Evaluation of lung function is central to the management of chronic obstructive respiratory diseases. It is typically evaluated with a spirometer by a specialized health professional, who ensures the correct execution of a forced expiratory manoeuvre (FEM). Audio recording of a FEM using a smart device embedded microphone can be used to self-monitor lung function between clinical visits. The challenge of microphone spirometry is to ensure the validity and reliability of the FEM, in the absence of a health professional. In particular, the absence of a mouthpiece may allow excessive mouth closure, leading to an incorrect manoeuvre. In this work, a strategy to automatically assess the correct execution of the FEM is proposed and validated. Using 498 FEM recordings, both specificity and sensitivity attained were above 90%. This method provides immediate feedback to the user, by grading the manoeuvre in a visual scale, promoting the repetition of the FEM when needed.

Since ancient times, Man has known the powers of thermal waters in a relationship that has not been monotonous. In its evolution, the world began to include the two aspects of thermalism (classic and wellness) in the sphere of health and wellness tourism, which is considered, since 2006, as a strategic product for Portugal by Turismo de Portugal, IP. The aim of this study was to analyse the financial stability of four Portuguese thermal establishments, selected from a set of common characteristics which made them comparable. Using the most popular technique of financial analysis, the ratio method, the financial stability of the four Portuguese thermal establishments studied was tested and the research question of the study was: do these thermal establishments meet their short-term obligations and their financial commitments? The data of each company was obtained from the SABI database and the sector data, economic activity code 86905 – thermal activities, were obtained from Banco de Portugal’s website. Data was processed and analysed using the Microsoft Excel software. The study concluded that the four companies studied have different financial characteristics and in general, the Termas de São Pedro do Sul are closest to the sector average of the analysed ratios. Nevertheless, the majority of the companies have short-term financial stability, highly conditioned by the accounts receivable, and a strong dependency on debt in their financial structures

Inhaled therapies are the cornerstone of effective asthma treatment and adequate inhaled medication adherence (IMA) is critical. mHealth technologies have shown to be promise for asthma self-management, including IMA improvement. InspirerMundi is a mobile application designed to support self-management of patients with asthma. It aims to transform the adherence to treatment into a positive experience through gamification and social interaction while allowing for ubiquitous verified IMA monitoring. The app includes an image-based inhaler usage detection tool, tools for reporting symptoms and burden of the asthma (disease monitoring) and Game & Peer support features. Still, the effectiveness of these tools depends on a regular app use and a real-life assessment of patient engagement and pattern of use is needed. This work evaluates the patient engagement, usage, and acceptance of InspirerMundi app during a real-world multicentre feasibility study. The app use was recommended for a 4-months period to 77 participants with persistent asthma. From those, 72 installed the app, with 67% of them beginning to use both the inhaler usage detection tool and the disease monitoring components within the first week. Over 95% used it more than once, with the period of usage (from first use to last registered monitoring in 2018) being over 30 days for almost 70% of the users, and over 90 days for around 35%. Nevertheless, the usage rate (ratio of the number of days with app usage and the period of use) had a median value of 0.6 and was above 75% for only 35% of the users, revealing room for improvement. In general, the users started to use the app features right after installation and the usage patterns and retention rates indicate that InspirerMundi is well accepted among patients with asthma.

Current tools for self-management of chronic obstructive respiratory diseases (CORD) are difficult to use, not individualized and requiring laborious analysis by health professionals, discouraging their use in healthcare. There is an opportunity for cost-effective and easy-to-disseminate advanced technological solutions directed to patients and attractive to different stakeholders. The strategy of AIRDOC is to develop and integrate self-monitoring and self-managing tools, making use of the smartphone's presence in everyday life. AIRDOC intends to innovate on: i) technologies for remote monitoring of respiratory function and computerized lung auscultation; ii) coaching solutions, integrating psychoeducation, gamification and disease management support systems; and iii) management of personal health data, focusing on security, privacy and interoperability. It is expected that AIRDOC results will contribute for the innovation in CORD healthcare, with increased patient involvement and empowerment while providing quality prospective information for better clinical decisions, allowing more efficient and sustainable healthcare delivery.

Smart device microphone spirometry, based on the audio recording of forced expiratory maneuver (FEM), can be a simple, ubiquitous and easy tool for patients to self-monitor their asthma. Automatic validity assessment is crucial to guarantee that the global effort of the FEM fulfil the admissible minimum or if the maneuver needs to be repeated. In this work an automatic method to classify the sounds from FEM with respect to global effort was developed and evaluated using data from 54 children (5-10 years). The method proposed was able to correctly classify the microphone spirometry with respect to admissible minimum of effort with an accuracy of 86% (specificity 87% and sensitivity 86%). This method can be used to provide immediate feedback of the correct execution of the maneuver, improving the clinical value and utility of this self-monitoring tool.

Evaluation of lung function is central to the management of chronic obstructive respiratory diseases. It is typically evaluated with a spirometer by a specialized health professional, who ensures the correct execution of a forced expiratory manoeuvre (FEM). Audio recording of a FEM using a smart device embedded microphone can be used to self-monitor lung function between clinical visits. The challenge of microphone spirometry is to ensure the validity and reliability of the FEM, in the absence of a health professional. In particular, the absence of a mouthpiece may allow excessive mouth closure, leading to an incorrect manoeuvre. In this work, a strategy to automatically assess the correct execution of the FEM is proposed and validated. Using 498 FEM recordings, both specificity and sensitivity attained were above 90%. This method provides immediate feedback to the user, by grading the manoeuvre in a visual scale, promoting the repetition of the FEM when needed.

O projeto FRASIS pretende desenvolver, integrar e validar um conjunto de tecnologias de informação e comunicação (TIC) de saúde móvel (mHealth) para a monitorização remota da função respiratória na asma, usando apenas o smartphone e os seus sensores integrados. As ferramentas atuais de automonitorização e autogestão da asma são complexas, pouco atrativas, não individualizadas e obrigam os profissionais de saúde a análises trabalhosas, desmotivando a sua utilização e integração nos cuidados de saúde. Existe uma clara oportunidade para soluções tecnológicas avançadas económicas para os doentes e atrativas para os diferentes intervenientes do setor da saúde. A estratégia do FRASIS é desenvolver e integrar tecnologias de automonitorização e autogestão sem a necessidade de dispositivos adicionais, fazendo uso da presença dos smartphones na vida diária e da sua futura integração com sensores ambientais em cidades inteligentes. O FRASIS pretende assim contribuir para a concretização dos princípios da saúde digital e inovar nas tecnologias de monitorização remota da função respiratória. Espera - se que os resultados do FRASIS tenham um impacto relevante na inovação em serviços de saúde para a asma, com maior envolvimento e capacitação do doente, fornecendo informação prospetiva e de qualidade para uma melhor decisão clínica, tornando assim os cuidados de saúde mais eficientes e sustentáveis.

Introduction When cognitive decline (CD) is present, attention is one of the impaired mental functions. CD is also associated with anxious/depressive symptoms and with some demographic variables, particularly, age. Objectives Investigate the associations between selective attention (Stroop Test: Stroop_Word, Stroop_Color, Difference between Stroop_Word and Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color and Difference between Stroop Ratio_Word and Stroop Ratio_ Color) and CD (Montreal Cognitive Assessment/MoCA) in institutionalized elders; explore the predictive value of Stroop variables for CD, controlling anxious/depressive symptoms and sociodemographic variables. Methods 140 institutionalized elders (mean age, M =78.4, SD =7.48, range =60-97) voluntarily answered to sociodemographic questions, the MoCA, the Geriatric Anxiety Inventory/GAI, the Geriatric Depression Scale/GDS and Stroop test. Results 73 elders (52, 1%) had CD. Dichotomized MoCA was associated with Stroop_Word, Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color, GDS and the sociodemographic variable schooling × profession. Age and education were not tested, since MoCA was stratified according to those variables. GDS, Stroop Ratio_Word and Stroop Ratio_Color showed to predict CD. Conclusions There was an association between Stroop_Word, Stroop_Color, Stroop Ratio_Word and Stroop Ratio_Color and CD, confirming that selective attention is smaller when the elderly reveal CD. GDS and CD were, also, associated. However, there was no association between MoCA dichotomized and differences between the correct answers (Stroop_Word and Stroop_Color) and Ratios (Stroop Ratio_Word and Stroop Ratio_Color). Selective attention and depressive symptoms predicted CD. It would be important to intervene through cognitive rehabilitation with the elders to improve their attention.

São diversas as forças que impulsionam as mudanças que as organizações têm de antecipar e gerir, com o objectivo de assegurar a sua sobrevivência e sucesso. A melhor solução que permite às empresas acompanhar estas mudanças, prende-se com o desenvolvimento e implementação de ideias criativas indutoras de procedimentos, produtos e serviços inovadores. Noutras palavras, para alcançar uma boa posição no mercado competitivo, o trabalho criativo deverá ser encorajado. O trabalho criativo requer que os colaboradores tenham competências criativas, mas mais do que isso depende também do ambiente que se vive no seio da organização e das atitudes resultantes da influência do mesmo, no dia-a-dia dos colaboradores. A relação entre a criatividade e variáveis macro-organizacionais como o clima organizacional e atitudinais como a satisfação no trabalho e expectativas face ao líder ou organização no seu todo, tem sido estudada internacionalmente. No entanto, a escassez de literatura na nossa sociedade, leva-nos a explorar ainda mais esta temática. Para tal, recorremos a um estudo correlacional, onde procurámos averiguar relações entre a criatividade e variáveis como o clima de inovação , satisfação e confiança . De forma a que os resultados reflictam a nossa cultura (societal), e na impossibilidade de recorrer a uma amostragem aleatória, decidimos contactar empresas dos mais variados sectores, tendo conseguido uma amostra de 515 participantes, que participaram no estudo através do preenchimento de um questionário colocado on-line, composto por quatro escalas: "Climate for Innovation", de Scott e Bruce (1994); " Trust in the leader" de Dirks (2000); "Job Satisfaction" de Spector (1985) e "Creativity" de Zhou e George (2001). Os resultados indicam-nos que, ao contrário do que tem sido sugerido na literatura, a criatividade não se relaciona significativamente com as variáveis atitudinais e relacionais em estudo (satisfação no trabalho e a confiança no líder), relacionando-se no entanto com o clima organizacional, relação esta largamente apoiada pela literatura existente. Estes dados levam-nos a concluir, por exemplo, que alguns dos instrumentos poderão não estar correctamente adaptados para a população portuguesa, comprometendo consequentemente a fiabilidade dos resultados. A consequência é que as conclusões aqui obtidas não deverão ser fielmente extrapoladas. No entanto, e apesar das fracas associações observadas, a relação positiva entre clima e criatividade, permite-nos igualmente concluir que independentemente dos indivíduos possuírem ou não um conjunto de características disposicionais que favorecem a criatividade, é imprescindível que a organização promova um clima aberto a novas ideias e à heterogeneidade, de forma a estimular o potencial criativo dos seus recursos humanos. O nosso estudo permitiu-nos tecer também algumas directrizes que se forem adoptadas cuidadosamente pelas organizações poderão incentivar o pensamento dito "irreverente". Foram levantadas por fim algumas questões com o intuito de orientar futuras investigações.

Within the scope of this work, we will first address the issue of compensation for non-pecuniary damage in Portugal. Then, starting with the insertion of Article 493-A, paragraph 3 of the Civil Code - which regulates compensation for non-pecuniary damage caused by serious bodily injury or death of a pet - into our legal system with Law n.º 8/2017, we will try to understand whether compensation for this type of damage is regulated in the same way as compensation for non-pecuniary damage to third parties in cases of serious bodily injury or death of another person which, in turn, is regulated in Article 496 of the Civil Code.We have compared these two solutions because both rules regulate damages in a reflexive context in which the damages to be compensated are not those of the immediate victim, that is the person who has suffered damage to their right to life or physical integrity, but rather the non-pecuniary damage suffered by third parties and also because the legislator, in both cases, chose to limit the subjective and objective scope of the right to compensation in these rules. The solution provided, according to the wording of Article 496(2) and (3), for non-pecuniary damage to third parties in cases of serious bodily injury or death of another person limits compensation for this type of damage to a single injury (fatal injury) and to the persons listed in its text. As it is considered too restrictive, some propose an extensive interpretation of the rule so that compensation can cover non-pecuniary damage to persons other than those listed in the precept and damage caused by injuries other than the fatal injury.This solution already prioritizes the material justice of solutions, to the detriment of values such as legal certainty and security. However, other proposals for justifying compensation for non-pecuniary damage in situations where material justice demands it will also do so, such as the thesis that compensation for direct non-pecuniary damage to third parties can be derived from the protection recognized for existential damage, as well as the thesis that bases compensation for direct non-pecuniary damage to third parties on Article 496(1) of the Civil Code, either through the protection recognized for the general right to personality, or through the protection recognized for the relational dimension of the person.Once we have finished asking about compensation for non-pecuniary damage to third parties resulting from the serious bodily injury or death of another person, we have taken a position on the question of whether the treatment of compensation for non-pecuniary damage caused by serious bodily injury or death of a pet should be the same or whether some differences are justified.