Access to medicines for acute illness in middle income countries in Central America

OBJECTIVE : To analyze the main predictors of access to medicines for persons who experienced acute health conditions. METHODS : This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition. RESULTS : The significant predictors of seeking health care for acute illnesses were urban geographic location, head of household with secondary school education or above, age under 15, severity of illness perceived by the respondent, and having health insurance. The most important predictor of obtaining full access to medicines was seeking care in the formal health care system. People who sought care in the formal system were three times more likely to receive all the medicines sought (OR 3.0, 95%CI 2.3;4.0). For those who sought care in the formal health system, the strongest predictors of full access to medicines were seeking care in the private sector, having secondary school education or above, and positive perceptions of quality of health care and medicines in public sector health facilities. For patients who did not seek care in the formal health system, full access to medicines was more likely in Honduras or Nicaragua than in Guatemala. Urban geographic location, higher economic status, and male gender were also significant predictors. CONCLUSIONS : A substantial part of the population in these three countries sought and obtained medicines outside of the formal health care system, which may compromise quality of care and pose a risk to patients. Determinants of full access to medicines inside and outside the formal health care system differ, and thus may require different strategies to improve access to medicines. 

Logística de coleta e transporte de material biológico e organização do laboratório central no ELSA-Brasil

O Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) é um estudo de coorte multicêntrico com o objetivo de identificar os fatores de risco associados ao diabetes tipo 2 e à doença cardiovascular na população brasileira. O artigo descreve as estratégias de coleta, processamento, transporte e de controle de qualidade dos exames de sangue e urina no ELSA. O estudo optou pela centralização dos exames em um único laboratório. O processamento das amostras foi realizado nos laboratórios locais, reduzindo o peso do material a ser transportado e diminuindo os custos do transporte para o laboratório central no Hospital da Universidade de São Paulo. O estudo incluiu exames para avaliação de diabetes, resistência à insulina, dislipidemias, alterações eletrolíticas, hormônios tireoidianos, ácido úrico, alterações de enzimas hepáticas, inflamação e hemograma completo. Além desses exames, foram estocados DNA de leucócitos, amostras de urina, plasma e soro. O laboratório central realizou aproximadamente 375.000 exames.

Soils of the Jurassic formations in the central Algarve; their occurrence, distribution, genesis and site qualities

In the central Algarve different soils have developed dependent on petrography of the parent material, slope position and recent erosion. The general patterns of occurence and distribution of different soils are described. The age of an eutric Nitosol is estimated and the relation between the soil and the parent material is investigated. Some different soils are described as examples with their chemical and physical properties. The water budget of soils is described in general with considerations concerning ground water recharge and run-off as well as in dependence of climate and of different site conditions.

Castor fiber na gruta do Caldeirão. Existência, distribuição e extinção do castor em Portugal

Beaver only had been found in Portugal in a Chalcolithic locality, the Vila Nova de S. Pedro castrum. It has now been identified in the Upper Paleolithic (Solutrean) from Gruta do Caldeirão, near Tomar. The species has been found recently at «Gruta do Almonda»; 4 teeth were collected in bed C, older than a Solutrean sequence (see Anexo for details). The species seems to have been rare, as it was also the case with portuguese Miocene Castoridae Enroxenomys minutus and Chalicomys jaegeri. If account is taken of the presence in the Middle Ages until Castille of words meaning beaver (relared to the popular latin Fiber/Biber), it is obvious that these animais still existed then. Such nouns were largely predominant over rhe rather erudite latin (greek deríved) words as Castor,-óris and derived ones, as it could be expected. This allowed us to recognize that veiro should be the corresponding word with Fiber affinities in archaic portuguese. It was previously supposed to mean only expensive furs then imported into Portugal. Indeed it was also a zoonym. Anywày, beaver should be scarce by XIIIth century since it is not included in the quite detailed price list imposed by the «Lei da Almotaçaria» from December 26, 1253 (see Quadro II). Toponyms in veiro and derived words (fig. 2; Quadro III) (plural, feminines, diminutives, inhabited places) give a resrrictive view of rhe Middle Age distribution. Some of them are certainly older than Portugal itself (firsr half of XIlth cenrury); others existed by the XIVth century bur were probably older. Some rare toponyms seem to be derived from the erudite latin Castor,-óris. Nothing suggests that these words were still in use as zoonyms during the Middle Ages. All toponyms are located in regions near rivers and other freshwaters ecologically suitable for beavers, so we can approximately retrace its former, Middle Age disrribution in Portugal (fig. 2; Quadro III). Most of them are locared in the Center-West and Northwest of Portugal, with a suitable c1imate (rainfall in general over 800 mílimerers per year); the only sure geographical exception is Veiros, in Alto Alentejo province, in a region with comparable precipitations and less dry climate conditions than mosr of the territories South of rhe Tagus. There are less and less of these toponyms towards rhe South and the inner part of the country, and they are enrirely lacking in all drier regions from Trás-os-Montes, Beira, Alentejo beyond Tagus' basin, and in Algarve. Nothing suggests beavers lived there, No post-medieval toponym is known, nor any reference after middle XVth century. No such locality was at, or close by to, any frontier. Hence the hypothesis of veiro (et al.} as meaning but points where expensive furs (supposedly known as veiros in general but without c1early saying from what animal they were obrained from) is to be discarded. During the Middle Ages, beaver discriburion concerned all the main river basins from Minho to Tagus ones. Quite rarefied in rhe XIIIth, the beavers may have disappeared from Portugal during the XVth century. Ecological requiremenrs restricted their former distriburion. Vulnerability to natural causes (i.e., severe drought) and to human pressure may have accounted heavily for this species' extinction. Last (1446) reference for Portugal known to us suggests the species was by then almost extinct.

Quantificação de metais em resíduos para valorização energética

Este trabalho tem como objectivo a quantificação de metais (Alumínio, Bário, Cádmio, Chumbo, Cobalto, Cobre, Crómio, Estanho, Níquel, Potássio, Selénio, Sódio, Antimónio, Vanádio, Zinco e Mercúrio), em resíduos com potencial para valorização energética, em particular o refugo da estação de triagem do embalão de Palmela e o rejeitado do TMB da Central de Setúbal. A partir destes resíduos pode produzir-se RDF que é um combustível heterogéneo e de elevado PCI, que é utilizado em diversos países Europeus, como a Alemanha, a Itália e a Holanda como combustível alternativo. Este tipo de combustível tem especial pertinência devido ao Protocolo de Quioto e à Directiva das Energias Renováveis, que sugerem a substituição dos combustíveis fósseis. Assim, indústrias como cimenteiras, produtoras de gesso, termoeléctricas entre outras podem fazer uso destes combustíveis de forma a cumprir alguns dos requisitos exigidos nestes documentos. Neste trabalho estudou-se o comportamento dos resultados dos metais relativamente à distribuição Normal, e sempre que possível, associaram-se intervalos com 95% de confiança para as médias, e fez-se uma comparação final entre os dois resíduos estudados. Seguidamente, fez-se a comparação dos valores das médias e dos máximos obtidos para os metais, com a Norma CEN/TC 343, com as Normas da Secil, EURITS, Alemanha, Finlândia, Itália e Suécia. Verificaram-se incumprimentos em todas as Normas estudadas, para ambos os resíduos, com excepção da Norma CEN/TC 343 e da Norma da Finlândia, segundo as quais estes resíduos podem ser usados na produção de RDF.

On the fractional central differences and derivatives

Fractional central differences and derivatives are studied in this article. These are generalisations to real orders of the ordinary positive (even and odd) integer order differences and derivatives, and also coincide with the well known Riesz potentials. The coherence of these definitions is studied by applying the definitions to functions with Fourier transformable functions. Some properties of these derivatives are presented and particular cases studied.

Critical reappraisal of Late Mesozoic-Cenozoic Central and North Atlantic, Caribbean and Mediterranean evolution

(l) The Pacific basin (Pacific area) may be regarded as moving eastwards like a double zip fastener relative to the continents and their respective plates (Pangaea area): opening in the East and closing in the West. This movement is tracked by a continuous mountain belt, the collision ages of which increase westwards. (2) The relative movements between the Pacific area and the Pangaea area in the W-EfE-W direction are generated by tidal forces (principle of hypocycloid gearing), whereby the lower mantle and the Pacific basin or area (Pacific crust = roof of the lower mantle?) rotate somewhat faster eastwards around the Earth's spin axis relative to the upper mantle/crust system with the continents and their respective plates (Pangaea area) (differential rotation). (3) These relative West to East/East to West displacements produce a perpetually existing sequence of distinct styles of opening and closing oeean basins, exemplified by the present East to West arrangement of ocean basins around the globe (Oceanic or Wilson Cycle: Rift/Red Sea style; Atlantic style; Mediterranean/Caribbean style as eastwards propagating tongue of the Pacific basin; Pacific style; Collision/Himalayas style). This sequence of ocean styles, of which the Pacific ocean is a part, moves eastwards with the lower mantle relative to the continents and the upper-mantle/crust of the Pangaea area. (4) Similarly, the collisional mountain belt extending westwards from the equator to the West of the Pacific and representing a chronological sequence of collision zones (sequential collisions) in the wake of the passing of the Pacific basin double zip fastener, may also be described as recording the history of oceans and their continental margins in the form of successive Wilson Cycles. (5) Every 200 to 250 m.y. the Pacific basin double zip fastener, the sequence of ocean styles of the Wilson Cycle and the eastwards growing collisional mountain belt in their wake complete one lap around the Earth. Two East drift lappings of 400 to 500 m.y. produce a two-lap collisional mountain belt spiral around a supercontinent in one hemisphere (North or South Pangaea). The Earth's history is subdivided into alternating North Pangaea growth/South Pangaea breakup eras and South Pangaea growth/North Pangaea breakup eras. Older North and South Pangaeas and their collisional mountain belt spirals may be reconstructed by rotating back the continents and orogenic fragments of a broken spiral (e.g. South Pangaea, Gondwana) to their previous Pangaea growth era orientations. In the resulting collisional mountain belt spiral, pieced together from orogenic segments and fragments, the collision ages have to increase successively towards the West. (6) With its current western margin orientated in a West-East direction North America must have collided during the Late Cretaceous Laramide orogeny with the northern margin of South America (Caribbean Andes) at the equator to the West of the Late Mesozoic Pacific. During post-Laramide times it must have rotated clockwise into its present orientation. The eastern margin of North America has never been attached to the western margin of North Africa but only to the western margin of Europe. (7) Due to migration eastwards of the sequence of ocean styles of the Wilson Cycle, relative to a distinct plate tectonic setting of an ocean, a continent or continental margin, a future or later evolutionary style at the Earth's surface is always depicted in a setting simultaneously developed further to the West and a past or earlier style in a setting simultaneously occurring further to the East. In consequence, ahigh probability exists that up to the Early Tertiary, Greenland (the ArabiaofSouth America?) occupied a plate tectonic setting which is comparable to the current setting of Arabia (the Greenland of Africa?). The Late Cretaceous/Early Tertiary Eureka collision zone (Eureka orogeny) at the northern margin of the Greenland Plate and on some of the Canadian Arctic Islands is comparable with the Middle to Late Tertiary Taurus-Bitlis-Zagros collision zone at the northern margin of the Arabian Plate.

Índice de distorção, parâmetros celulares e composição química de cordierite de granitóides e corneanas da região de Tondela - Oliveira do Hospital (Portugal Central)

Memórias e Noticias, PubI. Mus. Lab. Mineral. Geol., Univ. Coimbra, n.O 116, 1993

Fractional central pattern generators for bipedal locomotion

Locomotion has been a major research issue in the last few years. Many models for the locomotion rhythms of quadrupeds, hexapods, bipeds and other animals have been proposed. This study has also been extended to the control of rhythmic movements of adaptive legged robots. In this paper, we consider a fractional version of a central pattern generator (CPG) model for locomotion in bipeds. A fractional derivative D α f(x), with α non-integer, is a generalization of the concept of an integer derivative, where α=1. The integer CPG model has been proposed by Golubitsky, Stewart, Buono and Collins, and studied later by Pinto and Golubitsky. It is a network of four coupled identical oscillators which has dihedral symmetry. We study parameter regions where periodic solutions, identified with legs’ rhythms in bipeds, occur, for 0<α≤1. We find that the amplitude and the period of the periodic solutions, identified with biped rhythms, increase as α varies from near 0 to values close to unity.

Estudo da distribuição de dose em torno de fontes usadas em braquiterapia

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

Fractional central differences and derivatives

Journal of Vibration and Control, Vol. 14, Nº 9-10

Distribuição de Alcatraz (Morus bassanus) na costa continental portuguesa e sua relação com variáveis ambientais

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do Grau de Mestre em Ecologia, Gestão e Modelação dos Recursos Marinhos

Suporte à computação paralela e distribuída em Java: distribuição e execução de trabalho

Nos últimos anos começaram a ser vulgares os computadores dotados de multiprocessadores e multi-cores. De modo a aproveitar eficientemente as novas características desse hardware começaram a surgir ferramentas para facilitar o desenvolvimento de software paralelo, através de linguagens e frameworks, adaptadas a diferentes linguagens. Com a grande difusão de redes de alta velocidade, tal como Gigabit Ethernet e a última geração de redes Wi-Fi, abre-se a oportunidade de, além de paralelizar o processamento entre processadores e cores, poder em simultâneo paralelizá-lo entre máquinas diferentes. Ao modelo que permite paralelizar processamento localmente e em simultâneo distribuí-lo para máquinas que também têm capacidade de o paralelizar, chamou-se “modelo paralelo distribuído”. Nesta dissertação foram analisadas técnicas e ferramentas utilizadas para fazer programação paralela e o trabalho que está feito dentro da área de programação paralela e distribuída. Tendo estes dois factores em consideração foi proposta uma framework que tenta aplicar a simplicidade da programação paralela ao conceito paralelo distribuído. A proposta baseia-se na disponibilização de uma framework em Java com uma interface de programação simples, de fácil aprendizagem e legibilidade que, de forma transparente, é capaz de paralelizar e distribuir o processamento. Apesar de simples, existiu um esforço para a tornar configurável de forma a adaptar-se ao máximo de situações possível. Nesta dissertação serão exploradas especialmente as questões relativas à execução e distribuição de trabalho, e a forma como o código é enviado de forma automática pela rede, para outros nós cooperantes, evitando assim a instalação manual das aplicações em todos os nós da rede. Para confirmar a validade deste conceito e das ideias defendidas nesta dissertação foi implementada esta framework à qual se chamou DPF4j (Distributed Parallel Framework for JAVA) e foram feitos testes e retiradas métricas para verificar a existência de ganhos de performance em relação às soluções já existentes.

Radio frequency identification: o futuro da gestão de stocks na grande distribuição

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Estatística e Gestão de Informação

Pesados híbridos na distribuição alimentar

Dissertação apresentada ao Instituto Politécnico do Porto para obtenção do Grau de Mestre em Logística Orientada por: Professora Doutora Patrícia Alexandra Gregório Ramos