The healthcare debate in Portugal in the last decade has been witnessing, to some extent, two different urgings. On the one hand, the National Health Service is advocated as a supporter of the quality of life and well-being of citizens and, as such, its existence must be maintained as a pillar of the country’s development. On the other hand, the role of the State in the provision and management of health services is criticized, demanding accordingly a change of the existing model. Both arguments, nevertheless, tend to focus more on healthcare per se and its problems related  both to the financial sustainability of the health system and to the lack of patients’ empowerment, and much less on the persisting health disparities, which can exist across many determinants, such as gender, age, socioeconomic status and geographic location, and may also be a result of other policies outside the boundaries of the health sector. The purpose of this paper is precisely to contribute to the widening of this debate, emphasizing the importance of including a territorial perspective in health policy making to attain a greater social justice.

The World Health Organization definition of health is nowseventy-years old. From a personal perspective, its limitations are discussed from various angles, taking into accountthe demographic and social changes that have occurred inthe last decades. Huber et al alternative proposal for healthdefinition is presented, highlighting some obstacles to its operationalization. At a time that value-based healthcare significance emerges, it is appropriate to reflect on its implicationsfor the health system organization and for the Internal Medicine modern practice.

Several studies have established a direct relationship between environment exposure and the development of certain cancer pathologies. The state of the environment is directly influenced, in part, by anthropogenic activities, which highlight the typology of economic activity in the area. Starting from an initial project, namely WeGIx - WellBeing Global Index - this article aims to: Objectives: Establish an association between deaths due to malignant tumors of the larynx, bronchi, trachea and lungs and environmental exposure, namely PM10 , PM2,5 e NOx emissions, as well as to the type of economic activity allocated to the municipality, based on the typology of the territory - Predominantly Urban, Semi-urban and Predominantly Rural. Material and Method: Observational and transversal study; statistical data for the year 2015 from the PORDATA and APA - Portuguese Environment Agency - of the Portuguese population resident in the 308 municipalities. Data analysis performed using IBM® SPSS® Statistics vs.24.0, considering a significance level of 0.05 for all statistical inference situations. Results: The associations made reveal a statistically significant difference of means between the three types of territory with regard to mortality. The results show that the behavior of the independent variables - related to population characteristics, pollutant emissions and typology of economic activity – in relation to mortality – varies according to the type of territory - Predominantly Urban, Semi-urban and Predominantly Rural. Conclusions: The study of the variables under analysis allows us to conclude that there is an association between deaths due to malignant larynx, bronchial, tracheal and lung tumors and the exposure of people to the environment, namely PM10, PM2.5 and NOx emissions. Regarding the typology of economic activity, as an element conditioned by the characteristics of the territory, the impact of its variability differs from the type of territory, consequently, influencing in a different way the vulnerability to death.

The paper analyzes the conditions of the Santa Barbara childbirth ward, at the Royal Hospital of S. José, based on the understanding of Alfredo da Costa, a professor at the Lisbon Medical-Surgical School, an obstetrician at this hospital and the director of this maternity. Both the opening lessons of the Medical-Surgical School Obstetrics Course in 1899 and 1900, as well as the report delivered in 1906 to the Lisbon Medical-Surgical School Council, denounce the deficient conditions of the space and the lack of essential materials indispensable to the proper functioning of the ward, as well as the poor physical state of the parturients.

Purpose Physical activity (PA) is considered central to hypertension prevention and management. The main purpose of this article is to compare supervised exercise (SE) patterns among hypertensive and normotensive Portuguese adults. Methods A total of 966 participants aged between 15 and 90 years old (mean 41.9; SD 19.5) were surveyed face-to-face in public places across Portugal. Participants were considered hypertensives (n=144) if they have systolic and diastolic blood pressure higher than 160 and 90 mmHg or report taking antihypertensive medication. PA was assessed using the International Physical Activity Questionnaire (IPAQ). Descriptive statistics, Chi-square test for associations and t test for independent samples were used to analyze data. Results Hypertensive individuals show a higher prevalence of sedentary lifestyle than normotensive (31% vs 20%). About 40% of hypertensive patients have a high level of physical activity. Several signifcant diferences were found between hypertensives and normotensives regarding the causes for non-participation, information sources and motivation to participate. For infrastructures, only the quality of the equipment (p=0.032), innovative activities (p=0.027), and the opportunity to socialize (p=0.000) are capable of diferentiating the two groups. Conclusions This study shows the prevalence of sedentary behavior among the hypertensive population. Hypertensives and normotensive behavior reveal diferent patterns on the barriers, sources of information, and perception regarding the structures. Service providers seem incapable to make hypertensives aware of the risks associated with PA and the benefts associated with SE. More information is needed to make hypertensives aware of the benefts of SE programs.

We spend more than 90 per cent of our daily lives indoors. Managing the indoor environment so that we feel comfortable and healthy is therefore very important. However, this management is only possible if rigorous data on both construction parameters and indoor environment exists. Moreover, the evolution of construction techniques and materials used modulates both aspects. As a consequence, it is necessary that the information obtained reflects a long period of time. That is the main driver for the project “Six by Sixty by Six” undertaken by the Civil Engineering and Architecture Department and the Faculty of Health Sciences of the University of Beira Interior. Six houses constructed in six different decades (1960’s-2010’s) were surveyed for sixty days regarding a set of parameters (e.g., temperature, humidity, CO2, CO, VOCs). Additionally, dust was collected by the vacuum cleaner bag and was analyzed for specific contaminants. This work presents the results obtained for the toxics metals mercury, arsenic, cadmium, and lead in dust samples. There is no legislation regulating maximum permissible levels for any of the studied metals in dust. A comparison with ”Portaria Nº 1450/2007” which regulates the maximum metal contents in dredged sediment that can be safely deposited in soils (here used as an action threshold) reveals that the values for As in all houses were transcended. For Cd and Hg they were only transcended in one house, whereas for lead all the values were below this threshold. Linear regression with age of construction used as independent variable revealed no relationship between this variable and metal concentrations with the exception of As (R2 adjusted= 0.41). Findings are discussed under the light of potential health outcomes upon the residents.

Background: Mobile applications can be used for the monitoring of lifestyles and physical activity. It can be installed in commodity mobile devices, which are currently used by different types of people in their daily activities worlwide . Objective: This paper reviews and categorizes the mobile applications related to diet, nutrition, health, physical activity and education, showing the analysis of 73 mobile applications available on Google Play Store with the extraction of the different features. Methods: The mobile applications were analyzed in relation to each proposed category and their features, starting with the definition of the search keywords used in the Google Play Store. Each mobile application was installed on a smartphone, and validated whether it was researched in scientific studies. Finally, all mobile applications and features were categorized. Results: These mobile applications were clustered into four groups, including diet and nutrition, health, physical activity and education. The features of mobile applications were also categorized into six groups, including diet, anthropometric parameters, social, physical activity, medical parameters and vital parameters. The most available features of the mobile applications are weight, height, age, gender, goals, calories needed calculation, diet diary, food database with calories, calories burned and calorie intake. Conclusion: With this review, it was concluded that most mobile applications available in the market are related to diet, and they are important for different types of people. A promising idea for future work is to evaluate the acceptance by young people of such mobile applications.

Nowadays people spend a large amount of their time inside their homes. However, prevailing indoor conditions in terms of comfort and environmental quality could present health challenges to the inhabitants. Therefore, a good indoor environmental quality is essential, since in addition to the risk parameters present in indoor air, the relative humidity and the dangers inherent in housing, the health and human well-being can also be affected by high or low temperatures inside their homes. It is necessary that during the use of the building the sources of risk are identified, in order to prevent them and to promote the health of its occupants. In this context, this paper intends to describe a proposal to create a methodology that provides a risk assessment for the occupants of a dwelling, with certain technical features and also delivers some information about a pilot campaign that was launched by an interdisciplinary team from University of Beira Interior in order to collect and analyze some indoor environment data from 6 households representing 6 different decades.

The purpose of this article is to analyze the possible effects of job satisfaction on mental and physical health, happiness, subjective well-being and self-esteem. A total of 971 Portuguese-speaking adults participated in this study. Most participants reported high rates of satisfaction with their colleagues, the nature of their work and leadership, while reporting dissatisfaction with regard to salaries and promotions. Results indicated the existence of the protector effect of job satisfaction for health, happiness, subjective well-being and self-esteem, in addition to reinforcing the importance of maintaining a positive evaluation of one's work. As a practical implication, the results may suggest that the effects of personnel management policies which emphasize job satisfaction could potentially lead to improvements in levels of health, happiness, subjective well-being and workers' self-esteem, all of which are factors that can potentially improve organizational performance. The study also considered its limitations and the possibility for future investigation.

Justice is approached as equity as a path to equality. Starting from Aristotle, who was perhaps the one who best defined the concept of justice as equity; dialoguing with Rawls, whose perspective of justice aims not to result in the interest of all, or of the majority, but as a fundamental duty to understand collective needs, without, however, failing to bring into this dialogue Amartya Sem, who states that justice as equity resides in capabilities and in the freedom of each person to choose, among the possible paths, the one that best meets their own needs. As a way of responding to the objective of this study, which aims to highlight equity as a support for equal access to health, it was decided to use the exploratory bibliographic research method on reference authors on the topic under analysis. It was concluded that, of the different needs, access to health care is fundamental to ensuring a person's rights. From the point of view of bioethics and the right to health (biolaw), justice as equity (and not so much equality) is that which can best facilitate access to health care and services, since people are different and therefore have specific needs; In Portugal, a national strategy is necessary, which cannot and should not remain hostage to ideological policies, but rather involves all health sectors, including the private sector, to respond to needs and promote equitable access.