Responsibility to protect : conflict prevention through mediation

Na presente dissertação propomo-nos a explorar a possibilidade do desenvolvimento de um regime jurídico vinculativo, que possa ser desencadeado em contextos de crises humanitárias. O objetivo será agir eficazmente para prevenir a erupção ou escalada da violência e de conflitos armados. Em termos legais, é discutido se tal parâmetro preventivo já existe e, consequentemente, se as normas jurídicas internacionais impõem um dever à comunidade internacional de reagir perante graves violações de Direitos Humanos perpetradas pelos Governos. Concluímos que tal regime normativo existe, emanando do princípio da ‘Responsabilidade de Proteger’ e do dever de cooperação estabelecido no Projeto de Artigos sobre a Responsabilidade dos Estados. No entanto, carece de força vinculativa. Um dos obstáculos à adoção pelos Estados de regimes de prevenção de conflitos vinculativos tem sido a sua conotação com a intervenção militar para fins humanitários. Por este motivo, pretendemos reforçar a importância da prevenção de conflitos em contextos anteriores à comissão de grandes atrocidades. Damos ênfase à Mediação como método de prevenção de conflitos com especial relevância em contextos de conflitos internos. Analisamos a crise na Venezuela e a possibilidade da emergência de um costume internacional que valide a prática da Mediação como norma legal. A nossa análise assenta numa abordagem interdisciplinar, colhendo ensinamentos das Relações Internacionais, bem como (ainda que em menor extensão) dos Estudos da Paz e da Psicologia.This thesis explores the possibility of developing a legally binding framework for conflict prevention, that could be enacted in contexts of humanitarian crisis. The goal would be to act effectively to prevent the eruption or escalation of violence and armed conflicts. We discuss, in legal terms, whether such a preventive framework already exists. Moreover, whether general norms of International Law impose on States a duty to react to grave violations of Human Rights conducted by Governments. We conclude that such a regime exists and emanates from the principle of ‘Responsibility to Protect’ and from the duty of cooperation established under the ICL’s Draft Articles. However, the regime lacks binding character. One obstacle to the adoption by States of legally binding mechanisms for conflict prevention is the fact that the latter has been associated with military intervention for humanitarian purposes. For this reason, we intend to reinforce the importance of conflict prevention in contexts prior to the commission of mass atrocities. Mediation is emphasised as a conflict prevention method with special relevance in contexts of internal conflict. We analyse the Venezuelan crisis and the possibility of emergence of a customary norm, which validates the practise of Mediation as a legal rule. We conduct an interdisciplinary analysis, retrieving lessons from International Relations, as well as – to a lesser extent – Peace Studies and Psychology

Personal protective strategies for dengue disease: simulations in two coexisting virus serotypes scenarios

Dengue fever is a common mosquito-borne viral infectious disease in the world and is widely spread, especially in tropical and subtropical regions. At this moment, one of the best ways to fight the disease is to prevent mosquito bites. In this study, we present a mathematical model that carefully considers personal protection for humans. It is an epidemiological model that translates the dengue disease through a system of differential ordinary equations which takes in consideration the dynamics of the disease between human and mosquito populations. This model incorporates a parameter that simulates personal protection measures, namely insect repellent, special clothes, or bed nets, and a parameter that asserts the effectiveness of public awareness to the importance of using personal protective equipment. In 2012 there was a dengue disease outbreak in Madeira Island, in Portugal, and this study not only tries to predict what could happen if a second outbreak occurs, where it is considered that there are two serotypes of Dengue disease, but also tries to predict the effects and the importance of taking personal protection measures. The results show that the level of personal measures and the time that people are compelled to use them have a significant impact to prevent dengue disease.publishe

Economic burden of personal protective strategies for dengue disease: an optimal control approach

Dengue fever is a vector-borne disease that is widely spread. It has a vast impact on the economy of countries, especially where the disease is endemic. The associated costs with the disease comprise prevention and treatment. This study focus on the impact of adopting individual behaviors to reduce mosquito bites - avoiding the disease’s transmission - and their associated costs. An epidemiological model is presented with human and mosquito compartments, modeling the interaction of dengue disease. The model assumed some self-protection measures, namely the use of repellent in human skin, wear treated clothes with repellent, and sleep with treated bed nets. The household costs for these protections are taking into account to study their use. We conclude that personal protection could have an impact on the reduction of the infected individuals and the outbreak duration. The costs associated with the personal protection could represent a burden to the household budget, and its purchase could influence the shape of the infected’s curve.publishe

Perspectivas integradoras sobre o Psicodrama Moreniano: os teóricos, os terapeutas e os clientes

Tese apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Doutor em Ciências Sociais, especialidade de PsicologiaO Psicodrama Moreniano (PM) é um modelo psicoterapêutico que se baseia na ação, preferencialmente realizado em grupo, e cujo núcleo é a dramatização das experiências individuais dos protagonistas, i.e., os diversos papéis que estes assumem, na sua vida, enquanto indivíduos em relação com o mundo e com os outros. São muitos os autores a considerar que a psicoterapia de grupo nasceu com o PM. Além disso, existe também um vasto número de estudos que apontam no sentido do PM ter um impacto positivo em vários aspectos, tais como mudanças sintomáticas (Godinho & Vieira, 1999; Kipper & Ritchie, 2003; Wieser, 2007). No entanto, existem poucas evidências sobre o processo pelo qual a mudança ocorre nos indivíduos com o PM e desconhecem-se também metodologias de investigação, específicas para o PM, que permitam um estudo mais aprofundado desta matéria. Por outro lado, é também escassa a investigação em torno do que os clientes pensam sobre o PM, nomeadamente, sobre aquilo que o torna útil e não útil para o seu processo terapêutico. Partindo destas ideias, o principal objectivo deste trabalho prendeu-se com o estudo do processo do PM do ponto de vista do cliente, mais concretamente, o desenvolvimento de uma metodologia para analisar as experiências dos clientes com o PM. Para tal, foram realizados três estudos: o primeiro, constituiu uma revisão sistemática da literatura em que se identificaram e definiram as técnicas mais comummente usadas em PM; o segundo, propõe um sistema de codificação das experiências dos clientes sobre o processo de tratamento em PM; e o terceiro, uma aplicação preliminar deste sistema num grupo naturalístico de PM. Em suma, concluiu-se que as experiências dos clientes constituem uma fonte privilegiada de informação sobre o processo terapêutico em PM e que o método de análise desenvolvido tem inúmeras potencialidades para fazer avançar a investigação neste contexto. De futuro, espera-se que a utilização deste paradigma de investigação possa ser amplamente utilizado em diversas amostras, permitindo um conhecimento cada vez mais robusto sobre o que torna o PM útil para os clientes. Morenian Psychodrama (MP) is an action-based psychotherapeutic model, preferably administered in group, whose central point is the dramatization of the protagonist’s individual experiences, i.e., the roles which clients play, in their lives, as individuals interacting with the world and the others. There are many authors considering that group psychotherapy has born with MP. Besides, there is also a vast number of studies advocating that MP has a positive impact in many aspects, such as symptomatic changes (Godinho & Vieira, 1999; Kipper & Ritchie, 2003; Wieser, 2007). Nevertheless, the evidences about the process by which change occurs in individuals undergoing MP is scant, as well as MP-specific research methodologies that allow a deeper understanding of this subject. On the other hand, it is also unknown that do clients think about MP, namely, what makes it helpful and unhelpful for their psychotherapeutic process. Having this in mind, the main goal of this thesis was to study the process of MP through the perspective of clients, more specifically, the development of a methodology to analyze the experiences of clients in MP. Three studies were carried out to meet this goal: first, a systematic review of the literature to identify and define the MP techniques most commonly used; the second, proposes a coding system of clients experiences about the process treatment in MP; and third, a preliminary study using this system in a naturalistic group in MP. To sum up, we concluded that the experiences of clients are a privileged source of information about the process of MP and that the method developed in this thesis has numerous potentialities to improve the research in this field. In the future, we hope that this research paradigm might be widely used in various samples, so that our knowledge about that makes MP helpful can take many steps further. Le Psychodrame Morénien (MP) est un modèle psychothérapeutique, basé sur l'action, réalisée de préférence en groupe, et dont le coeur est la dramatisation de expériences individuelles des protagonistes, c'est-à-dire, les différents rôles qu'ils assument dans sa vie, en tant qu'individus en relation avec le monde et avec les autres. Il y a beaucoup d'auteurs à considérer que la psychothérapie de groupe est né avec le PM. De plus, il y a aussi un grand nombre d'études pointant vers le PM ont un impact positif sur plusieurs aspects, tels que les changements symptomatiques (Godinho & Vieira, 1999; Kipper & Ritchie, 2003; Wieser, 2007). Cependant, il y a peu d'indications sur le processus par lequel le changement se produit chez les individus avec le PM et ne sont pas connus des méthodologies de recherche, spécifiques à la PM, pour permettre un étude plus approfondie de cette matière. D'autre part, il est également rare la recherche autour de ce que les clients pensent de le PM, en particulier, sur ce qui le rend utile et pas utile pour leur processus thérapeutique. Basé sur ces idées, l'objectif principal de ce travail pris avec l'étude du processus du PM du point de vue du client, plus particulièrement, l'élaboration d'une méthodologie pour analyser les expériences des clients avec le PM. À ces fins, trois études ont été réalisées: la première, constituée un examen systématique de la littérature en ce que se identifié et défini les techniques les plus couramment utilisés dans les PM; le second propose un système de codification de l'expérience des clients sur le processus de traitement en PM; et le troisième, une demande préliminaire de ce système dans un groupe de naturaliste du PM. En bref, on a conclu que les expériences des clients constituent une source privilégiée d'informations sur le processus thérapeutique dans le PM et que la méthode d'analyse développée a de nombreuses possibilités pour faire avancer la recherche dans ce contexte. À l'avenir, il est attendue que l'utilisation de ce paradigme de recherche peut être largement utilisée dans plusieurs échantillons, ce qui permet de plus en plus robuste connaissance sur ce qui rend le PM utile pour les clients

Computerized dietary interviews: defining guidelines for the construction of food consumption assessment softwares for European populations

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Harmonization of Dietary Quantification Methods: Can quantification by a common based picture book cover specific needs of a country?

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Reliability and validity of the international physical activity questionnaire short-form (IPAQ-sf) in COPD

Physical activity (PA) may improve COPD prognosis, thus its assessment and promotion are crucial. The International Physical Activity Questionnaire Short-Form (IPAQ-sf) is widely used for assessing PA but there is limited evidence on its clinimetric properties in COPD. We assessed the test-retest reliability and validity of the IPAQ-sf in patients with COPD. Fifty-five participants (68.6±7.8yrs, 48 males, FEV1 52.3±22.5%pred) completed the IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with: Intraclass Correlation (ICC, 95%CI), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC95) for continuous variables; %agreement for categories (“active” vs “inactive”). Validity was assessed with Spearman’s correlations (ρ) between the IPAQ-sf (METs-min/week, time in vigorous [VPA] and moderate PA [MPA] per week) and accelerometry [time in MVPA, VPA and MPA per week] for continuous variables; %agreement, Cohen’s kappa, sensitivity and specificity (95%CI) for categories. Reliability was acceptable (ICC=0.738, 0.629→0.873) but with wide LoA (-5713→4793.3 METs-min/week). SEM and MDC95 were 1844.7 and 5113.3 METs-min/week, respectively. %agreement of the two IPAQ-sf was 85.5% (kappa=0.660, 0.444→0.876). Significant correlations were found between METsmin/week and accelerometry (0.515≤ρ≤0.596), except for VPA (p>0.05). %agreement between tools was 67.3% (kappa=0.350, 0.279→0.571) with high sensitivity (0.89, 0.887→0.891) but low specificity (0.46, 0.46→0.47). The IPAQ-sf could be used as PA measurement tool in COPD although caution is needed to avoid misclassification.publishe

Test-retest reliability, agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in people with COPD

Artigo 107027. In Press, Journal Pre-proof. YRMED 107087. PII S0954-6111(22)00352-3.Introduction This study assessed the test-retest reliability/agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in patients with chronic obstructive pulmonary disease (COPD). It also explored differences in its validity according to age, sex and GOLD airflow obstruction levels. Methods 62 participants (68 ± 8 years, 53 males, FEV1 51 ± 23%pred) completed the Portuguese IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with Intraclass Correlation Coefficient (ICC2,1), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC95) for continuous variables, and percentage of agreement (%agreement) for categories (“active”/“inactive”). Validity was assessed with 95% LoA and Spearman's correlations (ρ) between IPAQ-sf 2 (METs-min/week, time in vigorous [VPA], moderate PA [MPA] and walking) and accelerometry (time in MVPA, VPA, MPA and step counts) for continuous variables; %agreement, Cohen's kappa, and sensitivity specificity and±predictive values for categories. Correlations were also performed for age, sex and GOLD airflow obstruction grades. Results Reliability was good (ICC2,1 = 0.707) with wide LoA (-6446—6409 METs-min/week). SEM and MDC95 were 1840 and 4971 METs-min/week, respectively. %agreement between the two IPAQ-sf was 84% (kappa = 0.660). Positive, moderate and significant correlations were found between IPAQ-sf and accelerometry (0.396 ≤ ρ ≤ 0.527, p  0.05). The strongest correlations were found in age (<65 years) and male (0.466 ≤ ρ ≤ 0.653, p < 0.05). %agreement between tools was 65% (kappa = 0.313), with high sensitivity (0.830) but low specificity (0.500). Conclusions The IPAQ-sf seems valid to be used in COPD but caution on its widespread use is recommended as its accuracy may be limited.info:eu-repo/semantics/publishedVersio

Measurement properties

OBJECTIVE: The Assessments of SpondyloArthritis international Society Health Index (ASAS HI), estimates the impact of Spondyloarthritis (SpA) on global functioning and health. This article assesses the construct validity, reliability and responsiveness of the Portuguese version of the ASAS HI. PATIENTS AND METHODS: Patients fulfilling ASAS classification criteria for axial (axSpA) or peripheral SpA (pSpA) were included. Construct validity was assessed through Spearman's correlation analysis with other health outcomes. Discriminant validity was tested comparing the ASAS HI across disease activity and functional states using the Kruskal-Wallis test. Internal consistency was assessed by Cronbach's α, and test-retest reliability by intraclass correlation coefficients (ICC). Responsiveness was evaluated by the standardized response mean (SRM) in patients with active disease who required therapy escalation. RESULTS: Among the 91 patients included, 67% were male, mean (SD) age 47.2 (12.9) years, 63 patients with axSpA and 28 patients with pSpA. The hypothesis defined a priori to test construct validity were confirmed. The ASAS HI showed ability to discriminate between patients with different disease activity and functional states (p<0.001). Internal consistency (Cronbach's α: 0.88) and test-retest reliability [ICC=0.76 (95%CI 0.09-0.91)] were good. Responsiveness was moderate (SRM=-0.53). The smallest detectable change was 3.0. CONCLUSIONS: The Portuguese version of the ASAS HI is a comprehensible questionnaire that is valid, reliable and responsive. It can be used to assess the impact of SpA and its treatment on functioning and health, in clinical practice and for research purposes.publishersversionpublishe