Effects of team task structure on team climate for innovation and team outcomes

In this cross-sectional study we analyzed, whether team climate for innovation mediates the relationship between team task structure and innovative behavior, job satisfaction, affective organizational commitment, and work stress. 310 employees in 20 work teams of an automotive company participated in this study. 10 teams had been changed from a restrictive to a more self-regulating team model by providing task variety, autonomy, team-specific goals, and feedback in order to increase team effectiveness. Data support the supposed causal chain, although only with respect to team innovative behavior all required effects were statistically significant. Longitudinal designs and larger samples are needed to prove the assumed causal relationships, but results indicate that implementing self-regulating teams might be an effective strategy for improving innovative behavior and thus team and company effectiveness.

Castor fiber na gruta do Caldeirão Existência, distribuição e extinção do castor em Portugal

Beaver only had been found in Portugal in a Chalcolithic locality, the Vila Nova de S. Pedro castrum. It has now been idenrified in the Upper Paleolithic (Solurrean) from Gruta do Caldeirão, near Tomar. The species has been found recently at «Gruta do Almonda»; 4 teeth were collected in bed C, older than a Solutrean sequence (see Anexo for details). The species seems to have been rare, as it was also the case with portuguese miocene Castoridae Enroxenomys minutus and Chalicomys jaegeri. If account is taken of the presence in the Middle Ages until Castille of words meaning beaver (related to the popular latin Fiber/Biber), it is obvious that these animals still existed then. Such nouns were largely predominant over the rather erudite larin (greek derived) words as Castor, -óris and derived ones, as it could be expected. This allowed us to recognize that veiro should be the corresponding word with Fiber affinities in archaic portuguese. It was previously supposed to mean only expensive furs then imported into Portugal. Indeed it was also a zoonym. Anyway, beaver should be scarce by XIIIth century since it is not included in the quite detailed price list imposed by the «Lei da Almotaçaria» from December 26, 1253 (see Quadro II). Toponyms in veiro and derived words (fig. 2; Quadro III) (plural, feminines, diminutives, inhabited places) give a restrictive view of the Middle Age distribution. Some of them are certainly older than Portugal itself (first half of XIIth century); others existed by the XIVth century but were probably older. Some rare toponyms seem to be derived from rhe erudite latin Castor, -óris. Nothing suggests that these words were still in use as zoonyms during the Middle Ages. All toponyms are located in regions near rivers and other freshwaters ecologically suitable for beavers, so wecan approximately retrace irs former, Middle Age distribution in Portugal (fig. 2; Quadro III). Most of them are located in the Center-West and Northwest of Portugal, with a suitable c1imate (rainfall in general over 800 milimeters per year); the only sure geographical exception is Veiros, in Alto Alentejo province, in a region with comparable precipitations and less dry climare conditions than most of the territories South of the Tagus. There are less and less of these toponyms towards the South and the inner part of the country, and they are enrirely lacking in ali drier regions from Trás-os-Montes, Beira, Alentejo beyond Tagus' basin, and in Algarve. Nothing suggests beavers lived there, No pose-medieval toponym is known, nor any reference after middle XVth century. No such locality was at, or close by to, any frontier. Hence the hypothesis of veiro (e: al.) as meaning but points where expensive furs(supposedly known as veiros in general but without clearly saying from what animal they were obtained from) is to be discarded. During the Middle Ages, beaver distribution concerned all the main river basins from Minho to Tagus ones. Quice racefied in the XIIIth, the beavers may have disappeared from Portugal during the XVth century. Ecological requirements restricted their former distribution. Vulnerability to natural causes (i.e., severe drought) and to human pressure may have accounted heavily for this species extinction. Last (1446) reference for Portugal known to us suggests the species was by then almost extinct.

Anemia de células falciformes na idade pediátrica : contribuição para o estudo das suas principais complicações e indicadores de prognóstico

RESMO: Introdução: A anemia de células falciformes doença hereditária, com repercussão multi-orgânica, tem grande variabilidade na sua expressão clínica. Daí o interesse do estudo de indicadores de prognóstico. A investigação realizada foi precedida de um resumo histórico incidindo sobre a compreensão de aspectos fundamentais da doença ao longo dos tempos. Na primeira parte do estudo e após revisão bibliográfica, foram referidos dados da fisiopatologia como base para os estudos que integram a presente dissertação. Abordou-se o estado da arte relativamente às complicações, aos indicadores de prognóstico e à terapêutica utilizada. Objectivos: Constituíram objectivos deste estudo realizado numa amostra populacional representativa: identificar as lesões a nível dos sistemas cardio-respiratório e nervoso central, avaliando-se as respectivas repercussões; avaliar a presença de indicadores de prognóstico entre as variáveis seleccionadas; estudar a eficácia e toxicidade da HU nos doentes com as formas graves da ACF. Para a prossecução destes objectivos foram delineados para além do estudo global três estudos específicos: Estudo 1- repercussão no sistema cardio-respiratório; Estudo 2- repercussão no sistema nervoso central; Estudo 3- terapêutica com hidroxiureia. Doentes e métodos: Procedeu-se a um estudo prospectivo e multi-institucional durante um período de três anos tendo-se seleccionado para a amostra, e de acordo com critérios pré-definidos, 30 doentes com ACF na fase estável da doença, com idades compreendidas entre os sete e os 18 anos, todos de origem africana à excepção de um caucasiano. O diagnóstico baseou-se em técnicas de electroforese e estudo molecular que definiu o genotipo da doença e a presença da delecção da -talassémia assim como os haplotipos da amostra populacional. Foram utilizadas diferentes metodologias para avaliar a existência de lesão pulmonar e cerebral. Através do estudo estatístico foram seleccionadas diversas variáveis como hipotéticos indicadores de prognóstico. Estudo 1. Para determinar a existência de lesão a nível pulmonar usaram-se duas metodologias diferentes, a avaliação da função pulmonar com estudo da saturação da Hb em O2 no sangue arterial e a tomografia computadorizada de alta resolução. Estudou-se também a possível disfunção cardíaca como repercussão da lesão pulmonar, através do ecocardiograma, e os indicadores de prognóstico com significado estatístico para a lesão encontrada. Estudo 2. O desenho deste estudo foi sobreponível ao anterior, mas com metodologia adequada para o SNC. Procedeu-se ao estudo das lesões cerebrais por meio de exames imagiológicos, (RMN-CE e DTC) e de testes psicológicos. Correlacionaram-se as três metodologias utilizadas e a importância de cada uma para a decisão de atitudes terapêuticas preventivas. Estudo 3. Consistiu num estudo aberto prospectivo não controlado com nove crianças e adolescentes com formas graves de ACF, com o objectivo de avaliar a eficácia da terapêutica com hidroxiureia, durante um período de 24 meses. Todos os doentes completaram no mínimo 15 meses de terapêutica, com uma dose final média de 194 mg/K/dia. Resultados globais: Durante o período anterior à investigação caracterizou-se a amostra populacional estudada quanto ao fenotipo genético, clínico e hematológico de acordo com os critérios utilizados por outros investigadores. Verificou-se: predomínio do haplotipo Bantu na forma homozigótica em 53% dos doentes; número total de EVO ≥3/ano em 87,5% dos doentes; crises de sequestração em 18,75%; dactilites no primeiro ano de vida em 31,2%; quadro de sépsis grave apenas num doente; crises de hiper-hemólise em 50%; e STA em 59,38% dos doentes. Quanto ao fenotipo hematológico evidenciaram-se como factores de risco reticulocitose (13,1x103/l) e hiperbilirrubinémia (2,5 mg/dl) e como factores de bom prognóstico a presença de delecção de um gene da -talassémia em 46,9% dos doentes e valor médio de Hb 8,1 g/dl. Resultados dos estudos parcelares: Estudo 1. Deste estudo infere-se que a DPR ligeira foi diagnosticada em 70% dos doentes, uma vez que as alterações da difusão não foram estatisticamente significativas, o estudo dos gases no sangue não evidenciaram resultados anormais e a TCAR evidenciou alterações em 43,3% dos doentes. Apenas num doente se verificou doença pulmonar obstrutiva relacionada com maior número da STA.O estudo da disfunção cardíaca encontrada em 86,7% dos doentes não reflecte a repercussão da DPR a nível cardíaco, podendo estar associada às alterações fisiopatológicas da própria anemia crónica. Encontraram-se indicadores de prognóstico hematológicos e clínicos. Entre os primeiros, valores de Hb ≥8,5 g/dl e de HbF ≥13% foram considerados indicadores de bom prognóstico para a lesão pulmonar. Em relação aos parâmetros clínicos, as STA não foram consideradas indicadoras de prognóstico para a DPR ao contrário do que se verificou com o número de EVO. Pela análise dos parâmetros genéticos e socio-económicos provou-se a ausência de relação estatisticamente significativa com lesão pulmonar. Estudo 2. Pela RMN-CE foram diagnosticados ES em 33,3% com uma localização preferencial na substância branca profunda em 26,6% dos doentes. Relativamente aos parâmetros hematológicos seleccionados, o valor médio da HbF 8,6% constituíu um indicador de bom prognóstico para o aparecimento de ES, enquanto o valor médio de leucócitos 12.39x103/μl foi considerado um indicador de mau prognóstico. No estudo do DTC apenas um doente apresentou aumento da velocidade do fluxo cerebral na ACM igual a 196 cm/segundos, associado a vasculopatia grave. Os testes psicológicos alterados em 80% dos doentes mostraram ser o método mais sensível para detectar alterações do neurodesenvolvimento, mas sem correlação com os ES em 10% dos doentes. Realça-se a baixa percentagem de DTC patológicos encontrados neste estudo em relação ao número elevado de ES e de testes psicológicos alterados, não se verificando concordância entre os três exames. Dos indicadores de prognóstico estudados a -talassémia foi considerada um factor de protecção para o coeficiente de inteligência da escala de Wechsler. Em relação a parâmetros clínicos estudados os doentes com maior número de EVO, tem em média valores inferiores nos testes psicológicos. Estudo 3. Neste estudo verificou-se que o valor médio da HbF aumentou significativamente de 7,0±4% para 13,7±5,3% (p=0,028) ao fim de 15 meses de terapêutica com hidroxiureia. Clinicamente todos os doentes responderam significativamente com uma redução de 80% no número de EVO, 69% no número de internamentos, 76% no número de dias de hospitalização e 67% no número de transfusões. Deste modo comprovou-se não só a eficácia desta terapêutica neste grupo pediátrico como também a falta de efeitos secundários significativos. Considera-se a necessidade de estudos mais prolongados e em grande séries, para com segurança se usar a HU antes que a lesão orgânica se estabeleça, portanto logo nos primeiros anos de vida. Conclusão: Na amostra populacional estudada foram evidenciadas lesões pulmonares e cerebrais na grande maioria dos doentes que condicionaram a sua qualidade de vida. Foram identificados indicadores de prognóstico que poderão eventualmente ditar medidas terapêuticas precoces com o objectivo de diminuir a morbilidade e a mortalidade neste grupo etário. Demonstrou-se que a terapêutica com a HU foi eficaz e bem tolerada----------ABSTRACT: Background: Sickle cell anemia (SCA), a hereditary disease characterized by pain and lifetime multi-organic lesion, is a challenge for all that work with carriers of this disease. The clinical expression variability of SCA is a constant reality and a problem to be solved in the current world of investigation, for which the knowledge of prognostic indicators responsible for the different aspects of clinical evolution diversity wiil be an added value. The study is preceded by a historical summary of the most important factors in the evolution of SCA, which are in themselves, an incentive for future research. In the first part of the study, after an extensive bibliographical revision, physiopathology data is referred to in general and specifically regarding the target organs, that constituted the base for the studies presented in the dissertation. The state of the art for the complications to be studied, the choice of prognostic indicators and the therapeutics application, were approached for the renewed interest in the theme. Aims: In regard to the investigation, the objective was to study the lesions in the most affected organs of a chosen pediatric group, to investigate prognostic indicators for lung and cerebral lesions and to evaluate the protective effect of hydroxyurea in children with severe outcomes. Patients and methods: A prospective and multi-institutional study was carried out during a three-year period, February 1998 to March 2001, with children and adolescents followed up at a Immunohematology Outpatient Clinic of Dona Estefânia's Hospital, Lisbon. Based in predefined criteria, 30 children with SCA were selected in a stable phase of the disease, aged from seven to 18 years old, all of whom were of African origin with exception of one who was Caucasian. The diagnosis was based on electrophoresis techniques and molecular study that allowed to define the genotype, the presence of deletional alpha-thalassemia as well as haplotypes in the population. Different methodologies were used to evaluate the existence of lung and cerebral lesion. Statistical study of the different variables selected the prognostic indicators. In Study 1, to determine the existence of lung lesion two different methodologies were used: pulmonar function study with arterial blood gases determination; and high resolution computerized tomography. Heart dysfunction as a repercussion of lung lesion was also studied through echocardiography, and prognostic indicators were statistically significant for lesions found. The design of Study 2 was similar to Study 1, but with the appropriate methodology for CNS. After neurological examination, which was normal in all patients (control group), cerebral lesions were studied with imagiologic exams (MRN-CE and TCD) and psychological tests. These three methodologies were correlated and the importance of each one in the decision of the therapeutic profilactic attitudes. Study 3 consisted of a controlled prospective open study in children with severe forms of SCA, with the aim of the evaluating therapeutic effectiveness of hydroxyurea, during a period of 24 months. Results: In the global overall study preceding the Studies 1,2 and 3, there were a prevalence of haplotype Bantu (53%) and other risk factors, namely the number of VOC (87,5%), sequestration crisis (18,75%), dactilytis in first year of life(31,2%), hyperhemolysis crisis (50%) and ATC in more than half of the patients (59,38%). This group of bad prognostic indicators, associated with the population of the lower class according to the Graffar scale, demonstrates the importance of primary health care services, information provided to the children and their relatives, as well as the interest in prophylactic therapeutics, specific screening and prenatal diagnosis. Study 1. It was evident from this study that slight RPD was diagnosed in 70% of the patients, because alterations of the diffusion had no statistical significance and arterial blood gases determinations were normal. Only one patient had restrictive lung disease related with numerous ACS. However ACS was not considered a prognostic indicator for RPD, contrary to the number of EVO. HRTC revealed discreet fibrotic lines that could be related with slight RPD, but the lack of correlation of these two exams (33%) supports the value of lung function tests for precocious diagnosis of RPD. Heart dysfunction was found in 86,7% of patients, does not reflect the repercussion of RPD, but with the physiopathology of chronic anemia. Hematologic and clinical prognostic indicators were found. Good prognostic indicators for the non-evolution of RPD with average Hb values of ≥ 8,5 g/dl and average HbF values of ≥13%, respectively. The genetic and social-economic factors had no statistical significance; nevertheless, they were more prevalent among Bantu haplotype (53,3%) in patients with RPD. Study 2. RMN-CE detected SI in 33,3% of the patients, with preferential location in deep white substance in 26,6% and in front lobe in 20%. This distribution can be related to structural aspects of the brain and with the high sensibility of this organ to hypoxia. From the hematological parameters selected, average HbF value 8,6% and average leucocyte count 12.39x103/μl were prognostic indicators with different meaning to SI. The increase in the total bilirubin related to hyperhemolysis clinically explains the genesis of SI In the TCD study, only one patient had increased cerebral flow speed >196 cm/sec in CMA, which corresponded to serious vasculopathy in AngioMR. This patient never present previously neurological symptoms and had several hyperhemolysis crisis and VOC as risk factors. Low percentage of pathological TCD in this study, in relation to the high number of SI and altered tests, although without correlation among the three exams, is probably attributed to factors related to the methodology, aspects of cerebral physiopathology or perhaps a sign of good prognostic if the duration of study had not been so short. TCD should be used as a screening method in the age groups with higher risk of AVC and should never be considered separately in prophylactic therapeutics indication. Psychological tests were the most sensitive method to detect neurodevelopment impairment; in 80% of patients the neuropsychologics tests were altered, but without correlation with SI (10%). Since SI can become evident during the first two years of life and develop with time, the first psychological tests should be carried out between 3 and 5 years of age to timely be referred to special education and stimulation programs. Prognostic indicators to psychological tests were also found: alpha-thalassemia was found to be a protection factor of the IQ, just as other hematologic factors (hematocrit, MGCV and erythrocytes count). In relation to clinical parameters, although without statistical significance, patients with larger number of VOC had average lower scores versus the average in tests, except in TP. Results from different studies were conclusive as to the type of lesion found and the importance of prognostic indicators. Study 3. All the patients completed a minimum of 15 months therapeutic treatment with the final average daily dose of 19±4 mg/kg/day. The average value of the fetal hemoglobin increased significantly from 7,0±3,9% to 13,7±5,3% (p=0.028). The HbF average values increased from 6% to 15% after 15 months of therapeutic treatment. Clinically there was a reduction of 80% in the number of VOE , 69% in the number of hospitalization, 76% in the number of days of hospitalization and 67% in the number of transfusions. Once again the effectiveness of this treatment in this pediatric group, as well as the lack of any significant secondary effects, was evident. The study confirms the need for further detailed research in order to safely effect the appropriate treatment prior to the development of organic lesions, which ideally should be in the first year of life. Conclusions: These results allow us to clarify the importance of either pulmonary lesions or either nervous central system impairment among patients, children and adolescents, with sickle cell anemia. These lesions were demonstrated in most of the patients studied compromising their quality of life and the mortality. The treatment with HU is proved to be effective and having low toxicity.

Double coverage and demand for health care: Evidence from quantile regression

An individual experiences double coverage when he bene ts from more than one health insurance plan at the same time. This paper examines the impact of such supplementary insurance on the demand for health care services. Its novelty is that within the context of count data modelling and without imposing restrictive parametric assumptions, the analysis is carried out for di¤erent points of the conditional distribution, not only for its mean location. Results indicate that moral hazard is present across the whole outcome distribution for both public and private second layers of health insurance coverage but with greater magnitude in the latter group. By looking at di¤erent points we unveil that stronger double coverage e¤ects are smaller for high levels of usage. We use data for Portugal, taking advantage of particular features of the public and private protection schemes on top of the statutory National Health Service. By exploring the last Portuguese Health Survey, we were able to evaluate their impacts on the consumption of doctor visi

Integrating wind generation in the distribution network

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do Grau de Mestre em Energias Renováveis – Conversão Eléctrica e Utilização Sustentáveis

The politics of growth: Can lobbying raise growth and welfare?

This paper aims at analyzing the effects of lobbying over economic growth and primarily welfare. We model explicitly the interaction between policy-makers and firms in a setup where the latter undertakes political contributions to the former in exchange for more restrictive market regulations which induce exit and enhance the profitability of the market. In a sectorial equilibrium, despite stimulating growth, lobbying restricts the market structure and reduces welfare when compared to the free-entry outcome. However, once general equilibrium considerations are taken into account, we find that lobbying may improve welfare over a welfare maximizing free-entry equilibrium, by means of an expansion in aggregate demand. This introduces a new paradigm in the literature about the effects of lobbying over economic performance.

Reciprocity, inequity aversion, and oligopolistic competition

This paper studies how reciprocity and inequity aversion influence the behavior of firms in imperfectly competitive markets. The paper shows that if reciprocal firms compete à la Cournot, then they are able to sustain “collusive” outcomes under a positive reciprocity equilibrium. By contrast, Stackelberg warfare outcomes may emerge under a negative reciprocity equilibrium. The results for inequity aversion are similar. Cournot competition between inequity averse firms can be harmful to consumers if it leads to equilibria where firms feel compassion toward each other. However, in equilibria where inequity averse firms are envious of each other consumers are better off than if firms were selfish. The paper also shows that only under very restrictive conditions does reciprocity or inequity aversion have an impact on Bertrand competition. Finally, the paper shows that non-selfish preferences have a greater impact on equilibrium outcomes in markets with a small number of firms.

Of Structural Denial: A Narratological Study of the Structural Disintegration of the Novel Form

If an opening to the argument of this dissertation is of imperative necessity, one might tentatively begin with Herbert Quain, born in Roscommon, Ireland, author of the novels The God of the Labyrinth (1933) and April March (1936), the short-story collection Statements (1939), and the play The Secret Mirror (undated). To a certain extent, this idiosyncratic Irish author, who hailed from the ancient province of Connacht, may be regarded as a forerunner of the type of novels which will be considered in this dissertation. Quain was, after all, the unconscious creator of one of the first structurally disintegrated novels in the history of western literature, April March. His first novel, The God of the Labyrinth, also exhibits elements which are characteristic of structurally disintegrated fiction, for it provides the reader with two possible solutions to a mysterious crime. As a matter of fact, one might suggest that Quain’s debut novel offers the reader the possibility to ignore the solution to the crime and carry on living his or her readerly life, turning a blind eye to the novel itself. It may hence be argued that Quain’s first novel is in fact a compound of three different novels. It is self-evident that the structure of Quain’s oeuvre is of an experimental nature, combining geometrical precision with authorial innovation, and one finds in it a higher consideration for formal defiance than for the text itself. In other words, the means of expression are the concern of the author and not, interestingly, the textual content. April March, for example, is a novel which regresses back into itself, its first chapter focussing on an evening which is preceded by three possible evenings which, in turn, are each preceded by three other, dissimilar, possible evenings. It is a novel of backward-movement, and it is due to this process of branching regression that April March contains within itself at least nine possible novels. Structure, therefore, paradoxically controls the text, for it allows the text to expand or contract under its formal limitations. In other words, the formal aspects of the novel, usually associated with the restrictive device of a superior design, contribute to a liberation of the novel’s discourse. It is paradoxical only in the sense that the idea of structure necessarily entails the fixation of a narrative skeleton that determines how plot and discourse interact, something which Quain flouts for the purposes of innovation. In this sense, April March’s convoluted structure allows for multiple readings and interpretations of the same text, consciously germinating narratives within itself, producing different texts from a single, unique source. Thus, text and means of expression are bonded by a structural design that, rather than limiting, liberates the text of the novel.

Support in decision-making under uncertainty: a project risk assessment tool development and supplementary advances

A foremost dispute that persists on the contemporary world’s agenda is change. The on-going social/technological/economic changes create a competitive and challenging environment for companies to endure. To benefit from these changes, world economies partially depend on emerging Small and Medium Enterprises (SMEs) and their adaptability skills, and subsequently the development of an integrated capability to innovate has become the prime strategy for most of SMEs to subsist and grow. However, innovation and change are always somewhat bonded to an inherent risk development, which subsequently brings on the necessity of a revision of risk management approaches in innovative processes, whose importance SMEs tend to disregard. Additionally, little efforts have been made to improve and create empirical models, metrics and tools to assist SMEs managing latent risks in their innovative projects. This work seeks to present and discuss a solution to support SMEs in engaging on systematic risk management practices, which consists on an integrated risk assessment and response support web-based tool - Spotrisk® - designed for SMEs. On the other hand, an inherent subjectivity is linked with risk management and identification processes, due to uncertainty trait of its nature, for each individual perceives situations according to his own idiosyncrasy, which brings complications in normalizing risk profiles and procedures. This essay aims to bring insights concerning the support in decision-making processes under uncertainty, by addressing issues related with the risk behavior character among individuals. To address such issues, subjects of neuroscience or psychology are explored and models to identify such character are proposed, as well as models to improve presented tool. This work attempts to go beyond the restrictive aim of endeavoring on technical improvement dissertation, and in embraces an exploratory conceptualization concerning micro, small and medium businesses’ traits regarding risk characters and project risk assessment tools.

Fisiopatologia da microcirculação coronária e perfusão do miorcárdio : ecocardiografia de contraste do miocárdio e doppler transtorácico

RESUMO: Este trabalho tentou contribuir para a caracterização da fisiopatologia da microcirculação coronária em diferentes formas de patologia com o auxílio da ecocardiografia transtorácica. Com a aplicação da ecocardiografia Doppler transtorácica foi efectuado o estudo da reserva coronária da artéria descendente anterior e com a ecocardiografia de contraste do miocárdio foram analisados parâmetros de perfusão do miocárdio como a velocidade da microcirculação coronária, o volume de sangue miocárdico e a reserva de fluxo miocárdico. Estas técnicas foram utilizadas em diferentes situações fisiopatológicas com particular interesse na hipertrofia ventricular esquerda de diferentes etiologias como a hipertensão arterial, estenose aórtica e cardiomiopatia hipertrófica. Também na diabetes mellitus tipo 2 e na doença coronária aterosclerótica, estudámos as alterações da microcirculação coronária. Com a mesma técnica de ecocardiografia de contraste do miocárdio foi analisada a perfusão do miocárdio num modelo experimental animal sujeito a uma dieta aterogénica. Além das conclusões específicas em relação a cada um dos trabalhos efectuados há a referir como conclusões gerais a sua fácil aplicabilidade e exequibilidade em âmbito clínico, a sua reprodutibilidade e precisão. Quando comparadas com técnicas consideradas de referência mostraram resultados com significativa correlação estatística. Em todos os doentes e nos grupos controle foi possível comprovar e quantificar o gradiente de perfusão transmural em repouso e durante a acção de stress vasodilatador, relevando a importância da perfusão sub-endocárdica na função do ventrículo esquerdo. O estudo da microcirculação coronária no grupo de doentes com hipertrofia ventricular esquerda revelou que no grupo com hipertensão arterial existe disfunção da microcirculação coronária ainda antes de se observar aumento de massa do ventrículo esquerdo, e que esta disfunção é diferente em função da geometria ventricular. Nos doentes com estenose aórtica foi demonstrado que além da disfunção da microcirculação coronária, explicada pelo fenómeno de hipertrofia, existe outro componente extrínseco que depois de corrigido através de cirurgia de substituição valvular, conduziu a uma parcial normalização dos valores de reserva coronária. Na cardiomiopatia hipertrófica observou-se uma grande heterogeneidade de perfusão transmural e foi documentado, em imagens de ecocardiografia de contraste do miocárdio e após análise paramétrica, a ausência de perfusão do miocárdio na região sub-endocárdica durante o stress vasodilatador de reserva coronária diminuídos em fases precoces de evolução da doença. Foi demonstrado que a reserva coronária na DM2 em fases mais avançadas estava significativamente diminuída. Descrevemos também em doentes com DM2 e sem doença coronária angiográfica a existência de disfunção da microcirculação coronária. Durante o stress vasodilatador, observámos e documentámos neste grupo de doentes, a existência de defeitos de perfusão transitórios ou de diminuição da velocidade da microcirculação coronária. No grupo de doentes com doença coronária confirmámos o interesse da avaliação da reserva coronária após intervenção percutânea na definição de prognóstico pós EAM, em termos de recuperação funcional do ventrículo esquerdo. Em doentes com BCRE e de difícil estratificação de risco, foi possível calcular o valor de reserva coronária e estratificar o risco de doença coronária. Num modelo experimental animal demonstrámos a exequibilidade da técnica de ECM, e verificámos que nessas condições experimentais, uma sobrecarga aterogénica na dieta, ao fim de 6 semanas, comprometia severamente a reserva coronária. Estes resultados foram parcialmente reversíveis quando à dieta foi adicionada uma estatina. Estas técnicas pela sua não invasibilidade, fácil acesso, repetibilidade e inocuidade perspectivam-se de grande utilidade na caracterização de doentes com disfunção da microcirculação coronária, nas diferentes áreas de diagnóstico, terapêutica e prevenção. A possibilidade de adaptar a técnica em modelos experimentais animais também nos parece poder vir a ter grande utilidade em investigação.----------------ABSTRACT: This work is intended to be a contribution to the study of coronary microcirculation applying new echocardiographic techniques as transthoracic Doppler echocardiography of coronary arteries and myocardial contrast echocardiography. Coronary flow reserve may be assessed by transthoracic Doppler echocardiography, and important functional microcirculation parameters as microcirculation flow velocity, myocardial blood volume and myocardial flow reserve may be evaluated through myocardial contrast echocardiography. Microcirculation was analysed in different pathophysiological settings. We addressed situations with increased left ventricular mass as systemic arterial hypertension, aortic stenosis and hypertrophic cardiomyopathy. Also coronary microcirculation was studied in type 2 Diabetes and in different clinical forms of atherosclerotic coronary artery disease. Specific and detailed conclusions were withdrawn from each experimental work. In the overall it was concluded that these two techniques were important tools to easily assess specific pathophysiological information about coronary microcirculation at bed side which would be difficult to get through other techniques. When compared with gold standard techniques, similar sensibility and specificity was found. Because of their better temporal and spatial resolution it was possible to analyse the importance of transmural perfusion gradients, both in basal and during vasodilatation, and their relation to ischemia, and mechanical wall kinetics, as wall thickening and motion. Coronary microcirculation dysfunction was found in systemic arterial hypertension early evolution stages, also related to different left ventricular geometric patterns. Different etiopathogenical explanations for aortic stenosis coronary microcirculation dysfunction were analysed and compared after aortic valve replacement. Transmural myocardial perfusion heterogeneity pattern was observed in hypertrophic cardiomyopathy which was aggravated during adenosine challenge. Coronary microcirculation dysfunction was diagnosed in type 2 diabetes both with coronary artery disease and with normal angiographic coronary arteries. Dynamic transitory subendocardial perfusion defects with adenosine vasodilatation were visualized in these patients.In patients with left branch block, transthoracic Doppler echocardiography was able to suggest a coronary reserve cut-off value for risk stratification. Also it was possible with this technique to calculate coronary flow reserve and predict restenosis after PTCA Again, in an experimental animal model, applying myocardial contrast echocardiography technique it was possible to study the consequences of an atherogenic diet and statins action on the coronary microcirculation function. Because these techniques are easily performed at bed side, are harmless, use no ionizing radiation and because of their repeatability, reproducibility and accuracythey are promissory tools to assess coronary microcirculation. Both in clinic and research areas these techniques will probably have a role in clinical diagnosis, prevention and therapeutically decision.

Aplicação das medidas de coacção às pessoas colectivas

1. Legal system of coercive measures and applicability to legal persons: the criminal liability of legal persons, application requirements, fundamental principles; 2. Inapplicability of personal freedom coercive measures to legal persons; 3. Application in the specific case of legal persons: term of identity and residence; provision of security, the obligation of periodic presentation, suspension of exercise of functions, activities and rights, conducts prohibitions and obligations; 4. Break of coercive measure imposed on the legal person.

O princípio da confidencialidade na mediação em matéria civil e comercial

The purpose of the following study is to analyze the relevance of the principle of confidentiality concerning mediation on civil and commercial matters developed in Portugal. We will, essentially, try to determine just how pivotal is this principle and how it affects the effectiveness of that method of alternative dispute resolution. We believe it is fundamental to understand the true extent of this principle and its goals, emphasizing the protection given to those who decide to resort to mediation and its impact on this process. For this dissertation, we have based our analysis on the interpretation of the set rules assembled by Law nr 29/2013, April 19th, while combining it with data gathered from other laws and regulations that had also addressed mediation. Furthermore, given the fact that this subject has been regulated by Directive 2008/52/EC, we deem pertinent to include references to other European mediation regulations, namely from Germany, Spain and France. With this study, we have established that, even though the Portuguese mediation law is based on a European Directive, we have determined a more restrictive regulation for the principle of confidentiality. We have concluded that the rules regarding this principle try to preserve, above all, the trust and honesty established during the course of the mediation, while restricting the possibility of using the information disclosed during these sessions on other cases. Additionally, we believe confidentiality is such a distinctive and relevant feature that its legal framework leads us to deem it as a true obstacle to the parties’ private autonomy and their power to determine how the mediation should be carried out.

The emergence of product certification systems as trade barriers

This paper addresses the growing difficulties automobile manufacturers face within their after sales business: an increasing number of trade obstacles set up by import countries discriminates against the foreign suppliers and impedes the international sales of genuine parts. The purpose of the study is to explore the emergence of trade restrictive product certification systems, which affect spare parts exports of automobile manufacturers. The methodology used includes review of the literature and an empirical study based on qualitative interviews with representatives of major stakeholders of the automotive after sales business. Relevant key drivers, which initiate the introduction of technical regulations in importing countries, are identified and analysed to evaluate their effect on the emerging trade policy. The analysis of the key drivers outlines that several interacting components, such as the global competitiveness of the country, macroeconomic and microeconomic factors, and certain country-specific variables induce trade restrictive product certification systems. The findings allow for an early detection of the emergence of product certification systems and provide a means to early recognise the risks and opportunities for the sales of automotive spare parts in the automakers’ target markets. This allows the manufacturers to react immediately and adapt in time to the upcoming changes.