Model morphisms (MoMo) to enable language independent information models and interoperable business networks

MSc. Dissertation presented at Faculdade de Ciências e Tecnologia of Universidade Nova de Lisboa to obtain the Master degree in Electrical and Computer Engineering

New findings on the dynamics of HIV and TB coinfection models

In this paper we study a model for HIV and TB coinfection. We consider the integer order and the fractional order versions of the model. Let α∈[0.78,1.0] be the order of the fractional derivative, then the integer order model is obtained for α=1.0. The model includes vertical transmission for HIV and treatment for both diseases. We compute the reproduction number of the integer order model and HIV and TB submodels, and the stability of the disease free equilibrium. We sketch the bifurcation diagrams of the integer order model, for variation of the average number of sexual partners per person and per unit time, and the tuberculosis transmission rate. We analyze numerical results of the fractional order model for different values of α, including α=1. The results show distinct types of transients, for variation of α. Moreover, we speculate, from observation of the numerical results, that the order of the fractional derivative may behave as a bifurcation parameter for the model. We conclude that the dynamics of the integer and the fractional order versions of the model are very rich and that together these versions may provide a better understanding of the dynamics of HIV and TB coinfection.

Layerwise mixed models for analysis of multilayered piezoelectric composite plates using least-squares formulation

This work provides an assessment of layerwise mixed models using least-squares formulation for the coupled electromechanical static analysis of multilayered plates. In agreement with three-dimensional (3D) exact solutions, due to compatibility and equilibrium conditions at the layers interfaces, certain mechanical and electrical variables must fulfill interlaminar C-0 continuity, namely: displacements, in-plane strains, transverse stresses, electric potential, in-plane electric field components and transverse electric displacement (if no potential is imposed between layers). Hence, two layerwise mixed least-squares models are here investigated, with two different sets of chosen independent variables: Model A, developed earlier, fulfills a priori the interiaminar C-0 continuity of all those aforementioned variables, taken as independent variables; Model B, here newly developed, rather reduces the number of independent variables, but also fulfills a priori the interlaminar C-0 continuity of displacements, transverse stresses, electric potential and transverse electric displacement, taken as independent variables. The predictive capabilities of both models are assessed by comparison with 3D exact solutions, considering multilayered piezoelectric composite plates of different aspect ratios, under an applied transverse load or surface potential. It is shown that both models are able to predict an accurate quasi-3D description of the static electromechanical analysis of multilayered plates for all aspect ratios.

Is there space for senior civil servants hybrid management models across political- administrative systems?

Comunicação apresentada na 17.ª conferência anual da NISPACee, realizada de 14 a 16 de Maio de 2009.

How are top officials hybrid management models present across political-administrative systems?

Comunicação apresentada na 4th Annual ICPA - International Conference on Public Administration "Building bridges to the future: leadership and collaboration in public administration", na Universidade de Minnesota nos Estados Unidos, de 24 a 26 de setembro de 2008

Simulation of the velocity field in compound channel flow using different closure models

1st European IAHR Congress,6-4 May, Edinburg, Scotland

Prognostic modelling of breast cancer patients: a benchmark of predictive models with external validation

Dissertação apresentada para obtenção do Grau de Doutor em Engenharia Electrotécnica e de Computadores – Sistemas Digitais e Percepcionais pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Estimation of 3D shapes using active surface models

This paper addresses the estimation of surfaces from a set of 3D points using the unified framework described in [1]. This framework proposes the use of competitive learning for curve estimation, i.e., a set of points is defined on a deformable curve and they all compete to represent the available data. This paper extends the use of the unified framework to surface estimation. It o shown that competitive learning performes better than snakes, improving the model performance in the presence of concavities and allowing to desciminate close surfaces. The proposed model is evaluated in this paper using syntheticdata and medical images (MRI and ultrasound images).

The selection of senior civil servants in the context of the different public administration models: an issue of accountability

Comunicação apresentada no Congresso do IIAS-IISA no âmbito do IX Grupo de Estudo: Serviço público e política, realizado em Ifrane, Marrocos de 13 a 17 de junho de 2014

Algebraic structure for interaction on mixed models

Binary operations on commutative Jordan algebras, CJA, can be used to study interactions between sets of factors belonging to a pair of models in which one nests the other. It should be noted that from two CJA we can, through these binary operations, build CJA. So when we nest the treatments from one model in each treatment of another model, we can study the interactions between sets of factors of the first and the second models.

From weak Allee effect to no Allee effect in Richards’ growth models

Population dynamics have been attracting interest since many years. Among the considered models, the Richards’ equations remain one of the most popular to describe biological growth processes. On the other hand, Allee effect is currently a major focus of ecological research, which occurs when positive density dependence dominates at low densities. In this chapter, we propose the dynamical study of classes of functions based on Richards’ models describing the existence or not of Allee effect. We investigate bifurcation structures in generalized Richards’ functions and we look for the conditions in the (β, r) parameter plane for the existence of a weak Allee effect region. We show that the existence of this region is related with the existence of a dovetail structure. When the Allee limit varies, the weak Allee effect region disappears when the dovetail structure also disappears. Consequently, we deduce the transition from the weak Allee effect to no Allee effect to this family of functions. To support our analysis, we present fold and flip bifurcation curves and numerical simulations of several bifurcation diagrams.

Symbolic dynamics and big bang bifurcation in Weibull-Gompertz-Fréchet's growth models

In this paper, motivated by the interest and relevance of the study of tumor growth models, a central point of our investigation is the study of the chaotic dynamics and the bifurcation structure of Weibull-Gompertz-Fréchet's functions: a class of continuousdefined one-dimensional maps. Using symbolic dynamics techniques and iteration theory, we established that depending on the properties of this class of functions in a neighborhood of a bifurcation point PBB, in a two-dimensional parameter space, there exists an order regarding how the infinite number of periodic orbits are born: the Sharkovsky ordering. Consequently, the corresponding symbolic sequences follow the usual unimodal kneading sequences in the topological ordered tree. We verified that under some sufficient conditions, Weibull-Gompertz-Fréchet's functions have a particular bifurcation structure: a big bang bifurcation point PBB. This fractal bifurcations structure is of the so-called "box-within-a-box" type, associated to a boxe ω1, where an infinite number of bifurcation curves issues from. This analysis is done making use of fold and flip bifurcation curves and symbolic dynamics techniques. The present paper is an original contribution in the framework of the big bang bifurcation analysis for continuous maps.

Explosion birth and extinction: Double big bang bifurcations and Allee effect in Tsoularis-Wallace's growth models

This work concerns dynamics and bifurcations properties of a new class of continuous-defined one-dimensional maps: Tsoularis-Wallace's functions. This family of functions naturally incorporates a major focus of ecological research: the Allee effect. We provide a necessary condition for the occurrence of this phenomenon of extinction. To establish this result we introduce the notions of Allee's functions, Allee's effect region and Allee's bifurcation curve. Another central point of our investigation is the study of bifurcation structures for this class of functions, in a three-dimensional parameter space. We verified that under some sufficient conditions, Tsoularis-Wallace's functions have particular bifurcation structures: the big bang and the double big bang bifurcations of the so-called "box-within-a-box" type. The double big bang bifurcations are related to the existence of flip codimension-2 points. Moreover, it is verified that these bifurcation cascades converge to different big bang bifurcation curves, where for the corresponding parameter values are associated distinct kinds of boxes. This work contributes to clarify the big bang bifurcation analysis for continuous maps and understand their relationship with explosion birth and extinction phenomena.

Gestão de bloco operatório : modelos de gestão e monitorização

RESUMO - A consciência de uma necessidade clara em rentabilizar a capacidade instalada e os meios tecnológicos e humanos disponíveis no Bloco Operatório e face ao imperativo de um cabal desempenho e de uma adequada efectividade nestes serviços levou-nos à realização deste estudo. Objectivos: O trabalho de projecto centrou-se em quatro objectivos concretos: Elaboração de uma grelha de observação de Modelos de Gestão de Bloco Operatório; Observação de seis Modelos de Gestão de Blocos Operatórios em experiências nacionais e in-loco, de acordo com a grelha de observação; Avaliação da qualidade gestionária na amostra seleccionada à luz dos modelos existentes; Criação de uma grelha de indicadores para a monitorização e avaliação do Bloco Operatório. Metodologia: Na elaboração da grelha de observação dos Blocos Operatórios recorremos a um grupo de peritos, à bibliografia disponível e à informação recolhida em entrevistas. Aplicámos a grelha de observação aos seis Blocos Operatórios e analisámos as informações referentes a cada modelo com a finalidade de encontrar os pontos-chave que mais se destacavam em cada um deles. Para a elaboração da grelha de indicadores de monitorização do Bloco Operatório realizámos uma reunião recorrendo à técnica de grupo nominal para encontrar o nível de consenso entre os peritos. Resultados: Criámos uma grelha de observação de Modelos de Gestão de Bloco Operatório que permite comparar as características de gestão. Esta grelha foi aplicada a seis Blocos Operatórios o que permitiu destacar como elementos principais e de diferenciação: o sistema de incentivos implementado; o sistema informático, de comunicação entre os serviços e de débito directo dos gastos; a existência de uma equipa de gestão de Bloco Operatório e de Gestão de Risco; a importância de um planeamento cirúrgico semanal e da existência de um regulamento do Bloco Operatório. Desenhámos um painel de indicadores para uma monitorização do Bloco Operatório, de onde destacamos: tempo médio de paragem por razões técnicas, tempo médio de paragem por razões operacionais, tempo médio por equipa e tempo médio por procedimento. Considerações finais: Os Blocos Operatórios devem ponderar a existência das componentes mais importantes dos Modelos, bem como recolher exaustivamente indicadores de monitorização. A investigação futura deverá debruçar-se sobre a relação entre os indicadores de monitorização e os Modelos de Gestão, recorrendo à técnicas de benchmarking. -------------------ABSTRACT - This study was driven by the need to optimise available capacity, technology and human resources in the Operating Room and to address the corresponding goals of adequate performance and effectiveness. Objectives: This project focuses on four specific objectives: development of an observation grid of operating room management models; in-loco observation and documentation of six national operating room, according to the grid; assess the quality of management in the selected sample relative to existing management models; create a set of indicators for monitoring and evaluating operating rooms. Methodology: The design of the observation grid was based on experts’ consultation, a literature survey and information gathered in various interviews. The observation grid was applied to six operating rooms and the information for each management model was analysed in order to find its key characteristics. We used the Nominal Group Technique in order to develop a set of indicators for monitoring and evaluating operating rooms. Results: An observation grid was created for operating rooms management models, which allowed comparing management characteristics. This grid was applied to six operating rooms allowing disentangle its main features and differentiating characteristics: implementation of incentive systems; IT systems including information flow between services; inventory and expense management; existence of a management team and effective risk management; importance of weekly planning and regulations. We designed a set control indicators, whose major characteristics are the following: the average down time due to technical reasons, the average down time due to operational reasons, the average time per team and the average time per procedure. Final Conclusions: Operating rooms should consider the most relevant characteristics of management models and collect exhaustive information on control indicators. Future research should be devoted to assessing the operating room performance according to management models, using control indicators and benchmarking techniques.

Depressão : detecção, diagnóstico e tratamento. Estudo de prevalência e despite das perturbações depressivas e tratamento

RESUMO:A depressão clínica é uma patologia do humor, dimensional e de natureza crónica, evoluindo por episódios heterogéneos remitentes e recorrentes, de gravidade variável, correspondendo a categorias nosológicas porventura artificiais mas clinicamente úteis, de elevada prevalência e responsável por morbilidade importante e custos sociais crescentes, calculando-se que em 2020 os episódios de depressão major constituirão, em todo o mundo, a segunda causa de anos de vida com saúde perdidos. Como desejável, na maioria dos países os cuidados de saúde primários são a porta de entrada para o acesso à recepção de cuidados de saúde. Cerca de 50% de todas as pessoas sofrendo de depressão acedem aos cuidados de saúde primários mas apenas uma pequena proporção é correctamente diagnosticada e tratada pelos médicos prestadores de cuidados primários apesar dos tratamentos disponíveis serem muito efectivos e de fácil aplicabilidade. A existência de dificuldades e barreiras a vários níveis – doença, doentes, médicos, organizações de saúde, cultura e sociedade – contribuem para esta generalizada ineficiência de que resulta uma manutenção do peso da depressão que não tem sido possível reduzir através das estratégias tradicionais de organização de serviços. A equipa comunitária de saúde mental e a psiquiatria de ligação são duas estratégias de intervenção com desenvolvimento conceptual e organizacional respectivamente na Psiquiatria Social e na Psicossomática. A primeira tem demonstrado sucesso na abordagem clínica das doenças mentais graves na comunidade e a segunda na abordagem das patologias não psicóticas no hospital geral. Todavia, a efectividade destas estratégias não se tem revelado transferível para o tratamento das perturbações depressivas e outras patologias mentais comuns nos cuidados de saúde primários. Novos modelos de ligação e de trabalho em equipa multidisciplinar têm sido demonstrados como mais eficazes e custo-efectivos na redução do peso da depressão, ao nível da prestação dos cuidados de saúde primários, quando são atinentes com os seguintes princípios estratégicos e organizacionais: detecção sistemática e abordagem da depressão segundo o modelo médico, gestão integrada de doença crónica incluindo a continuidade de cuidados mediante colaboração e partilha de responsabilidades intersectorial, e a aposta na melhoria contínua da qualidade. Em Portugal, não existem dados fiáveis sobre a frequência da depressão, seu reconhecimento e a adequação do tratamento ao nível dos cuidados de saúde primários nem se encontra validada uma metodologia de diagnóstico simples e fiável passível de implementação generalizada. Foi realizado um estudo descritivo transversal com os objectivos de estabelecer a prevalência pontual de depressão entre os utentes dos cuidados de saúde primários e as taxas de reconhecimento e tratamento pelos médicos de família e testar metodologias de despiste, com base num questionário de preenchimento rápido – o WHO-5 – associado a uma breve entrevista estruturada – o IED. Foram seleccionados aleatoriamente 31 médicos de família e avaliados 544 utentes consecutivos, dos 16 aos 90 anos, em quatro regiões de saúde e oito centros de saúde dotados com 219 clínicos gerais. Os doentes foram entrevistados por psiquiatras, utilizando um método padronizado, o SCAN, para diagnóstico de perturbação depressiva segundo os critérios da 10ª edição da Classificação Internacional de Doenças. Apurou-se que 24.8% dos utentes apresentava depressão. No melhor dos cenários, menos de metade destes doentes, 43%, foi correctamente identificada como deprimida pelo seu médico de família e menos de 13% dos doentes com depressão estavam bem medicados com antidepressivo em dose adequada. A aplicação seriada dos dois instrumentos não revelou dificuldades tendo permitido a identificação de pelo menos 8 em cada 10 doentes deprimidos e a exclusão de 9 em cada 10 doentes não deprimidos. Confirma-se a elevada prevalência da patologia depressiva ao nível dos cuidados primários em Portugal e a necessidade de melhorar a capacidade diagnóstica e terapêutica dos médicos de família. A intervenção de despiste, que foi validada, parece adequada para ser aplicada de modo sistemático em Centros de Saúde que disponham de recursos técnicos e organizacionais para o tratamento efectivo dos doentes com depressão. A obtenção da linha de base de indicadores de prevalência, reconhecimento e tratamento das perturbações depressivas nos cuidados de saúde primários, bem como a validação de instrumentos de uso clínico, viabiliza a capacitação do sistema para a produção de uma campanha nacional de educação de grande amplitude como a proposta no Plano Nacional de Saúde 2004-2010.------- ABSTRACT: Clinical depression is a dimensional and chronic affective disorder, evolving through remitting and recurring heterogeneous episodes with variable severity corresponding to clinically useful artificial diagnostic categories, highly prevalent and producing vast morbidity and growing social costs, being estimated that in 2020 unipolar major depression will be the second cause of healthy life years lost all over the world. In most countries, primary care are the entry point for access to health care. About 50% of all individuals suffering from depression within the community reach primary health care but a smaller proportion is correctly diagnosed and treated by primary care physicians though available treatments are effective and easily manageable. Barriers at various levels – pertaining to the illness itself, to patients, doctors, health care organizations, culture and society – contribute to the inefficiency of depression management and pervasiveness of depression burden, which has not been possible to reduce through classical service strategies. Community mental health teams and consultation-liaison psychiatry, two conceptual and organizational intervention strategies originating respectively within social psychiatry and psychosomatics, have succeeded in treating severe mental illness in community and managing non-psychotic disorders in the general hospital. However, these strategies effectiveness has not been replicated and transferable for the primary health care setting treatment of depressive disorders and other common mental pathology. New modified liaison and multidisciplinary team work models have been shown as more efficacious and cost-effective reducing depression burden at the primary care level namely when in agreement with principles such as: systematic detection of depression and approach accordingly to the medical model, chronic llness comprehensive management including continuity of care through collaboration and shared responsibilities between primary and specialized care, and continuous quality improvement. There are no well-founded data available in Portugal for depression prevalence, recognition and treatment adequacy in the primary care setting neither is validated a simple, teachable and implementable recognition and diagnostic methodology for primary care. With these objectives in mind, a cross-sectional descriptive study was performed involving 544 consecutive patients, aged 16-90 years, recruited from the ambulatory of 31 family doctors randomized within the 219 physicians working in eight health centres from four health regions. Screening strategies were tested based on the WHO-5 questionnaire in association with a short structured interview based on ICD-10 criteria. Depression ICD-10 diagnosis was reached according to the gold standard SCAN interview performed by trained psychiatrists. Any depressive disorder ICD-10 diagnosis was present in 24.8% of patients. Through the use of favourable recognition criteria, 43% of the patients were correctly identified as depressed by their family doctor and about 13% of the depressed patients were prescribed antidepressants at an adequate dosage. The serial administration of both instruments – WHO-5 and short structured interview – was feasible, allowing the detection of eight in ten positive cases and the exclusion of nine in ten non-cases. In Portugal, at the primary care level, high depressive disorder prevalence is confirmed as well as the need to improve depression diagnostic and treatment competencies of family doctors. A two-stage screening strategy has been validated and seems adequate for systematic use in health centres where technical and organizational resources for the effective management of depression are made available. These results can be viewed as primary care depressive disorders baseline indicators of prevalence, detection and treatment and, along with clinical useful instruments, the health system is more capacitated for the establishment of a national level large education campaign on depression such as proposed in the National Health Plan 2004-2010.