Rights for all? Living conditions and (de)citizenship of adults with intellectual and complex disabilities in Portugal.

BACKGROUND: In 2009, Portugal ratified the UN CRPD and a turn to a rights-based approach in disability law and policy has intensified since. It thus becomes important to understand whether these legal changes are furthering the social inclusion of adults with intellectual and complex disabilities. METHOD: Questionnaires were applied to a stratified sample of 127 adults with intellectual and complex disabilities attending social care and vocational training programmes across the country. RESULTS: Participants reported low rates of social participation, and many (49%) were found to live below the poverty line. High rates of discrimination and violence and feelings of loneliness and sadness were also reported, which can be strong indicators of the oppression that many of them daily endure. CONCLUSION: Adults with intellectual and complex disabilities in Portugal face exclusion, discrimination, and violence. The poverty and isolation in which many of them live compounds their (de)citizenship status in Portuguese society.

The Meaning Making Model Applied to Community-Dwelling Adults with Chronic Pain.

PURPOSE: Chronic pain is a multidimensional experience that is influenced by biological, psychological, social, and spiritual factors. The Meaning Making Model is a recent cognitive behavioral model that has been developed to understand how psychosocial factors influence adjustment to stressful events, such as having a chronic illness. This qualitative study aims to understand the potential utility of this model for understanding the role of meaning making in adjustment to chronic pain. MATERIALS AND METHODS: Eighteen community-dwelling adults with chronic low back pain or chronic pain due to osteoarthritis participated in four focus groups. Participants were asked open-ended questions about their pain experience, pain-related beliefs, meaning of pain, and the perceived association between pain and their meaning in life and sense of purpose. Data were submitted to thematic analysis and the identified themes were considered in light of the Meaning Making Model. RESULTS: Three overarching themes emerged, each of which included two themes. The first overarching theme - "appraised meaning of pain" - included the themes "causal attributions" and "primary appraisals." The second - "meaning making processes" - included the themes "assimilation" and "accommodation." The third - "meanings made" - included the themes "pain as an opportunity" and "acceptance." CONCLUSION: The key themes that emerged as individuals with chronic pain discussed pain and its impact are consistent with those that would be hypothesized as important from the Meaning Making Model, providing preliminary support for the utility of this model in the context of chronic pain. People with chronic pain appear to appraise pain in terms of its cause, controllability, threat, loss, or challenge. When a discrepancy between the appraised meaning of pain and one's global meaning emerged, participants engaged in meaning making processes (accommodation and assimilation), resulting in meanings made, such as a reappraised meaning of pain, perceptions of growth, and acceptance.

Improving the Ambient Temperature Control Performance in Smart Homes and Buildings.

Currently, it is becoming increasingly common to find numerous electronic devices installed in office and residential spaces as part of building automation solutions. These devices provide a rich set of data related to the inside and outside environment, such as indoor and outdoor temperature, humidity, and solar radiation. However, commercial of-the-shelf climatic control systems continue to rely on simple controllers like proportional-integral-derivative or even on-off, which do not take into account such variables. This work evaluates the potential performance gains of adopting more advanced controllers, in this case based on pole-placement, enhanced with additional variables, namely solar radiation and external temperature, obtained with dedicated low-cost sensors. This approach is evaluated both in simulated and real-world environments. The obtained results show that pole-placement controllers clearly outperform on-off controllers and that the use of the additional variables in pole-placement controllers allows relevant performance gains in key parameters such as error signal MSE (17%) and control signal variance (40%), when compared with simple PP controllers. The observed energy consumption savings obtained by using the additional variables are marginal (≈1%, but the reduction of the error signal MSE and control signal variance have a significant impact on energy consumption peaks and on equipment lifetime, thus largely compensating the increase in the system complexity.

Tratamento endovascular da síndrome de compressão da veia ilíaca (May-Thurner): relato de caso / Endovascular treatment of iliac vein compression syndrome (May-Thurner): a case report

A Síndrome de May-Thurner é uma causa pouco comum de sinais e sintomas venosos relacionados ao membro inferior esquerdo. Esta síndrome é caracterizada pela compressão da veia ilíaca comum esquerda pela artéria ilíaca comum direita e, quando tal alteração anatômica causa sintomas que venham a prejudicar a qualidade de vida do paciente, existe a indicação de tratamento cirúrgico ou endovascular para correção desta alteração anatômica. Este artigo é o relato de um caso, no qual optou-se pelo tratamento endovascular com resultado satisfatório e as indicações, as nuances e os resultados esperados para esta técnica no tratamento da Síndrome de May-Thurner são discutidos. Foi concluído que, nesta síndrome, há eficácia do tratamento endovascular com melhora dos sintomas pela recanalização do sistema venoso, sem grandes riscos inerentes ao procedimento e com curto período de internação hospitalar.

May-Thurner Syndrome is an uncommon cause of venous symptoms and signs related to the left lower limb. It is characterized by compression of the left common iliac vein by the right common iliac artery and, when such anatomical change causes symptoms that may impair the patients' quality of life, surgical treatment is indicated. This article addresses a case of May-Thurner syndrome in which we opted for endovascular treatment with satisfactory outcome, as well as a discussion about indications, nuances, and expected results. We concluded that endovascular treatment is effective in treating this syndrome, for it resolves the symptoms by recanalization of the venous system with little risks during the procedure and with short hospital stay.

Prevalência de obesidade e sobrepeso em alunos do ensino fundamental de Aracaju/SE / Obesity and overweigth prevalences in students of Aracaju/SE-Northeast-Brazil

Objetivos: estudar a prevalência de obesidade e sobrepeso em alunos de primeira a quarta série do ensino fundamental de escolas públicas e particulares de Aracaju/SE. Método: durante o ano de 2002, foram estudados 500 alunos entre crianças (n=259) e adolescentes (n=241), sendo 240 (48%) do sexo masculino e 260 (52%) do sexo feminino. Foram sorteadas uma escola municipal, uma estadual e uma particular de cada um dos cinco distritos sanitários, perfazendo um total de 15 escolas. Trabalhou-se com as variáveis: sexo, faixa etária, tipo de escola e distritos sanitários. Resultados: encontrou-se prevalência geral de 6% para obesidade e 10% para sobrepeso. Não houve diferença entre os sexos (p=0,99), nem entre as faixas etárias estudadas (p=0,19 para obesidade e p=0,38 para sobrepeso). A prevalência de obesidade e sobrepeso foi significativamente maior (p< 0,01) em escolas particulares (12,1% e 16,2%) em relação ás escolas públicas (4,5% e 8,5%). Não houve significância estatística entre os distritos sanitários em relação ao sobrepeso (p=0,05). A maior prevalência de obesidade foi encontrada no terceiro distrito (11,2%), enquanto a menor foi a do quarto distrito (1,5%). Conclusão: a prevalência de obesidade e sobrepeso em escolares de Aracaju é elevada, semelhante à encontrada em outros estados brasileiros. Não houve diferença entre os sexos, no entanto foi significativamente maior nas escolas particulares e mostrou tendência maior nos distritos sanitários de melhores condições socioeconômicas.

Objectives: To study the prevalence of obesity and over-weight in first to fourth grade students attending private and public schools of Aracaju, SE, Brazil. Methods: During 2002 school year, 500 students from both sexes (240 males; 260 females) were studied. One private, one State, and one city school were randomly selected for each of the five sanitary districts with a total of 15 schools. The students were weighed and measured by the same investigator and studied according to the variables sex, age group, school type, and sanitary district. Results: The prevalence of obesity and overweight were 6% and 10%, respectively. There were no differences between sex (p=0.99) or age groups (p=0.19 for obesity and for overweight (p=0.38). Prevalence of obesity and overweight were significantly higher in private (12.0.and 16.2%, respectively) than in public school (4.5 and 8.5%, respectively). The prevalence of overweight and obesity was higher in higher socioeconomic districts. Conclusion: The prevalence of obesity and overweight in Aracaju is high, similar to other Brazilian cities. There were no differences between sexes. Overweight and obesity were significantly higher in private than in public school and higher in higher socioeconomic districts.

Hyperstomy syndrome

Hyperstomy syndrome is defined as a dysfuncion of microcirculatory arteriolo-venular flow which stimulates ischemic diseases without arterial occlusion and causes precocious venous backflow. This paper presents a review of hyperstomy syndrome since this entity was first described. It also presents six cases of patients with hyperstomy syndrome who were successfully treated.