The economic assessment of health benefits of active transport

Purpose:This chapter addresses the economic assessment of health benefits of active transport and presents most recent valuation studies with an overview of progresses made towards the inclusion of health benefits in the cost-benefit analysis (CBA) of active transport. Methodology/approach: It is built upon the contracted study for the World Health Organization (WHO) on the economic appraisal of health benefits of walking and cycling investments at the city of Viana do Castelo, the former pilot study in Portugal for evaluating the health benefits of non-motorized transport using the WHO Health Economic Assessment Tool (HEAT). The relative risk values adopted in the HEAT for walking refer to adult population of the age group 20â 74 years and the assessment focus in on average physical activity/regular behaviour of groups of pedestrians and all-cause mortality health impacts. During the case study, it was developed and implemented a mobility survey which aimed to collect behavioural data before and after a street intervention in the historic centre. Findings: Most recent appraisal guidance of walking and cycling and health impact modelling studies reviewed confirm that further research is expected before a more comprehensive appraisal procedure can be adopted in Europe, able to integrate physical activity effects along with other health risks such as those related to road traffic injuries and exposure to air pollution. Social implications: The health benefits assessment of walking investments helped local decision-makers to progress towards sustainable mobility options in the city. Making the population aware of the potential health benefits of regular walking can encourage more people to uptake active transport as part of their daily activities. Originality/value: This study provides a useful review of the health benefits of active transport with a comprehensive analysis of valuation studies, presenting value-added information. It then reports a former assessment of the health effects of active transport in the Portuguese context (case study) using the state-of-the-art economic analysis tool (HEAT) of the World Health Organization which is believed to contribute to a paradigm shift in the transport policy and appraisal practice given the need of shaping future cities (and their citizens) for health through more investments in active transport.

Inovação como fator de competitividade da cadeia de valor da moda

Tese de Doutoramento em Engenharia Têxtil

Improving buildings energy performance: comparison between simple payback period and life cycle costs analysis

The building sector is one of the Europeâ s main energy consumer, making buildings an important target for a wiser energy use, improving indoor comfort conditions and reducing the energy consumption. To achieve the European Union targets for energy consumption and carbon reductions it is crucial to act in new, but also in existing buildings, which constitute the majority of the building stock. In existing buildings, the significant improvement of their efficiency requires important investments. Therefore, costs are a major concern in the decision making process and the analysis of the cost effectiveness of the interventions is an important path in the guidance for the selection of the different renovation scenarios. The Portuguese thermal legislation considers the simple payback method for the calculations of the time for the return of the investment. However, this method does not take into consideration inflation, cash flows and cost of capital, as well as the future costs of energy and the building elements lifetime as it happens in a life cycle cost analysis. In order to understand the impact of the economic analysis method used in the choice of the renovation measures, a case study has been analysed using simple payback calculations and life cycle costs analysis. Overall results show that less far-reaching renovation measures are indicated when using the simple payback calculations which may be leading to solutions less cost-effective in a long run perspective.

The trading relationship between the EU and Mercosur: the mediatory role of Brazil

Dissertação de mestrado em European and Transglobal Business Law

Transições e percursos de alunos distinguidos na escola pública

A implementação de quadros de valor, mérito e excelência nas escolas portuguesas, nos quais se distinguem os alunos com comportamentos e desempenhos académicos exemplares, constitui o ponto de partida desta comunicação. Num primeiro momento, pretendemos abordar o processo de transição dos alunos distinguidos para o ensino superior. No momento seguinte, incidiremos o nosso olhar sobre as disposições destes jovens face ao ofício de aluno, aos atores e às instituições que marcaram os seus percursos e às expectativas que nortearam os diversos investimentos académicos. Os dados empíricos foram recolhidos no âmbito de um estudo de caso numa escola secundária do Norte de Portugal. Em relação aos alunos já ingressados no ensino superior e para aqueles que já concluíram este nível de ensino, tentaremos refletir sobre o grau de ajustamento destas experiências às expectativas inicialmente formuladas e/ou subsumidas nos sentidos das respostas e nas opções declaradas face ao futuro. Dos dados já obtidos, concluímos que a distinção académica parece escapar às lógicas do destino social, sendo a excelência escolar também visível em jovens de classes sociais mais baixas; concluímos também que estes percursos de excelência não têm na atualidade uma recompensa efetiva no acesso ao mercado de trabalho; e dentro do foco principal desta comunicação denotamos ainda a existência de transições não-lineares entre o secundário e o superior, designadamente no acesso ao curso pretendido e ao desempenho académico neste nível de ensino.

“Learning-by-producing” in the fashion value chain

Proceedings da AUTEX 2015, Bucareste, Roménia.

Clinical characteristics of women diagnosed with carcinoma who tested positive for cervical and anal high-risk human papillomavirus DNA and E6 RNA

High-risk human papillomavirus (hrHPV) is an essential cause of cervical carcinoma and is also strongly related to anal cancer development. The hrHPV E6 oncoprotein plays a major role in carcinogenesis. We aimed to evaluate the frequency of hrHPV DNA and E6 oncoprotein in the anuses of women with cervical carcinoma. We analyzed 117 women with cervical cancer and 103 controls for hrHPV and the E6 oncogene. Positive test results for a cervical carcinoma included 66.7 % with hrHPV-16 and 7.7 % with hrHPV-18. One case tested positive for both HPV variants (0.9 %). The samples from the anal canal were positive for HPV-16 in 59.8 % of the cases. Simultaneous presence of HPV in the cervix and anal canal was found in 53.8 % of the cases. Regarding expression of E6 RNA, positivity for HPV-16 in the anal canal was found in 21.2 % of the cases, positivity for HPV-16 in the cervix was found in 75.0 %, and positivity for HPV-18 in the cervix was found in 1.9 %. E6 expression in both the cervix and anal canal was found in 19.2 % of the cases. In the controls, 1 % tested positive for HPV-16 and 0 % for HPV-18. Anal samples from the controls showed a hrHPV frequency of 4.9 % (only HPV16). The presence of hrHPV in the anal canal of women with cervical cancer was detected at a high frequency. We also detected E6 RNA expression in the anal canal of women with cervical cancer, suggesting that these women are at risk for anal hrHPV infection.

Desenvolvimento de um protótipo didático de uma máquina de corte de pedra por fio diamantado

Dissertação de mestrado integrado em Engenharia Mecânica

Modelação de governo electrónico para países emergentes: O caso de São Tomé e Príncipe

Tese de Doutoramento em Tecnologias e Sistemas de Informação

Varões entrançados de material compósito com capacidade de monitorização

Dissertação de mestrado integrado em Engenharia Civil

Avaliação do transporte sedimentar na bacia do rio Lima baseada em ferramentas de modelação

Dissertação de mestrado integrado em Engenharia Civil

Relatório detalhado sobre a atividade profissional desenvolvida no perído 2007-2015 no Gabinete de Fundos Comunitários do Município da Póvoa de Lanhoso

Dissertação de mestrado em Geografia (área de especialização em Planeamento e Gestão do Território)

Primary coronary angioplasty and stent implantation in acute myocardial infarction. Comparative analysis of the in-hospital results in the CENIC/SBHCI registry

OBJECTIVE: Comparative analysis of the in-hospital results after primary implantation of stents or coronary balloon angioplasty in patients with acute myocardial infarction (MI). METHODS: CENIC (National Center of Cardiovascular Interventions) gathered data on 3,924 patients undergoing coronary angioplasty (in the primary form, without the previous use of thrombolytic agents) in the first 24 hours after a MI, during the period of 1996-1998. From these 3,924 patients, 1,337 (34%) underwent stent implantation. We analyzed the success of the procedure and the occurrence of adverse cardiac events. RESULTS: In patients undergoing stent implantation there were more males (77% vs 69%, p=0.001), previous by pass surgery (6.3% vs. 4.5%, p=0.01), anterior MI and stent implantation in left descending artery (55% vs. 48% vs. p=0.009), and saphenous vein bypass grafts (3.3% vs. 1.9%). the procedure was more succesful in the group of stents (97% vs. 84%, p=0.001) and reinfarction rate (2.5 vs. 4%, p=0.002). The need for emergency revascularization was similar (1% vs. 1.1%, NS). Total in-hospital mortality was lower in stent group (3.4% vs. 7. 2%, p=0.0001) and this effect was in patients Killip class III/V (19.5% vs. 32.5%, p= 0.002) because there was no difference in patients class I/II (1.7% vs. 2.8%, p=0.9). CONCLUSION: Primary stent implantation in acute myocardial infarction showed better early results than balloon angioplasty alome.

The use of primary stenting or balloon percutaneous transluminal coronary angioplasty for the treatment of acutely occluded saphenous vein grafts. Results from the Brazilian National Registry - CENIC

OBJECTIVE: We conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (PTCA) or stent implantation because of an acute myocardial infarction (AMI) related to an acute vein graft occlusion. METHODS: Since 1991 the Brazilian Society of Hemodynamic and Interventional Cardiology has maintained a large database (CENIC). From these, we selected all consecutive patients, who underwent primary PTCA or stenting in the first 24 hours of AMI, with the target vessel being an occluded vein graft. Immediate results and major coronary events occurring up until hospital discharge were analyzed. RESULTS: During this period, 5,932 patients underwent primary PTCA or stenting; 158 (3%) of the procedures were performed because of an acute vein graft occlusion. Stenting was performed in 74 (47%) patients. Patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon PTCA. The incidence of reinfarction and death were similar for stenting and balloon PTCA. CONCLUSION: Primary percutaneous treatment of AMI related to acute vein graft occlusion is still an uncommon practice. Primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with PTCA treatment.

Primary coronary angioplasty in 9,434 patients during acute myocardial infarction: predictors of major in- hospital adverse events from 1996 to 2000 in Brazil

OBJECTIVE: To verify the results after the performance of primary coronary angioplasty in Brazil in the last 4 years. METHODS: During the first 24 hours of acute myocardial infarction onset, 9,434 (12.2%) patients underwent primary PTCA. We analyzed the success and occurrence of major in-hospital events, comparing them over the 4-year period. RESULTS: Primary PTCA use increased compared with that of all percutaneous interventions (1996=10.6% vs. 2000=13.1%; p<0.001). Coronary stent implantation increased (1996=20% vs. 2000=71.9%; p<0.001). Success was greater (1998=89.5% vs. 1999=92.5%; p<0.001). Reinfarction decreased (1998=3.9% vs. 99=2.4% vs. 2000=1.5%; p<0.001) as did emergency bypass surgery (1996=0.5% vs. 2000=0.2%; p=0.01). In-hospital deaths remained unchanged (1996=5.7% vs. 2000=5.1%, p=0.53). Balloon PTCA was one of the independent predictors of a higher rate of unsuccessful procedures (odds ratio 12.01 [CI=95%] 1.58-22.94), and stent implantation of lower mortality rates (odds ratio 4.62 [CI=95%] 3.19-6.08). CONCLUSION: The success rate has become progressively higher with a significant reduction in reinfarction and urgent bypass surgery, but in-hospital death remains nearly unchanged. Coronary stenting was a predictor of a lower death rate, and balloon PTCA was associated with greater procedural failure.