Technological adoption in health care - The role of payment systems

This paper examines the incentive to adopt a new technology given by some popular reimbursement systems, namely cost reimbursement and DRG reimbursement. Adoption is based on a cost-benefit criterion. We find that retrospective payment systems require a large enough patient benefit to yield adoption, while under DRG, adoption may arise in the absence of patients benefits when the differential reimbursement for the old vs. new technology is large enough. Also, cost reimbursement leads to higher adoption under some conditions on the differential reimbursement levels and patient benefits. In policy terms, cost reimbursement system may be more effective than a DRG payment system. This gives a new dimension to the discussion of prospective vs. retrospective payment systems of the last decades centered on the debate of quality vs. cost containment.

Satisfação profissional dos dietistas nos hospitais do Serviço Nacional de Saúde : um primeiro estudo empírico

RESUMO - A satisfação no trabalho é entendida como um conjunto de sentimentos ou respostas afetivas relacionados com aspetos particulares do trabalho. Os autores não são unânimes na sua definição concetual. Neste estudo pretende-se compreender a satisfação profissional dos dietistas a exercer nos hospitais públicos em Portugal continental. A satisfação profissional foi avaliada através de um questionário (adaptado de Graça,1999) dividido em três partes. Foi aplicada uma escala de intervalos, na Discrepância entre as Expetativas (E) e Resultados (R), constituída por 8 dimensões e 44 itens. Mediu-se igualmente a importância motivacional que os dietistas atribuíram a cada uma das 8 dimensões, e foi feita a sua caraterização sociodemográfica da população estudada. De uma população inicial constituída por 42 elementos, contactada por email para responder ao questionário “on line”, tivemos 34 respondentes. Quatro respostas, por incompletas, não foram consideradas no tratamento. No final, temos uma amostra de conveniência constituída por 30 dietistas, todos eles a trabalhar atualmente em hospitais do SNS. A taxa de resposta válida é, pois, de 71,4%. Trata-se de um estudo descritivo, observacional e tipo transversal. A análise de dados baseou-se na estatística descritiva e analítica. O score médio global (2,59), indicador da discrepância E-R, permite classificar a amostra como estando “bastante satisfeita” em relação ao seu trabalho e à sua profissão. Em relação à ordenação das dimensões segundo a importância motivacional, a Realização pessoal e profissional & desempenho organizacional (1º) (2,57), é aquela que os inquiridos consideraram a mais importante, seguida da Relação profissional/utente (2º) (3,78) e finalmente a Autonomia & poder (3º) (3,96). Os melhores scores médios de cada dimensão são a Relação profissional/utente (1º) (1,36), seguida do Status e prestigio (2º) (1,51) e por último as Relações de trabalho e suporte social (3º) (2,39). Em conclusão, em relação à ordenação das dimensões segundo a importância motivacional, a Realização pessoal e profissional e desempenho organizacional foi considerada pelos dietistas a mais importante e a dimensão menos importante foi a do Status e prestígio. A Relação profissional/utente foi a dimensão com melhor score médio, ou seja, é a dimensão onde os dietistas se encontram mais satisfeitos, e a remuneração foi a dimensão onde a população se encontra menos satisfeita. A satisfação profissional dos dietistas que trabalham em hospitais públicos pode contribuir para melhorar a prestação de cuidados de saúde à população. Recomendamos por isso, mais investigação que aborde aquela temática, tornando mais visível a importância do dietista no contexto da saúde em Portugal.

Les Boeufs de Paix. Douglas H. Johnson et la violence Nuer (Soudan)

This article seeks to restore (anthropologically speaking) the warrior status of the Nuer during the colonial period. It challenges the negative conclusions of Douglas H. Johnson about the cultural dimension of fighting. In 1839, when the Nuer sacrificed an ox before a fleet from the North, the Egyptians thought it was an act of aggression and shot at them. But did this mistake inaugurate a series of misunderstandings on the offensive provision of this people? If that is Johnson's assertion, a return to the sources allows an alternative interpretation. The article puts in symmetry this episode and another, ninety years later, which also involved an "ox peace". The British killed this animal in 1929 during the repression of the Nuer prophetic movement. But if Johnson seeks to contradict the importance of the prophets as leaders of revolt, this article points out that their pacifism was embedded in the ideology of war.

Islão transnacional e os fantasmas do colonialismo português

Este artigo examina a forma como as políticas colónias portuguesas de enquadramento do Islão na Guiné e em Moçambique evoluíram de uma representação do muçulmano como ameaça para uma imagem mais conciliadora, pela qual os muçulmanos poderiam ser potenciais aliados do poder português na guerra contra os movimentos nacionalistas. Sendo ambas as representações marcadas pela ambivalência, a primeira predominou até ao final da década de 50 e a segunda desenhou-se em meados dos anos 60, acompanhando o restante trajecto das guerras coloniais. As duas imagens corresponderam a diferentes formas de lidar com a dimensão transnacional do Islão e com o seu alegado impacto sobre o colonialismo português em África. O artigo analisa essas estratégias, abordando a participação que nelas teve a Igreja Católica, o aparelho central de poder e as suas ramificações locais nas colónias.

Relações sinuosas: Portugal e o mundo árabe, 1950-1973

Nas três últimas décadas do colonialismo português, as políticas destinadas às populações muçulmanas da Guiné e de Moçambique passaram da hostilidade mais ou menos aberta para uma estratégia de sedução, com vista a promover um “Islão português” e a usar certos sectores muçulmanos no combate aos movimentos nacionalistas. Esta transição teve também uma componente transnacional, na medida em que se quis alargar a intervenção portuguesa a um espaço estratégico designado como “mundo islâmico”. O presente artigo procura analisar essa intervenção, debruçando-se sobre o pensamento geopolítico que a informou e as suas aplicações diplomáticas, em particular no relacionamento com os países árabes.

Lá fora um lugar para existir/Abroad a place where to exist

A exposição “Artistas Portugueses - Lá Fora” pretende mostrar uma parte significativa da produção de artes plásticas que resultou de processos de migração que tiveram origem em território português. Integra uma multiplicidade de situações temporais e sociais que, para serem lidas, necessitam de alguma contextualização. Trata-se, tal como no caso da emigração económica, de uma emigração de sobrevivência, sendo que aqui o sentido do termo sobrevivência assume uma dimensão mais existencial. Para elas, partir quer dizer, ao mesmo tempo, resistir enquanto ser humano e existir enquanto criador. The exhibition “ABROAD” aims to show a significant part of the Fine Arts production resulting from migration procedures starting from the Portuguese territory. It comprises multiple periods of time and social situations which, in order to be comprehended, need to be contextualized. This is, just like in the case of economic emigration, an emigration for survival even if in this context the meaning of the Word survival assumes an existential dimension. For those people to leave means, simultaneously, to resist as a human being and to exist as a creator.

Valuation of marine and coastal ecosystems: The role of ecological-economic modeling

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics

Country-of-origin effect applied to talent: Portugal abroad

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

The Future of services: Uncovering latent needs through trend analysis

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Les enquêtes royales au Portugal, 1220-1343

Actes du colloque international d' Aix-en-Provence et Marseille, 19-21 mars 2009

A chancelaria régia de D. Dinis : breves observações diplomáticas

Neste artigo, o autor propõe-­‐se refletir sobre a chancelaria do rei D. Dinis apresentando novas perspetivas para o seu entendimento do ponto de vista diplomático, ao mesmo tempo que valoriza, dá notícia e publica um conjunto de documentação, pouco divulgada, que permite reavaliar a dimensão e o significado históricos da produção documental dionisina.

A Constructivist perspective on EU'S democracy promotion in Turkey

The European Union, as a regional actor and an example of stability and well-being, has embraced a set of principles it has stood for and which constitute its own identity. The diffusion of these values among third countries is one of the objectives of EU’s External Policy. Democracy can be found among the principles that are sought to be exported through comprehensive and complex strategies within different frameworks, such as neighbourhood relations, trade partnerships and the accession process. Focusing on the latter, candidates are object of an intensive process of Europeanisation that operates through different mechanisms like socialisation and conditionality. Turkey, on the other side, has decided to apply for full membership several decades ago and, ever since, it has been pressured to Europeanise, which includes improving its unstable democracy. This case, however, is different from all other previous enlargements; for its special socio-cultural and civilisational features, Turkey constitutes a more complex novelty for the European Union. Therefore, this thesis aims to study the influence of the European Union on the democratisation process of Turkey, focusing on the period ranging between 1999, the year the European Council recognised Turkey’s candidacy status, and 2009 that marks the 10-year period of that condition. It is the intention of this project to assess the impact of the European Union at that level through the study of the democratic evolution of the country and its co-relation with other variables related to the presence or pressure of the EU. As this is a challenging objective, it will require a deep reflection upon central concepts like democracy and democratic consolidation, and a diversified use of methodological techniques, such as statistical analysis and mathematical co-relations, historical analysis, literature review and in-depth interviews. This study will privilege a Constructivist approach, emphasising the social construction of reality and the role of the ideational aspects – identity, perceptions and the broader socio-cultural dimension – in Turkey-EU relations.

Construction of Lean and Green indexes to measure companies’ performance

The demand for costs and time reductions in companies’ processes, in order to increase efficiency, leads companies to seek innovative management paradigms to support their needs for growth and continuous improvement. The Lean paradigm has great relevance in companies’ need for waste reduction, particularly in manufacturing companies. On the other hand the demand of companies for waste reduction has gained a new dimension not only at the material level, but also at the environmental level with the introduction of the Green paradigm. As such, manufacturing companies have been adopting practices that reduce the impact of their activities on the environment. Although nowadays many manufacturing companies already implement waste reduction practices related to Lean and Green paradigms, many of them are unable to understand specifically if their efforts are enough for the application of these practices to be successful or even if their actual performance in implementing Lean or Green practices reflects the self-assessment that they have of themselves. Thus, besides the study of the development of Lean and Green paradigms in recent years, the present dissertation has the important objective of the construction of two indexes (the Lean Index and the Green Index) enabling the measurement of the performance of Portuguese manufacturing companies relating the implementation of Lean and Green practices. The data used to create the Lean and Green indexes where obtained from the implementation of the European Manufacturing Survey 2012 in Portugal. The survey questions related to the implementation of Lean and Green practices are used as variables in the development of the model for the two indexes. For the construction of representative expressions of Lean Index and Green Index it was applied the Factorial Analysis for assigning the variables weights and aggregation.

Characterization tests for insulation boards made from corn cob and natural glues

In recent years there has been a growing interest in developing news solutions for more ecologic and efficient construction, including natural, renewable and local materials, thus contributing in the search for more efficient, economic and environmentally friendly construction. Several authors have assessed the possibility of using various agricultural sub products or wastes, as part of the effort of the scientific community to find alternative and more ecologic construction materials. Corn cob is an agricultural waste from a very important worldwide crop. Natural glues are made from natural materials, non-mineral, that can be used as such or after some modifications to achieve the behaviour and performance required. Two examples of these natural glues are casein and wheat flour-based glues that were used in the present study. Boards with different compositions were manufactured, having as variables the type of glue, the dimension of the corn cob particles and the features of the pressing process. The tests boards were characterized with physical and mechanical tests, such as thermal conductivity (λ) with a ISOMET 2104 and 60 mm diameter contact probe, density (ρ) based on EN 1602:2013, surface hardness (SH) with a PCE Shore A durometer, surface resistance (SR) with a PROCEQ PT pendular sclerometer, bending behaviour (σ) based on EN 12089:2013, compression behaviour (σ10) based on EN 826:2013 and resilience (R) based on EN 1094-1:2008, with a Zwick Rowell bending equipment with 2 kN and 50 kN load cells (Fig. 1), dynamic modulus of elasticity (Ed) with a Zeus Resonance Meter equipment (Fig. 5) based on NP EN 14146:2006 and water vapour permeability (δ) based on EN 12086:2013. The various boards produced were characterized according to the tests and the ones with the best results were C8_c8 (casein glue, grain size 2,38-4,76 mm, cold pressing for 8 hours), C8_c4 (casein glue, grain size 2,38-4,76 mm, cold pressing for 4 hours), F8_h0.5 (wheat flour glue, grain size 2,38-4,76 mm, hot pressing for 0,5 hours), FEV8_h0.5 (wheat flour, egg white and vinegar glue, grain size 2,38-4,76 mm, hot pressing for 0,5 hours) and FEVH68_c4 (wheat flour, egg white, vinegar and 6 g of sodium hydroxide glue, grain size 2,38-4,76 mm, cold pressing for 4 hours). Taking into account the various boards produced and respective test results the type of glue and the pressure and pressing time are very important factors which strongly influence the final product. The results obtained confirmed the initial hypotheses that these boards have potential as a thermal and, eventually, acoustic insulation material, to use as coating or intermediate layer on walls, floors or false ceilings. This type of board has a high mechanical resistance when compared with traditional insulating materials.The integrity of these boards seems to be maintained even in higher humidity environments. However, due to biological susceptibility and sensitivity to water, they would be more adequate for application in dry interior conditions.

Study of the electromyographic signal dynamic behavior in Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease characterized by motor neurons degeneration, which reduces muscular force, being very difficult to diagnose. Mathematical methods are used in order to analyze the surface electromiographic signal’s dynamic behavior (Fractal Dimension (FD) and Multiscale Entropy (MSE)), evaluate different muscle group’s synchronization (Coherence and Phase Locking Factor (PLF)) and to evaluate the signal’s complexity (Lempel-Ziv (LZ) techniques and Detrended Fluctuation Analysis (DFA)). Surface electromiographic signal acquisitions were performed in upper limb muscles, being the analysis executed for instants of contraction for ipsilateral acquisitions for patients and control groups. Results from LZ, DFA and MSE analysis present capability to distinguish between the patient group and the control group, whereas coherence, PLF and FD algorithms present results very similar for both groups. LZ, DFA and MSE algorithms appear then to be a good measure of corticospinal pathways integrity. A classification algorithm was applied to the results in combination with extracted features from the surface electromiographic signal, with an accuracy percentage higher than 70% for 118 combinations for at least one classifier. The classification results demonstrate capability to distinguish members between patients and control groups. These results can demonstrate a major importance in the disease diagnose, once surface electromyography (sEMG) may be used as an auxiliary diagnose method.