Abstract
Recent years witnessed an increase in income inequality. Several explanations have been put forward. In the present paper, we consider a series of technologically related events that have been crucial for the increased income inequality, that is, public R&D incentives, increasing horizontal integration and spillover effects. We found that public R&D incentives and the increasing horizontal integration have biased the income distribution towards the top income group. In particular, the high-skilled workers involved in the R&D process have benefited enormously from this process. Similarly, capital owners have seen an increase in their profits, because of the reduction in product market competition and technological improvements in the production process. We found the effect of knowledge spillovers to be less clear-cut. We conclude discussing the implications of our results and suggesting possible solutions to the increasing income inequality. We call for the creation of supranational institutions, and for stricter legislation on competition and antitrust policy.

Abstract
This paper compares the export promotion system of advanced and emerging economies in fifty countries. Results show that advanced economies offer, on average, more complete export promotion system, i.e. a greater variety of Export Promotion Programs (EPPs) than emerging economies. Advanced countries offer more financial support, informational services, facilitating activities and education and training services. The specific services that contribute most to these differences are also identified, which is important for national export promotion agencies and policy makers to upgrade their offer to firms in order for them to be better prepared for international trade interactions, especially emerging economies.

Abstract
Background: Disease-related malnutrition is a significant problem in hospitalized patients, with high prevalence rates depending on the studied population. Internal Medicine wards are the backbone of the hospital setting. However, prevalence and determinants of malnutrition in these patients remain unclear. We aimed to determine the prevalence of malnutrition in Internal Medicine wards and to identify and characterize malnourished patients. Methods: A cross-sectional observational multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Demographics, hospital admissions during the previous year, type of admission, primary diagnosis, Charlson comorbidity index, and education level were registered. Malnutrition at admission was assessed using Patient-Generated Subjective Global Assessment (PG-SGA). Demographic characteristics were compared between well-nourished and malnourished patients. Logistic regression analysis was used to identify determinants of malnutrition. Results: 729 participants were included (mean age 74 years, 51% male). Main reason for admission was respiratory disease (32%). Mean Charlson comorbidity index was 5.8 +/- 2.8. Prevalence of malnutrition was 73% (56% moderate/suspected malnutrition and 17% severe malnutrition), and 54% had a critical need for multidisciplinary intervention (PG-SGA score >= 9). No education (odds ratio [OR] 1.88, 95% confidence interval [CI]: 1.16-3.04), hospital admissions during previous year (OR 1.53, 95%CI: 1.05-2.26), and multiple comorbidities (OR 1.22, 95%CI: 1.14-1.32) significantly increased the odds of being malnourished. Conclusions: Prevalence of malnutrition in the Internal Medicine population is very high, with the majority of patients having critical need for multidisciplinary intervention. Low education level, admissions during previous year, and multiple comorbidities increase the odds of being malnourished.

Abstract
AbstractNear 20% of the Portuguese population is aged 65 years or above, a value similar to most developed countries. This older adult population also suffers from obesity and obesity-related pathologies. The environment encompasses a set of obesity determinants and knowing the associations between the environment and obesity may help health professionals and caregivers to provide for the older adults.In this study, we aimed to relate anthropometric measures with socio-demographic data in older adults.This is a cross-sectional study using data from the Pronutrisenior project, collected in Vila Nova de Gaia, Portugal. The sample consists of 456 older adults, aged 65 to 92 years without cognitive impairment. The sample consisted of older adults living at their homes. Socio-demographic, clinical, geographical, and anthropometric data was collected. The statistical analysis used IBM-SPSS-22.0 and consisted on descriptive statistics, Pearson correlations and UniANOVA. Significantly results (p < 0.05) are reported.These older adults were mostly females (54.2%) with a mean age of 73.8 years (sd = 6.3), mean body mass index (BMI) of 29.1kg/m2 (sd = 4.8), mean waist-to-height ratio (WHtR) of 0.623 (sd = 0.073) and mean percentage of body fat mass (%BFM) of 40.7% (sd = 8.9%) for females and 30.2% (sd = 8.5%) for males. BMI, WHtR and %BFM were positively correlated. In this sample of older adults, higher values of these measures were associated to being female, younger, less educated; to having articular pains and respiratory problems, and not having insomnia, hypertension, chewing problems nor hearing problems; to drink more liquids but not consuming dairy products daily; to not take nutritional supplements but to take more medicines; to be without somebody to talk to and to be more dependent; and to live in a house without stairs to climb and to live near other older adults, and in a more urbanized area with streets with steeper slopes.In this sample of older adults, obesity is related with health characteristics and those are related with socio-demographic and geographical characteristics of the area of residence. Besides the identification of risk factors for the older adult population, this information may help designing health care policies that takes in consideration the physical and geographical characteristics of the neighbourhood of the area of residence of the older adults.

Abstract
AbstractMalnutrition is associated to a progressive decline in health, reduced physical and cognitive functional status and mortality. However, the malnutrition prevalence differs across countries. Previous studies reported 19% of malnourished elderly in Turkey and 1.3% in Portugal.We aimed to compare the nutritional status between between Portuguese and Turkish older adults using the Mini-Nutritional Assessment.This is a cross-sectional study using data from the Pronutrisenior project, collected in Vila Nova de Gaia, Portugal (n = 430), and a study in Ankara, Turkey (n = 162). The sample consisted of older adults living at their homes. Socio-demographic data, clinical data from the medical records, the full form of Mini-Nutrititional Assessment, MNA-FF and anthropometry (weight, height, BMI, mid-arm circumference and calf circumference) were collected.Turkish older adults lived more frequently with children, are more likely to be widow/widower, and have a higher probability of being housewife/househusband. A larger proportion of the Portuguese have tooth loss, diabetes, hypertension, oncologic diseases, kidney diseases, osteoarticular problems, or eye problems and a larger proportion of the Turkish have anemia. The BMI average is smaller in the Turkish sample, while the calf circumference average is larger. Turkish have a larger proportion of malnourished or at risk of malnutrition (4.9% and 31.5% vs. 1.2% and 24.0%, respectively). The average MNA-FF score is higher among the Portuguese, males and on people using denture, and without: toothloss, hypertension, CVD, anemia and oncological diseases. Moreover, higher MNA-FF scores were associated with younger ages, higher BMI and higher calf circumference.The effect size was larger for CVD and sex.The prevalence of malnutrition in European and American populations ranges from 1% to 15% in ambulatory living elders, more common among females as in this work. Other studies showed that higher BMI is related with lower malnutrition prevalence and higher prevalence of obesity-related chronic diseases. Tooth loss was more frequent in the Portuguese, which may be due to a higher intake of sweets or packaged food. Portuguese elders had lower calf circumferences but higher BMI, which may be related to lower muscle mass and/or higher fat mass. The differences between the Portuguese and the Turkish may be related to the different per capita gross national product, positively correlated with BMI and the consumption of processed foods. Anemia in Turkish elders may be related with BMI and their lower consumption of meat and the higher tea intake that may reduce iron absorption, as reported by other studies.

Abstract
AbstractMalnutrition is a serious health problem among older adults. The Mini Nutritional Assessment (MNA) is the most used tool to assess malnutrition among older adults. It was proposed that the Screening section could be used as a short form of the MNA (MNA-SF), but the study of the two forms show a wide range of agreement (71.8 to 93.3% and Cohen's kappa from 0.52 to 0.78). Nevertheless, most of the studies recommend the use of the MNA-SF, but in some this conclusion is not completely congruent with the results. The aims of this work were to study the agreement between the nutritional status classification using the MNA-SF and the MNA-FF among Portuguese older adults living in the community, to compare the scores in each question of the MNA-FF between participants correctly or incorrectly classified using the MNA-SF, and to develop a more sensible version of the MNA-SF. The current study is part of the PRONUTRISENIOR project. Data from 456 older adults (54.2% females) aged 65 to 92 years (mean = 73; SD = 6) living in the community (Vila Nova de Gaia, Portugal) were analyzed. The agreement between the two classifications is 82.7%, but Cohen's k shows a weak agreement (weighted k = 0.497; p < 0,001). MNA-SF showed a very low sensitivity (42.6%) detecting participants malnourished or at risk of malnutrition. Participants classified as normal using the MNA-SF despite at risk using the MNA-SF presented lower scores in two items from the Assessment section: number of full meals eaten daily and amount of fluid consumed per day. These two items were included in MNA-SF to obtain an extended short-version (MNA-SF8), which presented a sensitivity of 91.8% (and a specificity of 79.9%). The areas under the ROC curves were 0.858 and 0.929, respectively for MNA-SF and MNA-SF8. The addition of two items to the MNA-SF provides a more sensible tool to detect risk of malnutrition among elderly. These findings suggest that, among the studied population, general eating-related questions regarding (full meals and fluid intake) are relevant to assess malnutrition. Similar studies should be carried out among other populations in order to verify the possibility of their generalization. [The PRONUTRISENIOR project was financed by Iceland, Liechtenstein and Norway through the EEA Grants (PT06 – Public Health Initiatives, reference 81NU5).]