissional, a hipótese de ocorrer suicídio e a eventual responsabilidade civil § Conclusão § “Ideia final” § Abstract: The Portuguese constitucional law to the work (labour): introduction § Some ideas on the moral or psychological siege (general mobbing): the main victims, the differences of bullying (and/or intimidation or “the labour tyrant”), the beddings, its study § The context of the Portuguese legal system § The context of the Portuguese legal system: some effects of the moral siege (general mobbing) § The general right to the personality § The distinction between the moral siege (general mobbing) and other figures § The sexual siege (sexual harassement or sexual mobbing) is part of the moral siege(general mobbing) in ample direction § Inside of the problem of the “moral siege” (general mobbing), “moral freedom” e, nominated, of the crimes against the sexual freedom and sexual self-determination, some notes, of Criminal law, on the “sexual coercion”: criminal liability § The moral siege (general mobbing) in Portuguese legal system and, appointedly, in the context of the Law of the work (labour law) § The moral siege (general mobbing) as ocupational disease, the hypothesis to occur suicide and the eventual civil liability § Conclusion § “Final Idea”

Geographical stratification by socio-economic status: methodology from a household survey with elderly people in S. Paulo, Brazil

Considering that in most developing countries there are still no comprehensive lists of addresses for a given geographical area, there has always been a problem in drawing samples from the community, ensuring randomisation in the selection of the subjects. This article discusses the geographical stratification by socio-economic status used to draw a multistage random sample from a community-based elderly population living in a city like S. Paulo - Brazil. Particular attention is given to the fact that the proportion of elderly people in the total population of a certain area appeared to be a good discriminatory variable for such stratification. The validity of the stratification method is analysed in the light of the socio-economic results obtained in the survey.

Cidade digital

A Resolução do Conselho de Ministros n.º 120/2008, de 30 de Julho, definiu como prioridade estratégica para o País, no sector das comunicações electrónicas, a promoção do investimento em redes de nova geração. Com o objectivo de dar execução às orientações estratégicas estabelecidas, o Decreto -Lei n.º 123/2009, de 21 de Maio, veio estabelecer um conjunto de obrigações aplicáveis ao Estado, às Regiões Autónomas, às autarquias locais, empresas públicas, concessionárias e, genericamente, às entidades que detenham infra-estruturas que se integrem em domínio público, de forma a garantir a todas empresas de comunicações electrónicas, o acesso às infra-estruturas aptas ao alojamento de redes de comunicações electrónicas. Em Portugal, o caminho a ser traçado até as redes de nova geração passa pela, abertura eficaz e não discriminatória de todas as condutas e outras infra-estruturas aptas ao alojamento de redes de comunicações electrónicas, elaboração de regras técnicas aplicáveis às infra-estruturas de telecomunicações em loteamentos, urbanizações e conjuntos de edifícios, adopção de soluções que eliminem ou atenuem as barreiras verticais à instalação de fibra óptica e que evitem a monopolização do acesso aos edifícios pelo primeiro operador. Neste âmbito, excluem-se, pela sua especial natureza e fins a que estão afectas, as redes privativas dos órgãos políticos de soberania, do Ministério da Defesa Nacional, das forças e serviços de segurança, de emergência e de protecção civil. Assim, este trabalho visa apresentar procedimentos aplicáveis às infra-estruturas de telecomunicações para elaboração de um cadastro de todas as infra-estruturas, públicas e privadas, aptas ao alojamento de redes de comunicações electrónicas, e propor instruções técnicas para as condições e direitos de acesso, construção e intervenção sobre estas infra-estruturas.

Estudo das alterações imunofenotípicas de populações linfocitárias em doentes com artrite reumatóide

A Artrite Reumatóide (AR) é uma doença auto-imune que devido às suas características tornam por si só os indivíduos afectados susceptíveis a infecções; imunocomprometimento que por vezes ainda é agravado por terapêuticas imunomodulatórias usadas para o seu tratamento. Este estudo tem como objectivo analisar, as populações/sub-populações de linfócitos conjuntamente com a análise das imunoglobulinas G e M, apresentando como factores discriminatórios, a idade, o sexo e a presença de terapêutica imunomodulatória, nos doentes com AR. Os resultados sugerem uma depleção significativa dos linfócitos B e um aumento dos T, os quais dão indícios para um aumento da susceptibilidade a infecções.

Microcytic anemia factor no estudo das anemias microcíticas

A anemia ferropénica e a β-Talassemia menor são as anemias microcíticas mais frequentes na prática laboratorial, sendo o seu diagnóstico de extrema importância clínica. O objectivo deste estudo consistiu na análise do poder discriminatório do MAF na caracterização destas anamias. Foi desenvolvido um estudo caso-controlo, tendo sido analisados os hemogramas de um grupo de 47 indivíduos com anemia ferropénica e 37 com β-talassemia, e de um grupo controlo constituído por 58 indivíduos saudáveis. Na diferenciação dos grupos patológicos, apenas a Hemoglobina, o VGM e o RDW apresentaram diferenças significativas. O MAF não demonstrou poder discriminatório relativamente às anemias microcíticas.

Contradiction between the average age of retirement at the time of death and the average pension time for men and women in public employment in Portugal

The short article attempts to make some very brief reflections on the effects a lack of public policies positively discriminatory in terms of public employment retirement. In particular, the observation of the absurd contradiction between the average age of retirement at the time of death (for men and women) and the average pension time for men and women in public employment in Portugal.

Explicit discrimination and health: development and psychometric properties of an assessment instrument

OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.

Tradução, validação e aplicação dos sistemas de pontuação de alerta precoce 'ViEWS' e 'NEWS' em Portugal

Mestrado em Gestão e Avaliação de Tecnologias da Saúde

Lysotypes and plasmidial profile of Salmonella Serovar Typhimurium isolated from children with enteric processes in the cities of Rio de Janeiro, RJ, and Salvador, BA - Brazil

The lysotypes, plasmidial profiles, and profiles of resistance to antimicrobial agents were determined in 111 Salmonella Typhimurium strains isolated from feces and blood of children treated in Rio de Janeiro and in Salvador. Six distinct lysotypes (19, 41, 97, 105, 120 and 193) were recognized, with a predominance of lysotype 193 (59.7%) in Rio de Janeiro and of phage type 105 (38.4) in Salvador. Approximately 86.7% of the lysotype 193 strains presented multiple resistance to more than six antimicrobial agents, whereas 93% of lysotype 105 strains were fully susceptible. More than 90% of the strains presented plasmids distributed into 36 different profiles in Rio de Janeiro and into 10 profiles in Salvador. A 40 MDa plasmid was the most frequent (47%) in the strains from Rio de Janeiro, whereas a 61 MDa plasmid predominated (14.5%) in Salvador. Combined analysis of plasmid profile and classification into lysotypes (especially those belonging to types 105 and 103, proved to be more discriminatory than the other methods applied).

Molecular typing of Candida albicans strains isolated from nosocomial candidemia

Yeasts of the genus Candida have been recognized as important microorganisms responsible for nosocomial fungemia. Six blood-stream and two intravenous central catheter C. albicans strains were isolated from eight patients and studied by electrophoretic karyotyping of chromosomal DNA by pulsed-field gel electrophoresis. Seven chromosomal DNA profiles were identified. Two patients showed isolates with the same profile, suggesting nosocomial transmission. Karyotyping of C. albicans revealed an excellent discriminatory power among the isolates and may therefore be useful in the study of nosocomial candidemia.

Conventional and molecular typing of Salmonella typhi strains from Brazil

Phenotypic and genotypic characteristics of Salmonella Typhi were studied in 30 strains, isolated in different years, from some areas in Brazil. Conventional typing methods were performed by biochemical tests, Vi phage-typing scheme, and antimicrobial susceptibility test. Molecular typing methods were performed by analysis of plasmid DNA and by random amplified polymorphic DNA (RAPD-PCR). For the latter, an optimization step was performed to ensure the reproducibility of the process in genetic characterization of S. Typhi. The predominance of 76.7% of biotype I (xylose +, arabinose -) was noticed in all studied areas. Three phage types were recognized, with prominence for the phage types A (73.3%) and I+IV (23.3%). All the strains were susceptible to the drugs used. However, 36.7% of the strains contained plasmids, with predominance of the 105 Kb plasmid. RAPD was capable of grouping the strains in 8 genotypic patterns using primer 784, in 6, using primer 787 and in 7, using primer 797. Conventional phenotypic typing methods, as well as the DNA plasmid analysis, presented nonsignificant discriminatory power; however, RAPD-PCR analysis showed discriminatory power, reproducibility, easy interpretation and performance, being considered as a promising alternative typing method for S. Typhi.

PCR-based identification of Burkholderia pseudomallei

DNA amplification techniques are being used increasingly in clinical laboratories to confirm the identity of medically important bacteria. A PCR-based identification method has been in use in our centre for 10 years for Burkholderia pseudomallei and was used to confirm the identity of bacteria isolated from cases of melioidosis in Ceará since 2003. This particular method has been used as a reference standard for less discriminatory methods. In this study we evaluated three PCR-based methods of B. pseudomallei identification and used DNA sequencing to resolve discrepancies between PCR-based results and phenotypic identification methods. The established semi-nested PCR protocol for B. pseudomallei 16-23s spacer region produced a consistent negative result for one of our 100 test isolates (BCC #99), but correctly identified all 71 other B. pseudomallei isolates tested. Anomalous sequence variation was detected at the inner, reverse primer binding site for this method. PCR methods were developed for detection of two other B. pseudomallei bacterial metabolic genes. The conventional lpxO PCR protocol had a sensitivity of 0.89 and a specificity of 1.00, while a real-time lpxO protocol performed even better with sensitivity and specificity of 1.00, and 1.00. This method identified all B. pseudomallei isolates including the PCR-negative discrepant isolate. The phaC PCR protocol detected the gene in all B. pseudomallei and all but three B. cepacia isolates, making this method unsuitable for PCR-based identification of B. pseudomallei. This experience with PCR-based B. pseudomallei identification methods indicates that single PCR targets should be used with caution for identification of these bacteria, and need to be interpreted alongside phenotypic and alternative molecular methods such as gene sequencing.

MOLECULAR TYPING OF Candida albicans ISOLATES FROM HOSPITALIZED PATIENTS

SUMMARYIntroduction: The majority of nosocomial fungal infections are caused by Candida spp. where C. albicans is the species most commonly identified. Molecular methods are important tools for assessing the origin of the yeasts isolated in hospitals.Methods: This is a study on the genetic profifiles of 39 nosocomial clinical isolates of C. albicans using two typing methods: random amplifified polymorphic DNA (RAPD) and microsatellite, two different primers for each technique were used.Results: RAPD provided 10 and 11 different profiles with values for SAB of 0.84 ± 0.126 and 0.88 ± 0.08 for primers M2 and P4, respectively. Microsatellite using two markers, CDC3 and HIS3, allowed the observation of six and seven different alleles, respectively, with combined discriminatory power of 0.91.Conclusions: Although genetic variability is clear, it was possible to identify high similarity, suggesting a common origin for at least a part of isolates. It is important to emphasize that common origin was proven from yeasts isolated from colonization (urine, catheter or endotracheal secretions) and blood culture from the same patient, indicating that the candidemia must have started from a site of colonization. The combination of RAPD and microsatellite provides a quick and efficient analysis for investigation of similarity among nosocomial isolates of C. albicans.

American Society of Anesthesiologists Score: Still Useful After 60 Years? Results of the EuSOS Study

OBJECTIVE: The European Surgical Outcomes Study described mortality following in-patient surgery. Several factors were identified that were able to predict poor outcomes in a multivariate analysis. These included age, procedure urgency, severity and type and the American Association of Anaesthesia score. This study describes in greater detail the relationship between the American Association of Anaesthesia score and postoperative mortality. METHODS: Patients in this 7-day cohort study were enrolled in April 2011. Consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery with a recorded American Association of Anaesthesia score in 498 hospitals across 28 European nations were included and followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Decision tree analysis with the CHAID (SPSS) system was used to delineate nodes associated with mortality. RESULTS: The study enrolled 46,539 patients. Due to missing values, 873 patients were excluded, resulting in the analysis of 45,666 patients. Increasing American Association of Anaesthesia scores were associated with increased admission rates to intensive care and higher mortality rates. Despite a progressive relationship with mortality, discrimination was poor, with an area under the ROC curve of 0.658 (95% CI 0.642 - 0.6775). Using regression trees (CHAID), we identified four discrete American Association of Anaesthesia nodes associated with mortality, with American Association of Anaesthesia 1 and American Association of Anaesthesia 2 compressed into the same node. CONCLUSION: The American Association of Anaesthesia score can be used to determine higher risk groups of surgical patients, but clinicians cannot use the score to discriminate between grades 1 and 2. Overall, the discriminatory power of the model was less than acceptable for widespread use.

HTLV-I associated myelopathy in the northern region of Brazil (Belém-Pará): serological and clinical features of three cases

Three patients (males, black, ages 37, 40 and 57) attended a university clinic with a progressive paraparesis of obscure origin. One patient who referred disease duration of more than 16 years, showed diminished deep reflexes, bilateral Babinski's sign, diminished sensation of vibration, abnormal bladder function and back pain. The other two patients (with one and six years of disease duration) complained of weakness in one leg, increased deep reflexes and back pain. Babinski's sign and bladder disturbance were also present in the patient with six years of disease. Blood samples tested by an enzyme immune assay and a discriminatory Western blot were positive for HTLV-I. The familial analysis of one patient showed a possible pattern of sexual and vertical transmission of the virus. To the best of our knowledge, these are the first cases of a proven association between HTLV-I and TSP/HAM in Belem, Para, and emphasize the need to actively look for cases of neurological disease associated to the virus.