Brazilian doctors' perspective on the second opinion strategy before a C-section

OBJECTIVE: To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section. METHODS: Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions. RESULTS: Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process. CONCLUSION: Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil.

Cost of schizophrenia: direct costs and use of resources in the State of São Paulo

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.

Dynamic power- and failure-aware cloud resources allocation for Sets of independent tasks

Cloud computing is increasingly being adopted in different scenarios, like social networking, business applications, scientific experiments, etc. Relying in virtualization technology, the construction of these computing environments targets improvements in the infrastructure, such as power-efficiency and fulfillment of users’ SLA specifications. The methodology usually applied is packing all the virtual machines on the proper physical servers. However, failure occurrences in these networked computing systems can induce substantial negative impact on system performance, deviating the system from ours initial objectives. In this work, we propose adapted algorithms to dynamically map virtual machines to physical hosts, in order to improve cloud infrastructure power-efficiency, with low impact on users’ required performance. Our decision making algorithms leverage proactive fault-tolerance techniques to deal with systems failures, allied with virtual machine technology to share nodes resources in an accurately and controlled manner. The results indicate that our algorithms perform better targeting power-efficiency and SLA fulfillment, in face of cloud infrastructure failures.

Interpretation of gravity data to delineate structural features connected to low-temperature geothermal resources at Northeastern Portugal

A great number of low-temperature geothermal fields occur in Northern-Portugal related to fractured rocks. The most important superficial manifestations of these hydrothermal systems appear in pull-apart tectonic basins and are strongly conditioned by the orientation of the main fault systems in the region. This work presents the interpretation of gravity gradient maps and 3D inversion model produced from a regional gravity survey. The horizontal gradients reveal a complex fault system. The obtained 3D model of density contrast puts into evidence the main fault zone in the region and the depth distribution of the granitic bodies. Their relationship with the hydrothermal systems supports the conceptual models elaborated from hydrochemical and isotopic water analyses. This work emphasizes the importance of the role of the gravity method and analysis to better understand the connection between hydrothermal systems and the fractured rock pattern and surrounding geology. (c) 2013 Elsevier B.V. All rights reserved.

Edible Azorean macroalgae as source of rich nutrients with impact on human health

Copyright © 2014 Elsevier Ltd. All rights reserved.

Expert opinion on best practice guidelines and competency framework for visual screening in children

PURPOSE: Screening programs to detect visual abnormalities in children vary among countries. The aim of this study is to describe experts' perception of best practice guidelines and competency framework for visual screening in children. METHODS: A qualitative focus group technique was applied during the Portuguese national orthoptic congress to obtain the perception of an expert panel of 5 orthoptists and 2 ophthalmologists with experience in visual screening for children (mean age 53.43 years, SD ± 9.40). The panel received in advance a script with the description of three tuning competencies dimensions (instrumental, systemic, and interpersonal) for visual screening. The session was recorded in video and audio. Qualitative data were analyzed using a categorical technique. RESULTS: According to experts' views, six tests (35.29%) have to be included in a visual screening: distance visual acuity test, cover test, bi-prism or 4/6(Δ) prism, fusion, ocular movements, and refraction. Screening should be performed according to the child age before and after 3 years of age (17.65%). The expert panel highlighted the influence of the professional experience in the application of a screening protocol (23.53%). They also showed concern about the false negatives control (23.53%). Instrumental competencies were the most cited (54.09%), followed by interpersonal (29.51%) and systemic (16.4%). CONCLUSIONS: Orthoptists should have professional experience before starting to apply a screening protocol. False negative results are a concern that has to be more thoroughly investigated. The proposed framework focuses on core competencies highlighted by the expert panel. Competencies programs could be important do develop better screening programs.

Práticas de inclusão com alunos com multideficiência no 1º Ciclo

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ciências da Educação, especialidade Educação Especial – Problemas Cognitivos e Multideficiência

Forest resources in Graciosa Island (Azores) : biomass availability for sustainable energetic use

Dissertação de Mestrado em Ambiente, Saúde e Segurança.

Contribuição para o conhecimento das propriedades pozolânicas da fracção fina resultante da produção de areia de origem granítica

O presente estudo diz respeito a um trabalho de pesquisa no âmbito de uma Tese de Mestrado incluída no segundo ciclo de estudos do curso de Engenharia Geotécnica e Geoambiente, realizado sobre as condições de desidroxilação para a obtenção de metacaulino com propriedades cimentíceas, a partir da fracção argilosa proveniente dos finos residuais da produção de areias de natureza granítica. O produto resultante da alteração e desintegração dos feldspatos constituintes dos granitos são ricos em caulinite. Na natureza e em particular no Norte de Portugal, existem significativos depósitos cauliníticos com características potenciadoras para a produção de metacaulino. O metacaulino utilizado neste estudo foi obtido de uma amostra de argila submetida a 750oC, por um período de tempo de 30 minutos, processo que permitiu a desidroxilação quase total da matéria-prima, transformando esta numa fase amorfa e irreversível, com propriedades pozolânicas. Os metacaulinos, também conhecidos por geopolímeros, são produtos de fácil produção utilizando uma matéria-prima abundante e proporcionam a obtenção de novos produtos que permitem a substituição parcial do cimento Portland normal na composição das pastas de betão, com vantagens significativas no comportamento mecânico e na resistência aos agentes atmosféricos. Neste estudo são apresentados os resultados dos ensaios de caracterização da matéria-prima, das condições de calcinação e do produto resultante da desidroxilação, nomeadamente a determinação da pozolanicidade e das características fundamentais para a aplicabilidade do produto. No âmbito da especialidade de Georrecursos, consideramos que este trabalho está perfeitamente adequado, já que, para além do estudo para o conhecimento das propriedades da matéria-prima, foi possível, através das alterações introduzidas com o tratamento térmico, obter um novo produto, cuja utilização terá importantes reflexos na sustentabilidade dos recursos naturais e sua utilização.

Reasserting curriculum design through virtual learning environments : The case of MAPE

II European Conference on Curriculum Studies. "Curriculum studies: Policies, perspectives and practices”. Porto, FPCEUP, October 16th - 17th.

Tags de opinião

As tags podem ser utilizadas com diferentes propósitos, entre os quais organizar os recursos para fins pessoais e partilhar informação potencialmente relevante com outros utilizadores. Este trabalho conjuga diversas áreas de conhecimento e explora a utilização de tags, debruçando-se numa categoria em particular que engloba as tags de opinião. Estas podem ser usadas para expressar sentimentos ou opiniões sobre os recursos. Foram realizadas análises sobre a utilização de tags na loja online Amazon. Recolhida uma amostra de dados, as tags foram classificadas e analisadas segundo diversos aspectos, inclusive quanto à sua polaridade. Além da atribuição de tags, na Amazon é possível atribuir pontuações (de 1 a 5) aos recursos. Neste trabalho compararam-se ainda as duas formas referidas de classificação de recursos, verificando a existência de alguma correspondência entre ambas, com significado estatístico. Adicionalmente, foi desenvolvido um classificador semi-automático que tem como objectivo classificar as tags atribuídas aos recursos para proporcionar uma classificação rápida e eficiente da polaridade das tags que considera também a informação disponível sobre os recursos durante o processo.

A importância do follow-up na auditoria interna em Portugal

Mestrado em Auditoria

Exporting "failure": why research from rich countries may not benefit the developing world

The '10/90 gap' was first highlighted by the Global Forum for Health Research. It refers to the finding that 90% of worldwide medical research expenditure is targeted at problems affecting only 10% of the world's population. Applying research results from the rich world to the problems of the poor may be a tempting, potentially easy and convenient solution for this gap. This paper had the objective of presenting arguments that such an approach runs the risk of exporting failure. Health interventions that are shown to be effective in the specific context of a Western industrialized setting will not necessarily work in the developing world.

Reply to letter to the Editor: Expert opinion on best practice guidelines and competency framework for visual screening in children

The aim of this study was to describe experts’ perception of best-practice guidelines and competency framework for visual screening in children. This study uses qualitative data and shows individual/ group conceptualization. The use of evidence from qualitative studies has traditionally been a fundamental source of knowledge in the clinical and social sciences.

Linking entrepreneural orientation to export performance: the role of intangible resources and dynamic capabilities

Understanding the determinants of international performance, and in particular, export performance is key for the success of international companies. Research in this area focuses mainly on how resources and capabilities allow companies to gain competitive advantage and superior performance in external markets. Building on the Resource-Based View (RBV) and the Dynamic Capabilities Approach (DCA), this study aims at analysing the effect of intangible resources and capabilities on export performance. Specifically, this study focuses on the proposition that entrepreneurial orientation potentiates the attraction of intangible resources, namely relational and informational resources. Moreover, we propose that these resources impact export performance both directly and indirectly through dynamic capabilities.