Determinants of the use of health care services: multilevel analysis in the Metropolitan Region of Sao Paulo

OBJECTIVE To evaluate the individual and contextual determinants of the use of health care services in the metropolitan region of Sao Paulo.METHODS Data from the Sao Paulo Megacity study – the Brazilian version of the World Mental Health Survey multicenter study – were used. A total of 3,588 adults living in 69 neighborhoods in the metropolitan region of Sao Paulo, SP, Southeastern Brazil, including 38 municipalities and 31 neighboring districts, were selected using multistratified sampling of the non-institutionalized population. Multilevel Bayesian logistic models were adjusted to identify the individual and contextual determinants of the use of health care services in the past 12 months and presence of a regular physician for routine care.RESULTS The contextual characteristics of the place of residence (income inequality, violence, and median income) showed no significant correlation (p > 0.05) with the use of health care services or with the presence of a regular physician for routine care. The only exception was the negative correlation between living in areas with high income inequality and presence of a regular physician (OR: 0.77; 95%CI 0.60;0.99) after controlling for individual characteristics. The study revealed a strong and consistent correlation between individual characteristics (mainly education and possession of health insurance), use of health care services, and presence of a regular physician. Presence of chronic and mental illnesses was strongly correlated with the use of health care services in the past year (regardless of the individual characteristics) but not with the presence of a regular physician.CONCLUSIONS Individual characteristics including higher education and possession of health insurance were important determinants of the use of health care services in the metropolitan area of Sao Paulo. A better understanding of these determinants is essential for the development of public policies that promote equitable use of health care services.

Implementation contexts of a Tuberculosis Control Program in Brazilian prisons

OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects.METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons.RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases.CONCLUSIONS The implementation degree and its contexts – external and political-organizational dimensions – simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons.

A magnanimidade da teoria: interpretar a ética em teoria da literatura

Tese de doutoramento, Teoria da Literatura, Universidade de Lisboa, Faculdade de Letras, 2003

Work, malaise, and well-being in Spanish and Latin-American doctors

ABSTRACT OBJECTIVE To analyze the relations between the meanings of working and the levels of doctors work well-being in the context of their working conditions. METHOD The research combined the qualitative methodology of textual analysis and the quantitative one of correspondence factor analysis. A convenience, intentional, and stratified sample composed of 305 Spanish and Latin American doctors completed an extensive questionnaire on the topics of the research. RESULTS The general meaning of working for the group located in the quartile of malaise included perceptions of discomfort, frustration, and exhaustion. However, those showing higher levels of well-being, located on the opposite quartile, associated their working experience with good conditions and the development of their professional and personal competences. CONCLUSIONS The study provides empirical evidence of the relationship between contextual factors and the meanings of working for participants with higher levels of malaise, and of the importance granted both to intrinsic and extrinsic factors by those who scored highest on well-being.

ALSMon: sistema para monitorizar ALS

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Informática e de Computadores

Impactos da inovação nas organizações do setor da saúde: evidência empírica do CIS

Objetivos: O objetivo deste estudo é descrever o quadro de inovação no setor da saúde em Portugal, identificar os fatores críticos de sucesso da inovação, investigando os impactos da inovação nas organizações do setor da saúde. Metodologia: Na concretização da presente dissertação, recorremos a uma abordagem quantitativa, combinando a análise documental com a estatística, ao nível da análise do tratamento dos dados recolhidos através do Inquérito Comunitário à Inovação, efetuando assim um estudo de caso exploratório, descritivo e transversal. Principais resultados: As organizações analisadas operam sobretudo em mercados locais e regionais, de onde provém, maioritariamente, o seu volume de negócios, 80% do qual é composto por produtos pré-existentes. A maioria introduziu inovações de produto, processo, organizacionais ou de marketing, revelando potencial inovador. A maioria dos produtos novos ou significativamente melhorados foram desenvolvidos internamente, privilegiando fornecedores, consultores, instituições privadas de I&D e instituições do ensino superior como parceiros de cooperação, localizados sobretudo em Portugal e outros países europeus. As razões que motivam estas organizações a inovar são a melhoria da qualidade dos produtos e da capacidade de resposta a clientes e fornecedores, a diversificação da gama de produtos e o reforço da capacidade de desenvolvimento de novos produtos. Conclusões: O setor revela dinamismo na introdução de produtos novos para o mercado e para a empresa, apostando sobretudo num processo de inovação fechada. A cooperação externa é muito orientada à I&D e há um reduzido envolvimento dos agentes de mercado nas atividades de I&D através de parcerias. Contudo, estes são considerados importantes como fonte de informação e as organizações procuram responder às suas necessidades. Diferentes tipos de organizações adotam diferentes estratégias de inovação, conforme o seu mercado e a sua situação atual, o que traduz a materialização de políticas de inovação contextual, em linha com os desenvolvimentos teóricos da atualidade.

Preventing human trafficking for the purpose of sexual exploitation: the need for a bottom-up approach : the case-study of Brazilians trafficked to Portugal

Masters Thesis – Academic Year 2007/2008 - European Master’s Degree in Human Rights and Democratization (E.MA) - European Inter-university Centre for Human Rights and Democratization (EIUC) -Faculdade de Direito, Universidade Nova de Lisboa (UNL)

Modified Particle Swarm Optimization Applied to Integrated Demand Response and DG Resources Scheduling

The elastic behavior of the demand consumption jointly used with other available resources such as distributed generation (DG) can play a crucial role for the success of smart grids. The intensive use of Distributed Energy Resources (DER) and the technical and contractual constraints result in large-scale non linear optimization problems that require computational intelligence methods to be solved. This paper proposes a Particle Swarm Optimization (PSO) based methodology to support the minimization of the operation costs of a virtual power player that manages the resources in a distribution network and the network itself. Resources include the DER available in the considered time period and the energy that can be bought from external energy suppliers. Network constraints are considered. The proposed approach uses Gaussian mutation of the strategic parameters and contextual self-parameterization of the maximum and minimum particle velocities. The case study considers a real 937 bus distribution network, with 20310 consumers and 548 distributed generators. The obtained solutions are compared with a deterministic approach and with PSO without mutation and Evolutionary PSO, both using self-parameterization.

Não sejas assim!: personagens - alter ego e encenação

Trabalho de Projecto submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro – Especialização em Encenação.

Melhoria da qualidade e da produtividade na indústria de transformação de mármores

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia e Gestão Industrial

O futuro da liderança de topo na administração pública portuguesa. Forças motrizes e cenários possíveis.

Dissertação de mestrado em Administração Pública, orientada pelo Professor Doutor J. A. Oliveira Rocha apresentada na Escola de Economia e Gestão da Universidade do Minho, em 2006.

Dynamic Approach and Testbed for Small and Medium Players Simulation in Smart Grid Environments

The Smart Grid environment allows the integration of resources of small and medium players through the use of Demand Response programs. Despite the clear advantages for the grid, the integration of consumers must be carefully done. This paper proposes a system which simulates small and medium players. The system is essential to produce tests and studies about the active participation of small and medium players in the Smart Grid environment. When comparing to similar systems, the advantages comprise the capability to deal with three types of loads – virtual, contextual and real. It can have several loads optimization modules and it can run in real time. The use of modules and the dynamic configuration of the player results in a system which can represent different players in an easy and independent way. This paper describes the system and all its capabilities.

CDIO and the European Project Semester: a match for capstone projects?

The CDIO Initiative is an open innovative educational framework for engineering graduation degrees set in the context of Conceiving – Designing – Implementing – Operating real-world systems and products, which is embraced by a network of worldwide universities, the CDIO collaborators. A CDIO compliant engineering degree programme typically includes a capstone module on the final semester. Its purpose is to expose students to problems of a greater dimension and complexity than those faced throughout the degree programme as well as to put them in contact with the so-called real world, in opposition to the academic world. However, even in the CDIO context, there are barriers that separate engineering capstone students from the real world context of an engineering professional: (i) limited interaction with experts from diverse scientific areas; (ii) reduced cultural and scientific diversity within the teams; and (iii) lack of a project supportive framework to foster the complementary technical and non-technical skills required in an engineering professional. To address these shortcomings, we propose the adoption of the European Project Semester (EPS) framework, a one semester student centred international capstone programme offered by a group of European engineering schools (the EPS Providers) as part of their student exchange programme portfolio. The EPS package is organised around a central module – the EPS project – and a set of complementary supportive modules. Project proposals refer to open multidisciplinary real world problems and supervision becomes coaching. The students are organised in teams, grouping individuals from diverse academic backgrounds and nationalities, and each team is fully responsible for conducting its project. EPS complies with the CDIO directives on Design-Implement experiences and provides an integrated framework for undertaking capstone projects, which is focussed on multicultural and multidisciplinary teamwork, problem-solving, communication, creativity, leadership, entrepreneurship, ethical reasoning and global contextual analysis. As a result, we recommend the adoption of the EPS within CDIO capstone modules for the benefit of engineering students.

Development of Biomimetic Robots in the EPS Engineering Programme Capstone Project

This paper proposes the development of biologically inspired robots as the capstone project of the European Project Semester (EPS) framework. EPS is a one semester student centred international programme offered by a group of European engineering schools (EPS Providers) as part of their student exchange programme portfolio. EPS is organized around a central module (the EPS project) and a set of complementary supportive modules. Project proposals refer to open multidisciplinary real world problems. Its purpose is to expose students to problems of a greater dimension and complexity than those faced throughout the degree programme as well as to put them in contact with the socalled real world, in opposition to the academic world. Students are organized in teams, grouping individuals from diverse academic backgrounds and nationalities, and each team is fully responsible for conducting its project. EPS provides an integrated framework for undertaking capstone projects, which is focused on multicultural and multidisciplinary teamwork, communication, problem-solving, creativity, leadership, entrepreneurship, ethical reasoning and global contextual analysis. The design and development of biologically inspired robots allows the students to fulfil the previously described requirements and objectives and, as a result, we recommend the adoption of these projects within the EPS project capstone module for the benefit of engineering students.

Geodupa - a geography-driven partial membership algorithm

Trabalho apresentado no âmbito do Mestrado em Engenharia Informática, como requisito parcial para obtenção do grau de Mestre em Engenharia Informática