Qualidade de vida, representações da doença, apoio social e relacionamento familiar em pacientes com tumores de pele, em fase de Follow-up

Dissertação de mestrado integrado em Psicologia (área de especialização em Psicologia Clínica e da Saúde)Este estudo teve como objetivo examinar a relação entre a qualidade de vida, as representações da doença, o apoio social e o stress intrafamiliar, bem como os melhores preditores de qualidade de vida, em pacientes com tumores de pele. A amostra foi constituída por 106 pacientes com tumores de pele (melanoma e carcinoma), em fase de follow-up da doença. Os participantes completaram o Questionário Clínico e Demográfico, o Dermatology Life Quality Index, o Illness Perception Questionnaire, o Medical Outcomes Study Social Support Survey e o Index of Family Relations. Os resultados revelaram que melhor qualidade de vida estava associada a representações da doença menos ameaçadoras, a maior perceção de apoio social e a menor stress intrafamiliar. As representações da doença consistiram num preditor negativo da qualidade de vida. Os participantes com melanoma evidenciaram pior qualidade de vida, quando comparados aos participantes com carcinoma. Os resultados enfatizam a necessidade de intervenção, incluindo as representações da doença, o apoio social e o stress intrafamiliar, no sentido de promover a qualidade de vida em pacientes com tumores de pele. A intervenção torna-se particularmente importante nos pacientes com melanoma.This study aimed to examine the relationship between quality of life, illness representations, social support and intra-family stress, as well as the best predictors of quality of life in patients with skin tumors. The sample consisted of 106 patients with skin tumors (melanoma and carcinoma) in the follow-up stage of the disease. Participants completed the Clinical and Demographic Questionnaire, the Dermatology Life Quality Index, the Illness Perception Questionnaire, the Medical Outcomes Study of Social Support Survey, and the Index of Family Relations. The results demonstrate that better quality of life was related to less threatening illness representations, greater perception of social support and lower intrafamily stress. Illness representations were a negative predictor of quality of life. Participants with melanoma evidenced worst quality of life when compared with patients with carcinoma. The results emphasize the need for intervention, including illness representations, social support and intra-family stress, in order to promote the quality of life in patients with skin tumors. Intervention becomes particularly important in patients with melanoma

Memorandum: Urban Centers

This Memorandum is a policy-oriented research document conducted by the ICS-ULisboa team of the Horizon 2020 project ROCK. It seeks to organise some of the most up-to-date knowledge around Urban Centers and highlight important discussion topics, requiring further attention. In addition to academic literature review, the Memorandum relies on contributions from the international conference “Urban Centers: Acting upon or with cities?” organised by the ICS-ULisboa on the 19th October 2018 (https://rockproject.eu/event-details/41). The Conference took place in the Centre for Urban Information of Lisbon with the participation of representatives from the following Urban Centers: Centro de Informação Urbana de Lisboa (Lisbon); Fondazione Innovazione Urbana (Bologna); Urban Center of Torino; Pavillon de L’Arsenal (Paris); Centro de Cultura Contemporània Barcelona; and casa della Città / Case del Municipio (Rome). The participating Urban Centers were selected from the list provided by the international laboratory on Urban Centers (http://www.urban-center.org/en/), on the basis of their different working contexts, management models and activity. Representatives were invited to share knowledge and experience about the role, the challenges and potential of Urban Centers today and the different forms of action and participation they may have in the development of their cities.info:eu-repo/semantics/publishedVersio

Justice and power relations in urban greening: can Lisbon’s urban greening strategies lead to more environmental justice?

As urban greening has become a prevalent tool in the context of global climate governance, this paper examines Lisbon’s greening strategies in the context of its election as European Green Capital 2020. While applying an analytical framework based on environmental justice, we perform a cross-analysis of the city-wide greening strategies, together with a peculiar and unusual planning process for a new green space in the neighbourhood of Marvila. Based on qualitative research carried out in-situ, we argue that Lisbon’s greening strategies are based on a discourse of ecological benefits, without aiming to ensure access to green space for different population groups. Procedural justice concerns are widely undervalued, resulting in limited space available for community involvement. We show how urban greening is essentially a multiscalar exercise, impacted by and affecting multiple scales simultaneously. Hence procedural justice deserves a much more prominent role in urban greening, as participation and recognition can give local communities the opportunity to adapt global urban agendas toward their particular needs and desires. Our findings lead us to conclude that environmental justice is ultimately an exercise of multiscalar governance, where local decision-making needs to attend to contextual challenges but also to a long-term sustainability vision at a larger scale.info:eu-repo/semantics/publishedVersio

Dynamics of HIV-1 transmission in Europe: a guidance for evidence-based prevention strategies

Introdução: Para controlar a pandemia de VIH a UNAIDS desenvolveu os objetivos 95- 95-95 para serem atingidos até 2030. A concretização destes objetivos pode ser dificultada pelo aparecimento de mutações de resistência devido ao uso intensivo da terapia antirretroviral ou também à existência de indivíduos com apresentação tardia (IAT) ao diagnóstico. Estes IAT não só impactam os resultados dos seus próprios tratamentos como são também uma ameaça para alcançar os objetivos da UNAIDS, uma vez que podem potenciar, de forma inconsciente, a transmissão do VIH. Objetivos: Primeiro, identificar as caraterísticas sociodemográficas e clínicas dos indivíduos infetados com VIH-1, bem como identificar os determinantes da apresentação tardia em Portugal e na Europa. Segundo, descrever os padrões de resistência transmitida (TDR) e de resistência adquirida (ADR) em indivíduos infetados com VIH-1 seguidos na Europa, comparar os seus padrões de resistência IAT e indivíduos com apresentação nãotardia (IANT) e analisar as mutações de resistência aos antirretrovirais nos diferentes subtipos de VIH-1. Para finalizar, descrever e caraterizar os clusters de transmissão (CT) de VIH-1 na Europa e comparar o papel dos IAT com os IANT nos CT do VIH-1. Metodologia: No primeiro estudo, a base de dados utilizada incluiu dados clínicos e sociodemográficos de indivíduos infetados com VIH-1 seguidos no Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental (CHLO), Lisboa, Portugal, entre1984 e 2017. Nos outros estudos, utilizou-se a EuResist Integrated Database (EIDB) que inclui dados sociodemográficos, clínicos e genómicos de indivíduos infetados com VIH-1 seguidos na Europa (Portugal, Espanha, Alemanha, Luxemburgo, Rússia, Reino Unido e Itália) entre 1981 e 2019. Para a análise dos CTs, foram utilizadas informações de indivíduos infetados pelos subtipos mais prevalentes (B, A e G). Resultados: No primeiro estudo, 68,7% dos indivíduos infetados com VIH-1 eram homens com uma mediana de idade de 37 anos (IQR 30–47). 50,6% destes indivíduos tinham apresentação tardia (AT) e desses 61,9% tinham apresentação tardia com doença avançada. Os determinantes associados à AT foram idade ao diagnóstico superior a 30 anos e origem em países da África subsaariana. No segundo estudo, entre os indivíduos incluídos na análise a mediana de idade foi igual a 33 anos (IQR: 27,0–41,0) e 74,4% eram homens. 50,4% destes indivíduos tinham AT e os determinantes associados foram idade acima de 56 anos, heterossexuais, indivíduos com origem em países africanos e com carga viral abaixo de 4,1cópias/mL. No terceiro estudo, a mediana de idades obtida foi igual a 37 anos (IQR: 27,0–45,0) e 72,2% eram homens. 71,9% dos indivíduos tinham sido infetados pelo subtipo B e 54,8% foram classificados com AT. Para AT e apresentação não-tardia (ANT) a prevalência de TDR foi 12,3% e 12,6% respetivamente, e a de ADR foi de 69,9% e de 68,2% respetivamente. As mutações mais prevalentes observadas em IAT e IANT foram K103N/S, T215rev, T215FY, M184I/V, M41I/L, M46I/L e L90M. No quarto estudo, o subtipo mais prevalente nos indivíduos infetados com VIH-1 foi o subtipo B (84,7%) seguido do subtipo G (9,4%) e subtipo A (5,9%). A idade mediana foi de 33 anos (IQR: 26,0-41,0) e 75,5% eram homens. 51,4% dos indivíduos infetados com VIH-1 tinham AT e 21,6% estavam dentro de CTs. As análises filogenéticas demonstraram que apenas 17,6% dos IAT estavam dentro de CTs comparados com 20,2% dos IANT. Para os subtipos A e B, verificou-se que os IAT dentro de CTs foram caracterizados por uma menor percentagem de homens e por uma maior percentagem de indivíduos mais velhos comparativamente aos IANT. Para os subtipos B e G, os IAT dentro de CTs apresentaram maior percentagem de tratados comparativamente com os IANT. No subtipo G, os IAT dentro de CTs, eram maioritariamente utilizadores de drogas intravenosas comparativamente com os IANT. Analisando o tamanho dos CTs, verificou-se que os IANT pertenciam a grandes CTs (>8 indivíduos) comparativamente aos IAT. Conclusão: A AT é considerada um dos grandes obstáculos para travar a epidemia do VIH e uma ameaça à transmissão do mesmo. Os nossos resultados apresentam as características sociodemográficas e clínicas dos IAT na Europa e indicam que estes não contribuem, de forma significativa, para a transmissão dos VIH-1. Os resultados encontrados podem contribuir para o desenvolvimento de medidas de prevenção e para uma melhor compreensão das mutações de resistência e falhas terapêuticas nesta população de indivíduos. Palavras-Background: To control the HIV pandemic, the UNAIDS set the 95-95-95 targets to be reached by 2030. These targets can be more difficult to achieve, whether due to the appearance of drug resistance mutations regarding the increasing use of antiretroviral therapy (ART) or due to individuals who present late at diagnosis (late presenters-LP). These individuals can not only impact treatment outcomes, but also threat UNAIDS goals, as well as potentiate the spread of HIV. Aims: First, to identify clinical and sociodemographic characteristics of HIV-1 infected patients, as well as to identify determinants of late presentation in Portugal and in Europe. Second, to describe the patterns of transmitted drug resistance (TDR) and acquired drug resistance (ADR) in HIV-1 infected patients followed in Europe (Portugal, Spain, Germany, Luxembourg, United Kingdom, Russia and Italy), to compare its patterns in late presenters (LP) vs non-late presenters (NLP), and to analyze the most prevalent drug resistance mutations among HIV-1 subtypes. And finally, to describe and characterize HIV-1 transmission clusters in Europe and to compare the role of LP vs NLP populations on HIV-1 transmission clusters (TC). Methods: For the first study, the database included clinical and sociodemographic information from HIV-1-infected patients followed in Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental (CHLO), Lisbon, Portugal, between 1984 and 2017. For the other studies, the EuResist Integrated Database (EIDB) included socio-demographic, clinical, and genomic information from HIV-1 infected patients followed between 1981 and 2019. For the analysis of TC, information from patients infected with the most prevalent subtypes B, A and G was analyzed. Results: In the first study, 68.7% of patients were males and the median age was 37 years (IQR 30–47). 50.6% patients were LP and, of those, 61.9% were late presenters with advanced disease (LPAD). The determinants associated with LP were age at diagnosis higher than 30 years and origin from sub-Saharan Africa. In the second study, among the HIV-1 infected patients included in the analysis, the median age was 33 (IQR: 27.0–41.0) years and 74.4% were males. 50.4% were late presenters and the determinants associated with late presentation were older patients (>56), heterosexuals, patients originated from Africa and patients presenting with log VL >4.1. In the third study, the median age of HIV-1 infected individuals was 37 (IQR: 27.0–45.0) years old and 72.6% were males. 71.9% of patients were infected by subtype B and 54.8% of patients were classified as LP. For LP and NLP, the TDR prevalence was 12.3% and 12.6%, respectively, while ADR, was 69.9% and 68.2%, respectively. The most prevalent TDR drug resistance mutations, in both LP and NLP, were K103N/S, T215rev, T215FY, M184I/V, M41I/L, M46I/L, and L90M. In the fourth study, the most prevalent subtype among those infected with HIV-1 was subtype B (84.7%), followed by subtype G (9.4%) and subtype A (5.9%). The median age was 33 (IQR: 26.0-41.0) years old and 75.5% of patients were males. 51.4% of patients were classified as LP and 21.6% of patients were inside TCs.Phylogenetic analyses showed that only 17.6% of LPs were inside clusters compared to 20.2% of NLPs. For subtypes A and B, we found that LP inside clusters were less frequently males and were older than NLPs. For subtypes B and G, LP inside clusters were more frequently treated than NLP. In subtype G, LP inside clusters more frequently had IDU transmission route than NLP. Finally, when analyzing cluster size, we found that NLP more frequently belonged to large clusters (>8 patients) when compared to LP. Conclusion: Late presentation is a major obstacle to halt the HIV epidemic and could be a threat to HIV-1 transmission. Our results characterize the socio-demographic and clinical characteristics of LPs in Europe and, all together, indicate that LPs are not important contributors to forward HIV-1 transmission. These results help to direct prevention measures for this population and to better understand drug resistance mutations and therapeutic failure in this population of patients

Tackling urban disparities through participatory culture-led urban regeneration. Insights from Lisbon

In the last few decades, the diffusion of culture-led urban regeneration schemes has intercepted the growth of participatory approaches across a wide range of policy domains. Partnerships between private and public agencies have sought, accordingly, the engagement of citizens and stakeholders to push forward context-specific interventions. From the participatory action research developed in Lisbon, one of the cities funded under the EU-funded project ROCK, we analyse the ways in which this project has tackled spatial divides and socioeconomic inequalities in the project demonstration area. Our main argument is that operational decisions and substantive mismatches have given rise to opportunities and bottlenecks throughout the implementation of the project. While the public investment has been directed to regenerate a deprived area, it has fallen short of promoting greater connections within the area and with the surrounding neighbourhoods. ROCK’s actions have only partially met local community expectations regarding the project’s objectives for the optimisation of tangible and intangible cultural heritage, with impacts over degrees of citizen engagement in the local Living Lab.info:eu-repo/semantics/publishedVersio

Territorialização e poder na América portuguesa. A criação de comarcas, séculos XVI-XVIII

The general aim of this article is to analyse the political organisation of the territory in Portuguese America from the start of the building up of the Crown judiciary system from in the 16th to the 18th centuries and to look into the causes of its belatedness in comparison to what happened in Spanish America. The focus will however be on the comarcas through the reconstitution of the process leading to the setting up of these judiciary divisions. Four stages of this process will be identified and discussion will ensue over the social and political contexts in which these political and administrative novelties came to happen. It is claimed that the delay in the structuring of the judicial network in the States of Brazil and Maranhão stems from the fact that the Portuguese advance into the territories took place at a later stage. The comparisons between the two systems will also bring other differences to the fore, not least the greater rigidity of the Spanish model in contrast to the more experimental character of the Portuguese one, and the resilience found to exist in the donatarial system. It is also worth to point out that given solutions were the result of the will of central power as much as of local initiative, and it is suggested that the building up of the crown’s political apparatus (in which the judiciary network is included) brought about the connivance,albeit ephemeral, of social interests which are considered contradictory or irreconcilable by some authors

Relações Públicas / Comunicação Institucional / Comunicação Corporativa: três designações para uma mesma realidade?

Artigo baseado na comunicação proferida no IX CONGRESSO SOPCOM, realizado na Escola Superior de Comunicação Social, em Lisboa, 17-19 outubro 2013Pretende-se com este artigo, a partir de uma revisão da literatura e das práticas profissionais, discutir a validade e pertinência das designações "Relações Públicas", "Comunicação Institucional" e "Comunicação Corporativa". De forma transversal a diferentes contextos linguísticos, a falta de consenso conceptual sobre realidades disciplinares e profissionais semelhantes, implica perdas significativas do ponto de vista do reconhecimento público dos investigadores e profissionais das áreas envolvidas. Defendemos o conceito de Relações Públicas como uma disciplina autónoma e como uma profissão com uma função estratégica a desempenhar, que não se deixa subsumir no conceito de Comunicação Institucional, este sim que poderá ser entendido na língua portuguesa como sendo idêntico ao de Comunicação Corporativa.info:eu-repo/semantics/publishedVersio

3rd sector PR or when Community is our main stakeholder

Purpose of the paper: The main purpose of this article is to discuss the connection of two disciplines considered as different till now both in their theoretic principles as well as in their practices: Public Relations (PR), or if you prefer Corporate Communications, and Communication in the Public Interest. Methodology: This is essentially a conceptual paper that applies a qualitative approach to the field in consideration. A review of the main literature is presented as well as the considerations gathered from empirical research during the last ten years among Portuguese nonprofit organizations and NGO. Findings: We conclude that Third Sector Public Relations are marked by an ongoing commitment to society and to the community and, therefore, should always incorporate what is usually conceived as Communication in the Public Interest into its core strategy. In the context of Civil Society organizations, Public Relations must be seen as negotiation and commitment Research limits: Its conceptual framework might need to be better developed Practical implications: According to our arguments a redefinition of the scope of both the conceptual and empirical field of Public Relations is needed. Originality of the study: It provides a new theoretical approach to Public Relations.info:eu-repo/semantics/publishedVersio

Alzheimer’s disease health literacy: a challenge for communication professionals

Artigo baseado na comunicação proferida no EUPRERA, realizado na Blanquerna School of Communication, em Barcelona, Espanha, 03-05 outubro 2013Alzheimer disease seems to be one of the greatest issues in occidental societies. In this paper we will discuss the level of knowledge among undergraduate communication students in Portugal and how the results helped developing the actual Portuguese Alzheimer Association‘s communication program.info:eu-repo/semantics/publishedVersio

a perícia psiquiátrica em Direito Penal

The report hereby presented was the culmination of my internship in the Criminal Local Court of Lisbon, located in the Campus of Justice, between the 10th October 2018 and the 15th February 2019. With an essentially practical aspect, this work presents, firstly, the characterization of the institution where my internship took place, making a brief reference to the campus and the framework of this specific Court, namely its competence and the criminal cases that are preponderant there. I also intend to present the activities developed in my internship, which consubstantiated in the assistance to judgments and processes consultation. In the third chapter, an in-depth analysis of the psychiatric expertise in Criminal Law is presented. Linked to the issues of imputability and reduced imputability, this research deals with psychiatric, psychological and social reports and their probative value. It also presents the differential treatment of a person suffering from psychic anomaly within the scope of the Mental Health Law and in the context of a criminal process and the possible consequences when it is proved in criminal proceedings that a dangerous person is present. Finally, I would present my conclusions regarding my internship, as well as my in-depth analysis-O relatório que se apresenta nas páginas seguintes resulta da atividade desenvolvida no âmbito do estágio realizado no Juízo Local Criminal de Lisboa, sito no Campus da Justiça, entre 10/10/2018 e 15/02/2019. Com uma vertente essencialmente prática, este trabalho apresenta, em primeiro lugar, a caracterização do local do estágio, fazendo um enquadramento do Tribunal Singular, nomeadamente a sua competência e a criminalidade preponderante naquele juízo. Em seguida, são apresentadas as atividades desenvolvidas no estágio, designadamente a assistência a julgamentos e consulta de processos. No terceiro capítulo, é exposta uma análise aprofundada da perícia psiquiátrica em Direito Penal. Ligada às questões de inimputabilidade e imputabilidade reduzida, esta investigação versa sobre relatórios psiquiátricos, psicológicos e sociais e o seu valor probatório. Apresenta também o tratamento diferenciado de um portador de anomalia psíquica no âmbito da Lei da Saúde Mental e no âmbito de um processo crime e as eventuais consequências quando se prova, em processo penal, que se está ante um inimputável perigoso. Por último, são apresentadas algumas conclusões referentes ao estágio realizado e à análise aprofundada no quarto capítulo