Health care professionals’ experience, understanding and perception of need of advanced cancer patients with cachexia and their families: The benefits of a dedicated clinic.

Background: Cachexia has been defined as an on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It can be found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. There is a paucity of studies examining the role and experience of healthcare professionals in relation to cachexia and existing studies suggest that professional staff have limited understanding and do not intervene effectively.
Aim: To identify barriers and facilitators to good practice in cachexia care in order to inform future developments in service provision.
Design: An exploratory qualitative study was conducted employing semi-structured interviews with a range of healthcare professionals recruited purposefully from an Australian hospital. Interviews were conducted in private rooms within the hospital.
Setting/participants: A range of healthcare professionals responsible for cancer care were recruited from a large Australian teaching hospital.
Results: Interviews were conducted with 8 healthcare professionals responsible for delivering cancer care. Four themes were identified: formal and informal education, knowledge and understanding, truth telling in cachexia and palliative care, and, a multi-disciplinary approach. Findings show how improved knowledge and understanding across a staff body can lead to improved staff confidence and a willingness to address cancer cachexia and its consequences with patients and their families.
Conclusion: Comparison with previous studies illustrates the importance of improving knowledge and understanding about cachexia and how this can contribute to staff having the skills and experience necessary to address cachexia and provide an improved care experience for patients and carers.

Techno-Economic Feasibility of Selective CO2 Capture Processes from Biogas Streams using Ionic Liquids as Physical Absorbents

Biogas from anaerobic digestion of sewage sludge is a renewable resource with high energy content, which is formed mainly of CH4 (40-75 vol.%) and CO2 (15-60 vol.%) Other components such as water (H2O, 5-10 vol.%) and trace amounts of hydrogen sulfide and siloxanes can also be present. A CH4-rich stream can be produced by removing the CO2 and other impurities so that the upgraded bio-methane can be injected into the natural gas grid or used as a vehicle fuel. The main objective of this paper is to develop a new modeling methodology to assess the technical and economic performance of biogas upgrading processes using ionic liquids which physically absorb CO2. Three different ionic liquids, namely the 1-ethyl-3-methylimidazolium bis[(trifluoromethyl)sulfonyl]imide, 1-hexyl-3-methylimidazoliumbis[(trifluoromethyl)sulfonyl]imide and trihexyl(tetradecyl)phosphonium bis[(trifluoromethyl)sulfonyl]imide, are considered for CO2 capture in a pressure-swing regenerative absorption process. The simulation software Aspen Plus and Aspen Process Economic Analyzer is used to account for mass and energy balances as well as equipment cost. In all cases, the biogas upgrading plant consists of a multistage compressor for biogas compression, a packed absorption column for CO2 absorption, a flash evaporator for solvent regeneration, a centrifugal pump for solvent recirculation, a pre-absorber solvent cooler and a gas turbine for electricity recovery. The evaluated processes are compared in terms of energy efficiency, capital investment and bio-methane production costs. The overall plant efficiency ranges from 71-86 % whereas the bio-methane production cost ranges from £6.26-7.76 per GJ (LHV). A sensitivity analysis is also performed to determine how several technical and economic parameters affect the bio-methane production costs. The results of this study show that the simulation methodology developed can predict plant efficiencies and production costs of large scale CO2 capture processes using ionic liquids without having to rely on gas solubility experimental data.

Economic optimization of wind farms in function of the cost of energy produced

Esta tese apresenta um estudo sobre otimização económica de parques eólicos, com o objetivo de obter um algoritmo para otimização económica de parques eólicos através do custo da energia produzida. No estudo utilizou-se uma abordagem multidisciplinar. Inicialmente, apresentam-se as principais tecnologias e diferentes arquiteturas utilizadas nos parques eólicos. Bem como esquemas de funcionamento e gestão dos parques. São identificadas variáveis necessárias e apresenta-se um modelo dimensionamento para cálculo dos custos da energia produzida, tendo-se dado ênfase às instalações onshore e ligados a rede elétrica de distribuição. É feita uma análise rigorosa das características das topologias dos aerogeradores disponíveis no mercado, e simula-se o funcionamento de um parque eólico para testar a validade dos modelos desenvolvidos. Também é implementado um algoritmo para a obtenção de uma resposta otimizada para o ciclo de vida económico do parque eólico em estudo. A abordagem proposta envolve algoritmos para otimização do custo de produção com multiplas funções objetivas com base na descrição matemática da produção de eletricidade. Foram desenvolvidos modelos de otimização linear, que estabelece a ligação entre o custo económico e a produção de eletricidade, tendo em conta ainda as emissões de CO2 em instrumentos de política energética para energia eólica. São propostas expressões para o cálculo do custo de energia com variáveis não convencionais, nomeadamente, para a produção variável do parque eólico, fator de funcionamento e coeficiente de eficiência geral do sistema. Para as duas últimas, também é analisado o impacto da distribuição do vento predominante no sistema de conversão de energia eólica. Verifica-se que os resultados obtidos pelos algoritmos propostos são similares às obtidas por demais métodos numéricos já publicados na comunidade científica, e que o algoritmo de otimização económica sofre influência significativa dos valores obtidos dos coeficientes em questão. Finalmente, é demonstrado que o algoritmo proposto (LCOEwso) é útil para o dimensionamento e cálculo dos custos de capital e O&M dos parques eólicos com informação incompleta ou em fase de projeto. Nesse sentido, o contributo desta tese vem ser desenvolver uma ferramenta de apoio à tomada de decisão de um gestor, investidor ou ainda agente público em fomentar a implantação de um parque eólico.

Potential health benefits of Artemisia gorgonum extracts

Relevância etnofarmacológica: Artemisia gorgonum (Asteraceae), conhecida como “losna ou lorna”, é usada em Cabo Verde na medicina tradicional para o tratamento de inflamações, febre e gastroenterites. Estudos recentes sugerem que artimetina, isolada a partir de Artemisa gorgonum, poderia ser usada para o tratamento da malária devido à sua atividade antiplasmodial. Objetivo do estudo: Avaliação in vitro da atividade anti-microbiana e sinergética dos extratos hidroetanol (70%) e metanol de A. gorgonum (EHAG e EMAG) em bactérias do trato urinário e uma espécie de fungo. A atividade antioxidante dos extratos de hidroetanol (70%), metanol, clorofórmio e clorofórmio-metanol (1:2), e o efeito protetor de EHAG contra lesões hepáticas em ratos induzidos com CCl4 também foram analisados. Material e métodos: A atividade antimicrobiana dos extratos de A. gorgonum foi testada in vitro contra sete estirpes de microrganismos, incluindo bactérias Gram-positivas, Gram-negativas e uma espécie de fungo. O método DAA (Decimal assay for additivity) foi determinado para atividade antibacteriana do EHAG contra Pseudomonas aeruginosa. O efeito antioxidante in vitro de vários extratos de A. gorgonum foi analisado pelo método DPPH. A lesão hepática foi induzida por injeção intrapeitoral do CCl4. Seguidamente, os ratos foram administrados oralmente com EHAG, diariamente, por um período de 7 dias. Resultados e Discussão: Foi observada atividade antibacteriana dos extratos de EHAG e EMAG contra todos os microrganismos usados neste estudo. O crescimento das estirpes de Escherichia coli e Pseudomonas aeruginosa foi o mais inibido por ambos os extratos, apresentando valores significativos, enquanto o crescimento das estirpes S. aureus e Klebsiella spp. foi o menos afetado. Candida albicans foi inibida fortemente pelo EMAG. As combinações de extrato hidroetanólico com antibióticos demonstraram atividade antibacteriana sinergética contra todos os patogénicos testados. Em contrapartida, a combinação de extrato metanólico com antibióticos permitiu observar efeitos antagónicos contra todas as bactérias, exceto Klebsiella spp. que apresentou atividade sinérgica. O EHAG e EMAG mostraram efeito significativo na eliminação do radical DPPH. A atividade hepatoprotetora foi observada em ratos previamente administrados com CCl4. Estes estudos evidenciam os potenciais benefícios de A. gorgonum.

The economic effects of common agricultural policy on Mediterranean montado/dehesa ecosystem

The decoupling of CAP payments leads production decisions and resources allocation to be more dependent on market prices and competitive advantages. The objective of this paper is to assess the effects of CAP trends on the montado/dehesa traditional ecosystem of Mediterranean regions in terms of farm income, land, labour and capital. A positive mathematical supply model disaggregated by the montado agro-forestry production systems of the Alentejo region in southern Portugal is developed. The results show that decoupling payments of CAP have negative economic effects on agricultural activities and resource use. Agricultural income increases with single farm payments but the foreseen increases in prices do not compensate the loss of the Agenda 2000 area payments in terms of competitiveness. These results reinforce the need to promote alternative agricultural and non-agricultural activities and policies in Mediterranean rural European areas and regions. (C) 2011 Society for Policy Modeling. Published by Elsevier Inc. All rights reserved.

Technical and economic viability of traps in the portuguese fishery of deepwater rose shrimp (Parapenaeus longirostris)

Dissertação de mestrado, Aquacultura e Pescas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Evaluation of the economic impact of tourism expenditures in Portugal

Dissertação de Mestrado, Economia do Turismo e Desenvolvimento Regional, Faculdade de Economia, Universidade do Algarve, 2015

Replicating the Networking, Mentoring and Venture Creation Benefits of Entrepreneurship Centres on a Shoestring: A Student-centred Approach to Entrepreneurship Education and Venture Creation

As support for both university-level entrepreneurial education and the use of experiential learning methods to foster student entrepreneurs increases, so too have the number of university-established or affiliated entrepreneurship centers. The activity at the center of this study aimed to combine experiential learning methods with assets associated with entrepreneurship centers, including venture creation, networking, and mentoring. Students were invited to participate in a competition wherein they were guided through the business creation process and pitched their ideas to investor judges who chose the winner and provided capital start-up funding and consulting. This research puts forth that university faculty at institutions without entrepreneurship centers can organize experiences to provide the benefits of entrepreneurship centers. The study used interviews to find that many of the benefits of entrepreneurship centers were able to be replicated using this method. The project is outlined, outcomes are analyzed, and the results and lessons learned are discussed.

The role of telecommunications infrastructure in the regional economic growth of Africa

This paper presents empirical evidence on how telecommunications infrastructure is related to economic growth in a panel dataset covering 44 African countries for the period from 1990 to 2010. A dynamic panel data approach model is employed, which suggests that telecommunications contribute in a major way to the economic development of the continent, after controlling for a number of other factors. Furthermore, the findings also show that investment in telecommunications is subject to increasing returns, demonstrating that an increase in telecommunications investment produces further growth. Therefore, telecommunications investment and services should be encouraged in the region.

Success, satisfaction and scrutiny: the business benefits of involving residents

This document summarises work to develop a compelling business case for landlord investment in resident involvement. Its key argument is involvement not only assists in improving satisfaction and service delivery, but also provides value for money.

A case-control study of the health and wellbeing benefits of allotment gardening

Background - Allotments in the UK are popular and waiting lists long. There is, however, little evidence on the health benefits of allotment gardening. The aims of this study were to determine the impacts of a session of allotment gardening on self-esteem and mood and to compare the mental well-being of allotment gardeners with non-gardeners. Methods - Self-esteem, mood and general health were measured in 136 allotment gardeners pre- and post- an allotment session, and 133 non-gardener controls. Allotment gardeners also detailed the time spent on their allotment in the current session and previous 7 days, and their length of tenure. Results - Paired t-tests revealed a significant improvement in self-esteem (P < 0.05) and mood (P < 0.001) as a result of one allotment session. Linear regression revealed that neither the time spent on the allotment in the current session, the previous 7 days or the length of tenure affected the impacts on self-esteem and mood (P > 0.05). One-way ANCOVA revealed that allotment gardeners had a significantly better self-esteem, total mood disturbance and general health (P < 0.001), experiencing less depression and fatigue and more vigour (P < 0.0083). Conclusions - Allotment gardening can play a key role in promoting mental well-being and could be used as a preventive health measure

Economic Evaluation of Ticagrelor for Secondary Prevention Following Acute Coronary Syndromes

INTRODUCTION AND OBJECTIVES: To estimate the cost-effectiveness and cost-utility of ticagrelor in the treatment of patients with acute coronary syndromes (unstable angina or myocardial infarction with or without ST-segment elevation), including patients treated medically and those undergoing percutaneous coronary intervention or coronary artery bypass grafting. METHODS: A short-term decision tree and a long-term Markov model were used to simulate the evolution of patients' life-cycles. Clinical effectiveness data were collected from the PLATO trial and resource use data were obtained from the Hospital de Santa Marta database, disease-related group legislation and the literature. RESULTS: Ticagrelor provides increases of 0.1276 life years and 0.1106 quality-adjusted life years (QALYs) per patient. From a societal perspective these clinical gains entail an increase in expenditure of €610. Thus the incremental cost per life year saved is €4780 and the incremental cost per QALY is €5517. CONCLUSIONS: The simulation results show that ticagrelor reduces events compared to clopidogrel. The costs of ticagrelor are partially offset by lower costs arising from events prevented. The use of ticagrelor in clinical practice is therefore cost-effective compared to generic clopidogrel.

An economic appraisal of the wealth-health gradient

In this study we aim to investigate the health discrepancies arising from unequal economic status, known as the “wealth-health gradient”. Our sample comprises 47,163 individuals from 14 European countries in the SHARE Wave 4 (2011), representing the population aged 50 and older. Through a cross-sectional OLS regression model, we have tested the impact of country-level indicators to infer their effect on personal health and on the magnitude of the gradient. The results find that private expenditure yields, on average, a higher, but fast decreasing, health benefit than public expenditure; and that income inequality is irrelevant for reducing health inequalities.

“What matters?”: The case of sustainability reporting in Spain and Portugal

This project explores the case of Sustainability Reporting in Spain and Portugal and the recently launched new generation of Global Reporting Initiative Guidelines. The sample of the study is composed of companies included in the “GRI Report list 1999-2015”. In particular 2013 onwards 51 companies that published their G4 Report are taken into consideration. An indirect study is conducted based on the content of the sustainability reports of companies that implemented the Global Report Initiatives (GRI) reporting guidelines in order to identify focus areas of sustainability reporting in Spain and Portugal, analyzing trends and patterns relevant for observation. The project also promotes a discussion of the usability of the G4 guidelines and the adoption of materiality definition.