Performance management in health centres: evidence from a field study

There has been a growing interest in research on performance measurement and management practices, which seems to reflect researchers’ response to calls for the need to increase the relevance of management accounting research. However, despite the development of the new public management literature, studies involving public sector organizations are relatively small compared to those involving business organizations and extremely limited when it comes to public primary health care organizations. Yet, the economic significance of public health care organizations in the economy of developed countries and the criticisms these organizations regularly face from the public suggests there is a need for research. This is particularly true in the case of research that may lead to improvement in performance measurement and management practices and ultimately to improvements in the way health care organizations use their limited resources in the provision of services to the communities. This study reports on a field study involving three public primary health care organisations. The evidence obtained from interviews and archival data suggests a performance management practices in these institutions lacked consistency and coherence, potentially leading to decreased performance. Hierarchical controls seemed to be very weak and accountability limited, leading to a lack of direction, low motivation and, in some circumstances to insufficient managerial abilities and skills. Also, the performance management systems revealed a number of weaknesses, which suggests that there are various opportunities for improvement in performance in the studied organisations.

Os deícticos no discurso narrativo: demonstrativos e advérbios de lugar em Far from the madding crowd

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Preparatory and field work phases in the qualitative empirical research process in management: the case studies approach

Purpose: The aim of this paper is to promote qualitative methodology within the scientific community of management. The specific objective is oriented to propose an empirical research process based on case study method. This is to ensure rigor in the empirical research process, that future research may follow a similar procedure to that is proposed. Design/methodology/approach: Following a qualitative methodological approach, we propose a research process that develops according to four phases, each with several stages. This study analyses the preparatory and field work phases and their stages. Findings: The paper shows the influence that case studies have on qualitative empirical research process in management. Originality/value:. Case study method assumes an important role within qualitative research by allowing for the study and analysis of certain types of phenomena that occur inside organisations, and in respect of which quantitative studies cannot provide an answer.

Avaliação geológica e geotécnica do maciço da Pedreira de S. Domingos n.º 2 (Armamar)

Neste trabalho, apresentam-se e discutem-se os resultados da aplicação da técnica de amostragem linear de descontinuidades em faces expostas do maciço rochoso da pedreira granítica de S. Domingos Nº 2 (Fontelo, Armamar; N de Portugal). É, igualmente, utilizada informação sobre a rede de fracturação regional, obtida através da análise morfoestrutural de mapas topográficos e mapas geológicos. São ainda referidos os métodos utilizados no tratamento dos dados de terreno com o objectivo de definir as famílias de descontinuidades e de caracterizar estatísticamente a sua atitude, espaçamento e extensão. Os resultados obtidos são comparados, à mega escala e macro-escala, no sentido de averiguar a presença de um padrão de fracturação com dimensão multiescala. Esta abordagem foi refinada através da aplicação de Sistemas de Informação Geográfica. A aplicação desta técnica para a caracterização da compartimentação do maciço poderá contribuir para aperfeiçoar a gestão sustentável do georrecurso da pedreira de S. Domingos Nº 2 (Fontelo). O controlo geomecânico do desmonte do maciço rochoso é salientado com o intuito de uma abordagem de geo-engenharia integrada dos maciços rochosos.

Integração da tecnologia Near Field Communications nas telecomunicações móveis

O telemóvel tem-se transformado numa ferramenta essencial no nosso dia-a-dia, constantemente são lançadas novas tecnologias que potenciam o uso do telemóvel nas tarefas do nosso quotidiano. Atualmente a grande tendência passa por fazer o download de aplicações com o objetivo de obter mais e diferentes tipos de informação, existe o desejo de ler de forma simples e intuitiva o mundo que nos rodeia, como se cada elemento fosse um objeto sobre o qual conseguiremos obter informação através do telemóvel. A tecnologia Near Field Communication (NFC) ajuda a transformar este desejo ou necessidade numa realidade de simples alcance. Podemos anexar “identificadores” nos objetos e “ver” estes identificadores através do telemóvel recorrendo a aplicações que fazem a ponte com os sistemas que nos permitem obter mais informação, por exemplo, internet. O NFC especifica um padrão de comunicação de redes sem fios, que permite a transferência de dados entre dois dispositivos separados por uma distância máxima de 10cm. NFC foi desenhado para ser integrado em telemóveis, que podem comunicar com outros telemóveis equipados com NFC ou ler informação de cartões ou tags. A dissertação avalia as oportunidades que a tecnologia NFC oferece ao mundo das telecomunicações móveis, nomeadamente na realidade do operador Vodafone Portugal, principalmente numa relação Empresa - Cliente. Esta tecnologia reúne o interesse dos fabricantes dos telemóveis, dos operadores e de parceiros críticos que vão ajudar a potenciar o negócio, nomeadamente entidades bancárias e interbancárias. A tecnologia NFC permite utilizar o telemóvel como um cartão de crédito/debito, ticketing, ler informação de posters (Smart Poster) que despoletem navegação contextualizada para outras aplicações ou para a internet para obter mais informação ou concretizar compras, estes são alguns cenários identificados que mais valor o NFC consegue oferecer. A dissertação foca-se na avaliação técnica do NFC na área de Smart Posters e resulta na identificação num conjunto de novos cenários de utilização, que são especificados e complementados com o desenvolvimento de um protótipo.

Análise do recurso a novas tecnologias no ensino de autistas

A massificação das tecnologias, abrangendo cada vez mais instituições e população em geral, originou uma aproximação da informação e do conhecimento às pessoas, permitindo um novo olhar para esta área, para as novas tecnologias e para o seu uso. Tendo como ponto de partida, a sociedade de informação e o recurso às tecnologias, recursos esses tão patentes actualmente, é possível pensar em criar as condições necessárias para que seja viável evoluir sempre mais, através da imaginação e de ideias criativas. Com base na aproximação das tecnologias que são cada vez mais acessíveis, o presente estudo pretende avaliar se as novas tecnologias, nas suas mais variadas formas, podem ser uma mais valia no ensino de autistas. O autismo começa a ser encarado como um campo a desenvolver estudos e a explorar os conceitos tecnológicos. O estudo aqui apresentado, não pretende ser apenas mais um, mas antes mostrar o trabalho efectuado até à data e o que pode ser realizado, expondo propostas. No sentido de conhecer um pouco melhor os conceitos relacionados com a área do autismo, foi necessário recorrer a pesquisas na Internet, à leitura de livros e a reuniões com pessoas ligadas a essa área, tornando possível uma aquisição de saberes e uma nova visão sobre a temática. Explorados os conceitos iniciais do autismo tornou-se imprescindível a procura dos recursos educativos utilizados nesta área, não só recursos empregados no método tradicional de ensino, como também, os modelos que procuram usar as novas tecnologias. A análise dos recursos existentes permitiu conhecer o panorama actual dos métodos e modelos em uso que conjugado com o levantamento de necessidades efectuado no decorrer deste trabalho, contribuíram para compreender as carências existentes e assim com base nesse conhecimento adquirido efectuar uma proposta de modelo educativo baseado em tecnologias para apoio educativo de autistas.

Cardiorespiratory fitness is negatively associated with metabolic risk factors independently of the adherence to a healthy dietary pattern

Background and aim: Cardiorespiratory fitness (CRF) and diet have been involved as significant factors towards the prevention of cardio-metabolic diseases. This study aimed to assess the impact of the combined associations of CRF and adherence to the Southern European Atlantic Diet (SEADiet) on the clustering of metabolic risk factors in adolescents. Methods and Results: A cross-sectional school-based study was conducted on 468 adolescents aged 15-18, from the Azorean Islands, Portugal. We measured fasting glucose, insulin, total cholesterol (TC), HDL-cholesterol, triglycerides, systolic blood pressure, waits circumference and height. HOMA, TC/HDL-C ratio and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score (MRS) was constructed by summing the Z scores of all individual risk factors. High risk was considered when the individual had 1SD of this score. CRF was measured with the 20 m-Shuttle-Run- Test. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire. Logistic regression showed that, after adjusting for potential confounders, unfit adolescents with low adherence to SEADiet had the highest odds of having MRS (OR Z 9.4; 95%CI:2.6e33.3) followed by the unfit ones with high adherence to the SEADiet (OR Z 6.6; 95% CI: 1.9e22.5) when compared to those who were fit and had higher adherence to SEADiet.

Hydroxycinnamic acid antioxidants: an electrochemical overview

Hydroxycinnamic acids (such as ferulic, caffeic, sinapic, and p-coumaric acids) are a group of compounds highly abundant in food that may account for about one-third of the phenolic compounds in our diet. Hydroxycinnamic acids have gained an increasing interest in health because they are known to be potent antioxidants. These compounds have been described as chain-breaking antioxidants acting through radical scavenging activity, that is related to their hydrogen or electron donating capacity and to the ability to delocalize/stabilize the resulting phenoxyl radical within their structure.The free radical scavenger ability of antioxidants can be predicted from standard one-electron potentials. Thus, voltammetric methods have often been applied to characterize a diversity of natural and synthetic antioxidants essentially to get an insight into their mechanism and also as an important tool for the rational design of new and potent antioxidants.The structure-property-activity relationships (SPARs) correlations already established for this type of compounds suggest that redox potentials could be considered a good measure of antioxidant activity and an accurate guideline on the drug discovery and development process. Due to its magnitude in the antioxidant field, the electrochemistry of hydroxycinnamic acid-based antioxidants is reviewed highlighting the structure-property-activity relationships (SPARs) obtained so far.

sMapReduce: a programming pattern for wireless sensor networks

Wireless Sensor Networks (WSNs) are increasingly used in various application domains like home-automation, agriculture, industries and infrastructure monitoring. As applications tend to leverage larger geographical deployments of sensor networks, the availability of an intuitive and user friendly programming abstraction becomes a crucial factor in enabling faster and more efficient development, and reprogramming of applications. We propose a programming pattern named sMapReduce, inspired by the Google MapReduce framework, for mapping application behaviors on to a sensor network and enabling complex data aggregation. The proposed pattern requires a user to create a network-level application in two functions: sMap and Reduce, in order to abstract away from the low-level details without sacrificing the control to develop complex logic. Such a two-fold division of programming logic is a natural-fit to typical sensor networking operation which makes sensing and topological modalities accessible to the user.

Flexible manufacturing field trial

Within the European project R-Fieldbus (http://www.hurray.isep.ipp.pt/activities/rfieldbus/), an industrial manufacturing field trial was developed. This field trial was conceived as a demonstration test bed for the technologies developed during the project. Because the R-Fieldbus field trial included prototype hardware devices, the purpose of this equipment changed and since the conclusion of the project, several new technologies also emerged, therefore an update of the field trial was required. This document describes an update of the manufacturing field trial. The purpose of this update, the changes and improvements introduced are described in the document. Additionally, this document also provides a reliable source of documentation for the equipment, configuration and software components of the manufacturing field trial.

Performance management in primary healthcare services: evidence from a field study

Health services

Fractional central pattern generators for bipedal locomotion

Locomotion has been a major research issue in the last few years. Many models for the locomotion rhythms of quadrupeds, hexapods, bipeds and other animals have been proposed. This study has also been extended to the control of rhythmic movements of adaptive legged robots. In this paper, we consider a fractional version of a central pattern generator (CPG) model for locomotion in bipeds. A fractional derivative D α f(x), with α non-integer, is a generalization of the concept of an integer derivative, where α=1. The integer CPG model has been proposed by Golubitsky, Stewart, Buono and Collins, and studied later by Pinto and Golubitsky. It is a network of four coupled identical oscillators which has dihedral symmetry. We study parameter regions where periodic solutions, identified with legs’ rhythms in bipeds, occur, for 0<α≤1. We find that the amplitude and the period of the periodic solutions, identified with biped rhythms, increase as α varies from near 0 to values close to unity.

INbreast: Toward a Full-field Digital Mammographic Database

Rationale and Objectives Computer-aided detection and diagnosis (CAD) systems have been developed in the past two decades to assist radiologists in the detection and diagnosis of lesions seen on breast imaging exams, thus providing a second opinion. Mammographic databases play an important role in the development of algorithms aiming at the detection and diagnosis of mammary lesions. However, available databases often do not take into consideration all the requirements needed for research and study purposes. This article aims to present and detail a new mammographic database. Materials and Methods Images were acquired at a breast center located in a university hospital (Centro Hospitalar de S. João [CHSJ], Breast Centre, Porto) with the permission of the Portuguese National Committee of Data Protection and Hospital's Ethics Committee. MammoNovation Siemens full-field digital mammography, with a solid-state detector of amorphous selenium was used. Results The new database—INbreast—has a total of 115 cases (410 images) from which 90 cases are from women with both breasts affected (four images per case) and 25 cases are from mastectomy patients (two images per case). Several types of lesions (masses, calcifications, asymmetries, and distortions) were included. Accurate contours made by specialists are also provided in XML format. Conclusion The strengths of the actually presented database—INbreast—relies on the fact that it was built with full-field digital mammograms (in opposition to digitized mammograms), it presents a wide variability of cases, and is made publicly available together with precise annotations. We believe that this database can be a reference for future works centered or related to breast cancer imaging.

Levels and risks of particulate-bound PAHs in indoor air influenced by tobacco smoke: a field measurement

Considering tobacco smoke as one of the most health-relevant indoor sources, the aim of this work was to further understand its negative impacts on human health. The specific objectives of this work were to evaluate the levels of particulate-bound PAHs in smoking and non-smoking homes and to assess the risks associated with inhalation exposure to these compounds. The developed work concerned the application of the toxicity equivalency factors approach (including the estimation of the lifetime lung cancer risks, WHO) and the methodology established by USEPA (considering three different age categories) to 18 PAHs detected in inhalable (PM10) and fine (PM2.5) particles at two homes. The total concentrations of 18 PAHs (ΣPAHs) was 17.1 and 16.6 ng m−3 in PM10 and PM2.5 at smoking home and 7.60 and 7.16 ng m−3 in PM10 and PM2.5 at non-smoking one. Compounds with five and six rings composed the majority of the particulate PAHs content (i.e., 73 and 78 % of ΣPAHs at the smoking and non-smoking home, respectively). Target carcinogenic risks exceeded USEPA health-based guideline at smoking home for 2 different age categories. Estimated values of lifetime lung cancer risks largely exceeded (68–200 times) the health-based guideline levels at both homes thus demonstrating that long-term exposure to PAHs at the respective levels would eventually cause risk of developing cancer. The high determined values of cancer risks in the absence of smoking were probably caused by contribution of PAHs from outdoor sources.

Dynamic Analysis and Pattern Visualization of Forest Fires

This paper analyses forest fires in the perspective of dynamical systems. Forest fires exhibit complex correlations in size, space and time, revealing features often present in complex systems, such as the absence of a characteristic length-scale, or the emergence of long range correlations and persistent memory. This study addresses a public domain forest fires catalogue, containing information of events for Portugal, during the period from 1980 up to 2012. The data is analysed in an annual basis, modelling the occurrences as sequences of Dirac impulses with amplitude proportional to the burnt area. First, we consider mutual information to correlate annual patterns. We use visualization trees, generated by hierarchical clustering algorithms, in order to compare and to extract relationships among the data. Second, we adopt the Multidimensional Scaling (MDS) visualization tool. MDS generates maps where each object corresponds to a point. Objects that are perceived to be similar to each other are placed on the map forming clusters. The results are analysed in order to extract relationships among the data and to identify forest fire patterns.