8 resultados para Primary health care. Non-transmissible chronic diseases. Assessment of health programs

em Universidade do Minho


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Kidney renal failure means that one’s kidney have unexpectedlystoppedfunctioning,i.e.,oncechronicdiseaseis exposed, the presence or degree of kidney dysfunction and its progression must be assessed, and the underlying syndrome has to be diagnosed. Although the patient’s history and physical examination may denote good practice, some key information has to be obtained from valuation of the glomerular filtration rate, and the analysis of serum biomarkers. Indeed, chronic kidney sickness depicts anomalous kidney function and/or its makeup, i.e., there is evidence that treatment may avoid or delay its progression, either by reducing and prevent the development of some associated complications, namely hypertension, obesity, diabetes mellitus, and cardiovascular complications. Acute kidney injury appears abruptly, with a rapiddeteriorationoftherenalfunction,butisoftenreversible if it is recognized early and treated promptly. In both situations, i.e., acute kidney injury and chronic kidney disease, an early intervention can significantly improve the prognosis. The assessment of these pathologies is therefore mandatory, although it is hard to do it with traditional methodologies and existing tools for problem solving. Hence, in this work, we will focus on the development of a hybrid decision support system, in terms of its knowledge representation and reasoning procedures based on Logic Programming, that will allow onetoconsiderincomplete,unknown,and evencontradictory information, complemented with an approach to computing centered on Artificial Neural Networks, in order to weigh the Degree-of-Confidence that one has on such a happening. The present study involved 558 patients with an age average of 51.7 years and the chronic kidney disease was observed in 175 cases. The dataset comprise twenty four variables, grouped into five main categories. The proposed model showed a good performance in the diagnosis of chronic kidney disease, since the sensitivity and the specificity exhibited values range between 93.1 and 94.9 and 91.9–94.2 %, respectively.

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Purpose:This chapter addresses the economic assessment of health benefits of active transport and presents most recent valuation studies with an overview of progresses made towards the inclusion of health benefits in the cost-benefit analysis (CBA) of active transport. Methodology/approach: It is built upon the contracted study for the World Health Organization (WHO) on the economic appraisal of health benefits of walking and cycling investments at the city of Viana do Castelo, the former pilot study in Portugal for evaluating the health benefits of non-motorized transport using the WHO Health Economic Assessment Tool (HEAT). The relative risk values adopted in the HEAT for walking refer to adult population of the age group 20â 74 years and the assessment focus in on average physical activity/regular behaviour of groups of pedestrians and all-cause mortality health impacts. During the case study, it was developed and implemented a mobility survey which aimed to collect behavioural data before and after a street intervention in the historic centre. Findings: Most recent appraisal guidance of walking and cycling and health impact modelling studies reviewed confirm that further research is expected before a more comprehensive appraisal procedure can be adopted in Europe, able to integrate physical activity effects along with other health risks such as those related to road traffic injuries and exposure to air pollution. Social implications: The health benefits assessment of walking investments helped local decision-makers to progress towards sustainable mobility options in the city. Making the population aware of the potential health benefits of regular walking can encourage more people to uptake active transport as part of their daily activities. Originality/value: This study provides a useful review of the health benefits of active transport with a comprehensive analysis of valuation studies, presenting value-added information. It then reports a former assessment of the health effects of active transport in the Portuguese context (case study) using the state-of-the-art economic analysis tool (HEAT) of the World Health Organization which is believed to contribute to a paradigm shift in the transport policy and appraisal practice given the need of shaping future cities (and their citizens) for health through more investments in active transport.

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This paper presents some of the results of the research project “Masonry Enclosures” developed in the framework of the transnational access (TA) to LNEC’s triaxial shake table within the FP7 project SERIES.

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The assessment of existing timber structures is often limited to information obtained from non or semi destructive testing, as mechanical testing is in many cases not possible due to its destructive nature. Therefore, the available data provides only an indirect measurement of the reference mechanical properties of timber elements, often obtained through empirical based correlations. Moreover, the data must result from the combination of different tests, as to provide a reliable source of information for a structural analysis. Even if general guidelines are available for each typology of testing, there is still a need for a global methodology allowing to combine information from different sources and infer upon that information in a decision process. In this scope, the present work presents the implementation of a probabilistic based framework for safety assessment of existing timber elements. This methodology combines information gathered in different scales and follows a probabilistic framework allowing for the structural assessment of existing timber elements with possibility of inference and updating of its mechanical properties, through Bayesian methods. The probabilistic based framework is based in four main steps: (i) scale of information; (ii) measurement data; (iii) probability assignment; and (iv) structural analysis. In this work, the proposed methodology is implemented in a case study. Data was obtained through a multi-scale experimental campaign made to old chestnut timber beams accounting correlations of non and semi-destructive tests with mechanical properties. Finally, different inference scenarios are discussed aiming at the characterization of the safety level of the elements.

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Ageing and skin exposure to UV radiation induces production and activation of matrix metalloproteinases (MMPs) and human neutrophil elastase (HNE). These enzymes are known to break down the extracellular matrix (ECM) which leads to wrinkle formation. Here, we demonstrated the potential of a solid-in-oil nanodispersion containing a competitive inhibitor peptide of HNE mixed with hyaluronic acid (HA), displaying 158 nm of mean diameter, to protect the skin against the ageing effects. Western blot analysis demonstrated that activation of MMP-1 in fibroblasts by HNE treatment is inhibited by the solid-in-oil nanodispersion containing the peptide and HA. The results clearly demonstrate that solid-in-oil nanodispersion containing the HNE inhibitor peptide is a promising strategy for anti-ageing effects. This effect can be seen particularly by ECM regulation by affecting fibroblasts. The formulation also enhances the formation of thicker bundles of actin filaments.

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Olive oils may be commercialized as intense, medium or light, according to the intensity perception of fruitiness, bitterness and pungency attributes, assessed by a sensory panel. In this work, the capability of an electronic tongue to correctly classify olive oils according to the sensory intensity perception levels was evaluated. Cross-sensitivity and non-specific lipid polymeric membranes were used as sensors. The sensor device was firstly tested using quinine monohydrochloride standard solutions. Mean sensitivities of 14±2 to 25±6 mV/decade, depending on the type of plasticizer used in the lipid membranes, were obtained showing the device capability for evaluating bitterness. Then, linear discriminant models based on sub-sets of sensors, selected by a meta-heuristic simulated annealing algorithm, were established enabling to correctly classify 91% of olive oils according to their intensity sensory grade (leave-one-out cross-validation procedure). This capability was further evaluated using a repeated K-fold cross-validation procedure, showing that the electronic tongue allowed an average correct classification of 80% of the olive oils used for internal-validation. So, the electronic tongue can be seen as a taste sensor, allowing differentiating olive oils with different sensory intensities, and could be used as a preliminary, complementary and practical tool for panelists during olive oil sensory analysis.

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Dissertação de mestrado em Engenharia Industrial

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B-Lactoglobulin (b-Lg) is the major protein fraction of bovine whey serum and a primary gelling agent. b-Lg has a high nutritional value, is stable at low pH being highly resistant to proteolytic degradation in the stomach, besides, it has the ability of acting as an encapsulating agent. This study aims at assessing the ability of b-Lg nanostructures to associate a nutraceutical - i.e. riboflavin - and release it in a controlled manner throughout an in vitro gastrointestinal (GI) system. For this reason b-Lg nanostructures loaded with riboflavin were critically characterized in terms of their morphology (i.e. size, polydispersity, -potential and shape) by dynamic light scattering (DLS) and transmission electron microscopy (TEM), and efficiency to associate to riboflavin through spectrofluorimetry. Furthermore, these nanocomplexes were evaluated in an in vitro GI model, simulating the physiological conditions. Stable b-Lg nanostructures were obtained at pH 6, of spherical shape, characterized by particle size of 172±1 nm, low polydispersity (i.e. PDI of 0.06±0.02), -potential of -32±3 mV and association efficiency (AE) of 26±1 %. b-Lg nanostructures showed to be stable upon their passage throughout stomach (i.e. particle size, PDI and potential of 248±10 nm, 0.18±0.03 and 18±3 mV, respectively). Concerning their passage throughout the intestine, such nanostructures were mostly degraded in the duodenum. Regarding riboflavin, a release of about 11 % was observed after their passage through stomach, while 35 %, 38 % and 5 % were the released percentages of the total riboflavin associated observed after passage through duodenum, jejunum and ileum, respectively. Hence,b-Lg nanostructures showed to be suitable carriers for riboflavin until the intestine, where their degradation occurs. b-Lg also showed to be structurally stable, under food simulant conditions (yoghurt simulant, composed of 3 % acetic acid), over 14 days, with a protective effect upon riboflavin activity, releasing it in a 7 day period.