A type system for access control in an object-oriented language

Trabalho apresentado no âmbito do Mestrado em Engenharia Informática, como requisito parcial para obtenção do grau de Mestre em Engenharia Informática

The Farol Deposit (Depósito do Farol) – a Pleistocene beach deposit from Cape Mondego (Figueira da Foz, West Central Portugal)*

Among the Pleistocene and Holocene units recorded near the marine cliffs of Cape Mondego (Figueira da Foz, West Central Portugal) stands out the Farol Deposit (Depósito do Farol), at an altitude of ±95 m above present sea level. It is a marine terrace with three exposures of interstratified conglomerates and sands, overlapped by calclititic-fanglomerates. This sedimentary setting indicates that deposition took place in a seashore environment influenced by the proximity of a marine palaeocliff. The deposit has an interesting subfossil fauna with abraded and fragmented shells of Nucella lapillus (LINNÉ, 1758), Patella vulgata (LINNÉ, 1758) and Littorina littorea (LINNÉ, 1758), suggesting the existence of an environment with colder surface seawater, when compared with the present day Portuguese seashore. These specimens belonged to marine communities adapted to live in intertidal rocky platforms, which have been exposed to the cyclic action of waves and tidal flows, on the swash and surf zones. The Farol Deposit can be related to an Early/Middle Pleistocene “cold-water” episode, earlier to the Isotopic Stages 7 and 11. This episode occurred before the deposition of the units Quiaios Sands (Areias de Quiaios) and Cantanhede Sands (Areias de Cantanhede) (Sicilian?), but later than the Arazede Sands (Areias de Arazede) and Marinha das Ondas Sands (Areias de Marinha das Ondas) (Early Pleistocene).

Obama's law : analysis of a breakthrough law on healthcare access and lessons for the Portuguese health system management

ABSTRACT - The Patient Protection and Affordable Care Act shook the foundations of the US health system, offering all Americans access to health care by changing the way the health insurance industry works. As President Obama signed the Act on 23 March 2010, he said that it stood for “the core principle that everybody should have some basic security when it comes to their health care”. Unlike the U.S., the Article 64 of the Portuguese Constitution provides, since 1976, the right to universal access to health care. However, facing a severe economic crisis, Portugal has, under the supervision of the Troika, a tight schedule to implement measures to improve the efficiency of the National Health Service. Both countries are therefore despite their different situation, in a conjuncture of reform and the use of new health management measures. The present work, using a qualitative research methodology examines the Affordable Care Act in order to describe its principles and enforcement mechanisms. In order to describe the reality in Portugal, the Portuguese health system and the measures imposed by Troika are also analyzed. The intention of this entire analysis is not only to disclose the innovative U.S. law, but to find some innovative measures that could serve health management in Portugal. Essentially we identified the Exchanges and Wellness Programs, described throughout this work, leaving also the idea of the possibility of using them in the Portuguese national health system.

A random access MAC protocol for MPR satellite networks

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

Implementation of a cognitive radio access system

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

Access to essential medicines in Timor-leste: availability, prices and affordability

O acesso a medicamentos essenciais a preços acessíveis de forma sustentável é um dos indicadores do cumprimento dos Objectivos de Desenvolvimento do Milénio e pode ser considerado como parte do direito universal à saúde. Tal como acontece com outros bens essenciais, o acesso aos medicamentos depende de múltiplos factores, como a sua disponibilidade, preços e capacidade de aquisição por parte da população. Na última década, foram efectuados mais de 50 estudos para avaliar esses factores, em países de baixos e médios rendimentos, utilizando uma metodologia desenvolvida pela Organização Mundial de Saúde e a organização Health Action International, numa tentativa de compreender as possíveis causas para o baixo acesso aos medicamentos. Os resultados destes estudos revelam uma baixa disponibilidade de medicamentos essenciais de um modo geral, sobretudo no sector público, e preços elevados, sobretudo no sector privado. O objectivo deste estudo foi descrever a disponibilidade, os preços e a capacidade de aquisição de medicamentos essenciais em Timor-Leste, com recurso à metodologia da OMS/HAI. Foram recolhidos dados sobre a disponibilidade e os preços de uma lista de medicamentos em hospitais, centros de saúde e farmácias comunitárias. Embora os resultados pareçam apontar para uma disponibilidade global razoável de medicamentos genéricos no sector público (59,2%), algumas substâncias activas e classes terapêuticas encontravam-se sistematicamente esgotadas em vários pontos do país. Nas unidades situadas em locais mais remotos, a disponibilidade de medicamentos chegava a descer para valores na ordem dos 47,5%. Verificou-se que a disponibilidade de medicamentos nas farmácias privadas era ainda mais baixa do que nos serviços públicos (38,0%). Os medicamentos são dispensados gratuitamente nos hospitais e centros de saúde, mas nas farmácias privadas chegam a ultrapassar 40 vezes os seus preços de referência internacionais, mesmo como genéricos. Consequentemente, estima-se por exemplo, que um funcionário público que utilize diclofenac para o tratamento crónico da artrose, tenha de trabalhar durante mais de 2 dias para pagar o seu tratamento mensal com o medicamento genérico, ou 12,5 dias, se for prescrito o medicamento de marca. Durante o estudo, foram detectados vários outros problemas que podem comprometer a qualidade e segurança dos medicamentos. Apesar das limitações inerentes a uma investigação deste tipo, foi possível concluir através do presente estudo que, ao contrário da tendência geral observada em países similares, o sector público de cuidados de saúde em Timor-Leste parece ter um melhor desempenho do que o privado. No entanto, as condições limitadas da maioria das unidades de saúde públicas pode forçar alguns doentes a recorrer ao sector privado, onde os preços pagos pelos tratamentos são inaceitavelmente elevados. A ausência de regulamentação do sector farmacêutico (e fiscalização insuficiente da existente) parece estar a contribuir para a estagnação do sector privado e a encorajar indirectamente a falta de transparência nas práticas farmacêuticas. Dada a escassez de estudos sobre este assunto em Timor-Leste, espera-se que o presente trabalho forneça evidências importantes que possam ser utilizadas em estudos subsequentes e como base a uma intervenção por parte das autoridades com o objectivo de melhorar a disponibilidade de medicamentos no sistema público e de encorajar o desenvolvimento do sector privado como alternativa viável, segura e de custo aceitável.

The ambivalence of two-part tariffs for bottleneck access

Two-part tariffs, when used at the retail level, increase efficiency by lowering the price of marginal units. The same potential for higher efficiency exists for two-part tariffs at wholesale level for a given market structure, but the fixed part of the wholesale tariff can negatively affect the latter. In a simulated competition model of next-generation telecommunications access networks that has been calibrated with engineering cost data, we show that the latter effects strongly outweigh the former. That is, substituting a cost-based linear wholesale access tariff with revenue-equivalent two-part tariffs reduces the number of access seekers and therefore leads to higher prices and lower welfare and consumer surplus.

Equity in access to MRI equipment: the Portuguese case

Magnetic resonance imaging (MRI) is a method of image diagnose proven to be of undeniable importance when it comes to neuro and cardio related diseases. In fact, these diseases (such as: ischemic heart disease, stroke and acute myocardial infection) have high incidence in Portugal. For these reasons, the allocation of this medical technology should not be considered with light thoughts. In fact, making decision of resource allocation in health care can be a very complex and contested matter. The impacts of new technology allocation, such MRI, can be assessed in a variety of ways. However, a fundamental component should always be present: the use of evidence-based decision-making methods. One of these methods is Technology Assessment (TA). This paper aims to characterize the equity on access of the Portuguese population in general, to a specific medical device such as MRI, under the TA point of view. It is hoped to promote a bridge of scientific knowledge between the gap on research and policy-making through TA that can emerge as a tool to aid decision-makers in the organization of health systems. There are gaps in providing healthcare, due to geographical imbalances, with some areas unable to provide certain specialized services, as hospitals in the countryside do not provide all medical specialties. Portugal has also a large independent private sector that provides diagnostic and therapeutic services to NHS users under contracts called conventions. These medical contracts cover ambulatory health facilities for laboratory tests and examinations such as diagnostic tests and Radiology. However, there is no convention from the NHS when concerning the MRI exam. Therefore, this reality can be considered a limitation in the access of the general population to this kind of clinical exam. TA can play an useful and important role in helping the decision-makers to explore potential gains that might be achieved by introducing a more rational decision making into health care management, namely into the Radiology area, regarding the allocation of MRI equipment.

Energy-efficient diversity combining for different access schemes in a multi-path dispersive channel

Dissertação para obtenção do Grau de Doutor em Engenharia Electrotécnica e Computadores

Medium access control design for distributed opportunistic radio networks

Existing wireless networks are characterized by a fixed spectrum assignment policy. However, the scarcity of available spectrum and its inefficient usage demands for a new communication paradigm to exploit the existing spectrum opportunistically. Future Cognitive Radio (CR) devices should be able to sense unoccupied spectrum and will allow the deployment of real opportunistic networks. Still, traditional Physical (PHY) and Medium Access Control (MAC) protocols are not suitable for this new type of networks because they are optimized to operate over fixed assigned frequency bands. Therefore, novel PHY-MAC cross-layer protocols should be developed to cope with the specific features of opportunistic networks. This thesis is mainly focused on the design and evaluation of MAC protocols for Decentralized Cognitive Radio Networks (DCRNs). It starts with a characterization of the spectrum sensing framework based on the Energy-Based Sensing (EBS) technique considering multiple scenarios. Then, guided by the sensing results obtained by the aforementioned technique, we present two novel decentralized CR MAC schemes: the first one designed to operate in single-channel scenarios and the second one to be used in multichannel scenarios. Analytical models for the network goodput, packet service time and individual transmission probability are derived and used to compute the performance of both protocols. Simulation results assess the accuracy of the analytical models as well as the benefits of the proposed CR MAC schemes.

Access of WetAMD and DME patients to treatment in public hospitals

Degeneration (WetAMD) and Diabetic Macular Edema (DME) patients’ access to treatment in public hospitals, by identifying bottlenecks and stress points that prevent timely and adequate care to patients who suffer from a degenerative disease, and consequently for whom the lack of access to treatment can have disastrous consequences. Considering the specificity and degenerative traits of these conditions, the long queues for specialty appointments in public hospitals are a significant threat to patients’ health, as the disease may be misdiagnosed and or progress significantly, causing unnecessary permanent and non-reversible loss in visual acuity. Therefore optimizing the patient journey will increase patients’ access to adequate treatment, and prevent avoidable progress of a degenerative condition which causes permanent and non-reversible blindness. Following the investigation which supports this thesis, the patient journey was broken down into its different phases, so that key issues could be identified, and referred back to the main stress points highlighted during the interviews with physicians and administrators. Finally results were scrutinized and systematized, and a set of action points was proposed, considering what may cause major impact and is actually feasible to implement.