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.

Development of new methodologies in sample treatment for proteomics workflow based on enzymatic probe sonication technology and mass spectrometry

Thesis submitted to the Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia, for the degree of Doctor of Philosophy in Biochemistry

Development and efficiency optimizing of the human body energy converters

Nowadays it is known that the human body is continuous source of many types of energy and the devices used for collecting energy taken from the environment also have the required capabilities for the collection of the energy produced by the Human body (HB), but very limited and with very low efficiency. Low power and high yield converters are particularly needed in these cases of collecting energy from human activity and its movements due to the small amount of energy generated this way. But this situation can be improved. Enhancing or focusing the human movements by using mechanical amplifiers applied to the piezoelectric element. By doing so the input of energy in the element increases. As such increasing its output, therefore producing more energy.

Phage display as a tool for development of novel therapeutics for breast cancer

Phage display technology is a powerful platform for the generation of highly specific human monoclonal antibodies (Abs) with potential use in clinical applications. Moreover, this technique has also proven to be a reliable approach in identifying and validating new cancer-related targets. For scientific or medical applications, different types of Ab libraries can be constructed. The use of Fab Immune libraries allows the production of high quality and affinity antigen-specific Abs. In this work, two immune human phage display IgG Fab libraries were generated from the Ab repertoire of 16 breast cancer patients, in order to obtain a tool for the development of new therapeutic Abs for breast cancer, a condition that has great impact worldwide. The generated libraries are estimated to contain more than 108 independent clones and a diversity over 90%. Libraries validation was pursued by selection against BSA, a foreign and highly immunogenic protein, and HER2, a well established cancer target. Preliminary results suggested that phage pools with affinity for these antigens were selected and enriched. Individual clones were isolated, however, it was not possible to obtain enough data to further characterize them. Selection against the DLL1 protein was also performed, once it is a known ligand of the Notch pathway, whose deregulation is associated to breast cancer, making it an interesting target for the generation of function-blocking Abs. Selection resulted in the isolation of a clone with low affinity and Fab expression levels. The validation process was not completed and further effort will have to be put in this task in the future. Although immune libraries concept implies limited applicability, the library reported here has a wide range of use possibilities, since it was not restrained to a single antigen but instead thought to be used against any breast cancer associated target, thus being a valuable tool.

Contribution to drug discovery and development for tauopathies using yeast as a model

This work aimed to contribute to drug discovery and development (DDD) for tauopathies, while expanding our knowledge on this group of neurodegenerative disorders, including Alzheimer’s disease (AD). Using yeast, a recognized model for neurodegeneration studies, useful models were produced for the study of tau interaction with beta-amyloid (Aβ), both AD hallmark proteins. The characterization of these models suggests that these proteins co-localize and that Aβ1-42, which is toxic to yeast, is involved in tau40 phosphorylation (Ser396/404) via the GSK-3β yeast orthologue, whereas tau seems to facilitate Aβ1-42 oligomerization. The mapping of tau’s interactome in yeast, achieved with a tau toxicity enhancer screen using the yeast deletion collection, provided a novel framework, composed of 31 genes, to identify new mechanisms associated with tau pathology, as well as to identify new drug targets or biomarkers. This genomic screen also allowed to select the yeast strain mir1Δ-tau40 for development of a new GPSD2TM drug discovery screening system. A library of unique 138 marine bacteria extracts, obtained from the Mid-Atlantic Ridge hydrothermal vents, was screened with mir1Δ-tau40. Three extracts were identified as suppressors of tau toxicity and constitute good starting points for DDD programs. mir1Δ strain was sensitive to tau toxicity, relating tau pathology with mitochondrial function. SLC25A3, the human homologue of MIR1, codes for the mitochondrial phosphate carrier protein (PiC). Resorting to iRNA, SLC25A3 expression was silenced in human neuroglioma cells, as a first step towards the engineering of a neural model for replicating the results obtained in yeast. This model is essential to understand the mechanisms of tau toxicity at the mitochondrial level and to validate PiC as a relevant drug target. The set of DDD tools here presented will foster the development of innovative and efficacious therapies, urgently needed to cope with tau-related disorders of high human and social-economic impact.

Bibliotecas públicas, responsabilidade social e cidadania

Este trabalho de investigação visa estudar e compreender a responsabilidade social de três bibliotecas públicas da margem sul do Tejo, analisando de que forma estas contribuem para o desenvolvimento de cidadãos civicamente mais ativos. Neste sentido, determina-se que modelo de responsabilidade social aplicam, que meios utilizam para incentivar o envolvimento cívico e que parcerias estabelecem. O método de recolha de dados utilizado foi a entrevista, tendo esta sido realizada aos responsáveis de cada bibliotecas em análise. Os resultados evidenciam que não existe uma política formal de responsabilidade social, mas sim ações que se assemelham a modelos práticos de RS que se classificam nas Teorias Integrativas. Relativamente às iniciativas desenvolvidas pelas bibliotecas públicas para a promoção da cidadania, estas vão de encontro ao Manifesto da IFLA/UNESCO para as Bibliotecas Públicas, podendo dizer-se que as suas ações se encontram confinadas à responsabilidade legal da organização. As bibliotecas identificam os seus stakeholders, mas é necessário que estes possuam um papel mais ativo no desenvolvimento de iniciativas que respondam às suas expetativas e necessidades. Efetuam-se cinco recomendações para melhorar o desempenho das bibliotecas públicas no domínio da responsabilidade social e da cidadania: implementar políticas de responsabilidade social; respeitar os interesses dos stakeholders; apostar na formação em responsabilidade social; investir na aprendizagem ao longo da vida; e inovar, no sentido de desenvolver atividades que vão além do cumprimento do Manifesto da IFLA/UNESCO para as Bibliotecas Públicas.