Para um Portugal 100% livre de tabaco: Sem mais demoras

Letter to the edito

The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH): a consumer‐based measure for the evaluation of community mental health interventions

The capabilities approach offers a multidimensional, ecological, and agent‐ centered framework that may inspire models of intervention and evaluation. A growing number of measures grounded on the capabilities approach for outcome measurement are appearing. Regarding community mental health, new consumer‐valued measures—constructed in collaboration with consumers—are here considered crucial for a transformative shift. Meanwhile, new measurements need to provide psychometric evidence to enable proper choice and application. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ‐CMH) was developed in collaboration with consumers of community mental health services. It aims to assess consumers' capabilities achieved through program support. The present paper shows advancements in the measure validation through a confirmatory factor analysis within a sample of community mental health consumers (N = 225). Reliability and construct‐related validity were also observed. A structural solution composed of five factors and 43 items revealed a better model fit than that obtained in a previous exploratory study. Findings support the reliability, sensibility, and both convergent and discriminant validity of using the ACQ‐CMH in the evaluation of community mental health interventions. The ACQ‐CMH offers a consumer‐valued framework with specific dimensions and indicators of capabilities for use in a routine service evaluation setting.info:eu-repo/semantics/publishedVersio

Second hand smoke (SHS) exposure in children: an evaluation of a preventative measure

Objectivo: Avaliar a eficácia de uma intervenção preventiva, dirigida a alunos do 4.º ano de escolaridade e aos seus pais/encarregados de educação, com a finalidade de reduzir a exposição das crianças ao fumo ambiental do tabaco (FAT) no domicílio. Material e métodos: Trata -se de um estudo pré-experimental, do tipo pré -teste e pós -teste, com alunos pertencentes a 32 escolas do 1.º ciclo do ensino básico, de cinco agrupamentos de escolas do concelho de Braga, no ano lectivo 2007/08. Foi aplicado um questionário de autorrelato, em contexto de sala de aula, antes e depois da intervenção. Na análise de dados, foi utilizado o qui -quadrado, por se tratarem de variáveis de categoria. Resultados: A prevalência de crianças expostas diária ou ocasionalmente ao FAT, pelo facto de pelo menos um dos conviventes fumar em casa, desceu dos 42,2% para os 32,6% (p=0,001). A percentagem de alunos, filhos de fumadores, que percepcionam que o pai fuma diária ou ocasionalmente em casa baixou de 68,0% no pré -teste para 51,6% no pós -teste (p=0,001). Em relação às mães, não houve uma redução estatisticamente significativa. Conclusão: O Programa Domicílios Sem Fumo terá sido eficaz em prevenir o consumo dos pais e outros conviventes em casa, tendo por isso ajudado a reduzir a prevalência de crianças expostas ao fumo ambiental. No entanto, verifica -se que ainda há cerca de um terço de crianças expostas, o que releva a necessidade de investimento em intervenções nesta área. Os profissionais de saúde, em especial os pediatras, devem aconselhar os pais a parar de fumar, sobretudo em casa.Aims: To evaluate the effectiveness of the preventative programme “Smoke-free Homes” undertaken in 4th year children and their parents or guardians, aiming to reduce children’s exposure to second hand smoke (SHS) in the home. Material and methods: This was a pre- and post-test pre-experimental study, in students from 32 Braga district primary schools 2007/08. A self-administered and structured questionnaire was given out to 795 students in the classroom before and after the programme. In analysing data, we used the chi-squared test for the categorical variables.Results: The rate of children exposed to regular or occasional SHS due to living with at least one smoker dropped from 42.2% to 32.6% (p=0.001). The percentage of students, children of smokers who stated that their father smoked regularly or occasionally at home, dropped from 68.0% pre-test to 51.6% posttest (p=0.000). No significant reduction was seen in mothers. Conclusion: Based on the data, we can conclude that the “Smoke-free Homes” programme was effective in preventing smoking in the home, and therefore reducing the rate of children exposed to SHS by about 10%. However, it appears that about a third of children are still exposed, which highlights the need for further measures in this area. Healthcare professionals, particularly those working in Paediatrics, should advise parents to quit smoking, especially in the home

Avaliação do cumprimento da lei portuguesa de prevenção do tabagismo no sector da restauração

O objectivo deste estudo é avaliar o cumprimento da nova legislação no sector da restauração e similares. Realizou-se na cidade de Braga – Portugal, em 2008. Foram objecto de observação: restaurantes com mais de 100 m2 (14); restaurantes com menos de 100 m2 (16); cafés, pastelarias e similares (29); e bares, pubs e discotecas (10). 76,8% dos locais da restauração e similares optaram por se declarar espaços sem fumo. A maior taxa de adesão encontra-se nos restaurantes com mais de cem metros (85,7%) e a menor nas discotecas, bares e pubs (70,5%).The objective of this study is to evaluate the fulfilment of the new legislation of tobacco control at the sector of the hospitality. The study was carried out in the city of Braga – Portugal, in 2008. Which evaluated: 14 restaurants with more than 100 m2; 16 restaurants with less than 100 m2; 29 coffees, cake shops and similar; and 10 bars, pubs and discotheques. 76,8% of the places observed had been declared smoke free environments. The largest percentage of adhesion meets in the restaurants with more than 100 m2 (85,7%) and the least in the discotheques, bars and pubs (70,5%)

Estado actual e evolução da epidemia tabágica em Portugal e na Europa

O consumo de tabaco fumado, é a causa de mais de meio milhão de mortes/ano na União Europeia (UE). Para se poder avaliar a eficácia das medidas preventivas, é importante fazer a monitorização da prevalência do consumo de tabaco. A comparação entre países, pode ajudar a identificar boas práticas nesse controlo. Objectivos: Descrever o estado actual e a evolução da epidemia tabágica em vários países da EU e caracterizar a situação Portuguesa. Métodos: A descrição dos hábitos tabágicos e a sua evolução, na população com mais de 15 anos, em vários Países da UE, foi feita com base nos inquéritos realizados pelo Eurobarómetro entre 1995 e 2007. A caracterização dos hábitos tabágicos dos adolescentes escolarizados foi feita com base nos dados do Health Behaviour in School-Aged Children referentes a 1993-4 e 2002. Na análise da situação portuguesa foi utilizada, adicionalmente, a informação disponível nos Inquéritos Nacionais de Saúde realizados entre 1987 e 2005/06. Resultados: A prevalência de fumadores na população adulta na maioria dos países Europeus considerados é superior a 25%. A prevalência média de fumadores e de fumadoras na população de jovens escolarizados é da ordem dos 18%, em ambos os sexos. Na maioria dos países estudados a prevalência do consumo de tabaco nas raparigas é superior à dos rapazes. Apesar de Portugal ter das mais baixas prevalências na população com mais de 15 anos (30,6% nos homens e 11,6% nas mulheres), constata-se, no entanto, elevadas prevalências nas faixas etárias de 25-34 e dos 35-44 em homens (39,9% e 44,6% respectivamente) e em mulheres (17,6 e 21,2% respectivamente). A percentagem de raparigas fumadoras com 15 anos de idade, era em 2002 de 19,5%, valor próximo do grupo de países europeus com mais elevada prevalência de adolescentes fumadoras. Na EU registou- se, na última década (1996-2006), uma diminuição do consumo de tabaco na maioria dos países, tanto na população adulta como nos jovens escolarizados. Em Portugal, o consumo estabilizou nos homens e nos jovens de 15 anos, mas regista um aumento apreciável na população feminina adulta e escolarizada. Conclusões: Apesar de Portugal apresentar valores globais relativamente baixos de prevalência no contexto Europeu, os substanciais aumentos verificados na população feminina são particularmente preocupantes não só pelo impacto na saúde das mulheres mas também pelas consequências pré e pós natais que o fumo na mulher acarreta. Esta situação ilustra, entre nós, a falência das estratégias preventivas, nomeadamente ao nível da escola. Tobacco smoking is the cause of more than half million deaths/year in the European Union (EU). Monitoring smoking prevalence is an important tool to evaluate the epidemic and its evolution and to assess the effectiveness of preventive measures. The comparison between countries may help us identify good control practices. Objective: To describe the current state and evolution of the smoking epidemic in several EU countries, and to characterize the Portuguese situation in comparison with those countries. Methods: To characterize smoking habits and their evolution in the population over 15 years old, several Eurobarometer reports from 1995 to 2007 were used. The characterization of School Aged Children’s smoking habits was based on the Health Behaviour in School-Aged Children data of 1993-4 and 2002. The Portuguese situation also used the information available from the National Health Surveys of 1987 up to 2005/06. Results: The global prevalence of smoking in adult population in most of the European countries is over 25%. The average prevalence of male and female smokers in School- Aged Children over 15 years of age is approximately 18% if we consider both genders together. In most countries the prevalence of tobacco consumption is higher in girls when compared to boys. In Portugal, the prevalence in the population over 15 years of age has one of the lowest values among European countries (30,6 % for men and 11,6% for women). Despite these crude prevalence rates, high age-sex-specific prevalence rates were found in age groups 25-34 and 35-44 in men (39,9% e 44,6% respectively) and in women (17,6 e 21,2% respectively). In 2002, at the age of 15, the percentage of daily smoking girls in Portugal was 19.5%. This value reveals that Portugal is among the countries with higher prevalence rates of smoking among adolescent girls. Over the last decade (1996-2006), a decrease in tobacco consumption has been observed in most EU countries, both in adult population and in School-Aged Children. In Portugal, this consumption has levelled off in adult men and in youngsters aged 15, but shows a significant increase in female adults and school-aged girls. Conclusions: Although Portugal presents low global prevalence rates in the European context, the substantial increases observed in the young adult female population are of particular concern because of its impact on women’s health and the risk of pre and post-natal associated childhood exposure. These results reveal that current preventive strategies in Portugal are ineffective in reducing smoking prevalence among children and young adults

Equilibrium and nonequilibrium thermodynamics of a photon gas in the near field

In this paper, we study the near-field thermodynamics of a photon gas at equilibrium as well as out-of-equilibrium in the presence of dissipative effects. As a consequence of Heisenberg's uncertainty principle, we are able to eliminate the low-frequency modes in both cases, providing an analytical expression for the near-field entropy. In addition, we obtain the entropic-force contributions to the Casimir effect. At zero temperature the well-known 1/l^4 behavior of the pressure is obtained. In the nonequilibrium case, we compute the entropy production, showing that the excess of heat in each bodies must be dissipated into the respective thermal reservoirs

The SUPWAVE Theory of International Marketing: an analogy between catching the best waves and foreign market entry decisions

The main objective of this paper is to propose a user-friendly approach (SUPWAVE acronym - S – Support; U – Upgradable products; P – Pivoting capability; W – Wages to attract the best employees; A – Ambition; V – Value Proposition; E – Earnings) that helps to explain the several complex dimensions of a foreign market entry decision, using an analogy between successfully catching and surfing waves and entering new markets, especially those that Micro, Small and Medium Enterprises (MSMEs) do not know well or are culturally very different from the ones the entrant is used to supplying. Sometimes the hurdles are not self-evident, nor self-explanatory in an a-priori analysis, particularly for managers without in-depth knowledge in marketing campaigns and their possible side-effects across all channels and therefore this paper develops an analogy that helps business owners visualize and consider the essential relevant variables when choosing a market, while also assimilating the concept that only those who try will enter the new market/surf the wave, since planning without action is a waste of money, and vice-versa. Therefore, through a systematic literature review and using keywords such as “wave”, “marketing” “market entry”, and autoethnographic considerations, the authors first try to demonstrate the originality of the hypothesis and then portray a parallelism between strategic international business management choices and the ones a paddlesurfer has to make when choosing the right wave to catch, perceiving that the theory will help global trade entrepreneurs, national manufacturers and members of academia to figure out why some companies have not been achieving the intended Return on Investment (ROI), even when carefully planned – as each wave is unique and you can only pivot and persist, until you succeed. An interview and exploratory survey response were received, which both support the SUPWAVE acronym.publishe

Theory of Casimir forces without the Proximity-Force approximation

We analyze both the attractive and repulsive Casimir-Lifshitz forces recently reported in experimental investigations. By using a kinetic approach, we obtain the Casimir forces from the power absorbed by the materials. We consider collective material excitations through a set of relaxation times distributed in frequency according to a log-normal function. A generalized expression for these forces for arbitrary values of temperature is obtained. We compare our results with experimental measurements and conclude that the model goes beyond the proximity-force approximation

Are physicians aware of their role in tobacco control? A conference-based survey in Portugal

Authors’ contributions: SBR conceived the study and gathered the information, completed data entry, data analysis and drafting of the manuscript. All authors participated in the design of the study, analysed and interpreted the data and critically reviewed the original draft. SBR and JMC coordinated the study design. PA coordinated the statistical analysis. All authors read and approved the final manuscript.Acknowledgements: The authors would like to thank the survey respondents for their participation and also the board and organising committee of the two conferences. In addition, the authors would like to thank Steve Dyson for the English text review.BACKGROUND: The crucial role of physicians in tobacco control (TC) is widely recognized. In 2008, Portugal implemented a non-comprehensive smoke-free policy (SFP). In 2009, a conference-survey was carried out to explore Portuguese physicians' engagement in tobacco control, by evaluating the following: 1) attendance at TC training and awareness of training needs; 2) participation in TC activities; 3) attitudes and beliefs regarding SFPs. METHODS: Questionnaire-based cross-sectional study conducted during two major national medical conferences targeting GPs, hospitalists, and students/recent graduates. Descriptive analysis and logistic regression were performed. RESULTS: Response rate was 63.7% (605/950). Of the 605 participants, 58.3% were GPs, 32.4% hospitalists, 9.3% others; 62.6% were female; mean age was 39.0 ± 12.9 years. Smoking prevalence was 29.2% (95% CI: 23.3-35.1) in males; 15.8% (95% CI: 12.1-19.5) in females, p < 0.001. While the overwhelming majority of physicians strongly agreed that second-hand smoke (SHS) endangers health, awareness of SFP benefits and TC law was limited, p < 0.001. A significant minority (35.5%) believed that SHS can be eliminated by ventilation systems. Most physicians lacked training; only a minority (9.0%) participated regularly in TC. Training was the most consistent predictor of participation in TC. General agreement with SFP was high; but significantly lower for indoor leisure settings, outdoors bans in healthcare/schools settings and smoking restrictions in the home/car, p < 0.001. Smoking behaviour strongly predicted support for smoking restrictions in restaurants and bars/discos, healthcare outdoors and private settings. CONCLUSIONS: The findings suggest that Portuguese physicians are not aware of their role in tobacco control. Poor engagement of physicians in TC may contribute to the current lack of comprehensive policies in Portugal and Europe and undermine social norm change. Medical and professional continuing education on tobacco control should be made top priorities

Mesoscopic Non-Equilibrium Thermodynamics: Application to Radiative Heat Exchange in Nanostructures

Systems in conditions of equilibrium strictly follow the rules of thermodynamics (Callen, 1985). In such cases, despite the intricate behaviour of large numbers of molecules, the system can be completely characterized by a few variables that describe global average properties. The extension of thermodynamics to non-equilibrium situations entails the revision of basic concepts such as entropy and its related thermodynamic potentials as well as temperature that are strictly defined in equilibrium. Non-equilibrium thermodynamics proposes such an extension (de Groot & Mazur, 1984) for systems that are in local equilibrium. Despite its generality, this theory is applicable only to situations in which the system manifests a deterministic behaviour where fluctuations play no role. Moreover, nonequilibrium thermodynamics is formulated in the linear response domain in which the fluxes of the conserved local quantities (mass, energy, momentum, etc.) are proportional to the thermodynamic forces (gradients of density, temperature, velocity, etc.). While the linear approximation is valid for many transport processes, such as heat conduction and mass diffusion, even in the presence of large gradients, it is not appropriate for activated processes such as chemical and biochemical reactions in which the system immediately enters the non-linear domain or for small systems in which fluctuations may be relevant..