On the initial conditions in continuous-time fractional linear systems

Signal Processing, Vol. 83, nº 11

A new approach to the initial value problem

5th Portuguese Conference on Automatic Control, September, 5-7, 2002, Aveiro, Portugal

Estudo descritivo do perfil de utilizador da linha Saúde 24 com análise de impacto ao nível da eficiência, equidade e empowerment em comparação com o modelo inglês NHS Direct

RESUMO - A 8 de Maio de 2008 surgiu o centro de atendimento “Linha Saúde24” (S24) no sentido de modernizar o SNS, aproximando-o do cidadão. O serviço surge baseado no modelo inglês – o NHS Direct – que pode ser encarado como um serviço de informação telefónico apoiado por enfermeiros, disponível 24h por dia, concebido para expandir os serviços púbicos de acesso à rede prestadora de cuidados com intuito de aliviar a pressão da procura na rede de urgências hospitalares e médicos de família, assim como diluir as iniquidades regionais na prestação de serviços. A S24 assenta na perspectiva de ser um ponto de contacto inicial do utente com a rede de prestação de cuidados de saúde com capacidade de orientação. O objectivo da linha está na tentativa mais eficiente no uso dos recursos disponíveis, ao mesmo tempo que delega responsabilidade no cidadão na forma como este utiliza os recursos disponíveis, com melhor racionalização financeira na área da saúde aliada a uma melhor qualidade de serviço prestada e adequada, colocando os cidadãos no mesmo patamar, diluindo as dificuldades de acesso a aqueles que necessitam na tentativa de harmonizar e racionalizar o consumo de serviços de saúde. Esta estrutura permite ao cidadão conhecer melhor o seu estado de saúde e decidir mais acertadamente quanto à decisão a tomar. Com este estudo, e com base na literatura nacional e internacional, pretende-se descrever o perfil de utilizador que acede à S24 – definir o tipo de utilizador, disposição geográfica, motivos pelo qual acede ao serviço e qual o seu destino final, fazendo comparação com o perfil do NHS Direct. Assim, e com os dados obtidos, far-se-á uma avaliação preliminar em termos do contributo da linha S24 no que concerne à sua eficiência, equidade e empowerment dado ao utilizador. --- ------------------------------ABSTRACT - Saúde 24 (S24) is a national 24-hour health line initiated in May 2008 aiming at modernizing the Portuguese NHS by bringing it closer to the citizen. Indeed, S24 be seen as an initial contact point between the patient and the healthcare network, facilitating a better a management of health care demand. The service is inspired on the UK NHS Direct – a nurse-led telephone line to provide easier and faster advice information to people about health, illness and NHS services. It is expected to provide information so that people can deal with their health problems or their families´ on their own, with the purpose of reducing demand to A&E department and out-of-hours GP services. Additionally it can contribute to a reduction in regional inequities in healthcare provision through bringing health care advice to remote areas. The purpose of S24 is to handle more efficiently the available resources by enabling responsibilities in citizens. By doing so, S24 encourages a more appropriate use of available resources, with better financial outcomes and a better quality of care. It is meant, in terms of empowerment, to help people to be in control of their health and healthcare interactions by participating in the final decision. Based on quantitative data, this study defines the S24 caller user profile in terms of type, geographical reference, reasons for calling and outcome. This analysis allows us to perform a preliminary evaluation of the S24 in terms of its contribution to efficiency, equity and empowerment. Then the S24 is compared to

Algorithms and methodologies for decision support in energy efficiency on buildings

Dissertação apresentada na faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para a obtenção do grau de Mestre em Engenharia Electrotécnica e de Computadores

Indicadores de qualidade para a contratualização de cuidados paliativos

RESUMO - Âmbito e objectivos: O presente trabalho incide sobre a área dos cuidados paliativos, nomeadamente, visa contribuir para uma maior efectividade do processo de aquisição e acompanhamento deste tipo de cuidados. Neste contexto, e como objectivo principal do estudo, foram identificados os indicadores chave, na vertente da qualidade, indispensáveis para a conceptualização de um modelo de contratualização e, consequentemente, para assegurar a monitorização, acompanhamento e avaliação da actividade realizada. Método e metodologias: Numa primeira fase, foi conduzida uma pesquisa documental tendente ao levantamento dos indicadores, na dimensão da qualidade, em utilização nos cuidados paliativos em vários países, tendo sido escolhidos aqueles que apresentavam indicadores já validados, designadamente, o Canadá, Reino Unido, Austrália, Espanha e EUA. Desta forma, foram seleccionados os indicadores comuns aos vários países estudados, para efeitos de discussão e consensualização, no âmbito de uma Técnica de Grupo Nominal, passíveis de integrarem um modelo de contratualização nesta área em Portugal. Apresentação e discussão de resultados: Da pesquisa documental resultaram 188 indicadores na dimensão qualidade, em utilização nos países estudados, tendo sido identificados 19 indicadores comuns. Estes indicadores foram submetidos a discussão e consensualização em reunião de peritos, tendo sido hierarquizados os sete indicadores mais adequados para a contratualização em cuidados paliativos: composição de uma equipa interdisciplinar; capacidade de resposta doentes tratados/pedido de acesso; avaliação inicial e periódica das necessidades (oito domínios); acessibilidade farmacológica; congruência entre os cuidados prestados e os desejados; prática regular de reuniões multidisciplinares; conferência familiar, pelo menos 2 vezes. Conclusões: No panorama nacional, não se conhecem indicadores unanimemente ratificados como adequados à avaliação da efectividade, qualidade e eficiência dos cuidados paliativos. Por outro lado, atento o objectivo do presente trabalho, a informação recolhida a nível internacional devolveu indicadores aplicáveis maioritariamente num contexto da avaliação da prestação dos cuidados paliativos, e Indicadores de Qualidade para a Contratualização de Cuidados Paliativos em Portugal x/ 93 não tanto num contexto de um processo de contratualização efectivo. Assim, partindo destes indicadores, em utilização nos vários países estudados, o estudo permitiu identificar sete indicadores considerados como adequados para a contratualização destes cuidados, em Portugal. -------------- ABSTRACT - Scope and objectives: This work focuses on the palliative care area, in particular, aims to contribute to greater effectiveness of the monitoring and procurement process of this type of care. In this context, as the main objective of the study, key indicators were identified regarding the quality issue, crucial to the conceptualization of a contracting model, and consequently to ensure the monitoring, supervising and evaluating of the undertaken activities. Method and methodology: Initially, a documentary research was held. That research aimed to surveying the indicators in their dimension of quality, regarding their use in palliative care throughout several countries. The chosen countries already had validated indicators, namely, Canada, United Kingdom , Australia, Spain and the USA. Thus, the indicators selected were common to all the above mentioned countries, for discussion purposes and agreement, as part of a Nominal Group Technique, that could integrate a model of contracting in this area in Portugal. Presentation and result discussion: The documentary research resulted in 188 quality indicators in use in the referred countries, 19 of those indicators were common to all countries. These indicators were submitted for discussion and agreement at a meeting of experts, having been ranked the seven most appropriate indicators for palliative care contracting: composition of an interdisciplinary team; response ability to the patients / access requests, initial and periodic assessment of the needs (eight areas), pharmacology accessibility; congruence between the desired care and its effective provision and regular practice of multidisciplinary meetings, family conferences, at least two times. Conclusions: In the national scene, unanimously ratified as suitable indicators to assess the effectiveness, efficiency and quality of palliative care are unknown. On other hand, given the objective of this work, the international collection of information has given applicable indicators mostly in the context of assessing the provision of palliative care, rather than an effective contracting process context. Thus, based on these indicators in use in the studied countries, the study itself identified seven indicators considered appropriate for the contracting of such care in Portugal.

Providing energy efficiency location-based strategies for buildings using linked open data

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Advanced instrumentation for superheated liquid detectors in dark matter searches

Dissertação para obtenção do Grau de Doutor em Engenharia Física

Energy efficiency in energy policy: Empirical evidence of direct rebound effect in Portuguese households' demand for electricity

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

The effects of OF ETF creation on the price efficiency of underlying stocks

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

Hospital Efficiency: Directed internship: Deloitte & NOVA SBE

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

Comparing the efficiency of advergames vs. social networks when communicating with children

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

Web-assisted tobacco intervention in Portuguese : intentions to make behavioural changes and behavioural changes

ABSTRACT - The problem of how to support “intentions to make behavioural changes” (IBC) and “behaviour changes” (BC) in smoking cessation when there is a scarcity of resources is a pressing issue in public health terms. The present research focuses on the use of information and communications technologies and their role in smoking cessation. It is developed in Portugal after the ratification of WHO Framework Convention on Tobacco Control (on 8 November 2005). The prevalence of smokers over fifteen years of age within the population stood at 20.9% (30.9% for men and 11.8% for women). While the strategy of helping people to quit smoking has been emphasised at National Health Service (NHS) level, the uptake of cessation assistance has exceeded the capacity of the service. This induced the search of new theoretical and practical venues to offer alternative options to people willing to stop smoking. Among these, the National Health Plan (NHP) of Portugal (2004-2010), identifies the use of information technologies in smoking cessation. eHealth and the importance of health literacy as a means of empowering people to make behavioural changes is recurrently considered an option worth investigating. The overall objective of this research is to understand, in the Portuguese context, the use of the Internet to help people to stop smoking. Research questions consider factors that may contribute to “intentions to make behavioural changes” (IBC) and “behavioural changes” (BC) while using a Web-Assisted Tobacco Intervention Probe (WATIP). Also consideration is given to the trade-off on the use of the Web as a tool for smoking cessation: can it reach a vast number of people for a small cost (efficiency) demonstrating to work in the domain of smoking cessation (efficacy)”? In addition to the introduction, there is a second chapter in which the use of tobacco is discussed as a public health menace. The health gains achieved by stopping smoking and the means of quitting are also examined, as is the use of the Internet in smoking cessation. Then, several research issues are introduced. These include background theory and the theoretical framework for the Sense of Coherence. The research model is also discussed. A presentation of the methods, materials and of the Web-Assisted Tobacco Intervention Probe (WATIP) follows. In chapter four the results of the use of the Web-Assisted Tobacco Intervention Probe (WATIP) are presented. This study is divided into two sections. The first describes results related to quality control in relation to the Web-Assisted Tobacco Intervention Probe (WATIP) and gives an overview of its users. Of these, 3,150 answered initial eligibility questions. In the end, 1,463 met all eligibility requirements, completed intake, decided on a day to quit smoking (Dday) and declared their “intentions to make behavioural changes” (IBC) while a second targeted group of 650 did not decide on a Dday. With two quit attempts made before joining the platform, most of the participants had experienced past failures while wanting to stop. The smoking rate averaged 21 cigarettes per day. With a mean age of 35, of the participants 55% were males. Among several other considerations, gender and the Sense of Coherence (SOC) influenced the success of participants in their IBC and endeavour to set quit dates. The results of comparing males and females showed that, for current smokers, establishing a Dday was related to gender differences, not favouring males (OR=0.76, p<0.005). Belonging to higher Socio-economic strata (SES) was associated with the intention to consider IBC (when compared to lower SES condition) (OR=1.57, p<0.001) and higher number of school years (OR=0.70, p<0.005) favoured the decision to smoking cessation. Those who demonstrated higher confidence in their likelihood of success in stopping in the shortest time had a higher rate of setting a Dday (OR=0.51, p<0.001). There were differences between groups in IBC reflecting the high and low levels of the SOC score (OR=1.43, p=0.006), as those who considered setting a Dday had higher levels of SOC. After adjusting for all variables, stages of readiness to change and SOC were kept in the model. This is the first Arm of this research where the focus is a discussion of the system’s implications for the participants’ “intentions to make behavioural changes” (IBC). Moreover, a second section of this study (second Arm) offers input collected from 77 in-depth interviews with the Web-Assisted Tobacco Intervention Probe (WATIP) users. Here, “Behaviour Change” (BC) and the usability of the platform are explored a year after IBC was declared. A percentage of 32.9% of self-reported, 12-month quitters in continuous abstinence from smoking from Dday to the 12-month follow- up point of the use of the Web-Assisted Tobacco Intervention Probe (WATIP) has been assessed. Comparing the Sense of Coherence (SOC) scores of participants by their respective means, according to the two groups, there was a significant difference in these scores of non smokers (BC) (M=144,66, SD=22,52) and Sense of Coherence (SOC) of smokers (noBC) (M=131,51, SD=21,43) p=0.014. This WATIP strategy and its contents benefit from the strengthening of the smoker’s sense of coherence (SOC), so that the person’s progress towards a life without tobacco may be experienced as comprehensible, manageable and meaningful. In this sample the sense of coherence (SOC) effect is moderate although it is associated with the day to quit smoking (Dday). Some of the limitations of this research have to do with self-selection bias, sample size (power) and self-reporting (no biochemical validation). The enrolment of participants was therefore not representative of the smoking population. It is not possible to verify the Web-Assisted Tobacco Intervention Probe (WATIP) evaluation of external validity; consequently, the results obtained cannot be applied generalized. No participation bias is provided. Another limitation of this study is the associated limitations of interviews. Interviewees’ perception that fabricating answers could benefit them more than telling the simple truth in response to questions is a risk that is not evaluated (with no external validation like measuring participants’ carbon monoxide levels). What emerges in this analysis is the relevance of the process that leads to the establishment of the quit day (Dday) to stop using tobacco. In addition, technological issues, when tailoring is the focus, are key elements for scrutiny. The high number of dropouts of users of the web platform mandates future research that should concentrate on the matters of the user-centred design of portals. The focus on gains in health through patient-centred care needs more research, so that technology usability be considered within the context of best practices in smoking cessation.

The impact of banks dimension on profitability, sustainability and efficiency: An analysis for the Iberian financial system

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

Design of multidimensional compact constellations with high power efficiency

Dissertação apresentada para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Cost efficiency in the Portuguese water sector: The case of multimunicipal systems operating at the bulk level

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