Couple's willingness to donate embryos for research: a longitudinal study

Introduction. Decision-making on embryo disposition is a source of distress and is subject to change over time. This paper analyses the willingness of couples undergoing in vitro fertilization to donate cryopreserved embryos for research from 15 days after embryo transfer to 12 months later, taking into account the influence of psychosocial, demographic, and reproductive factors. Materials and methods. Prospective longitudinal study, with 74 heterosexual couples undergoing in vitro fertilization in a public fertility centre in Portugal, recruited between 2011 and 2012. Participants were evaluated twice: 15 days after embryo transfer and 12 months later. Results. A significant decrease in patients’ willingness to donate embryos for research over time was observed [86.5% to 73.6%; relative risk (RR) = 0.85; 95% CI 0.76–0.95]. A higher education level (>12 years) [adjusted RR (RRadj) = 0.79; 95% CI 0.64–0.96], considering research on human embryos to be important (vs. very important) (RRadj = 0.59; 95% CI 0.39–0.85) and practicing a religion less than once a month (vs. at least once a month) (RRadj = 0.73; 95% CI 0.53–1.00) seemed associated with unwillingness to donate embryos for research over time. Change towards non-donation happened mainly among couples who first considered that it was better to donate than wasting the embryos. Change towards donation occurred mostly among those stating that their priority at time 1 was to have a baby and who became pregnant in the meantime. Conclusions. Quality of care guided by patients’ characteristics, values, preferences, and needs calls for considering the factors and reasons underlying couples’ willingness to donate embryos for research over time as a topic in psychosocial guidelines for infertility and medically assisted reproductive care.

A clinical recommendation system to maternity care

Nowadays in healthcare, the Clinical Decision Support Systems are used in order to help health professionals to take an evidence-based decision. An example is the Clinical Recommendation Systems. In this sense, it was developed and implemented in Centro Hospitalar do Porto a pre-triage system in order to group the patients on two levels (urgent or outpatient). However, although this system is calibrated and specific to the urgency of obstetrics and gynaecology, it does not meet all clinical requirements by the general department of the Portuguese HealthCare (Direção Geral de Saúde). The main requirement is the need of having priority triage system characterized by five levels. Thus some studies have been conducted with the aim of presenting a methodology able to evolve the pre-triage system on a Clinical Recommendation System with five levels. After some tests (using data mining and simulation techniques), it has been validated the possibility of transformation the pre-triage system in a Clinical Recommendation System in the obstetric context. This paper presents an overview of the Clinical Recommendation System for obstetric triage, the model developed and the main results achieved.

Aplicação do paradigma Lean em processos clínicos do Centro Hospitalar do Alto Ave

Dissertação de mestrado em Engenharia Industrial

Operation modes for the electric vehicle in smart grids and smart homes : present and proposed modes

This paper presents the main operation modes for an electric vehicle (EV) battery charger framed in smart grids and smart homes, i.e., are discussed the present-day and are proposed new operation modes that can represent an asset towards EV adoption. Besides the well-known grid to vehicle (G2V) and vehicle to grid (V2G), this paper proposes two new operation modes: Home-to-vehicle (H2V), where the EV battery charger current is controlled according to the current consumption of the electrical appliances of the home (this operation mode is combined with the G2V and V2G); Vehicle-for-grid (V4G), where the EV battery charger is used for compensating current harmonics or reactive power, simultaneously with the G2V and V2G operation modes. The vehicle-to-home (V2H) operation mode, where the EV can operate as a power source in isolated systems or as an off-line uninterruptible power supply to feed priority appliances of the home during power outages of the electrical grid is presented in this paper framed with the other operation modes. These five operation modes were validated through experimental results using a developed 3.6 kW bidirectional EV battery charger prototype, which was specially designed for these operation modes. The paper describes the developed EV battery charger prototype, detailing the power theory and the voltage and current control strategies used in the control system. The paper presents experimental results for the various operation modes, both in steady-state and during transients.

A comunicação e a imagem do Gabinete de Apoio a Projectos: um estudo de caso

Dissertação de mestrado em Ciências da Comunicação (área de especialização em Publicidade e Relações Públicas)