Estimation Models for the adoption and use of information technology: internet-related technologies at firm level in the Portuguese and European context

Dissertação apresentada como requisito parcial para obtenção do grau de Doutor em Gestão de Informação

Cidadão e comunidade : que relevância no processo de contratualizaç

RESUMO - Nas últimas décadas, a especialização dos cuidados médicos tem conduzido a uma fragmentação do sistema de prestação, que, associada a uma deficiente coordenação entre serviços, cuidados e prestadores, torna a navegabilidade dos utentes nos sistemas de saúde uma tarefa complexa. Um novo modelo de organização, assente na procura de valor para os cidadãos, deve adoptar uma abordagem sistémica, que tenha subjacente uma coordenação integrada de serviços, numa perspectiva de ciclo de cuidados. Reorientar a prestação de cuidados para a obtenção de resultados e valor em saúde, exige uma reengenharia em torno da estrutura, organização e avaliação1 dos cuidados, requerendo, nomeadamente: i) instrumentos e ferramentas que auxiliem e estruturem este novo modelo; ii) assumpção dos papéis definidos para cada um dos actores do sistema, nomeadamente ao nível da coordenação; iii) encorajamento à adopção de modelos de contratualização, pagamento e competição, que responsabilizem os actores envolvidos não só pela prática que desenvolvem, mas pelos resultados em saúde. Estes mecanismos constituem uma oportunidade para expandir e sustentar abordagens, programas e intervenções integradas. Investir num sistema de pagamento por valor em saúde — P4V — payment for value, traduz uma aposta na relação entre diagnóstico, tratamento, resultados clínicos e custos, enquanto estratégia para assegurar ganhos em qualidade dos cuidados, eficiência dos processos e valor em saúde para o cidadão. Neste contexto, a gestão da doença enquanto modelo direccionado para o reforço da perspectiva e participação activa do cidadão, e avaliação compreensiva de novas formas de organização e gestão do sistema de prestação, constitui um instrumento para informar e sustentar esse processo de reengenharia do sistema. Um modelo que procura assegurar o encontro entre o estado da arte na prestação de cuidados e um nível óptimo, garantindo a qualidade de vida expectável para a pessoa com doença crónica. ----------------- ---------ABSTRACT – In the last decades advanced medical sciences trend to specialized care and fragmented health systems, leaving patients with a challenge on navigating services and care, requiring them to see a sequence of specialists each delivering discrete interventions. To overcome these challenges, every health system must redefine health care delivery to use its resources more efficiently and improve quality of care through an organization of the system as a whole. A system currently organized around value for patients, entails a framework that comprises the entire set of activities needed to address a patient´s medical condition, over the full cycle of care. Value- based care delivery therefore requires an integrated practice, both across services and time, and implies a movement through new structures, organization models, evaluation efforts and payment systems that enables, catalyze and reinforces the extension and sustainability of the steps needed to the change required. A shift from a payment for performance to a payment for value focuses attention on maximizing the overall value of care, and encourages coordination and integration between components of care that extends from screening, diagnoses, all the way through treatment, outcomes and costs, and ensuring an incentive for potentially high value types of care as well as innovation. These leave the actors of the system with the task of best allocating and valuing components of care. Disease management as a model designed to structure patient engagement and involvement in their care, and assure a comprehensive evaluation and monitoring of new organization and care delivery strategies align an opportunity as a source of information and sustainability for the progress of a growing number of likeminded efforts now underway across care delivery for chronic diseases. This framework will allow the fulfillment of the gap between sta

Behavioral and synaptic circuit analysis in models of neuropsychiatric disorders: Dissecting the in vivo role of the postsynaptic density proteins nArgBP2 and Shank3 using genetic engineered mice

Dissertation presented to obtain the Ph.D degree in Biology

Models for pheromone evaluation in Ant Systems for Mobile Ad-hoc networks

On a mobile ad-hoc network environment, where the resources are scarce, the knowledge about the network's link state is essential to optimize the routing procedures. This paper presents a study about different pheromone evaluation models and how they react to possible changes in traffic rate. Observing how the pheromone value on a link changes, it could be possible to identify certain patterns which can indicate the path status. For this study, the behavior of the Ant System evaluation model was compared with a Temporal Active Pheromone model (a biological approach) and a Progressive Pheromone Reduction model with and without a maximum pheromone limit.

Mathematical modelling of shallow flows: closure models drawn from grain-scale mechanics of sediment transport and flow hydrodynamics

Canadian Journal of Civil Engineering 36(10) 1605–16

Probabilistic models for mechanical properties of prestressing strands

This study focus on the probabilistic modelling of mechanical properties of prestressing strands based on data collected from tensile tests carried out in Laboratório Nacional de Engenharia Civil (LNEC), Portugal, for certification purposes, and covers a period of about 9 years of production. The strands studied were produced by six manufacturers from four countries, namely Portugal, Spain, Italy and Thailand. Variability of the most important mechanicalproperties is examined and the results are compared with the recommendations of the ProbabilisticModel Code, as well as the Eurocodes and earlier studies. The obtained results show a very low variability which, of course, benefits structural safety. Based on those results, probabilistic modelsfor the most important mechanical properties of prestressing strands are proposed.

Non-linear time series models

The last three decades have seen quite dramatic changes the way we modeled time dependent data. Linear processes have been in the center stage in modeling time series. As far as the second order properties are concerned, the theory and the methodology are very adequate.However, there are more and more evidences that linear models are not sufficiently flexible and rich enough for modeling purposes and that failure to account for non-linearities can be very misleading and have undesired consequences.

A score test for non-nested hypotheses with applications to discrete data models

This paper suggests that a convenient score test against non-nested alternatives can be constructed from the linear combination of the likelihood functions of the competing models. It is shown that this procedure is essentially a test for the correct specification of the conditional distribution of the variable of interest.

Tuple-based morphisms for interoperability establishment of financial information models

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Electrotécnica e Computadores

Landslide susceptibility assessment in Karanganyar regency - Indonesia - Comparison of knowledge-based and Data-driven Models

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Cognitive assessment of topological movement Patterns and direction turns: An influence of scale

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Algorithm for the Parkinson’s disease behavioural models characterization using a biosensor

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica

Development of novel human cellular models for neurotoxicity studies

Dissertation to obtain master degree in Genética Molecular e Biomedicina

Neolithic transitions: can genetic data help us understand a major demographic event in human prehistory?

Dissertation presented to obtain the Ph.D degree in Biology

Analysis of mental health service financial models with a particular emphasis of Ireland

ABSTRACT: Financing is a critical factor in ensuring the optimal development and delivery of a mental health system. The primary method of financing worldwide is tax-based. However many low income countries depend on out-of-pocket payments. There is a report on Irish Health Care funding but none that deals exclusively with mental health care. This paper analyses the various financial models that exist globally with respect to financing the mental health sector, examines the impact of various models on service users, especially in terms of relative ‘financial burden’ and provides a more detailed examination of the current mental health funding situation in Ireland After extensive internet and hardcopy research on the above topics, the findings were analysed and a number of recommendations were reached. Mental health service should be free at the point of delivery to achieve universal coverage. Government tax-based funding or mandatory social insurance with government top-ups, as required, appears the optimal option, although there is no one funding system applicable everywhere. Out-of-pocket funding can create a crippling financial burden for service users. It is important to employ improved revenue collection systems, eliminate waste, provide equitable resource distribution, ring fence mental health funding and cap the number of visits, where necessary. Political, economic, social and cultural factors play a role in funding decisions and this can be clearly seen in the context of the current economic recession in Ireland. Only 33% of the Irish population has access to free public health care and the number health insurance policy holders has dramatically declined, resulting in increased out-of-pocket payments. This approach risks negatively impacting on the social determinants of health, increasing health inequalities and negatively affecting economic productivity. It is therefore important the Irish government examines other options to provide funding for mental health services.