Models and tools for value systems analysis in collaborative environments

Dissertation to obtain the degree of Doctor in Electrical and Computer Engineering, specialization of Collaborative Networks

Rhinoscleroma: eight Peruvian cases

Rhinoscleroma is a rare infection in developed countries; although, it is reported with some frequency in poorer regions such as Central Africa, Central and South America, Eastern and Central Europe, Middle East, India and Indonesia. Nowadays, rhinoscleroma may be erroneously diagnosed as mucocutaneos leishmaniasis, leprosy, paracoccidioidomycosis, rhinosporidiasis, late syphilis, neoplasic diseases or other upper airway diseases. From 1996 to 2003, we diagnosed rhinoscleroma in eight patients attended in the Dermatologic and Transmitted Diseases service of "Cayetano Heredia" National Hospital, in Lima, Peru. The patients presented airway structural alterations producing nasopharyngeal, oropharyngeal and, in one patient, laryngeal stenosis. Biopsy samples revealed large vacuolated macrophages (Mikulicz cells) in all patients. Ciprofloxacin 500 mg bid for four to 12 weeks was used in seven patients and oxytetracycline 500 mg qid for six weeks in one patient. After follow-up for six to 12 months the patients did not show active infection or relapse, however, all of them presented some degree of upper airway stenosis. These cases are reported because of the difficulty diagnosing the disease and the success of antibiotic treatment.

HTLV- I infection is not associated with a higher risk of death in peruvian HIV-infected patients

Limited and contradictory information exists regarding the prognosis of HIV/HTLV-I co-infection. Our goal was to estimate the effect of HTLV-I infection on mortality in HIV-infected patients at a HIV reference center in Peru. We studied a retrospective cohort of HIV-infected patients, who were exposed or unexposed to HTLV-I. Exposed patients were Western Blot (WB) positive for both retroviruses. Unexposed patients were WB positive for HIV, and had least one negative EIA for HTLV-I. These were selected among patients who entered our Program immediately before and after each exposed patient, between January 1990 and June 2004. Survival time was considered between the diagnosis of exposure to HTLV-I and death or censoring. Confounding variables were age, gender, baseline HIV clinical stage, baseline CD4+ T cell count, and antiretroviral therapy. We studied 50 exposed, and 100 unexposed patients. Exposed patients had a shorter survival compared to unexposed patients [median survival: 47 months (95% CI: 17-77) vs. 85 months (95% CI: 70-100), unadjusted p = 0.06]. Exposed patients had a higher rate of mortality compared to unexposed patients (HIV/HTLV-I (24/50 [48%]) vs. HIV only (37/100 [37%]), univariable p = 0.2]. HTLV-I exposure was not associated to a higher risk of death in the adjusted analysis: HR: 1.2 (0.4-3.5). AIDS clinical stage and lack of antiretroviral therapy were associated to a higher risk of dying. In conclusions, HTLV-I infection was not associated with a higher risk of death in Peruvian HIV-infected patients. Advanced HIV infection and lack of antiretroviral therapy may explain the excess of mortality in this population.

Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon

We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.

Epidemiological investigation of an acute case of Chagas disease in an area of active transmission in Peruvian Amazon region

The study objective was to investigate an acute case of Chagas disease in the San Pedro de Shishita community, Pebas District, in the Peruvian Amazon basin, a non-endemic area. Both parents of the index case (acute case) were thoroughly interviewed, a seroepidemiological survey was carried out in the community, parasitological exams were carried out only in relatives of the index case, and triatomine bugs were searched for inside houses, peridomiciliary, and in wild environments. Seroprevalence for IgG anti-T. cruzi antibodies was 1/104 (0.96%), using an ELISA test and an indirect immunofluorescence assay. Panstrongylus geniculatus and Rhodnius pictipes adults were found. The index case is autochthonous from San Pedro de Shishita, but the source of transmission is unknown.

Spatio-temporal analyses of the relationship between armed conflict and climate change in the eastern Africa

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

Different in Vivo Reactivity Profile in Health Care Workers and Patients with Spina Bifida to Internal and External Latex Glove Surface-Derived Allergen Extracts

BACKGROUND: Allergy to natural rubber latex is a well-recognized health problem, especially among health care workers and patients with spina bifida. Despite latex sensitization being acquired in health institutions in both health care workers and patients with spina bifida, differences in allergen sensitization profiles have been described between these two risk groups. OBJECTIVE: To investigate the in vivo reactivity of health care workers and patients with spina bifida to extracts of internal and external surfaces of latex gloves and also to specific extracts enriched in major allergens for these risk groups. METHODS: Gloves from different manufacturers were used for protein extraction, and salt precipitation and hydrophobic interaction chromatography (HIC) were applied to obtain the enriched latex extracts. The major latex allergens were quantified by an enzyme immunoassay. The extracts obtained were tested in 14 volunteers using skin prick tests (SPT). RESULTS: Latex glove extracts enriched in the hydrophobic allergens that are most often seen in patients with spina bifida were obtained by selective precipitation, whereas HIC produced extracts enriched in the hydrophilic allergens commonly found in health care workers. The health care workers had positive SPTs to glove extracts from internal surfaces and to the hydrophilic allergen-enriched extracts. By contrast, patients with spina bifida had larger skin reactions both to external glove extracts and to the extracts enriched with the hydrophobic major allergens for this risk group. Despite the protein concentration of these extracts being less than half the concentration of the commercial extract, the weal-and-flare reactions were of similar magnitude. CONCLUSION: Using novel latex extracts, our study showed a different in vivo reactivity pattern in health care workers and in patients with spina bifida to extracts of the internal and external surfaces of gloves, which suggests that sensitization may occur by different routes of exposure, and that this influences the allergen reactivity profiles of these risk groups

Differential exploitation of cashew - a low conflict crop - by sympatric humans and chimpanzees

Modification of natural areas by human activities mostly has a negative impact on wildlife by increasing the geographical and ecological overlap between people and animals. This can result in escalating levels of competition and conflict between humans and wildlife, for example over crops. However, data on specific crops and crop parts that are unattractive to wildlife yet important for human livelihoods are surprisingly scarce, especially considering their potential application to reducing crop damage by wildlife. Here we examine the co-utilization of a nationally important and spatially abundant cash crop, cashew Anacardium occidentalis, by people and chimpanzees Pan troglodytes verus inhabiting a forested–agricultural matrix in Cantanhez National Park in Guinea-Bissau. In this Park people predominantly harvest the marketable cashew nut and discard the unprofitable fruit whereas chimpanzees only consume the fruit. Local farmers generally perceive a benefit of raiding by chimpanzees as they reportedly pile the nuts, making harvesting easier. By ensuring that conflict levels over crops, especially those with high economic importance, remain low, the costs of living in proximity to wildlife can potentially be reduced. Despite high levels of deforestation associated with cashew farming, these findings point to the importance of cashew as a low-conflict crop in this area.

Internal consultants as positive change agents

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

An internal analysis of Amorim Turismo’s operations regarding food and beverage with a focus on operational efficiency and quality of service

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

Corporate social responsibility: How internal and external CSR perceptions influence employee outcomes

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

The Course of Conflict. A Study in the Thought of Paul Ricoeur

Esta tese leva a cabo uma clarificação conceptual e uma reconstrução histórica da noção de conflito, tal como ela aparece na filosofia. Num primeiro momento, analisa-se o fenómeno do conflito na fonte Grega (em Homero, Heraclito, Platão, nas tragédias gregas e nas formas de interação agonística no espaço público) e na filosofia moderna (principalmente em Kant, Hegel e Marx). Num segundo momento, estabelece-se, nos seus traços gerais, uma cartografia da recuperação desta noção na contemporaneidade através da discussão das contribuições provenientes da teoria crítica (Habermas, Honneth, Hunyadi), da sociologia pragmática (Boltanski, Thévenot) e da filosofia política anglo-saxónica (Rawls, Walzer, Taylor), entre outras. Estas partes iniciais da tese desembocam numa análise aprofundada da obra do filósofo francês Paul Ricoeur e das muitas instanciações do conflito nessa obra, naquilo a que chamo o “percurso do conflito” no pensamento de Ricoeur. Neste “percurso do conflito” o objetivo é duplo: por um lado, provar que o conflito é a pedra de toque não só da filosofia de Ricoeur, mas também de um grande conjunto de outros autores; por outro lado, que é necessário reavaliar o papel desta noção no debate contemporâneo e que nesse contexto a filosofia de Ricoeur e as suas análises finas e plurais podem ser de uma grande utilidade. Assim sendo, este “percurso do conflito” divide-se em três partes, as quais lidam com diferentes tipos de conflito: conflitos “existenciais”, “hermenêuticos” e “práticos”. Ao longo destas partes, várias disciplinas são chamadas à colação, como a hermenêutica, a psicanálise e a filosofia prática (ética, filosofia política e filosofia social), numa tentativa de esclarecer os diferentes fenómenos em causa. Em última instância, chega-se à conclusão que o conflito é inevitável em filosofia, tal como na vida, mas que este não é (pelo menos não em todas as suas formas e instanciações) um fenómeno estritamente negativo; por vezes, os conflitos podem ser criativos e positivos. Porém, aceitar este facto implica igualmente consentir que o reconhecimento dos conflitos está intrinsecamente ligado à busca de soluções para eles, formas de lidar com eles e torná-los criativos e positivos. Para que possa ser compreendido, em traços gerais, como é que estes procedimentos funcionam, esta tese elabora uma tipologia de diferentes tipos de conflito e respetivas formas de lidar com eles, mediando-os, conciliando-os ou, nalguns casos, apenas aceitando a sua existência e mesmo multiplicando-os. A busca da melhor solução tem sempre de ser operada caso a caso. Nas partes finais da tese, e partindo das análises de Ricoeur e dos outro autores apresentadas ao longo da mesma, delineia-se o projeto de uma filosofia social hermenêutica e argumenta-se que aquilo de que precisamos hoje em dia é de uma nova crítica da razão, uma “crítica da razão miserável” que possa repensar o mundo social em novos termos e que, ao fazê-lo, possa evitar os perigos do reducionismo nas suas múltiplas formas.

Cryptococcus gattii meningoencephalitis in an HIV-negative patient from the Peruvian Andes

We report a case of an immunocompetent Peruvian patient from the Andes with a one-month history of meningoencephalitis. Cryptococcus gattii was identified from a cerebrospinal fluid culture through assimilation of D-proline and D-tryptophan as the single nitrogen source. Initially, the patient received intravenous antifungal therapy with amphotericin B. The patient was discharged 29 days after hospitalization and continued with oral fluconazole treatment for ten weeks. During this period, the patient showed clinical improvement with slight right-side residual weakness. Through this case report, we confirm the existence of this microorganism as an infectious agent in Peru.

New focus of active transmission of Chagas disease in indigenous populations in the Peruvian Amazon basin

Introduction Several cases of acute Chagas disease (ACD) have been reported in the Peruvian Amazon basin. Methods The objective was to describe and investigate 6 ACD cases in children from indigenous Amazon communities in the province of Datem del Marañón in Loreto department (2006-2010). Results The mean age was 3.6 years. All patients had fever, 4/6 hepatomegaly, 2/6 splenomegaly, and 5/6 had trypomastigotes of Trypanosoma cruzi on thick smears. The fatality rate was 33.3%. Rhodnius pictipes and Rhodnius robustus adults were found inside the homes and in the peri-domiciles. Conclusions All cases reported were isolated cases. We report a new focus of ACD in indigenous populations.

Escalation of conflict in FMCG industry: A negotiation case

This work project develops a case-study to be used in Negotiation courses, both in Masters programs and in executive education workshops. The case-study is based on a real-life negotiating situation in Belgium between Unilever, the second largest Fast Moving Consumer Goods (FMCG) company in the world, and Delhaize, one of the most important Belgium’s retailers, with a significant international presence. We also present an analysis of the negotiation based on relevant literature. First, a brief literature review is presented about how to deal with multiple-issue negotiations and how to deal with processes of escalation of conflict. These concepts are then applied to the analysis of the case-study.