Epidemiologia e Saúde Públi

RESUMO - Visa-se explicitar a origem, a razão de ser, a natureza e o que se perspectiva da relação entre a Epidemiologia e a Saúde Pública, através de uma leitura histórica. As duas entidades foram-se definindo e fazendo sentido em conjunto, com sucessos e, também, muita polémica, desde há milénios e até meados do século XIX. Nesta época, uma combinação de circunstâncias proporcionou-lhes uma explosão de crescimento e de definição, de par com várias outras áreas disciplinares. Desde o antigo relato bíblico de como boa alimentação explica o bom estado de saúde, até à valorização científica das condicionantes sociais e económicas da saúde por Marmot e Rose, passando por «miasmas» causando doença e pela deslocação do conceito de risco individual de saúde para o de risco populacional — com as implicações inerentes a essa importante inovação —, este percurso permite identificar as fundações de tão notável simbiose, explicar o estado presente, vê-la evoluir e achar nela o significado do património hoje disponível, e o que ele promete. Algumas discrepâncias quanto à designação dos seus métodos, bem como a contínua discussão quanto à sua verdadeira natureza e orientação futura, atestam a juventude da Epidemiologia como disciplina científica. Entretanto, a Saúde Pública esforça-se por manter a sua essência integradora, à medida que outras disciplinas contribuem mais para que concretize os seus objectivos; é desafiada pela exposição das populações, em larga escala, a factores de doença, por vezes de intensidade mínima, e pelo surgimento de novas doenças ou a ampliação do volume de outras na população, muitas vezes não respeitando fronteiras. A história dessa simbiose mostra bem que conhecer o modo como uma doença se origina permite controlá-la na população, ou mesmo evitá-la, e que é grande o número de problemas que, em sinergia, as duas disciplinas podem clarificar e resolver. Assim, a Epidemiologia oferece à Saúde Pública explicações (olhos, inteligência e linguagem) para os problemas de saúde das populações — o que permite à segunda saber sobre o quê agir —, cenários de possível evolução dos problemas — o que permite aos decisores optarem em função de diferentes pressupostos, sobre como agir — e capacidade de juízo sobre os resultados das acções empreendidas, em simultâneo com a elevação do nível de consciência, de compreensão e de intervenção quanto ao que se está a passar, tanto pelos profissionais, como pela população — transferência do conhecimento. Facilmente se antecipa que a relação entre as duas disciplinas irá evoluir para maior complexidade e, também, solicitação e exigência da Saúde Pública sobre a Epidemiologia, que terá que corresponder em utilidade. E esta, continuando a subespecializar-se e a sofisticar-se tanto nos métodos, como nos enfoques sobre categorias específicas de factores, precisará de progredir muito na gestão da sua consistência enquanto corpo de conhecimento integrado e com peculiaridades metodológicas, à semelhança da Saúde Pública.O modo como evoluirá a relação entre ambas depende ainda da evolução dos próprios problemas, conceitos, teorias e soluções relacionados com a saúde das populações, e ainda do desenvolvimento das demais disciplinas chamadas à integração por ambas, para enfrentarem esses desafios. Nomeadamente, a Epidemiologia terá que gerir com perícia dificuldades já identificadas, como: incorporar métodos qualitativos de investigação na sua fortíssima tradição e cultura quantitativa; operacionalizar satisfatoriamente o conceito de «risco atribuível na população», ao serviço da definição de prioridades de acção dirigida às necessidades de saúde; aperfeiçoar modelos de interpretação causal que respeitem a multicausalidade; aproveitar as técnicas estatísticas de análise multivariada, sem se perder na abstracção dos seus modelos; desenvolver a investigação nas dimensões positivas de saúde, além da doença, para contribuir melhor para a realização da Saúde Pública, sua principal cliente e fornecedora de oportunidades.--------------------------ABSTRACT - The aim of the author is to explicit the origin, the rationale, the nature and the prospects of the relationship between Epidemiology and Public health, through an historic approach. The two entities have been defining and making sense together, by achieving successes, but also with much controversy, since millennia ago, until mid XIX century. A combination of circumstances provided them the opportunity for an explosion of growth and definition, then, alongside several other disciplines. From the ancient biblical report on how good food explains good health, up to the scientific appreciation of both social and economical constraints to health by Marmot and Rose, passing through «miasma» causing disease and through displacing from individual health risk to population risk — with the inherent implications of that important innovation —, this route allows the identification of the foundations of such remarkable symbiosis, the explanation of current status, to see its evolution and find in it the meaning of today’s heritage and what it promises. Some discrepancies on the name of its methods, as well as the continuing discussion about its true nature and future orientation, attest Epidemiology’s youth as a scientific discipline. Meanwhile, Public Health strives to keep its integrating essence, while other disciplines increasingly contribute so that it achieves its objectives; it is challenged by large scale population exposure to disease factors, sometimes with a minimum intensity, and by new diseases emerging in the population or by old ones getting amplified, often not respecting regions boundaries. The history of such a symbiosis shows that knowing the way a disease is generated allows to control it in the population, or even to avoid it, and that the number of problems that the two disciplines are able to clarify and solve together in synergy is considerable. Therefore, Epidemiology offers Public Health explanations (eyes, intelligence and language) for populations’s health problems — allowing that the latter knows on what to act —, scenarios on how problems may tend to evolve — allowing decision-makers to make their choices as a function of different assumptions, on how to act — and judgement capabilities on the results of already undertaken actions, accompanied by the raising of conscience level, understanding and intervention of what is going on by both professionals and the population – knowledge transfer. It is easy to anticipate that the relationship between both disciplines will develop towards increasing complexity and demand from Public Health to Epidemiology, and that this one will have to correspond in usefulness. And the latter, while continuing its subspecialisation and sophistication either in its methods, or in its approaches to specific factor categories, will need to progress in managing its consistency as an integrated body of knowledge having methodological peculiarities, similarly to Public Health. Further, the way the relationship between both will evolve depends on the evolution of the problems themselves, of the concepts, theories and solutions related to the health of populations, and on the development of remaining disciplines called to integration by both, in other to face those problems. Namely, Epidemiology will have to manage with expertise some already known difficulties, as: the inclusion of qualitative research methods in its very strong quantitative tradition and culture; to grant satisfactory operation to the «population attributable risk» concept, in support to the definition of action priorities envisaging health needs; to improve causal interpretation models that comply with multicausality; to take advantage of multivariate statistical techniques, without get

UsaGame – A new methodology to support user- centered design of touchscreen game applications

Dissertação para Obtenção do Grau de Mestre em Engenharia e Gestão Industrial

Efficient paraconsistent reasoning with rules and ontologies for the semantic web

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.

DYNAMOD – A dynamic agent based modelling framework for digital businesses

Digital Businesses have become a major driver for economic growth and have seen an explosion of new startups. At the same time, it also includes mature enterprises that have become global giants in a relatively short period of time. Digital Businesses have unique characteristics that make the running and management of a Digital Business much different from traditional offline businesses. Digital businesses respond to online users who are highly interconnected and networked. This enables a rapid flow of word of mouth, at a pace far greater than ever envisioned when dealing with traditional products and services. The relatively low cost of incremental user addition has led to a variety of innovation in pricing of digital products, including various forms of free and freemium pricing models. This thesis explores the unique characteristics and complexities of Digital Businesses and its implications on the design of Digital Business Models and Revenue Models. The thesis proposes an Agent Based Modeling Framework that can be used to develop Simulation Models that simulate the complex dynamics of Digital Businesses and the user interactions between users of a digital product. Such Simulation models can be used for a variety of purposes such as simple forecasting, analysing the impact of market disturbances, analysing the impact of changes in pricing models and optimising the pricing for maximum revenue generation or a balance between growth in usage and revenue generation. These models can be developed for a mature enterprise with a large historical record of user growth rate as well as for early stage enterprises without much historical data. Through three case studies, the thesis demonstrates the applicability of the Framework and its potential applications.