Crime, violência e insegurança na população jovem e sénior – um estudo exploratório no Concelho de Cabeceiras de Basto

A insegurança surge associada a um clima generalizado de ansiedade relacionada com o processo de mudanças sociais que carateriza a sociedade moderna e de que o aumento da criminalidade é uma das consequências mais visíveis (Lourenço, 2004). Este estudo tem como principal objetivo explorar os sentimentos de insegurança e medo gerados pelo fenómeno do crime e da violência nos indivíduos em meio rural em função da idade.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT

Válvulas de bloqueio de emergência e aplicação na indústria química

Mestrado em Engenharia QuímicaO presente trabalho teve como principal objetivo efetuar uma classificação das válvulas da fábrica Dow Portugal quanto ao seu desempenho como válvulas de bloqueio de emergência, a sua necessidade de terem uma atuação remota e quanto à sua classificação como firesafe. Inicialmente, procedeu-se a uma leitura extensiva de todos os documentos disponibilizados pela empresa para conhecimento do processo, e compreensão dos critérios utilizados. De seguida foi efetuado um levantamento das válvulas potenciais da fábrica capazes de isolar os equipamentos. Por fim, procedeu-se à avaliação de todas as válvulas identificadas a partir de uma página de trabalho já construída e adotada pela empresa que expunha os critérios necessários para cada avaliação. Para exemplificar o trabalho realizado, recorreu-se a uma unidade da fábrica, a unidade de metanol. Para além disso, foi também demonstrado o procedimento de cálculo das válvulas de proteção de tanques atmosféricos. O número total de válvulas da fábrica avaliadas foi de 145, sendo que 84% correspondiam à área do processo e utilidades e 16% à área de armazenagem. Após a realização do trabalho verificou-se que a maior percentagem de avaliações positivas como válvulas de bloqueio de emergência e de atuação remota foi a área de armazenagem com 62.5% e 75%, respetivamente. Na avaliação firesafe foi a área do processo e utilidades com 58.1%. Quanto à contribuição dos critérios nos resultados obtidos verificou-se que no caso da avaliação de válvulas de bloqueio de emergência o critério que mais contribuiu foi o índice de exposição química (38%). Na avaliação de atuação remota foi a falta de acessibilidade das válvulas em caso de fogo e a necessidade da sua operação (Hipótese 2 – 84%). Por fim, na avaliação firesafe foi a necessidade das válvulas serem classificadas como válvulas de bloqueio de emergência e estarem muito próximas do nível do chão (Hipótese B – 62%) o critério mais relevante.The purpose of this dissertation was to make a classification of Dow Portugal valves on their performance as emergency block valves, the need to have remote actuation and classification like firesafe valves. Initially, there was an extensive reading of all documents provided by the company to process knowledge, and understanding of the criteria used. Next, a research was done of candidate valves from the factory to give isolation of equipment. Finally, the assessment of all valves identified was made from a working page built and adopted by the company that contained the criteria for each assessment. For demonstration of the work done, this was applied to a plant unit, methanol recuperation unit. Additionally, it was shown the calculation procedure of protection valves for atmospheric tanks. The assessment was applied to a total number of 145 valves, in which 84% corresponded to a process and utilities area and 16% to storage area. At the end of the work, it was found that the highest percentage of positive evaluations in emergency block valves and remote actuation assessment was storage area with 62.5 and 75%, respectively. In firesafe assessment it was the process and utilities area with 58.1%. Looking to the contribution of the criteria on the results obtained, it was found that in the case of emergency block valves assessment, chemical exposure index was the largest contributor (38%). In the evaluation of remote actuation were the lack of accessibility of valves and the need of its operation in case of fire (Hypothesis 2 – 84%). Finally, in the evaluation of firesafe valves the main criteria were the need of them being classified as emergency block valves and the height near the ground simultaneously (Hypothesis B – 62%)

Dopaminergic inhibition of human neutrophils is exerted through D1-like receptors and affected by bacterial infection

Dopamine (DA) affects immune functions in healthy subjects (HS) and during disease by acting on D1-like (D1 and D5) and D2-like (D2, D3 and D4) dopaminergic receptors (DR); however, its effects on human polymorphonuclear leukocytes (PMN) are still poorly defined. We investigated DR expression in human PMN and the ability of DA to affect cell migration and reactive oxygen species (ROS) production. Experiments were performed on cells from HS and from patients (Pts) with bacterial infections as well, during the acute phase and after recovery. Some experiments were also performed in mice knockout (KO) for the DRD5 gene. PMN from HS express both D1-like and D2-like DR, and exposure to DA results in inhibition of activation-induced morphological changes, migration and ROS production which depend on the activation of D1-like DR. In agreement with these findings, DA inhibited migration of PMN obtained from wild-type mice, but not from DRD5KO mice. In Pts with bacterial infections, during the febrile phase D1-like DRD5 on PMN were downregulated and DA failed to affect PMN migration. Both D1-like DRD5 expression and DA-induced inhibition of PMN migration were however restored after recovery. Dopaminergic inhibition of human PMN is a novel mechanism which is likely to play a key role in the regulation of innate immunity. Evidence obtained in Pts with bacterial infections provides novel clues for the therapeutic modulation of PMN during infectious disease

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Crime and insecurity in young and senior population: an exploratory study in the county of Cabeceiras de Basto

Dissertação de mestrado em Crime, Diferença e DesigualdadeA insegurança surge associada a um clima generalizado de ansiedade relacionada com o processo de mudanças sociais que carateriza a sociedade moderna e de que o aumento da criminalidade é uma das consequências mais visíveis (Lourenço, 2004). Este estudo tem como principal objetivo explorar os sentimentos de insegurança e medo gerados pelo fenómeno do crime e da violência nos indivíduos em meio rural em função da idade. Método: Trata-se de uma pesquisa de caráter qualitativo, em que 40 participantes, divididos em 2 grupos etários – jovens e idosos - são inquiridos mediante entrevista semiestruturada. Resultados: Os resultados alcançados permitiram perceber que em ambos os grupos o medo não é prevalecente, uma vez que a população habita no meio rural, onde o crime e a violência pública são praticamente inexistentes. Os inquiridos afirmam estar atentos à situação do dia-a-dia através de conversas com amigos, familiares, vizinhos e pelos meios de comunicação social. São os assaltos, especialmente no período da noite, o que mais receiam. A crise económica, o domínio de valores capitalistas e a morosidade da justiça são identificados como fatores de insegurança. Conclusões: Em ambientes sentidos como seguros, o crime e a violência são percebidos de forma análoga por jovens e seniores, não desencadeando sentimentos de especial insegurança ou medo.Insecurity arises associated with a general climate of anxiety related to the process of social change which characterizes the modern society where the increase in crime is one of the most visible consequences (Lourenço, 2004). This study aims to explore the feelings of insecurity and fear generated by the phenomenon of crime and violence in individuals in rural areas according to their ages. Method: This was a qualitative research study in which 40 participants, divided into 2 age groups - young and old - are interviewed by semistructured interview. Results: The results obtained allow us to realize that in both groups fear is not prevalent since the population lives in rural areas where crime and public violence are virtually inexistent. Respondents claim to be attentive to the situation of the day-to-day through conversations with friends, family, neighbors and the media. Are the assaults, especially in the evening, what more fear. The economic crisis, the dominance of capitalist values and the slow pace of justice are identified as factors of insecurity. Conclusions: In environments senses as insurance, crime and violence are perceived analogously for youth and seniors, not triggering feelings of special insecurity or fear