The state of environmental performance evaluation in the public sector: the case of the Portuguese defence sector

Journal of Cleaner Production, nº 17, p. 36-52

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

Pervasive business intelligence platform to improve the quality of decision process in primary and secondary education – A Portuguese case study

Business Intelligence (BI) can be seen as a method that gathers information and data from information systems in order to help companies to be more accurate in their decision-making process. Traditionally BI systems were associated with the use of Data Warehouses (DW). The prime purpose of DW is to serve as a repository that stores all the relevant information required for making the correct decision. The necessity to integrate streaming data became crucial with the need to improve the efficiency and effectiveness of the decision process. In primary and secondary education, there is a lack of BI solutions. Due to the schools reality the main purpose of this study is to provide a Pervasive BI solution able to monitoring the schools and student data anywhere and anytime in real-time as well as disseminating the information through ubiquitous devices. The first task consisted in gathering data regarding the different choices made by the student since his enrolment in a certain school year until the end of it. Thereafter a dimensional model was developed in order to be possible building a BI platform. This paper presents the dimensional model, a set of pre-defined indicators, the Pervasive Business Intelligence characteristics and the prototype designed. The main contribution of this study was to offer to the schools a tool that could help them to make accurate decisions in real-time. Data dissemination was achieved through a localized application that can be accessed anywhere and anytime.

Approche interdisciplinaire de la decision de don d'organes: l'experience lausannoise [An interdisciplinary approach of the organ donation decision: the Lausanne's experience].

Since 2007, the Interdisciplinary Ethics Platform (Ethos) of the University of Lausanne is leading an interdisciplinary reflection on the organ donation decision. On this basis, the project "Organ transplantation between the rhetoric of the gift and a biomedical view of the body" studies the logics at stake in the organ donation decision-making process. Results highlight many tensions within practices and public discourses in the field of organ donation and transplantation and suggest lines of inquiry for future adjustments.

A model for organ donation in switzerland, the latin organ donation programme (lodp); an ongoing successful regional initiative

Background: The 1st Swiss federal Transplant Law was finally enforced in July 2007 with the obligation to promote quality and efficiency in transplant procedures. The LODP was created to develop organ and tissue donation in the Latin area of Switzerland covering seventeen hospitals (29% of the population).Methods: Each of the partner hospitals designated at least one Local Donor Coordinator (LDC), member of the Intensive Care team, trained in the organ donation (OD) process. The principal tasks of the LDC's are the introduction of OD procedures, organisation of educational sessions for hospital staff and execution of the Donor Action programme. The LODP has been operational since July 2009, when training of the LDC's was completed, the web-site and hotline activated and the attendance of Transplant Procurement Coordinators (TPC) during the OD process organised.Results: National and regional guidelines are accessible on the LODP website. The Hospital Attitude Survey obtained a 57% return rate. Many of the staff requested training and sessions are now running in the partner hospitals. The Medical Record Revue revealed an increase in the conversion rate from 3.5% to 4.5%. During the 5 years before creation of LODP the average annual number of utilised donors was 31, an increase of 70%, has since been observed.Conclusion: This clear progression in utilised donors in the past two years can be attributed to the fact that partner hospitals benefit from the various support given (hotline, website and from TPC's). Despite the increase in OD within the LODP the Swiss donation rates remain low, on average 11.9 donors per million population. This successful model should be applied throughout Switzerland, but the crucial point is to obtain financial support.

Le rôle des associations de patients face au don d'organes en Suisse romande [Organ donation and the role of patients' associations in Western Switzerland].

In the context of lay mobilization in health-related areas, this article addresses the role and activities of patients' associations in connection with organ donation, on the basis of interviews carried out with thirty members of transplant patients' associations in the French-speaking part of Switzerland. First, we describe the three main categories of activities conducted by these associations. While self-help and public awareness activities are predominant, policy-oriented actions are marginal. Then, we examine the factors likely to explain why these associations have a limited capacity to be active, especially in the public sphere. Such a lack of social visibility is all the more important in the current political context, characterized by the implementation of a national action plan designed to improve organ donation.

Role of patient factors, preferences, and distrust in health care and access to liver transplantation and organ donation.

Despite major improvements in access to liver transplantation (LT), disparities remain. Little is known about how distrust in medical care, patient preferences, and the origins shaping those preferences contribute to differences surrounding access. We performed a single-center, cross-sectional survey of adults with end-stage liver disease and compared responses between LT listed and nonlisted patients as well as by race. Questionnaires were administered to 109 patients (72 nonlisted; 37 listed) to assess demographics, health care system distrust (HCSD), religiosity, and factors influencing LT and organ donation (OD). We found that neither HCSD nor religiosity explained differences in access to LT in our population. Listed patients attained higher education levels and were more likely to be insured privately. This was also the case for white versus black patients. All patients reported wanting LT if recommended. However, nonlisted patients were significantly less likely to have discussed LT with their physician or to be referred to a transplant center. They were also much less likely to understand the process of LT. Fewer blacks were referred (44.4% versus 69.7%; P = 0.03) or went to the transplant center if referred (44.4% versus 71.1%; P = 0.02). Fewer black patients felt that minorities had as equal access to LT as whites (29.6% versus 57.3%; P < 0.001). For OD, there were more significant differences in preferences by race than listing status. More whites indicated OD status on their driver's license, and more blacks were likely to become an organ donor if approached by someone of the same cultural or ethnic background (P < 0.01). In conclusion, our analysis demonstrates persistent barriers to LT and OD. With improved patient and provider education and communication, many of these disparities could be successfully overcome. Liver Transplantation 22 895-905 2016 AASLD.

Hope for a peaceful death and organ donation

The therapeutic, social and economic benefits of organ transplantation are irrefutable; however, organ shortages contribute to avoidable patient deaths and burgeoning health care costs. This problem can be addressed by increasing family consent to deceased organ donation. There are high levels of community support for deceased organ donation in Australia and yet, almost fifty percent of families decline the request to donate. Increasing the number of families who agree to deceased organ donation is key to increasing national and international transplantation rates. The purpose of this study was to identify the major factors that influence a family to agree or decline deceased organ donation during the process of decision-making. The aims of the study were three-fold: to identify the key stages and the major influencers’ in the decisionmaking process; to determine if hope, deep hope and trust played a role in the decision, and to explore families’ perceptions of their decision-making experience. The study utilised an exploratory case study approach to examine the family decisionmaking process of deceased organ donation. Following ethics approval, recruitment was conducted utilising a qualitative purposive snowball strategy across Australia. A pilot study was conducted to test the study procedures prior to the main data collection, and 22 participants who had been involved in a deceased organ donation decision from nine families were interviewed. In five deaths family members had agreed to organ donation, and in four deaths the family declined. A theoretical framework based on the Precaution Adoption Process Model of decision-making was applied to propose trust, hope and deep hope underpin family organ donation decisions. Thematic analysis was conducted and three key themes comprising ‘In the fog drowning’, ‘Harvesting humanity’, and ‘It’s all up to Mum’ were revealed. The study found women, and in particular mothers, played a significant role in organ donation decision-making, and that the decision-making is bounded by family needs of trust, hope and deep hope across the continuum of time. It also found families who had their trust, hope and deep hope needs met expressed satisfaction about their decision-making experience and agreed to organ donation. Some families perceived that organ donation was a sacrifice that was too great to endure, even if the deceased had previously indicated intent to donate, and therefore declined donation. This study found that families’ ideas of a peaceful death and organ donation are not mutually exclusive. It concludes that when decision-makers’ trust and deep hope needs are met they are more willing to agree to donation. This study recommends that the idea of a ‘right’ to a peaceful death should be aligned with deceased organ donation practices and normalised.

The two opposing impacts of heritage making on local communities : residents’ perceptions: a Portuguese case

This article examines the impact associated with the making of heritage and tourism at a destination. Special attention is paid to the residents’ perceptions of the impact. The examination is focused on the rural village of Sortelha, in Portugal, where, in recent decades, a state-led programme was implemented in order to renovate the historic buildings and built fabric and to generate benefits for the local community. Based on ethnographic materials collected in 2003, 2009 and 2013, the study demonstrates that the making of heritage may give rise to two opposing impacts simultaneously – increased social cohesion and place pride, on the one hand, and envy and competition (and, hence, social atomisation), on the other hand – and that residents are entirely cognisant of the tension between the two. The study has the potential to contribute to both the theoretical and the applied literature on heritage making.