47 resultados para Schwinger Variational Principle
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ABSTRACT - The Patient Protection and Affordable Care Act shook the foundations of the US health system, offering all Americans access to health care by changing the way the health insurance industry works. As President Obama signed the Act on 23 March 2010, he said that it stood for “the core principle that everybody should have some basic security when it comes to their health care”. Unlike the U.S., the Article 64 of the Portuguese Constitution provides, since 1976, the right to universal access to health care. However, facing a severe economic crisis, Portugal has, under the supervision of the Troika, a tight schedule to implement measures to improve the efficiency of the National Health Service. Both countries are therefore despite their different situation, in a conjuncture of reform and the use of new health management measures. The present work, using a qualitative research methodology examines the Affordable Care Act in order to describe its principles and enforcement mechanisms. In order to describe the reality in Portugal, the Portuguese health system and the measures imposed by Troika are also analyzed. The intention of this entire analysis is not only to disclose the innovative U.S. law, but to find some innovative measures that could serve health management in Portugal. Essentially we identified the Exchanges and Wellness Programs, described throughout this work, leaving also the idea of the possibility of using them in the Portuguese national health system.
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics
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Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.
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Dissertation presented to obrain the Ph.D degree in Biology. Developmental Biology
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RESUMO: A população prisional é constituída por indivíduos geralmente sujeitos a alguma forma de exclusão social e que apresentam problemas de saúde física e mental mais frequentes do que na população em geral. A prevalência mais elevada de perturbações mentais e de suicídio nos reclusos, em relação à população civil, é consensual e está demonstrada em numerosos estudos internacionais. O abuso/dependência de substâncias, a depressão, as psicoses e a perturbação anti-social de personalidade são as perturbações mais comuns na população prisional. As perturbações mentais são importantes factores de risco de suicídio, de vitimização, de reincidência e de reentrada no sistema prisional. Assim sendo, o grupo de reclusos com perturbação mental constitui um grupo de risco relevante. A avaliação de necessidades de cuidados foi iniciada no Reino Unido como um método para o planeamento, medição dos resultados e financiamento dos cuidados de saúde. Para esta avaliação foram desenvolvidos instrumentos que avaliam as necessidades em diversos domínios (clínicos e sociais) para aplicação aos utentes, cuidadores e profissionais. Até aos anos noventa, a avaliação de necessidades no contexto prisional incidia especialmente nas necessidades de segurança dos serviços, segundo a perspectiva dos profissionais. Contudo, a partir do relatório Reed (1992), sobre a situação dos reclusos com perturbação mental, verificou-se uma abordagem mais abrangente, que incluía a avaliação das necessidades de cuidados dos reclusos. Embora as necessidades dos reclusos com perturbação mental pareçam ser similares às dos doentes psiquiátricos em geral, existem diferenças em determinados domínios como a comorbilidade do eixo II, o abuso de substâncias e o risco de violência. Por este motivo, as necessidades de cuidados de saúde mental dos reclusos são elevadas e frequentemente não se encontram satisfeitas. De forma a incluir estas especificidades foi desenvolvida a versão forense do Camberwell Assessment of Need (CAN), designada por CAN - Forensic Version (CANFOR). Actualmente existe um consenso generalizado entre as instituições internacionais do dever de proporcionar aos reclusos cuidados de saúde, de prevenção e de tratamento, equivalentes aos cuidados disponíveis para a população civil - o princípio da equivalência de cuidados. A presente investigação pretendeu caracterizar e avaliar as necessidades de cuidados dos reclusos acompanhados nos serviços de psiquiatria prisionais na área da Grande Lisboa (internamento no Serviço de Psiquiatria do Hospital Prisional de S. João de Deus (HPSJD) e consultas nos Estabelecimentos Prisionais (EP) de Caxias e de Tires). De modo a estabelecer uma comparação com sujeitos civis foi seleccionada uma amostra de conveniência de pacientes acompanhados num departamento de psiquiatria da mesma região, segundo um emparelhamento por sexo, escalão etário, e por diagnóstico, num período de 3 meses. Realizou-se um estudo de tipo observacional, transversal e comparativo. Aplicaram-se os seguintes instrumentos de avaliação: questionário específico, Brief Psychiatric Rating Scale 4.0, Mini International Neuropsychiatric Interview 5.0.0, Global Assessment Functioning, CAN-R e CANFOR-R. No período do estudo (12 meses) foram assistidos 149 reclusos, dos quais, 35 (23,5%) não cumpriram os critérios de inclusão. A amostra final de reclusos (PRs) (n=114) foi constituída por 79 homens (69,3%) e 35 mulheres (30,7%), dos quais 77 eram condenados (67,5%) e 37 (32,5%) encontravam-se detidos preventivamente. A amostra final de participantes civis (PCs) foi constituída por 121 indivíduos, dos quais 76 eram homens (62,8%) e 45 eram mulheres (37,2%).A amostra final de participantes civis (PCs) foi constituída por 121 indivíduos, dos quais 76 eram homens (62,8%) e 45 eram mulheres (37,2%). Relativamente aos PRs, o diagnóstico mais frequente foi a Perturbação Anti-social da Personalidade (57,9%), seguida pela Depressão Major (56,1%). A maioria (53,5%) apresentava três ou mais categorias diagnósticas. Aproximadamente um terço dos PRs (30%) pontuou o nível elevado de risco de suicídio. A probabilidade deste risco aumentava, significativamente, nos portadores de Depressão Major, de um maior nível de psicopatologia e de uma condenação actual. Perto de metade dos PRs (47,4%) possuía duas ou mais condenações prévias e mais de metade estavam envolvidos em crimes contra pessoas (53,5%). A probabilidade de condenações múltiplas foi significativamente superior nos portadores de Perturbação Antisocial da Personalidade e nos reclusos com maior número de necessidades totais. Entre os PRs dos dois sexos, as principais diferenças significativas residiram na maior frequência de consumo de substâncias e no maior número de necessidades de cuidados nãosatisfeitas nos homens versus mulheres. A comparação entre os PRs, antes da detenção, e os PCs mostrou que os primeiros possuíam menor escolaridade, menos medicação psiquiátrica, mas mais emprego e mais consumos de substâncias ilícitas. A Perturbação Anti-social da Personalidade (OR=26,4; IC95%: 10,7-64,9), a Perturbação Pós-stress Traumático (OR=15,0; IC95%: 3,5-65,4), a Dependência/Abuso de Substâncias (OR=8,5; IC95%: 4,2-17,6) a Depressão Major (OR=2,6; IC95%: 1,5-4,4) e o Risco de Suicídio Elevado (OR=2,6; IC95%: 1,4-5,0) foram significativamente mais frequentes nos PRs versus PCs. Relativamente à avaliação de necessidades de cuidados, os PRs mostraram maior número de necessidades não-satisfeitas e maior necessidade de ajuda profissional, em relação aos PCs. Embora diversas necessidades não-satisfeitas possam resultar da condição de recluso, outras, em domínios da saúde física, da segurança do próprio e dos consumos tóxicos, poderão indicar que os PRs recebem um nível de cuidados inferior ao necessário, em comparação com os PCs. Os PRs apresentaram patologia mental, predominantemente não-psicótica e elevado risco de suicídio/auto-agressão, associado a depressão, necessidades de cuidados e uma pena de prisão. Possuíam, numa frequência elevada, características, consistentemente, associadas à reincidência criminal (personalidade anti-social, consumos tóxicos, condenações anteriores), pelo que se justifica um especial acompanhamento deste grupo, no período pré e pós-libertação. A comparação de necessidades de cuidados no contexto civil e prisional indica um maior nível de necessidades e um menor nível de cuidados recebidos pelos PRs, em relação aos PCs. O princípio da equivalência de cuidados poderá estar comprometido nos indivíduos reclusos com perturbação mental. A utilização do CANFOR foi fácil e poderá contribuir para um melhor planeamento, oferta e avaliação de resultados ao nível individual. Os PRs e PCs revelaram características clínicas e de necessidades muito diferentes entre si, pelo que, os reclusos com perturbação mental deverão ser assistidos em serviços de saúde mental preparados para abordar as suas especificidades.---------------ABSTRACT: The prison population is generally made up of individuals who are usually subject to some sort of social exclusion and who show physical and mental problems more frequently than the general population. Various international studies have found higher rates of mental disturbances and suicide within the prison population. The most common mental disturbances found are substance abuse or dependency, depression, psychosis, and anti-social personality disturbance. Such mental disturbances are important factors in suicide, victimization, delinquency recurrence, and the risk of reentry into prison. As a result, prison inmates with mental disturbances are a relevant at risk group. Assessment of needs of care first started in the United Kingdom as a method of care planning, results measuring and finance health care. The method involved the development of certain measuring instruments to be used by patients, caregivers and professionals in order to evaluate needs in various domains (clinical and social). Until the nineties, the assessment of needs of care in a prison context focused mainly on the service’s security needs. However, after the Reed (1992) report on mentally disturbed inmates, a much wider approach was considered, which included evaluation of the inmate’s needs of care. However similar mentally disturbed prison inmates’ needs may appear to those of other psychiatric patients, there are some differences in particular domains, namely, co-morbidity of Axis II, substance abuse and the risk of violence. For this reason, inmates’ mental health care needs are high and very often not met. In order to include these specificities, a forensic version of the Camberwell assessment of need (CAN,) designated CAN – Forensic version (CANFOR) was developed. There is now generalized consensus among international institutions of the duty under the equivalent health care principle to provide inmates with preventative health care and treatment, that are equivalent to the care available to the civil population. This investigation aims to characterize and assess the health care provision of prison inmates admitted to Lisbon’s Psychiatric Prison ward - the Psychiatric Ward of São João de Deus Hospital (HPSJD) - and inmates in the Caxias and Tires Prison Establishments (EP) undertaking outpatient treatment. In order to establish a comparison between prison and civilian patients, a convenience sample was selected from civilian patients being treated in a psychiatric ward in the same geographical area. This sample was paired by gender, age group and diagnosis during a three month period. The study was observational, transversal and comparative. The following measuring instruments were used: a purpose-built questionnaire, Brief Psychiatric Rating Scale 4.0, Mini International Neuropsychiatric Interview 5.0.0, Global Assessment Functioning Scale, CAN-R and CANFOR-R. During the research period (12 months), 149 inmates received care, of whom 35 (23.5%) did not comply with the prerequisite criteria of this study. The final sample of inmates (PRs) (n=114) comprised 79 men (69.3%) and 35 (30.7%) women, of whom 77 (67.5%) were convicted prisoners and 37 (32.5%) were in preventive custody. The final sample for Civilian Participants (PCs) was made up of 121 individuals, of whom 76 (62.8%) were men and 45 (37.2%) were women. The most common diagnosis among the PRs was Anti-Social Personality Disorder (57.9%), followed by Major Depression (56.1%). More than half of the subjects in the sample (53.5%) showed three or more diagnostic categories. Approximately one third (30%) of the PRs showed a high level of suicide risk. The probability of this risk was significantly higher among Major Depression patients, those showing a higher level of psychopathology and those with a current conviction. Almost half of the PRs (47.4%) had been given two or more prior convictions and more than half (53.5%) were involved in crimes against people. The probability of multiple convictions was significantly higher among inmates with Anti-Social Personality Disorder and in those with more total needs. With regard to gender, the main significant difference among the PRs was that men were found to have a higher frequency of substance use and a greater number of unsatisfied caring needs than women. Comparison between the PRs prior to detention and PCs revealed that the former held lower educational qualifications and received less psychiatric medication, but had higher levels of employment and showed greater consumption of illicit substances. In addition Anti-Social Personality Disorder (OR=26.4; IC 95%: 10.7-64.9), Post-Stress Traumatic Disturbance (OR=15.0; IC 95%: 3.5-65.4), Substance Dependency/Abuse (OR=8.5; IC 95%: 4.2-17.6), Major Depression (OR=2.6; IC 95%: 1.5-4.4), and High Suicide Risk (OR=2.6; IC 95%: 1.4-5.0) were significantly more frequent amongst PRs than PCs. The results for needs assessment revealed that the PRs showed higher levels of unmet needs and a greater need for professional help in comparison with the PCs. Although various unmet needs may result from the inmate’s condition, other needs - in particular those regarding physical health, personal security and toxic substance use - suggest that the care given to PRs may be inadequate in comparison with that given to PCs. This implies that the principle of equivalent health care for PRs with mental illnesses may not be upheld. Furthermore, the mental morbidity results of the PRs indicated that they suffer predominantly from non-psychotic and high suicide/self inflicted aggression risk associated with depression, caring needs and a prison sentence. They also often showed characteristics that are consistently associated with criminal recidivism (Anti-social Personality, use of toxic substances, prior convictions). This result justifies that there should be special follow-up for this group in the pre- and after release period. The use of CANFOR proved to be simple and the application delay was acceptable. No difficulties were encountered in the understanding of its categories by its users. As a result, itcould contribute towards better planning, supply and assessment of results at an individual level. Given that the PRs and PCs revealed different clinical and needs characteristics, it is recommended that inmates with mental disturbances should be assisted in mental health services that are adequately prepared to address their specificities.
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Breast cancer is the most common type of cancer worldwide. The effectiveness of its treatment depends on early stage detection, as well as on the accuracy of its diagnosis. Recently, diagnosis techniques have been submitted to relevant breakthroughs with the upcoming of Magnetic Resonance Imaging, Ultrasound Sonograms and Positron Emission Tomography (PET) scans, among others. The work presented here is focused on studying the application of a PET system to a Positron Emission Mammography (PEM) system. A PET/PEM system works under the principle that a scintillating crystal will detect a gamma-ray pulse, originated at the cancerous cells, converting it into a correspondent visible light pulse. The latter must then be converted into an electrical current pulse by means of a Photo- -Sensitive Device (PSD). After the PSD there must be a Transimpedance Amplifier (TIA) in order to convert the current pulse into a suitable output voltage, in a time period lower than 40 ns. In this Thesis, the PSD considered is a Silicon Photo-Multiplier (SiPM). The usage of this recently developed type of PSD is impracticable with the conventional TIA topologies, as it will be proven. Therefore, the usage of the Regulated Common-Gate (RCG) topology will be studied in the design of the amplifier. There will be also presented two RCG variations, comprising a noise response improvement and differential operation of the circuit. The mentioned topology will also be tested in a Radio-Frequency front-end, showing the versatility of the RCG. A study comprising a low-voltage self-biasing feedback TIA will also be shown. The proposed circuits will be simulated with standard CMOS technology (UMC 130 nm), using a 1.2 V power supply. A power consumption of 0.34 mW with a signal-to-noise ratio of 43 dB was achieved.
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In his Answer to the Question: What is Enlightenment (1784), Kant puts forward his belief that the vocation to think freely, which humankind is endowed with, is bound to make sure that “the public use of reason” will at last act “even on the fundamental principles of government and the state [will] find it agreeable to treat man – who is now more than a machine – in accord with his dignity”. The critical reference to La Mettrie (1747), by opposing the machine to human dignity, will echo, in the dawn of the 20th century, in Bergson’s attempt to explain humor. Besides being exclusive to humans, humor is also a social phenomenon. Freud (1905) assures that pleasure originated by humor is collective, it results from a “social process”: jokes need an audience, a “third party”, in order to work and have fun. Assuming humor as a social and cultural phenomenon, this paper intends to sustain that it played a role in the framing of the public sphere and of public opinion in Portugal during the transition from Absolute Monarchy to Liberalism. The search for the conditions which made possible the critical exercise of sociability is at the root of the creation of the public sphere in the sense developed by Habermas (1962), whose perspective, however, has been questioned by those who point 2 out the alleged idealism of the concept – as opposed, for example, to Bakhtin (1970), whose work stresses diversity and pluralism. This notwithstanding, the concept of public sphere is crucial to the building of public opinion, which is, in turn, indissoluble from the principle of publicity, as demonstrated by Bobbio (1985). This paper discusses the historical evolution of the concept of public opinion from Ancient Greece doxa, through Machiavelli’s “humors” (1532), the origin of the expression in Montaigne (1580) and the contributions of Hobbes (1651), Locke (1690), Swift (1729), Rousseau (1762) or Hume (1777), up to the reflection of Lippman (1922) and Bourdieu’s critique (1984). It maintains that humor, as it appears in Portuguese printed periodicals from 1797 (when Almocreve de Petas was published for the first time) to the end of the civil war (1834) – especially in those edited by José Daniel Rodrigues da Costa but also in O Piolho Viajante, by António Manuel Policarpo da Silva, or in the ones written by José Agostinho de Macedo, as well as in a political “elite minded” periodical such as Correio Braziliense –, contributed to the framing of the public sphere and of public opinion in Portugal.
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The term res publica (literally “thing of the people”) was coined by the Romans to translate the Greek word politeia, which, as we know, referred to a political community organised in accordance with certain principles, amongst which the notion of the “good life” (as against exclusively private interests) was paramount. This ideal also came to be known as political virtue. To achieve it, it was necessary to combine the best of each “constitutional” type and avoid their worst aspects (tyranny, oligarchy and ochlocracy). Hence, the term acquired from the Greeks a sense of being a “mixed” and “balanced” system. Anyone that was entitled to citizenship could participate in the governance of the “public thing”. This implied the institutionalization of open debate and confrontation between interested parties as a way of achieving the consensus necessary to ensure that man the political animal, who fought with words and reason, prevailed over his “natural” counterpart. These premises lie at the heart of the project which is now being presented under the title of Res Publica: Citizenship and Political Representation in Portugal, 1820-1926. The fact that it is integrated into the centenary commemorations of the establishment of the Republic in Portugal is significant, as it was the idea of revolution – with its promise of rupture and change – that inspired it. However, it has also sought to explore events that could be considered the precursor of democratization in the history of Portugal, namely the vintista, setembrista and patuleia revolutions. It is true that the republican regime was opposed to the monarchic. However, although the thesis that monarchy would inevitably lead to tyranny had held sway for centuries, it had also been long believed that the monarchic system could be as “politically virtuous” as a republic (in the strict sense of the word) provided that power was not concentrated in the hands of a single individual. Moreover, various historical experiments had shown that republics could also degenerate into Caesarism and different kinds of despotism. Thus, when absolutism began to be overturned in continental Europe in the name of the natural rights of man and the new social pact theories, initiating the difficult process of (written) constitutionalization, the monarchic principle began to be qualified as a “monarchy hedged by republican institutions”, a situation in which not even the king was exempt from isonomy. This context justifies the time frame chosen here, as it captures the various changes and continuities that run through it. Having rejected the imperative mandate and the reinstatement of the model of corporative representation (which did not mean that, in new contexts, this might not be revived, or that the second chamber established by the Constitutional Charter of 1826 might not be given another lease of life), a new power base was convened: national sovereignty, a precept that would be shared by the monarchic constitutions of 1822 and 1838, and by the republican one of 1911. This followed the French example (manifested in the monarchic constitution of 1791 and in the Spanish constitution of 1812), as not even republicans entertained a tradition of republicanism based upon popular sovereignty. This enables us to better understand the rejection of direct democracy and universal suffrage, and also the long incapacitation (concerning voting and standing for office) of the vast body of “passive” citizens, justified by “enlightened”, property- and gender-based criteria. Although the republicans had promised in the propaganda phase to alter this situation, they ultimately failed to do so. Indeed, throughout the whole period under analysis, the realisation of the potential of national sovereignty was mediated above all by the individual citizen through his choice of representatives. However, this representation was indirect and took place at national level, in the hope that action would be motivated not by particular local interests but by the common good, as dictated by reason. This was considered the only way for the law to be virtuous, a requirement that was also manifested in the separation and balance of powers. As sovereignty was postulated as single and indivisible, so would be the nation that gave it soul and the State that embodied it. Although these characteristics were common to foreign paradigms of reference, in Portugal, the constitutionalization process also sought to nationalise the idea of Empire. Indeed, this had been the overriding purpose of the 1822 Constitution, and it persisted, even after the loss of Brazil, until decolonization. Then, the dream of a single nation stretching from the Minho to Timor finally came to an end.
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Este trabalho, realizado no âmbito do Interacionismo Sociodiscursivo, combina uma reflexão sobre a noção de género textual com a observação do agir do aluno, em particular, em momentos de escrita do texto expositivo-argumentativo, de correção do trabalho do colega e através de um questionário. É de admitir que uma metodologia descendente, assente num princípio retórico-hermenêutico, defendido por autores como Rastier e Bronkcart, deva estar subjacente ao ensino do género, articulando, o texto, como ponto de partida da aprendizagem, com o ensino da língua.
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Ontologies formalized by means of Description Logics (DLs) and rules in the form of Logic Programs (LPs) are two prominent formalisms in the field of Knowledge Representation and Reasoning. While DLs adhere to the OpenWorld Assumption and are suited for taxonomic reasoning, LPs implement reasoning under the Closed World Assumption, so that default knowledge can be expressed. However, for many applications it is useful to have a means that allows reasoning over an open domain and expressing rules with exceptions at the same time. Hybrid MKNF knowledge bases make such a means available by formalizing DLs and LPs in a common logic, the Logic of Minimal Knowledge and Negation as Failure (MKNF). Since rules and ontologies are used in open environments such as the Semantic Web, inconsistencies cannot always be avoided. This poses a problem due to the Principle of Explosion, which holds in classical logics. Paraconsistent Logics offer a solution to this issue by assigning meaningful models even to contradictory sets of formulas. Consequently, paraconsistent semantics for DLs and LPs have been investigated intensively. Our goal is to apply the paraconsistent approach to the combination of DLs and LPs in hybrid MKNF knowledge bases. In this thesis, a new six-valued semantics for hybrid MKNF knowledge bases is introduced, extending the three-valued approach by Knorr et al., which is based on the wellfounded semantics for logic programs. Additionally, a procedural way of computing paraconsistent well-founded models for hybrid MKNF knowledge bases by means of an alternating fixpoint construction is presented and it is proven that the algorithm is sound and complete w.r.t. the model-theoretic characterization of the semantics. Moreover, it is shown that the new semantics is faithful w.r.t. well-studied paraconsistent semantics for DLs and LPs, respectively, and maintains the efficiency of the approach it extends.
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The personal legal status of native non catholic people of Portuguese colonial Empire during the nineteenth century, their position in what concerns Portuguese citizenship, is the main subject of this article. While discussing constitutional articles on religion, Portuguese deputies of the nineteenth century were confronted with a set of problems about that status which they find difficult to solve: should non catholic peoples who were born in Portuguese colonial territory be treated as plain Portuguese citizens or where they just “savage people”, “colonial subjects” or, in a more optimistic approach, “civilizing subjects”. The results were not conclusive, giving rise to an “uncertainty principle” which enabled central and local government to decide in an almost casuistic way about native people status and rights.
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Proceedings of the 16th Annual Conference organized by the Insurance Law Association of Serbia and German Foundation for International Legal Co-Operation (IRZ), entitled "Insurance law, governance and transparency: basics of the legal certainty" Palic Serbia, 17-19 April 2015.
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Versão online da Revista Brasileira de Estudos Políticos, Belo Horizonte, nº 107, pp. 149-200, jul./dez.2013
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This study specifically addresses the situation of minority shareholders after the transfer of control in an listed company. The various underlying interests and reasons that shareholders have for investing in a company can demonstrate shareholders’ reasoning for taking radically different positions on issues relating to the transfer of control of the referred company. This study analyses the current legal system in Portugal and in the European Union in order to assess whether, in the event of a takeover bid of a listed company where there is a transfer of control, minority shareholders have the same appraisal rights as other shareholders to sell their shares and leave the company. The study then examines the European Court of Justice decision on whether a general principle of equal treatment of minority shareholders exists upon a transfer of control (Audiolux) and the Portuguese Securities Market Commission decision regarding the delisting of Brisa - Autoestradas de Portugal, S.A. based on the principle of investor protection. The study concludes that although the principle of equality amongst shareholders has made progress in the European legal system e.g. it is laid down in Directive 2004/25/EC of 21 April 2004 on takeover bids and the Portuguese Securities Market Code, there is also a need for further improvement, which can be accomplished by allowing minority shareholders to exercise an appraisal right in similar unregulated situations.