First Diabetic Retinopathy Prevalence Study in Portugal: RETINODIAB Study-Evaluation of the Screening Programme for Lisbon and Tagus Valley Region

BACKGROUND/AIMS: In Portugal, so far, there is no study or even accurate data on the prevalence of diabetic retinopathy (DR), based on a large representative sample and on a long-term follow-up. The objective of our study was to determine the prevalence of DR based on a national screening community-based programme. METHODS: A 5-year retrospective analysis of the RETINODIAB screening programme results was implemented in Lisbon and Tagus Valley area between July 2009 and October 2014. We estimated the prevalence of retinopathy for all patients with type 2 diabetes and studied the association between known risk factors and retinopathy emergence at their first screening. RESULTS: Throughout this period, from a total of 103 102 DR readable screening examinations, 52 739 corresponded to patients who attended RETINODIAB screening at entry. Globally, DR was detected in 8584 patients (16.3%). Of these, 5484 patients (10.4%) had mild non-proliferative (NP) DR, 1457 patients (2.8%) had moderate NPDR and 672 (1.3%) had severe NPDR. Finally, 971 patients (1.8%) had proliferative DR requiring urgent referral to an ophthalmologist. The presence of any DR, non-referable DR or referable DR was strongly associated with increasing duration of diabetes and earlier age at diagnosis. CONCLUSIONS: The prevalence rate of DR in our study (16.3%) was slightly lower than other published international data. The RETINODIAB network proved to be an effective screening programme as it improved DR screening in Lisbon and Tagus Valley surrounding area

Public Participation geographic information systems in developing countries: lessons from Uganda on the impacts of interactive screens PPGIS and community perceptions of space

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

Humor and the framing of the public sphere and public opinion in Portugal (1797-1834)

In his Answer to the Question: What is Enlightenment (1784), Kant puts forward his belief that the vocation to think freely, which humankind is endowed with, is bound to make sure that “the public use of reason” will at last act “even on the fundamental principles of government and the state [will] find it agreeable to treat man – who is now more than a machine – in accord with his dignity”. The critical reference to La Mettrie (1747), by opposing the machine to human dignity, will echo, in the dawn of the 20th century, in Bergson’s attempt to explain humor. Besides being exclusive to humans, humor is also a social phenomenon. Freud (1905) assures that pleasure originated by humor is collective, it results from a “social process”: jokes need an audience, a “third party”, in order to work and have fun. Assuming humor as a social and cultural phenomenon, this paper intends to sustain that it played a role in the framing of the public sphere and of public opinion in Portugal during the transition from Absolute Monarchy to Liberalism. The search for the conditions which made possible the critical exercise of sociability is at the root of the creation of the public sphere in the sense developed by Habermas (1962), whose perspective, however, has been questioned by those who point 2 out the alleged idealism of the concept – as opposed, for example, to Bakhtin (1970), whose work stresses diversity and pluralism. This notwithstanding, the concept of public sphere is crucial to the building of public opinion, which is, in turn, indissoluble from the principle of publicity, as demonstrated by Bobbio (1985). This paper discusses the historical evolution of the concept of public opinion from Ancient Greece doxa, through Machiavelli’s “humors” (1532), the origin of the expression in Montaigne (1580) and the contributions of Hobbes (1651), Locke (1690), Swift (1729), Rousseau (1762) or Hume (1777), up to the reflection of Lippman (1922) and Bourdieu’s critique (1984). It maintains that humor, as it appears in Portuguese printed periodicals from 1797 (when Almocreve de Petas was published for the first time) to the end of the civil war (1834) – especially in those edited by José Daniel Rodrigues da Costa but also in O Piolho Viajante, by António Manuel Policarpo da Silva, or in the ones written by José Agostinho de Macedo, as well as in a political “elite minded” periodical such as Correio Braziliense –, contributed to the framing of the public sphere and of public opinion in Portugal.

Fostering e-participation sustainability through a BPM-driven semantic model

According to a recent Eurobarometer survey (2014), 68% of Europeans tend not to trust national governments. As the increasing alienation of citizens from politics endangers democracy and welfare, governments, practitioners and researchers look for innovative means to engage citizens in policy matters. One of the measures intended to overcome the so-called democratic deficit is the promotion of civic participation. Digital media proliferation offers a set of novel characteristics related to interactivity, ubiquitous connectivity, social networking and inclusiveness that enable new forms of societal-wide collaboration with a potential impact on leveraging participative democracy. Following this trend, e-Participation is an emerging research area that consists in the use of Information and Communication Technologies to mediate and transform the relations among citizens and governments towards increasing citizens’ participation in public decision-making. However, despite the widespread efforts to implement e-Participation through research programs, new technologies and projects, exhaustive studies on the achieved outcomes reveal that it has not yet been successfully incorporated in institutional politics. Given the problems underlying e-Participation implementation, the present research suggested that, rather than project-oriented efforts, the cornerstone for successfully implementing e-Participation in public institutions as a sustainable added-value activity is a systematic organisational planning, embodying the principles of open-governance and open-engagement. It further suggested that BPM, as a management discipline, can act as a catalyst to enable the desired transformations towards value creation throughout the policy-making cycle, including political, organisational and, ultimately, citizen value. Following these findings, the primary objective of this research was to provide an instrumental model to foster e-Participation sustainability across Government and Public Administration towards a participatory, inclusive, collaborative and deliberative democracy. The developed artefact, consisting in an e-Participation Organisational Semantic Model (ePOSM) underpinned by a BPM-steered approach, introduces this vision. This approach to e-Participation was modelled through a semi-formal lightweight ontology stack structured in four sub-ontologies, namely e-Participation Strategy, Organisational Units, Functions and Roles. The ePOSM facilitates e-Participation sustainability by: (1) Promoting a common and cross-functional understanding of the concepts underlying e-Participation implementation and of their articulation that bridges the gap between technical and non-technical users; (2) Providing an organisational model which allows a centralised and consistent roll-out of strategy-driven e-Participation initiatives, supported by operational units dedicated to the execution of transformation projects and participatory processes; (3) Providing a standardised organisational structure, goals, functions and roles related to e-Participation processes that enhances process-level interoperability among government agencies; (4) Providing a representation usable in software development for business processes’ automation, which allows advanced querying using a reasoner or inference engine to retrieve concrete and specific information about the e-Participation processes in place. An evaluation of the achieved outcomes, as well a comparative analysis with existent models, suggested that this innovative approach tackling the organisational planning dimension can constitute a stepping stone to harness e-Participation value.

E-government e participação política em Portugal

Dissertação de Mestrado em MPA - Administração Pública

In search of a language textile and text in contemporary women's art

This research uses the textile/text axis concept as a conceptual tool to investigate the role of textile and text in contemporary women’s art practice and theorizing, investigating textile as a largely hitherto unacknowledged element in women’s art practice of the late 20th and early 21st centuries. Textile and text share a common etymological root, from the Latin textere to weave, textus a fabric. The thesis illuminates the pathways whereby textile and text played an important role in women reclaiming a speaking voice as creators of culture and signification during a revolutionary period of renewal in women’s cultural contribution and positioning. The methodological approach used in the research consisted of a comprehensive literature review, the compilation of an inventory of relevant women artists, developing a classificatory system differentiating types of approaches, concerns and concepts underpinning women’s art practice vis a vis the textile/text axis and a series of three in-depth case studies of artists Tracey Emin, Louise Bourgeois and Faith Ringgold. The thesis points to the fact that contemporary women artists and theorists have rounded their art practice and aesthetic discourse in textile as prime visual metaphor and signifier, turning towards the ancient language of textile not merely to reclaim a speaking voice but to occupy a ground breaking locus of signification and representation in contemporary culture. The textile/text axis facilitated women artists in powerfully countering a culturally inscribed status of Lacanian ‘no-woman’ (a position of abjection, absence and lack in the phallocentric symbolic). Turning towards a language of aeons, textile as fertile wellspring, the thesis identifies the methodologies and strategies whereby women artists have inserted their webs of subjectivities and deepest concerns into the records and discourses of contemporary culture. Presenting an anatomy of the textile/text axis, the thesis identifies nine component elements manifesting in contemporary women’s aesthetic practice and discourse. In this cultural renaissance, the textile/text axis, the thesis suggests, served as a complex lexicon, a system of labyrinthine references and signification, a site of layered meanings and ambiguities, a body proxy and a corporeal cartography, facilitating a revolution in women’s aesthetic praxis.

Globalization and Europeanization: Analysing Change

The main motivation for exploring the relationship between globalization and Europeanization is the understanding of the importance of exogenous factors for policy change at the domestic level. Can we distinguish the impact of Europeanization to that of globalization? What is the relationship between globalization and Europeanization and what can we learn about the impact of the two phenomena upon political institutions, public policies, identities and values of EU member-states? Can we distinguish the traces of globalization to those of Europeanization upon the domestic level? The paper draws upon International Relations and International Political Economy theories of globalization as well as upon the Europeanization literature. Both phenomena are multi-dimensional and in order to assess their impact and their relationship three dimensions are explored: political institutions, public policies and values and identities. It is concluded that the two phenomena are interwoven and that there is no antithetical relationship between them. Their core is similar, based on the values of neo-liberalism, representative democracy and open market economy.

Organisational status and efficiency: the case of the spanish SOE "Paradores"

The purpose of this paper is to provide new evidence on the issue of the effect on public enterprises economic performance of the introduction of some given changes in organisational status and management practices, while keeping the enterprises under public control. Our approach is case study type and relies on comparative efficiency literature. We identify relevant changes on the organisational status of a State owned large hotel group along a period of twenty years, next we measure its annual efficiency indicators, and then evaluate to which extent the observed changes in economic performance can be attributable to the corresponding management reforms carried out. As a result we find that the formally more relevant change in organisational status (the enterprise passing to be a Limited Company), which implied a substantial increase in the enterprise autonomy, did not produce a significant improvement in its economic performance; a finding contrary to what we expected according to agency theory. However, a second relevant organisational change –five years later- when both the principal (government) and the agent (firm’s CEO) changed is consistently related to a significant improvement in economic performance. As a research implication we abide for use more precise agency theory statements; and as a practical implication we argue here that potentialities of improvement brought about by a formal-legal change in the status of the enterprise may require also –in order to actually improve firm’s efficiency- some changes in the firm’s key personal positions: supervisor (principal) and CEO (agent), in the sense that a change to a greater-autonomy for the enterprise it seems should come together a parallel new ‘management culture’. Practical implications Management good practises to apply to other public enterprise’s restructuring in order to improve their efficiency. It’s the first study on organizational changes and efficiency for an important Spanish public enterprise.

Endogenous and exogenously-induced immunomodulation of tumour-host responsiveness

In spite of the availability of multiple effector mechanisms of the immune system to combat tumour growth and metastases, their impairment frequently accompanies the appearance of cancer. Factors contributing to this impairment may be related to properties of the host and/or the tumour itself and may be with respect to their origin -endogenous or exogenour. Based on the unique biological behavior of prostate cancer (PCa), and its apparent escape from immune surveillance in the presence of tumour immuno genicity, continuing investigation of endogenous and exogenous factors thought to be relevant to its pathogenesis have been made. For this purpose further studies of the suggested role of human seminal plasma (SePl) and the synthetic oestrogen, diethylstiboestrol (DES), as representative endogenous and exogenous immunomodulatory factors (IMF) of tumour-host responsiveness, together with evaluation of human prostatic tissue extracts and leuprolide (the luteinizing-hormone-releasing-hormone proposed as an alternate to DES therapy) have been made by evaluating their effect on the lytic activity of natural killer (NK) cells. SePl and prostate extracts significantly suppressed NK cell lysis. Physicochemical studies suggest SePl and prostate IMF to be associated with high and low molecular weight macromolecules; and implicate the participation of transglutaminase and prostaglandins. Comparative study of therapeutic levels of DES vs. leuprolide on NK cell lysis demonstrated significant suppression by DES vs. a negligible effect of leuprolide. Metastases are highly prevalent in PCa, and contribute significantly to its morbidity and mortality. Further knowledge of the range of effects of endogenous and exogenous IMF on effector mechanisms of tumour-host responsiveness, to include suppression of NK cells, and elucidation of their nature, may contribute toward our understanding of the unique biological behavior of tumours of the prostate, in addition to improvement in their clinical management.

The Expenditure Impacts of Individual Higher Education Institutions (HEIs) and their Students on the Scottish Economy under Devolution: Homogeneity or Heterogeneity?

Comparing each of the twenty Higher Education Institutions (HEIs) in Scotland as separate sectors in an Input-Output table suggests their expenditure patterns are homogenous and that the apparent heterogeneity of their impacts is primarily driven by scale. However, a disaggregation of their income by source reveals a disparity in their dependence upon funding from the devolved Scottish Government and their ability to draw in income/funding from external sources. Acknowledging the binding budget constraint of the Scottish Government and deriving balanced expenditure multipliers reveals large differences in the net-expenditure impact of HEIs upon the Scottish economy, with the source of variation being the origin of income. Applying a novel treatment of student expenditure impacts, identifying the amount of exogenous spending per student, modifies the heterogeneity of the overall expenditure impacts. On balance this suggests that the impacts of impending budget cut-backs will be quite different by institution depending on their sensitivity to public funding. However, predicting the outcome of budget cutbacks at the margin is problematic as we do not know whether public and external incomes are complements or substitutions (and indeed this may vary between individual HEIs).

The Distributional Consequences of Supply-Side Reforms in General Equilibrium

This paper addresses the issue on whether tax reforms consisten with lower public debt-to-GDP in the long-run can lead to a more efficient and equitable economy. To this end we solve a heterogeneous agent model comprised of a government, a representative capitalist and representative skilled and unskilled workers, under both rational expectations and adaptive learning. Our main ndings are that (i) reductions in capital taxation, while bene cial at the aggregate level, lead to increased inequality mainly due to the substitutability of un- skilled labour and capital; (ii) a fall in taxation for skilled labour is Pareto improving, which is largely explained by its complementarity with the other factor inputs; (iii) all agents would prefer increasing the tax rate on capital to increasing the tax rate on skilled and un- skilled labour since it leads to relatively lower welfare losses; and (iv) heterogeneity in initial beliefs under adaptive learning quantitatively matters for welfare.

The Expenditure Impacts of Individual Higher Education Institutions (HEIs) and their Students on the Welsh Economy: Homogeneity or Heterogeneity?

This paper replicates the analysis of Scottish HEIs in Hermannsson et al (2010a) for the case of Wales in order to provide a self-contained analysis that is readily accessible by those whose primary concern is with the regional impacts of Welsh HEIs. When we treat each of the twelve Higher Education Institutions (HEIs) that existed in Wales in 2006 as separate sectors in conventional input-output analysis, their expenditure impacts per unit of final demand appear rather homogenous, with the apparent heterogeneity of their overall impacts being primarily driven by scale. However, a disaggregation of their income by source reveals considerable variation in their dependence upon funding from the devolved Welsh Assembly Government and their ability to draw in income/funding from external sources. Acknowledging the binding budget constraint of the Welsh Assembly Government and deriving balanced expenditure multipliers reveals large differences in the net-expenditure impact of HEIs upon the Welsh economy, with the source of variation being the origin of income. Applying a novel treatment of student expenditure impacts, identifying the amount of exogenous spending per student, modifies the heterogeneity of the overall expenditure impacts. On balance this suggests that the impacts of impending budget cut-backs will be quite different by institution depending on their sensitivity to public funding. However, predicting the outcome of budget cutbacks at the margin is problematic for reasons that we identify.

International Aid to Tanzania – with some comparisons from Ghana and Uganda

This paper has three principal objectives. First, to review the level of Official Development Assistance (ODA) to Tanzania over the last two to three decades, and to place this into an economic context. This review includes some comparisons with the experience of Ghana and Uganda. Second, to discuss three major issues for the Tanzanian aid: the position of ODA as budget support, corruption, and alignment with the principles of the Paris Declaration on Aid Effectiveness. Third, to review the literature on the Tanzanian aid experience, including a range of official evaluation reports produced by the Tanzanian government and by the donor community. The conclusions, broadly, are that ODA has been at a sustained high level for most of the period reviewed, funding a significant amount of government development expenditure, and that economic growth has been strong, with poverty reduction ‘flat-lining’ in Tanzania but being significant in Ghana and Uganda. Experience with budget support in Tanzania has been mixed, corruption continues as a major concern, and improvements to public finance management have been difficult to achieve. In this context governance adjustments come slowly, requiring patience on the part of both recipient governments and the ODA donor community.

The Political Economy of Resource Rent Distribution

I model the link between political regime and level of diversification following a windfall of natural resource revenues. The explanatory variables I make use of are the political support functions embedded within each type of regime and the disparate levels of discretion, openness, transparency, and accountability of government. I show that a democratic government seeks to maximize the long-term consumption path of the representative consumer, in order to maximize its chances of re-election, while an authoritarian government, in the absence of any electoral mechanism of accountability, seeks to buy off and entrench a group of special interests loyal to the government and potent enough to ensure its short-term survival. Essentially the contrast in the approaches towards resource rent distribution comes down to a variation in political weights on aggregate welfare and rentierist special interests endogenized by distinct political support functions.

Perceptions of Europe in political and economic elites: a geographical compared analysis of Germany, Spain and Poland

Elite perceptions about Europe are a very important point in order to understand the current European integration process, as well as the future perspectives for the continent. This study makes a comparison between the perceptions which political and economical elites in some European countries have about the European Union process and its mechanisms. The main goal is to identify the differences in positions of each type of elites, as well as the variations among three key countries. The database built thanks to the INTUNE (Integrated and United? A quest for Citizenship in an ¨ever closer Europe¨) Project Survey on European Elites and Masses, funded by the Sixth Framework Programme of the EU [Contract CIT 3-CT-2005-513421] have being used. The questionnaire was applied between February and May 2007, in a total of 18 European countries. The national teams got a total of almost 2000 valid responses at European level. In the analysis we have showed some general descriptive statistics about the perception of Europe taking as a reference two dimensions of the INTUNE project: identity (attachment to the national level, the meaning of being a truly national, and the threats from Turkey that EU is facing at this moment) and representation (trust in European and national institutions, preferences for a national or an European army). The results are presented distinguishing between political (national MP’s in low chambers) and economical elites (presidents of corporations, general managers…) and, at the same time, among three countries: Germany as an original member of the European Union; Spain, incorporated in 1986; and a new member, Poland, joining the EU in 2004.