Sustainability reporting and financial reporting: the relevance of an integrated reporting approach

In the business world, there are issues such as globalisation, environmental awareness, and the rising expectations of public opinion which have a specific role in what is required from companies as providers of information to the market. This chapter refers to the current state of corporate reporting (financial reporting and sustainability reporting) and demonstrates the need for evolution to a more integrated method of reporting which meets the stakeholders’ needs. This research offers a reflection on how this development can be achieved, which notes the ongoing efforts by international organisations in implementing the diffusion and adoption, as well as looking at the characteristics which are needed for this type of reporting. It also makes the link between an actual case of a company that is one of the world references in sustainable development and integrated reporting. Whether or not the integrated reporting is the natural evolution of the history of financial and sustainability reporting, it still cannot yet claim to be infallible. However, it may definitely be concluded that a new approach is necessary to meet the needs which are continuously developing for a network of stakeholders

Traqueostomia: Indicações e complicações em doentes pediátricos

AbstractDespite advances in non-invasive ventilation techniques, tracheostomy is still indicated in children with serious airway obstruction or with the need for long-term ventilation. Alternatives should be studied before deciding to tracheostomise as complications exist, despite the simple procedure.The aims of this study were the identification of tracheostomised children followed in a tertiary care paediatric department, the characterisation of primary disease, the indications leading to tracheostomy and any complications.We present a case review of tracheostomised children followed in our department.Sixteen tracheostomised children were followed, median age of 4.5months, neuromuscular disease – 5, cerebral palsy – 3 and pulmonary or airway disease – 7. Indications were long-term invasive ventilation – 12, subglottic or tracheal stenosis – 3 and laryngomalacia – 1. The most frequent complications found were persistent bacterial colonisation, accidental decannulation and obstruction. There was a tracheostomy-related death in 1 child. Outcome: 9 children maintained tracheostomy, 5 were successfully decannulated and 2 children died while on tracheostomy.Tracheostomised children usually have complex disease that requires a multidisciplinary team and should be followed-up at a specialised reference centre.Rev Port Pneumol 2009; XV (2): 227-23

Contribuição para o estudo das origens pediátricas da doença pulmonar obstrutiva crónica do adulto : bronquiolite obliterante pós-infecciosa

Tese de doutoramento, Medicina (Pediatria), Universidade de Lisboa, Faculdade de Medicina, 2011Os doentes com Bronquiolite Obliterante (BO) são em regra referenciados pela gravidade da sua situação clínica. A maioria apresenta tosse persistente, dispneia e perturbação do crescimento após um episódio de bronquiolite mais grave e com evolução mais arrastada. Fervores à auscultação pulmonar são uma constante. Desconhece-se a evolução a longo prazo de bronquiolite obliterante e permanece alguma confusão diagnóstica entre esta e outras doenças pulmonares obstrutivas crónicas com início precoce na vida. A identificação de marcadores que identifiquem a BO, que determinem a sua expressão fenotípica, extensão do compromisso e a evolução clínica e fisiopatológica, constitui um desafio na investigação diagnóstica da doença pulmonar obstrutiva crónica. Esta tese teve como principal objectivo caracterizar alterações funcionais respiratórias e imagiológicas que, de forma específica, permitissem quantificar a gravidade do atingimento fisiopatológico da BO e identificar factores diagnósticos que, em conjunto, permitissem distingui-la de outras patologias obstrutivas, como Asma problemática ou de difícil controlo (Asma), e pudessem ser utilizados como marcadores prognósticos e de resposta a terapêuticas. Foi desenhado um estudo com duas componentes, uma longitudinal observacional, retrospectiva, com medições repetidas em duas populações (BO e Asma) e outra consistindo no estudo transversal, comparativo entre as duas populações. O estudo longitudinal investiga a extensão do compromisso fisiopatológico e compara a velocidade de crescimento ou declínio dos resultados funcionais respiratórios e antropométricos em 30 doentes com BO, comparativamente a 28 doentes com asma, ao longo de um período médio de observação por doente, de 6 anos, abrangendo desde o grupo pré-escolar ao adulto jovem. Para determinar os declives dos resultados dos estudos funcionais respiratórios (EFR) foi utilizado o método de modelação para medições repetidas ao longo do tempo, “general linear mixed model”. O estudo transversal investiga a associação entre compromisso da estrutura e função, através da análise dos resultados de EFR e de achados de TC de alta resolução (TC-AR) e dos factores de risco clínicos, ambientais, atópicos e inflamatórios e o seu impacto na evolução clínica, na globalidade dos doentes e por grupo de diagnóstico. Neste estudo incluíram-se 25 doentes com BO e 15 doentes com Asma, maioritariamente subgrupos da anterior análise. Por último, através de análises de curvas ROC e de clusters, pretendeu-se investigar o poder discriminante destas variáveis face à precisão diagnóstica para BO e Asma e a eventual identificação de um grupo com características de sobreposição. Os resultados deste estudo evidenciam a precocidade do declínio dos volumes pulmonares e dos débitos ventilatórios nos doentes com BO (z-score FEV1-0,09/ano e FEV1/FVC -0,17/ano), com persistência do padrão de retenção gasosa, claramente distintos do que ocorre no grupo Asma. Nos doentes com Asma verifica-se aumento dos volumes pulmonares e dos débitos ventilatórios e apenas a razão FEV1/FVC decresce, embora com uma velocidade de declínio significativamente diferente (z-score FEV1 +0,02/ano e FEV1/FVC-0,02/ano). O padrão de retenção aérea foi um achado fisiopatológico importante no grupo BO e embora se tivesse verificado um declínio da razão RV/TLC ao longo dos anos, estes doentes permaneciam insuflados na última avaliação. O TLC manteve-se normal na quase totalidade dos doentes. Uma resposta positiva ao broncodilatador foi mais frequente no grupo Asma, mas verificou-se numa proporção significativa de doentes com BO, distinta de acordo com o valor seleccionado para a sua valorização (variação percentual ou volume de variação relativamente ao basal). Em ambos os grupos verificou-se um predomínio do género masculino e de exposição ao fumo de tabaco (superior a 60%). Internamento prolongado por um episódio agudo de doença respiratória inferior, numa criança previamente saudável, sobretudo consequente a uma infecção grave de etiologia viral, e a persistência de fervores na auscultação pulmonar foram os factores clínicos que caracterizaram BO. Em ambos os grupos ocorreu perturbação nutricional, traduzida por IMC revelador de desnutrição ou excesso de peso/obesidade, numa proporção elevada de doentes. A atopia ocorreu com maior frequência no grupo Asma, sem que se tivessem demonstrado associações determinantes com outros factores. Verificou-se associação entre o compromisso funcional e a extensão e gravidade dos achados morfológicos encontrados na TC-AR, com particular relevância nos doentes do grupo BO, sendo quase imperceptível no grupo Asma, proporcionando elementos adicionais para a caracterização e discriminação entre estes diagnósticos. Aumento do volume pulmonar, hipoatenuação inspiratória, retenção gasosa expiratória e padrão de atenuação em mosaico foram achados de TC-AR em ambos os grupos de diagnóstico. Porém, a extensão destas alterações em conjunto com bronquiectasias, espessamento da parede brônquica e bronquiolectasias foram mais graves nos doentes com BO, permitindo a discriminação com o grupo Asma. A conclusão mais surpreendente desta tese é ter verificado uma enorme sobreposição entre o espectro das características clínicas, funcionais, imagiológicas e atópicas entre os doentes com BO e a asma de difícil controlo. Na análise final, FVC%t, FEV1 (ml), testes de sensibilidade cutânea, IgE para D.pteronyssinus e padrão em mosaico de atenuação, foram as variáveis que apresentaram valores mais extremos na identificação dos grupos de diagnóstico BO e Asma e permitiram a identificação de um 3º grupo com características de sobreposição, com valores intermédios entre ambas as patologias. Demonstrou-se, adicionalmente, a aplicabilidade de ferramentas de medida, interpretação e análise, com poder diagnóstico em diferentes doenças pulmonares obstrutivas crónicas, num largo espectro etário, permitindo a continuidade de avaliação na transição entre a idade pediátrica e a idade adulta. Os resultados desta investigação poderão influenciar o desenho de estudos e os cálculos, em investigações futuras, e em ensaios clínicos terapêuticos.Patients with Bronchiolitis Obliterans (OB) are referred to the hospital usually by the seriousness of their medical condition. Most displays persistent cough, dyspnea and growth impairment after a severe episode of acute bronchiolitis in a previously healthy child. Rales are a constant. Long-term prognosis remains to be established and there seems to be some overlap between this and other chronic obstructive pulmonary disease beginning in early life. Identifying markers of OB phenotypic expression, determining the extension of impairment and clinical and lung function evolution, represents a challenge in the diagnostic investigation of chronic obstructive pulmonary diseases. The aim of this thesis was three-fold: 1) to characterize the lung function compromise and HRCT features of cases with OB, from one tertiary pediatric respiratory unit; 2) to find discriminative factors between OB and other obstructive diseases, such as difficult to control asthma (Asthma); and 3) to assess whether diagnostic tools from adult recommendations were applicable in pediatric patients, and could be used longitudinally as markers of prognostic and therapeutic responses. The study design had two components: 1) a longitudinal observational, retrospective study, with repeated measurements in two populations (BO and Asthma); and 2) a cross-sectional study, comparing the two populations. The longitudinal study investigates the extent of the lung function compromise and compares the trends of functional respiratory and anthropometric results in 30 patients with BO, compared to 28 patients with asthma, over an average period of 6 years/patient, ranging from the pre-school ages to the young adult. To determine the slopes of the results of lung function tests (LFT) we used the general linear mixed model for modeling repeated measurements over time. The cross-sectional study investigates the association between structure and function, by analyzing the LFT results and high-resolution CT (HRCT) features, clinical and environmental risk factors, atopy and inflammation and its impact on clinical evolution. This study included 25 OB patients and 15 patients with Asthma, mostly subsets of the previous analysis. Finally, through ROC curves and clusters analysis we aimed to investigate the discriminating power of these variables face to the diagnostic accuracy for BO and Asthma and the possible identification of a group with overlapping characteristics. The results of these studies demonstrate the precocity of the decline of lung volumes and airway flows in OB patients (z-score FEV1-0,09/year; FEV1/FVC -0,17/year), with persistence of airway trapping, clearly different from the group Asthma. In Asthma patients, lung volumes and airway flows showed a positive increment and only FEV1/FVC reason declined at a rate significantly different from OB patients (z-score FEV1 +0,02/year; FEV1/FVC-0,02/year). Air trapping was remarkable in OB patients and although RV/TLC reason showed a significant decline over time, these patients remained inflated in the last evaluation. The TLC remained normal in almost all patients. Despite bronchodilator airway hyperreactivity being more frequent in the Asthma group, it also occurred in a significant proportion of OB patients. This number differed according to the parameter selected (percentage variation or absolute amount of change from the basal values). In both groups, there was a predominance of the male gender and exposure to tobacco smoke (over 60%). Having a long-term hospitalization after an acute episode of a severe lower respiratory viral infection, in a previously healthy child, and persistent rales were the predominant clinical features in OB patients. Nutritional compromise with BMI showing malnutrition or overweight/obesity occurred in both groups in a high proportion of patients. The atopy markers were more frequent in the Asthma group, without other relevant associations. We noticed an association between LF compromise and the extent and severity of morphological findings found in HRCT, particularly relevant in the OB patients, being almost unnoticeable in Asthma group, providing additional elements for characterization and discrimination between these diagnoses. Increased lung volumes, inspiratory decreased attenuation, expiratory air trapping and mosaic pattern were findings of HRCT in both diagnostic groups. However, the extent of these changes together with bronchiectasis, bronchial wall thickening and bronquiolectasis were more severe in OB, allowing for discrimination with Asthma. The most startling conclusion of this thesis is the demonstration of a huge overlap between the spectrum of clinical, functional and CT features and atopic markers among patients with OB and difficult to control asthma. In the final analysis, FVC%t, FEV1(ml), skin Prick tests, IgE for D.pteronyssinus and a mosaic pattern of attenuation, were the variables that showed extreme values for the diagnosis of BO and Asthma groups and allowed for the identification of a 3rd group with overlapping characteristics, showing intermediate values between both pathologies. It has been demonstrated, in addition, the applicability of measuring, interpretation and analysis tools used or adapted for this research plan, with diagnostic power in different chronic obstructive pulmonary disease and age spectrum, enabling continuity of evaluation of lung disease in the transition from pediatric ages to adulthood. The results of this research will influence the design of studies and future calculations in both planning research and on therapeutic clinical trials.Fundação para a Ciência e Tecnologia (SFRH/BD/28317/2006

Imágenes de la salud pública : la institucionalización del Instituto Oswaldo Cruz en Brasil

En este artículo se desarrolla el importante rol que desempeñó la fotografía en el proceso de institucionalización y legitimación del Instituto Oswaldo Cruz (IOC) durante la primera mitad del siglo XX. El uso de imágenes fotográficas no sólo acompañó el trabajo científico cotidiano, sino que se convirtió en una herramienta central en la promoción de las actividades del IOC. El artículo es acompañado por una serie de imágenes que nos dan cuenta del uso que se hizo de la actividad fotográfica en la construcción institucional del IOC

Calpain inhibition reduces ataxin-3 cleavage alleviating neuropathology and motor impairments in mouse models of Machado-Joseph disease

Machado–Joseph Disease (MJD) is the most prevalent autosomal dominantly inherited cerebellar ataxia. It is caused by an expanded CAG repeat in the ATXN3 gene, which translates into a polyglutamine tract within the ataxin-3 protein. Present treatments are symptomatic and do not prevent disease progression. As calpain overactivation has been shown to contribute to mutant ataxin-3 proteolysis, translocation to the nucleus, inclusions formation and neurodegeneration, we investigated the potential role of calpain inhibition as a therapeutic strategy to alleviate MJD pathology. For this purpose, we administered orally the calpain inhibitor BDA-410 to a lentiviral mouse model of MJD. Western-blot and immunohistochemical analysis revealed the presence of N- and C-terminal mutant ataxin-3 fragments and the colocalization of large inclusions with cleaved caspase-3 in the mice brain. Oral administration of the calpain inhibitor BDA-410 decreased both fragments formation and full-length ataxin-3 levels, reduced aggregation of mutant ataxin-3 and prevented cell injury and striatal and cerebellar degeneration. Importantly, in correlation with the preserved cerebellar morphology, BDA-410 prevented motor behavioural deficits. In conclusion, BDA-410 alleviates Machado–Joseph neuropathology and may therefore be an effective therapeutic option for MJD

How to weave a collaborative city

O presente livro resulta da participação do Município de Braga na rede europeia URBACT Urban Regeneration Mix: Weaving a colaborative city. Esta rede, liderada pela cidade de Lódz (Polónia), e que integra, para além de Braga, as cidades de Baena (Espanha), Birmingham (Inglaterra), Bolonha (Itália), Toulouse (França) e Zagreb (Croácia), visa criar o espaço e o tempo para debater e partilhar boas práticas em temas de participação e envolvimento de cidadãos em processos de reabilitação urbana. O livro reúne toda a ref!exão que foi realizada entre 2019 e 2021 pelo Grupo Local URBACT: um grupo composto por diversos parceiros da cidade como associações, juntas de freguesia e a universidade. Este grupo selecionou uma iniciativa municipal de mobilidade sustentável e acessível – Área Mais – como caso de estudo para debater o tema da participação. Após os textos introdutórios, o livro desdobra-se em três capítulos, representados por 3 cores. O primeiro capítulo “O que fizemos” apresenta o projeto de requalificação urbana Área Mais que foi implementado em 4 zonas residenciais da cidade. O segundo capítulo “Onde estamos” apresenta uma ref!exão sobre o trabalho desenvolvido pelo Grupo Local URBACT de Braga dentro da rede. E, por último, o capítulo “Onde queremos chegar” lança as pistas metodológicas para o tema da participação em projetos municipais futuros.This book results from the participation of the Municipality of Braga in the European network URBACT “Urban Regeneration Mix: Weaving a collaborative city”. This network, led by the city of Lodz (Poland), which also includes, besides Braga, the cities of Baena (Spain), Birmingham (England), Bologna (Italy), Toulouse (France) and Zagreb (Croatia), aims to create space and time to debate and share good prac tices regarding subjects of participation and involvement of citizens in processes of urban rehabilitation. The book brings together all the reflection that was carried out between 2019 and 2021 by URBACT Local Group: a group made up of several stakeholders of the city such as associations, parish councils and the university. This group has selected the municipal initiative of accessible and sustainable mobility – Área Mais – as a case study to debate the subject of participation. After the introductory texts, the book unfolds in three chapters, represented by three colours. The first chapter “What we have done” presents the urban revitalisation project Área Mais which was implemented in 4 residential areas of the city. The second chapter “Where we are now” presents a reflection on the work developed by URBACT Local Group of Braga within the network. And lastly, the chapter “What we want to achieve” establishes the methodological hints for the subject of participation in future municipal projects.Urbact: Regeneration Mix; This research was funded by Fundação para a Ciência and a Tecnologia, IP (FCT)/ Massachusetts Institute of Technology (MIT-Portugal), grant number SFRH/BD/151416/2021, in the context of the doctoral thesis of Filipa Corais, with the title “THE CITY “WALKING” TO 2050. BRAGA AS A LABORATORY FOR A RESILIENT & SUSTAINABLE SYSTEM”

(Vi)ver mais: a realidade silenciada pela dependência

info:eu-repo/semantics/publishedVersio

Design research applicability on Portuguese Industry

The present paper works on the potential applicability of design research based on a practical experience with the Portuguese company Recipor — Recuperação e Valorização de Resíduos (residues recovery and valuation), S.A., who’s mission is to collect, treat and valuate in a profitable way plastic residues e non iron metals, with domestic or industrial origins. The ecological appeal, the economical recovery process and the innovation investment justified the choice and the decision of taking this company as a subject to study design’s influence on building and confirming it’s corporate identity and in the implementation of design culture and thinking. The empirical search on collecting processes, treatment and application of residues took place at the company’s premises. From the direct contact with raw materials, equipment and finished products we developed a quality based methodology study. The results denoted a strong relation between the company’s vision, the organizational strategy and the market’s affection for recycled products. This triangulation allowed a favourable environment for a temporary inclusion of a design investigating team, and leads to the understanding that, as the high-level project orientations were exposed, the expectation increased and acquired a more instrumental format with strategic effects. Grounded on data from field literature we draw the path of thermoplastics in general and of PVC specifically. We must highlight the growth of the investment made in collecting and recycling; the birth of a European network of certified recycling companies and the enormous applicability of this material on artefact production. This project’s boundaries were established by practical challenges introduced by the company’s direction; namely the optimization of the plastic reel products. The team’s proposals were the result of the adopted design process

Between the unstoppable and the feasible: the lucid pragmatism of transition processes for sustainable urban mobility: a literature review

This article presents a literature review of Transition Experiments applied to the Sustainable Urban Mobility context from a critical and operative point of view. The moment of transformation that we are living through determines concerns about the decarbonization and compliance with the 2050 Targets and imposes a paradigm shift towards sustainable urban mobility. In this regard, the necessary physical change will have to be accompanied by a socio–cultural transition, of which the challenge implies the construction of a collective ideal, shared by the population and the main stakeholders, leading to the opening of new political spaces and a change, also in terms of governance.This research was funded by Fundação para a Ciência and a Tecnologia, IP (FCT)/ Massachusetts Institute of Technology (MIT-Portugal), grant number SFRH/BD/151416/202

Implementation of a Nationwide Surveillance Network of Respiratory Syncytial Virus in Children < 2 years old in Portugal

Human respiratory syncytial virus (RSV) is associated with substantial morbidity and mortality in infants, young children and elderly. Monoclonal antibodies (MAb) therapy is the available method to prevent and combat severe disease in infants, nevertheless there is a global effort in the development of vaccines and new generation of MAb. In this sense, RSV surveillance is essential to estimate the burden of RSV infection, evaluate the impact of preventive measures and to support public health decisions. Following European recommendations, a nationwide hospital-based RSV sentinel network denominated VIGIRSV was set up in Portugal. The aim of this work is to describe the implementation of VIGIRSV and report preliminary results obtained in this surveillance. VIGIRSV was implemented in 2021 with the initiative of the National Institute of Health Dr.outor Ricardo Jorge (INSA) and the Portuguese Paediatrics Society (PPS), and in 2023, 20 Hospitals collaborate in the surveillance. The surveillance is based on the recruitment of children <2 years-old hospitalized for, at least, 24 hours, that fulfill the case definition fordue to an RSVAcute Respiratory Infection (ARI). At recruitment, the paediatrician fills an epidemiological clinical questionnaire, and biological samples are collected for laboratorial diagnosis. Positive samples for RSV are forwarded to INSA for complementary virological analyses such as genetic characterization of the virus. Preliminary results from the first 2 years of surveillance are presented in table 1 and show an early RSV activity with high intensity in the 2022/23 season.. The data obtained from VIGIRSV´s results integrate the weekly published “Epidemiological surveillance bulletin of Influenza and other respiratory viruses” which can be foundavailable at https://www.insa.min-saude.pt/category/informacao-e-cultura-cientifica/publicacoes/atividade-gripal/, as well as the surveillance at European level. In addition, epidemiological and virological results are disclosed in scientific publications. The maintenance of such important surveillance is possible due to effort of distinct organizations and professionals, and has impact on the public health service.N/