Das CPCJ aos tribunais da relação : caracterização dos processos de promoção e proteção

O progressivo reconhecimento do lugar que as crianças e jovens ocupam na sociedade enquanto sujeitos de direitos e a importância de incentivar, desenvolver e assegurar o exercício efetivo dos mesmos, tem convocado os interventores políticos e sociais para a observância de boas práticas em matéria de infância e juventude. Mas nem sempre foi desta forma, e existirá ainda um longo caminho a percorrer no que respeita a esta temática. Neste trabalho foi feito o enquadramento da evolução dos direitos da criança até se chegar à intervenção no âmbito da Lei 147/99. Esta intervenção foi depois seguida, desde o seu início até à chegada a sede judicial, através da análise de 92 acórdãos que implicam a matéria de facto. Obtiveram-se resultados que apontam para a maior frequência da aplicabilidade das medidas de “confiança a instituição com vista a futura adoção” e “acolhimento residencial” pelos Tribunais de Família e Menores e da Relação. Também foi possível apurar que a maioria dos recursos são indeferidos pelos Tribunais de Relação. Este estudo aponta para a necessidade de intervenção precoce em matéria de promoção e protecção, para que se possam evitar muitas vezes situações remediativas que acontecem, assim como para a importância do trabalho de acompanhamento das famíliasThe progressive recognition of the place that children and young people have in society as subjects of rights and the importance of encourage, develop and secure its effective exercise, has summoned the political and social intervenors to observe good practices within childhood and youth. It hasn’t always been like this and there’s still a long way to run regarding this issue. In this report we’ve approached the children’s rights evolution until reaching the intervention under the law 147/99. This intervention has been followed since its beginning until reaching the judicial seat, through the analysis of judgements which imply this matter.Results were obtained which aim to a greater frequency of the applicability of measures related with “the trust on an institution regarding a future adoption” and “child residential reception”. Among other results, it was also possible to gather that most of the appeals are denied by Supreme Court. This study aims to the need of early intervention, which can avoid many of the fixing situations happening, as well as the importance of working with the families and families monitoring

Vascular calcifications, vertebral fractures and mortality in haemodialysis patients

Background. Vascular calcifications and the bone fractures caused by abnormal bone fragility, also called osteoporotic fractures, are frequent complications associated with chronic kidney diseases (CKD). The aim of this study was to investigate the association between vascular calcifications, osteoporotic bone fractures and survival in haemodialysis (HD) patients

Cancer-associated bone disease

Bone is commonly affected in cancer. Cancer-induced bone disease results from the primary disease, or from therapies against the primary condition, causing bone fragility. Bone-modifying agents, such as bisphosphonates and denosumab, are efficacious in preventing and delaying cancer-related bone disease. With evidence-based care pathways, guidelines assist physicians in clinical decision-making. Of the 57 million deaths in 2008 worldwide, almost two thirds were due to non-communicable diseases, led by cardiovascular diseases and cancers. Bone is a commonly affected organ in cancer, and although the incidence of metastatic bone disease is not well defined, it is estimated that around half of patients who die from cancer in the USA each year have bone involvement. Furthermore, cancer-induced bone disease can result from the primary disease itself, either due to circulating bone resorbing substances or metastatic bone disease, such as commonly occurs with breast, lung and prostate cancer, or from therapies administered to treat the primary condition thus causing bone loss and fractures. Treatment-induced osteoporosis may occur in the setting of glucocorticoid therapy or oestrogen deprivation therapy, chemotherapy-induced ovarian failure and androgen deprivation therapy. Tumour skeletal-related events include pathologic fractures, spinal cord compression, surgery and radiotherapy to bone and may or may not include hypercalcaemia of malignancy while skeletal complication refers to pain and other symptoms. Some evidence demonstrates the efficacy of various interventions including bone-modifying agents, such as bisphosphonates and denosumab, in preventing or delaying cancer-related bone disease. The latter includes treatment of patients with metastatic skeletal lesions in general, adjuvant treatment of breast and prostate cancer in particular, and the prevention of cancer-associated bone disease. This has led to the development of guidelines by several societies and working groups to assist physicians in clinical decision making, providing them with evidence-based care pathways to prevent skeletal-related events and bone loss. The goal of this paper is to put forth an IOF position paper addressing bone diseases and cancer and summarizing the position papers of other organization

Response to IJTLD article, "Having diabetes and being underweight in Asia: a potent risk factor for tuberculosis"

Contains fulltext : 220544pub.pdf (Publisher’s version ) (Closed access

Reproductive Intentions and Outcomes among Women on Antiretroviral Therapy in Rural Uganda: A Prospective Cohort Study

Background: Antiretroviral therapy (ART) may influence the biological, social and behavioral determinants of pregnancy in HIV-infected women. However, there are limited longitudinal data on the reproductive intentions and outcomes among women on ART in Africa. Methodology /Principal Findings: Using a prospective cohort design, we analyzed trends in desire for children and predictors of pregnancy among a cohort of 733 HIV-infected women in rural Uganda who initiated ART between May 2003 and May 2004 and were followed up in their homes until June 2006. Women answered in-depth social and behavioral questionnaires administered every quarter in year 1 after initiating ART, and every 6 to 12 months thereafter. Use of family planning methods was assessed at 18 and 24 months after starting ART. We tested for non-constant pregnancy incidence by using a shape parameter test from the Weibull distribution. We modeled repeated measurements of all variables related to the women’s desire for children over time using a generalized estimating equation (GEE) extension to the logistic regression model. Risk factors for pregnancy were examined using Cox proportional hazards model. 711 women eligible for the study were followed-up for a median time of 2.4 years after starting ART. During this time, less than 7 % of women reported wanting more children at any time point yet 120 (16.9%) women experienced 140 pregnancies and pregnancy incidence increased from 3.46 per 100 women-years (WY) in the first quarter to 9.5 per 100 WY at 24 months (p,0.0001). This wa

Family planning among people living with HIV in post-conflict Northern Uganda: A mixed methods study

<p>Abstract</p> <p>Background</p> <p>Northern Uganda experienced severe civil conflict for over 20 years and is also a region of high HIV prevalence. This study examined knowledge of, access to, and factors associated with use of family planning services among people living with HIV (PLHIV) in this region.</p> <p>Methods</p> <p>Between February and May 2009, a total of 476 HIV clinic attendees from three health facilities in Gulu, Northern Uganda, were interviewed using a structured questionnaire. Semi-structured interviews were conducted with another 26 participants. Factors associated with use of family planning methods were examined using logistic regression methods, while qualitative data was analyzed within a social-ecological framework using thematic analysis.</p> <p>Results</p> <p>There was a high level of knowledge about family planning methods among the PLHIV surveyed (96%). However, there were a significantly higher proportion of males (52%) than females (25%) who reported using contraception. Factors significantly associated with the use of contraception were having ever gone to school [adjusted odds ratio (AOR) = 4.32, 95% confidence interval (CI): 1.33-14.07; p = .015], discussion of family planning with a health worker (AOR = 2.08, 95% CI: 1.01-4.27; p = .046), or with one's spouse (AOR = 5.13, 95% CI: 2.35-11.16; p = .000), not attending the Catholic-run clinic (AOR = 3.67, 95% CI: 1.79-7.54; p = .000), and spouses' non-desire for children (AOR = 2.19, 95% CI: 1.10-4.36; p = .025). Qualitative data revealed six major factors influencing contraception use among PLHIV in Gulu including personal and structural barriers to contraceptive use, perceptions of family planning, decision making, covert use of family planning methods and targeting of women for family planning services.</p> <p>Conclusions</p> <p>Multilevel, context-specific health interventions including an integration of family planning services into HIV clinics could help overcome some of the individual and structural barriers to accessing family planning services among PLHIV in Gulu. The integration also has the potential to reduce HIV incidence in this post-conflict region.</p

Variational Foundations and Generalized Unified Theory of RVE-Based Multiscale Models

A unified variational theory is proposed for a general class of multiscale models based on the concept of Representative Volume Element. The entire theory lies on three fundamental principles: (1) kinematical admissibility, whereby the macro- and micro-scale kinematics are defined and linked in a physically meaningful way; (2) duality, through which the natures of the force- and stress-like quantities are uniquely identified as the duals (power-conjugates) of the adopted kinematical variables; and (3) the Principle of Multiscale Virtual Power, a generalization of the well-known Hill-Mandel Principle of Macrohomogeneity, from which equilibrium equations and homogenization relations for the force- and stress-like quantities are unequivocally obtained by straightforward variational arguments. The proposed theory provides a clear, logically-structured framework within which existing formulations can be rationally justified and new, more general multiscale models can be rigorously derived in well-defined steps. Its generality allows the treatment of problems involving phenomena as diverse as dynamics, higher order strain effects, material failure with kinematical discontinuities, fluid mechanics and coupled multi-physics. This is illustrated in a number of examples where a range of models is systematically derived by following the same steps. Due to the variational basis of the theory, the format in which derived models are presented is naturally well suited for discretization by finite element-based or related methods of numerical approximation. Numerical examples illustrate the use of resulting models, including a non-conventional failure-oriented model with discontinuous kinematics, in practical computations