Repositório RCAAP

Continental Portugal presents an extensive and diversified coastal zone which concentrates the main public and private infrastructures of the different economic sectors, as well as the main critical infrastructures. This area is also characterized by a high population density, being a differentiated territory in geophysical, biological and landscape terms. The wave regime is highly energetic, and storms are frequent. In the last decades, the coast of continental Portugal has been affected numerous times by overtopping and coastal flooding processes. Identifying the critical coastal typologies affected by flooding can contribute to a comprehensive flood risk management framework for the Portuguese coastal zones. Hence, a historical database of coastal flooding occurrences was created for the period 1980–2018 based on national and regional newspapers. For this period 650 occurrences were identified as well as 1708 impacts associated with them. In terms of impacts, the typologies associated with public areas, human impacts, the natural system, environmental degradation and buildings stand out. Results provide relevant temporal and spatial information about coastal historical flood occurrences related to extreme storm events and associated impacts, and contribute to the design of a risk framework.

O presente estudo foca três dimensões – stress parental, estilo de vinculação materno e estilo de vinculação da criança (percepção materna) - numa amostra não-clínica de mães. Pretende-se: (1) averiguar se as mães com estilos de vinculação seguro e inseguro se distinguem no stress parental; (2) analisar se há variações no estilo de vinculação da criança (seguro, ansioso/ambivalente e evitante) em função do estilo de vinculação da mãe; (3) determinar se o estilo de vinculação da criança é um preditor do stress parental; (4) explorar a relação do stress parental e dos estilos de vinculação da mãe e da criança com variáveis sócio-demográficas (mãe/criança). Participaram no estudo 73 mães de crianças com idades entre os 7 e os 12 anos. Utilizaram-se três instrumentos, o Índice de Stress Parental, o Questionário de Estilo Relacional, e o Inventário sobre a Vinculação na Infância e Adolescência, para avaliar, respectivamente, o stress parental, o estilo de vinculação da mãe e a percepção materna da vinculação da criança. Foi ainda construída uma Ficha de Recolha de Informação para a obtenção de dados sócio-demográficos (mãe, criança e agregado familiar). Os resultados mostram que as mães com estilos de vinculação seguro e inseguro não se distinguem significativamente no stress parental experimentado, mas distinguem-se na percepção do estilo de vinculação da criança (resultado significativo para o estilo evitante e marginalmente significativo para os estilos seguro e ansioso/ambivalente). Verifica-se ainda que a vinculação segura na criança é um preditor do stress parental (Domínio da Criança/Domínio dos Pais), sendo este menor quando há a percepção de maior recurso a comportamentos de tipo seguro. Relativamente às variáveis sócio-demográficas, o número de filhos associa-se significativamente com o estilo de vinculação materno, e o desempenho escolar com o stress parental e com o estilo de vinculação da criança.

This study investigates the differences observed in the rate of tax evasion between the Global North and South countries, with special focus on Brazil, by comparing key parameters of their tax systems, namely, tax burden, audit cost, and fines. This is achieved by extending and applying Graetz, Reinganun, and Wilde’s model using data from tax authorities from European and Latin American countries, which produced parameters that are used for Bayesian games. The results show that tax evasion is directly associated with tax burden and audit cost, but the effect of fines is unclear. Overall, findings pointed to shortcomings in the tax system of Latin American countries that create the avenue for high tax evasion.

Este capítulo começa por proporcionar uma breve panorâmica sobre as formas como as autarquias portuguesas têm vindo a lidar corl os temas da democracia participativa ao longo desta pandemia. Para facultar uma leitura mais pormenorizada das questões que se consideram fundamentais e para promover uma reflexão ao mesmo tempo crítica e de esperança neste âmbito, o capítulo debruçar-se-á sobre algumas histórias que os autores acompanharam no terreno e/ou tiveram a oportunidade de analisar mais a fundo, por meio de análise documental e entrevistas com os seus responsáveis. As histórias mostram como os municípios de Lisboa, Cascais e Valongo decidiram abrir novas vertentes de diálogo com os munícipes e de colaboração com outras instituições, capitalizando assim aprendizagens num período que se espera de forte transição.

Complement has been considered as an important factor impacting the host-pathogen association of spirochetes belonging to the Borrelia burgdorferi sensu lato complex, and may play a role in the spirochete's ecology. Birds are known to be important hosts for ticks and in the maintenance of borreliae. Recent field surveys and laboratory transmission studies indicated that certain avian species act as reservoir hosts for different Borrelia species. Nevertheless, our current understanding of the molecular mechanisms determining host tropism of Borrelia is still in its fledgling stage. Concerning the role of complement in avian-host tropism, only a few bird species and Borrelia species have been analysed so far. Here, we performed in vitro serum bactericidal assays with serum samples collected from four bird species including the European robin Erithacus rubecula, the great tit Parus major, the Eurasian blackbird Turdus merula, and the racing pigeon Columba livia, as well as four Borrelia species (B. afzelii, B. garinii, B. valaisiana, and B. burgdorferi sensu stricto). From July to September 2019, juvenile wild birds were caught using mist nets in Portugal. Racing pigeons were sampled in a loft in October 2019. Independent of the bird species analysed, all Borrelia species displayed an intermediate serum-resistant or serum-resistant phenotype except for B. afzelii challenged with serum from blackbirds. This genospecies was efficiently killed by avian complement, suggesting that blackbirds served as dead-end hosts for B. afzelii. In summary, these findings suggest that complement contributes in the avian-spirochete-tick infection cycle and in Borrelia-host tropism.

Grip strength (GS) is an indicator of health and vulnerability and inversely associated with depressive symptoms. The aim of this study was to explore GS discrimination capacity for depression; and possible GS cut-off values for depression by sex and age group. Data from 2011 and 2015 on 20,598 (10,416 women) middle-aged and older adults from 14 European countries was analysed. GS was assessed by dynamometer, and depressive symptoms using the EURO-D scale. GS cut-off values for depression were calculated and logistic regression models were used to quantify the odds of having depression in 2011 and in 2015 according to being bellow or above the cut-off value. GS had a weak discriminant capacity for depression, with the area under the curve varying between 0.54 and 0.60 (p < 0.001). Sensitivity varied between 0.57 and 0.74; specificity varied between 0.46 and 0.66. GS cut-off values for discriminating depression were 43.5 kg for men and 29.5 kg for women aged 50–64 years, 39.5 kg for men and 22.5 kg for women aged ≥ 65 years. Having GS above the cut-off represents significant lower odds of depression in 2011 and 4 years later, in 2015. Healthcare practitioners and epidemiologic researchers may consider the low GS cut-off values to screen for potential depression risk. However, due to its weak discriminant values these cut-offs should not be used to identify depression.

Background: Cardiopulmonary exercise test (CPET) is indicated as part of the assessment in hypertrophic cardiomyopathy (HCM) patients and stress echocardiography is often used to assess symptoms. However, the role of exercise testing for prognostic stratification in HCM is still not established. Aims: To systematically review the evidence on the role of exercise testing for prognostic stratification in hypertrophic cardiomyopathy. Methods: A systematic review was conducted for eligible publications, between 2010 and 2020, that included evaluation of outcomes and prognosis. In these studies, patients underwent exercise echocardiography and/or cardiopulmonary exercise testing, performed according to predefined protocols. Diverse parameters were assessed in order to determine which were relevant for the prognosis. Analyzed outcomes included death from any cause, sudden cardiac death (SCD) and equivalents, cardiovascular death, heart failure requiring hospitalization or progression to New York Heart Association classes III or IV, cardiac transplantation, non-sustained ventricular tachycardia, stroke, myocardial infarction and invasive septal reduction therapy. Results: Eighteen publications were included, corresponding to a total of 7525 patients. The mean follow-up period varied between 1 and 8 years. The main findings of these studies revealed that the major predictors of outcomes were abnormal heart rate recovery, abnormal blood pressure response exercise induced wall motion abnormalities, lower peak VO2, higher VE/VCO2, and pulmonary hypertension/exercise-induced pulmonary hypertension. Conclusion: Although most studies concluded that exercise test results are useful to determine prognosis in HCM, further investigation is needed regarding whether it adds independent value to the current risk stratification strategies.

Background: State-of-the-art research highlights that borderline personality disorder (PD) and bipolar spectrum disorders have clinical characteristics in common, which imply uncertainty in differential diagnoses. Although there is a growing body of literature on the DSM-5 dimensional model of personality disorder, its discriminative features between these clinical samples are still understudied. In this study, we seek to identify the best set of predictors that differentiate between borderline PD and bipolar spectrum, based on pathological and normative personality traits and symptoms. Methods: A cross-sectional study of three clinical samples: 1) Borderline PD group of 63 participants; 2) Major depressive disorder group of 89 participants; 3) Bipolar disorder group of 65 participants. Self-reported assessment: Personality Inventory for DSM-5; Brief Symptom Inventory; FFM Inventory. A series of one-way ANOVAs and logistic regression analyses were computed. Results: The major set of data emerging as common discriminants of borderline PD across the bipolar spectrum are unusual beliefs & experiences, paranoid ideation, obsession-compulsion and extraversion. Depressivity (OR: 34.95) and impulsivity (OR: 22.35) pathological traits displayed the greatest predictive values in the differential diagnosis. Limitations: The small size of the samples; a lack of data from participants' previous clinical history. Conclusions: Findings support the DSM-5 pathological traits as differentiating borderline PD through bipolar spectrum, and reinforcing the joint use of symptom-related pathological functioning and normal-range personality traits. Alongside the bipolar spectrum, borderline pathology sheds light upon a hypothetical overlap along the depressive and schizoaffective/schizophrenia spectra, representing a borderland space at a crossroads with the psychopathology of a meta-spectrum.

This study aimed to understand how beliefs and attitudes regarding COVID-19 are associated with self-perceived changes in food consumption during lockdown between March 19 and May 2, 2020. We conducted a cross-sectional study with a non-probabilistic weighted sample of the Portuguese population. Data were collected using an online survey and telephone interviews. The association between agreement with sentences about food and COVID-19 and perceived changes in food consumption were assessed by multinomial logistic regression models. Overall, 5858 citizens were included, with a mean age of 38.2 (17.3) years. Exclusive agreement with the belief “SARS-CoV-2 can be transmitted by food” (27.5%) was associated with decreased odds of perceived positive changes (e.g., increased consumption of fruit and vegetables). Agreement only with the attitudinal sentence “I started to consume foods that may protect against COVID-19” (11.9%) was associated with positive perceived consumption changes (e.g., increasing fruit and vegetables, and decreasing soft drinks and snacks). Cumulative agreement (with both sentences; 10.6%) was also associated with mostly positive food consumption changes. Specific beliefs and attitudes regarding COVID-19 and food are associated with self-perceived changes in food consumption. Longitudinal research is needed to understand how beliefs and/or attitudes about the role of food in infectious diseases act as determinants of eating behavior modification.

Water in the city is typically exploited in a linear process, in which most of it is polluted, treated, and discharged; during this process, valuable nutrients are lost in the treatment process instead of being cycled back and used in urban agriculture or green space. The purpose of this paper is to advance a new paradigm to close water cycles in cities via the implementation of naturebased solutions units (NBS_u), with a particular focus on building greening elements, such as green roofs (GRs) and vertical greening systems (VGS). The hypothesis is that such “circular systems” can provide substantial ecosystem services and minimize environmental degradation. Our method is twofold: we first examine these systems from a life-cycle point of view, assessing not only the inputs of conventional and alternative materials, but the ongoing input of water that is required for irrigation. Secondly, the evapotranspiration performance of VGS in Copenhagen, Berlin, Lisbon, Rome, Istanbul, and Tel Aviv, cities with different climatic, architectural, and sociocultural contexts have been simulated using a verticalized ET0 approach, assessing rainwater runoff and greywater as irrigation resources. The water cycling performance of VGS in the mentioned cities would be sufficient at recycling 44% (Lisbon) to 100% (Berlin, Istanbul) of all accruing rainwater roof–runoff, if water shortages in dry months are bridged by greywater. Then, 27–53% of the greywater accruing in a building could be managed on its greened surface. In conclusion, we address the gaps in the current knowledge and policies identified in the different stages of analyses, such as the lack of comprehensive life cycle assessment studies that quantify the complete “water footprint” of building greening systems.

The growing needs for agricultural expansion and intensification will likely continue to reduce and fragment the terrestrial habitats fundamental to mammalian carnivores. Recent research identified benefits of agroecosystems to carnivores recognizing their multifunctionality, mostly for common species. However, the variability of carnivore ecology investigated in agroecosystems, biases in agriculture types and species targeted, and methodological approaches may affect the available knowledge to reconcile conservation and agricultural production. To fill this gap, we conducted a systematic literature review to identify which aspects of and how is carnivore spatial ecology being investigated within agroecosystems. Of the 110 reviewed studies, most focused on agricultural crops (55%) and grasslands (47%) and half referred to monocultures. We found that 61% of the studies were conducted in Europe and North America. Eighty-four carnivore species were studied, 73% classified as Least Concern, with 67% of the studies targeting a single species and 30% focused on only seven common species. Almost all studies included some form of habitat use analysis and species’ home-range and its attributes (e.g. size, resource selection), the most common spatial ecology aspects studied. Most studies suggested that agriculture functions as food provisioning (69%) but few used direct food availability measures. Our results highlight that studies tend to be descriptive and geographically biased towards northern hemisphere and to non-forested agricultural types. We suggest that future carnivore spatial ecology research in agroecosystem should be hypotheses-driven, with greater focus on the mechanisms and processes through which agroecosystems might affect carnivore spatial ecology in particular for areas with high priority for carnivore conservation.

Esta Newsletter (NL) resulta de uma parceria entre o Instituto de Saúde Baseada na Evidência e a Cochrane Portugal, e tem como objectivo disponibilizar informação sobre áreas interessantes para a prática clínica, com base na melhor evidência científica. São incluídos estudos relevantes, criticamente avaliados pela sua validade, importância dos resultados e aplicabilidade prática, resumidos numa óptica de suporte à decisão. É dada prioridade a estudos de causalidade incluindo-se ainda, quando justificado, estudos qualitativos e metodológicos, assim como revisões científicas. O conteúdo da NL é da exclusiva responsabilidade do(s) seu(s) autor(es).

À luz do que foi lido em textos de crítica, ensaio ou ficção do autor Marcel Proust, pretendo com este trabalho mostrar que a utilização do pastiche no seu discurso consiste numa interpretação criativa fundada na influência e consideração por outros escritores, aqui tomados, em certa medida, como modelos. Proust detecta na dicção escolhida os traços que a distinguem de outras, e elabora, com eles, uma nova configuração daquilo que será facilmente reconhecido como um estilo característico. Interessa-me argumentar que este é um processo consciente, reforçado na entidade particularmente mimética do autor, que não exclui, no entanto, o pastiche imediato ou involuntário. Gostaria de concluir que a escolha do pastiche integra o discurso proustiano na originalidade reconhecida, tanto no estilo quanto no conteúdo essencial do programa estético que toma a arte (e a literatura) como actos para a perenidade.

O presente estudo exploratório, no âmbito da temática da leitura, mais especificamente da compreensão leitora, pretende promover o auto-questionamento de alunos do 5º ano de escolaridade para a identificação das estratégias de metacompreensão leitora utilizadas antes, durante e após uma tarefa de leitura de um texto e perceber as potencialidades desta metodologia para a intervenção de um psicólogo educacional em contexto. Para a operacionalização do estudo foi necessário construir um instrumento e ensaiar uma metodologia de recolha de dados. O estudo incidiu sobre um total de 237 participantes do 5º ano de escolaridade, a frequentar uma escola de uma zona rural do distrito de Lisboa. O procedimento utilizado foi a aplicação colectiva do instrumento de recolha de dados no grupo turma, antes, durante e após a leitura de um texto. Os resultados permitem-nos verificar que a leitura é percepcionada como tendo um grande objectivo: a aprendizagem. Reler; perguntar a alguém ou consultar fontes de conhecimento quando não se compreende; ler de várias formas, nomeadamente com atenção; verificar o tipo de texto; observar a figura; pensar na história para a compreender; autoquestionar- se perante as incompreensões e relembrar as ideias principais são as estratégias de metacompreensão leitora mais referidas pelos alunos. Activar conhecimentos prévios, determinar objectivos de leitura, auto-questionar-se sobre o que leu, sublinhar e tirar notas são as estratégias menos frequentes. Menos de metade dos alunos activa conhecimentos prévios e uma grande percentagem consegue antecipar os acontecimentos com elementos relacionados com o tema. A metodologia, na presença da tarefa é uma potencialidade deste instrumento que poderá ser usado por professores, utilizando textos dos manuais escolares. Outro contributo desta metodologia é promover o auto-questionamento tornando-o interventivo, no sentido em que potencia a aquisição de estratégias.

Introduction: Breast volume estimation is considered crucial for breast cancer surgery planning. A single, easy, and reproducible method to estimate breast volume is not available. This study aims to evaluate, in patients proposed for mastectomy, the accuracy of the calculation of breast volume from a low-cost 3D surface scan (Microsoft Kinect) compared to the breast MRI and water displacement technique. Material and methods: Patients with a Tis/T1-T3 breast cancer proposed for mastectomy between July 2015 and March 2017 were assessed for inclusion in the study. Breast volume calculations were performed using a 3D surface scan and the breast MRI and water displacement technique. Agreement between volumes obtained with both methods was assessed with the Spearman and Pearson correlation coefficients. Results: Eighteen patients with invasive breast cancer were included in the study and submitted to mastectomy. The level of agreement of the 3D breast volume compared to surgical specimens and breast MRI volumes was evaluated. For mastectomy specimen volume, an average (standard deviation) of 0.823 (0.027) and 0.875 (0.026) was obtained for the Pearson and Spearman correlations, respectively. With respect to MRI annotation, we obtained 0.828 (0.038) and 0.715 (0.018). Discussion: Although values obtained by both methodologies still differ, the strong linear correlation coefficient suggests that 3D breast volume measurement using a low-cost surface scan device is feasible and can approximate both the MRI breast volume and mastectomy specimen with sufficient accuracy. Conclusion: 3D breast volume measurement using a depth-sensor low-cost surface scan device is feasible and can parallel MRI breast and mastectomy specimen volumes with enough accuracy. Differences between methods need further development to reach clinical applicability. A possible approach could be the fusion of breast MRI and the 3D surface scan to harmonize anatomic limits and improve volume delimitation.

Introduction: Potentially life-threatening disorders may present in the emergency department with acute tetraparesis, and their recognition is crucial for an appropriate management and timely treatment. Our review aims to systematize the differential diagnosis of acute non-traumatic tetraparesis. Results: Causes of tetraparesis can be classified based on the site of defect: upper motor neuron (UMN), peripheral nerve, neuromuscular junction or muscle. History of present illness should include the distribution of weakness (symmetric/asymmetric or distal/proximal/diffuse) and associated clinical features (pain, sensory findings, dysautonomia, and cranial nerve abnormalities such as diplopia and dysphagia). Neurological examination, particularly tendon reflexes, helps further in the localization of nerve lesions and distinction between UMN and lower motor neuron. Ancillary studies include blood and cerebral spinal fluid analysis, neuroaxis imaging, electromyography, muscle magnetic resonance and muscle biopsy. Conclusions: Acute tetraparesis is still a debilitating and potentially serious neurological condition. Despite all the supplementary ancillary tests, the neurological examination is the key to achieve a correct diagnosis. The identification of life-threatening neurologic disorders is pivotal, since failing to identify patients at risk of complications, such as acute respiratory failure, may have catastrophic results.

Esta Newsletter (NL) resulta de uma parceria entre o Instituto de Saúde Baseada na Evidência e a Cochrane Portugal, e tem como objectivo disponibilizar informação sobre áreas interessantes para a prática clínica, com base na melhor evidência científica. São incluídos estudos relevantes, criticamente avaliados pela sua validade, importância dos resultados e aplicabilidade prática, resumidos numa óptica de suporte à decisão. É dada prioridade a estudos de causalidade incluindo-se ainda, quando justificado, estudos qualitativos e metodológicos, assim como revisões científicas. O conteúdo da NL é da exclusiva responsabilidade do(s) seu(s) autor(es).

In this article, we study the role played by pottery production in the transition from Early Neolithic to Middle Neolithic in Western Iberia (∼4500–3300 cal BC) based on a critical analysis of the available empirical data. We establish a chronological and cultural sequence for this period, regarding which the historical problematic is still poorly defined due to a lasting absence of scientific discussion about the long Neolithisation process. During the evolved Early Neolithic (∼5200–4500 cal BC), archeological record shows regional specificities and cultural identities in human groups occupying a vast territory. Pottery collections evidence the strong social importance of decorative grammars, marked by a wide variety of techniques and decorative patterns. In quantitative terms, decorated vessels largely prevail over undecorated vessels. However, in the following chrono-cultural phase, the Initial Middle Neolithic (∼4500–3700 cal BC), it starts an increasing prevalence of undecorated vessels over decorated. Decorative systems prefer the incision technique to impression (dominant in the Early Neolithic). Recurrent use of an incised motif called incised line below the rim. In this period, this type of decoration prevails in the set of decorated pottery and is found in different geographic contexts. This adds consistency to the interpretation according to which the same artifact collections are found in all settlements of the initial Middle Neolithic. Finally, by the time of the first-known Megalithic burials – Full Moment of the Middle Neolithic (3700–3300 cal BC) – the decorative grammars almost disappear from pottery sets, which became more “common” and missed some of their symbolic and social meaning. Undecorated vessels prevail even more strongly than in the previous period.

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