Welfare regimes, work-life balance public policies and gender equality - parental leaves in Portugal and Sweden

Comunicação apresentada na "European Sociological Association Conference" em Lisboa de 2 a 5 de Setembro de 2009.

Quality of Life Predictors and Normative Data

This study identifies predictors and normative data for quality of life (QOL) in a sample of Portuguese adults from general population. A cross-sectional correlational study was undertaken with two hundred and fifty-five (N = 255) individuals from Portuguese general population (mean age 43 years, range 25–84 years; 148 females, 107 males). Participants completed the European Portuguese version of the World Health Organization Quality of Life short-form instrument and the European Portuguese version of the Center for Epidemiologic Studies Depression Scale. Demographic information was also collected. Portuguese adults reported their QOL as good. The physical, psychological and environmental domains predicted 44 % of the variance of QOL. The strongest predictor was the physical domain and the weakest was social relationships. Age, educational level, socioeconomic status and emotional status were significantly correlated with QOL and explained 25 % of the variance of QOL. The strongest predictor of QOL was emotional status followed by education and age. QOL was significantly different according to: marital status; living place (mainland or islands); type of cohabitants; occupation; health. The sample of adults from general Portuguese population reported high levels of QOL. The life domain that better explained QOL was the physical domain. Among other variables, emotional status best predicted QOL. Further variables influenced overall QOL. These findings inform our understanding on adults from Portuguese general population QOL and can be helpful for researchers and practitioners using this assessment tool to compare their results with normative data

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.

Life-cycle performance of structures: combining expert judgment and results of inspection

Life-Cycle Civil Engineering – Biondini & Frangopol

Mapping the quality of life experience in Alfama: a case study in Lisbon, Portugal.

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

Solar Intensity Forecasting using Artificial Neural Networks and Support Vector Machines

This paper presents several forecasting methodologies based on the application of Artificial Neural Networks (ANN) and Support Vector Machines (SVM), directed to the prediction of the solar radiance intensity. The methodologies differ from each other by using different information in the training of the methods, i.e, different environmental complementary fields such as the wind speed, temperature, and humidity. Additionally, different ways of considering the data series information have been considered. Sensitivity testing has been performed on all methodologies in order to achieve the best parameterizations for the proposed approaches. Results show that the SVM approach using the exponential Radial Basis Function (eRBF) is capable of achieving the best forecasting results, and in half execution time of the ANN based approaches.

Artificial Intelligence in geospatial analysis: applications of self-organizing maps in the context of geographic information science.

A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Information Systems.

Improving discovery in the life sciences using semantic Web technologies and linked data: design principles for life sciences knowledge organization systems

Dissertation presented to obtain the Ph.D degree in Bioinformatics

An Exercise Program Improves Health-Related Quality of Life of Workers

Low back problems are associated with decreased quality of life. Specific exercises can improve quality of life, resulting in better professional performance and functionality. The purpose of this study was to evaluate the effect of following a 21-month exercise program on the quality of life of warehouse workers. The population included 557 male warehouse workers from a food distribution company in Oporto, Portugal. Upon application of the selection criteria, 249 workers were deemed eligible, which were randomized into two groups (125 in the intervention group and 124 in the control group). Then, subjects were asked to volunteer for the study, the sample being formed by 229 workers (112 in the intervention group and 117 in the control group). All subjects completed the SF-36 questionnaire prior to beginning the program and on the 11th and 21st months following it. The exercises were executed in the company facilities once a day for 8 min. Data were analyzed using SPSS® 17.0 for Windows®. After 11 months of following the exercise program, there was an increase in all scores for the experimental group, with statistically significant differences in the dimensions physical functioning (0.019), bodily pain (0.010), general health (0.004), and rolephysical (0.037). The results obtained at the end of the study (21 months) showed significant improvements in the dimensions physical functioning (p = 0.002), rolephysical (p = 0.007), bodily pain (p = 0.001), social functioning (p = 0.015), role-emotional (p = 0.011), and mental health (p = 0.001). In the control group all dimensions showed a decrease in mean scores. It can be concluded that the implementation of a low back specific exercise program has changed positively the quality of life of warehouse workers.

Trypanosoma cruzi parasitemia observed in immunocompromised patients: the importance of the artificial xenodiagnosis

Trypanosoma cruzi parasitemia observed in immunocompromised patients (transplant or positive HIV) occurred more frequently by the artificial xenodiagnosis method (10/38) compared with hemoculture (2/38), given the same quantity of blood. Other ways of diagnosis, like mice inoculation (5/38), QBC and buffy coat (2/38), were evaluated also. This result showed the importance of the artificial xenodiagnosis. The other techniques increased only one more patient positive.

Artificial antibodies for troponin T by its imprinting on the surface of multiwalled carbon nanotubes: Its use as sensory surfaces

A novel artificial antibody for troponin T (TnT) was synthesized by molecular imprint (MI) on the surface of multiwalled carbon nanotubes (MWCNT). This was done by attaching TnT to the MWCNT surface, and filling the vacant spaces by polymerizing under mild conditions acrylamide (monomer) in N,N′-methylenebisacrylamide (cross-linker) and ammonium persulphate (initiator). After removing the template, the obtained biomaterial was able to rebind TnT and discriminate it among other interfering species. Stereochemical recognition of TnT was confirmed by the non-rebinding ability displayed by non-imprinted (NI) materials, obtained by imprinting without a template. SEM and FTIR analysis confirmed the surface modification of the MWCNT. The ability of this biomaterial to rebind TnT was confirmed by including it as electroactive compound in a PVC/plasticizer mixture coating a wire of silver, gold or titanium. Anionic slopes of 50 mV decade−1 were obtained for the gold wire coated with MI-based membranes dipped in HEPES buffer of pH 7. The limit of detection was 0.16 μg mL−1. Neither the NI-MWCNT nor the MWCNT showed the ability to recognize the template. Good selectivity was observed against creatinine, sucrose, fructose, myoglobin, sodium glutamate, thiamine and urea. The sensor was tested successfully on serum samples. It is expected that this work opens new horizons on the design of new artificial antibodies for complex protein structures.

Biomimetic Sensor Potentiometric System for Doxycycline Antibiotic Using a Molecularly Imprinted Polymer as an Artificial Recognition Element

Molecular imprinting is a useful technique for the preparation of functional materials with molecular recognition properties. A Biomimetic Sensor Potentiometric System was developed for assessment of doxycycline (DOX) antibiotic. The molecularly imprinted polymer (MIP) was synthesized by using doxycycline as a template molecule, methacrylic acid (MAA) and/or acrylamide (AA) as a functional monomer and ethylene glycol dimethacrylat (EGDMA) as a cross-linking agent. The sensing elements were fabricated by the inclusion of DOX imprinted polymers in polyvinyl chloride (PVC) matrix. The sensors showed a high selectivity and a sensitive response to the template in aqueous system. Electrochemical evaluation of these sensors under static (batch) mode of operation reveals near-Nernstian response. MIP/MAA membrane sensor was incorporated in flow-through cells and used as detectors for flow injection analysis (FIA) of DOX. The method has the requisite accuracy, sensitivity and precision to assay DOX in tablets and biological fluids.

Fatigue life assessment of exhaust systems for naval gas turbines

Dissertação para obtenção do Grau de Mestre em Engenharia Mecânica