Mental health and neuroscience. A perspective from the magazine market

Mental health awareness has been rising worldwide, motivated by its social and economic costs. Despite the investment in research in neuroscience in the recent years, little is known about the underlying mechanisms in the brain that are correlated with psychiatric conditions. This project, through two feature articles suitable to be published in magazines, provides perspectives onto mental health research. First it presents an example where psychiatry joins forces with neuroscience and computer science in an interdisciplinary effort to improve the life of those affected by mental disorders. The second article gathers opinions which claim that mental health research priorities should be set by patients themselves, or even that people with lived experience of mental health issues should have an active role in that research. This project was planned and researched while I was an Erasmus student at Nottingham Trent University, in the United Kingdom.

Responsible research and innovation: a global perspective

Based on the paper presented at the Doctorate Conference on Technologogy Assessment in July 2013 at the University Nova Lisboa, Caparica campus

Arboviral diseases in the Western Brazilian Amazon: a perspective and analysis from a tertiary health & research center in Manaus, State of Amazonas

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.

Critérios de adequação em ecocardiografia e a repercussão clinica no outcome do paciente: a realidade do Lister Hospital - East and North Hertfordshire NHS Trust, Reino Unido

RESUMO - Introdução: Os critérios de adequação (Appropriate Use Criteria - AUC) em Ecocardiografia Transtorácica (ETT) foram publicados com o intuito de permitir o uso racional da ecocardiografia, de influenciar decisões clinicas, prestar cuidados de saúde de elevada qualidade e melhorar o outcome dos pacientes. A relação entre a adequação destes e o seu impacto clinico ainda não se encontra largamente estudada. Objectivo: Neste estudo pretendeu-se avaliar o grau de adesão aos AUC em ETT, em diferentes contextos de atendimento e de acordo com diferentes especialidades, bem como o impacto clínico do exame no outcome do paciente, num hospital público terciário no Reino Unido. Metodologia: 859 ETTs realizados consecutivamente no mês de Janeiro de 2014, foram revistos por forma a avaliar a sua adequação e foram classificados como adequados, incertos ou inadequados de acordo com as guidelines de 2011. De seguida os registos dos pacientes foram revistos com o intuito de avaliar o impacto clinico dos ETTs e foram classificados de acordo com uma das 3 seguintes categorias: (1) alteração ativa dos cuidados – por continuação ou descontinuação dos cuidados como resultado do ETT, (2) continuação dos cuidados – sem continuação ou descontinuação dos cuidados, mas comunicação ao paciente dos resultados do ETT, (3) sem alteração dos cuidados – os cuidados ao paciente já estavam a ser aplicados previamente ao resultado do ETT, causa de sintomas já estabelecida no momento da requisição para exame, exame prévio explicativo dos sintomas e sem indicação aguda para novo ETT, terapêutica não alterada ou inexistência de documentação relativa aos achados ecocardiográficos. Pacientes cujos registos não se encontravam disponíveis foram excluídos (259). Todas as classificações foram avaliadas por uma cardiologista independente, sem relação direta com o estudo. Resultados: A nossa amostra apresentou uma média de idades de 63 ± 17 anos, com uma equilíbrio de géneros. A maioria dos exames foi solicitada em contexto de ambulatório (81,4%), pela Cardiologia (50,3%) e pela Medicina Geral e Familiar (13,4%). Relativamente aos achados ecocardiográficos dos exames, 7,6% demonstraram disfunção sistólica do ventrículo esquerdo moderada a grave, 4,0% revelaram doença valvular grave e 5,1% hipertensão pulmonar significativa. Em relação à adequação dos pedidos para ETTs, 76,5% foram adequados, 7,1% inadequados e 12,6% incertos. Relativamente ao impacto clínico dos ETTs, 42,7% dos exames revelaram uma alteração ativa nos cuidados, 15,6% mostraram uma continuação dos cuidados e 11,5% demonstraram não haver alteração nos cuidados. A idade (P=0,05), o contexto de atendimento (P<0,01) e o pedido realizado pela especialidade medicina geral e familiar (MGF) (P=0,02) foram os preditores mais importantes de uma alteração ativa nos cuidados. Numa perspectiva de prestação de cuidados a uma população mais idosa, o contexto de atendimento, a presença de achados ecocardiográficos significativos e a não alteração dos cuidados apresentam uma relação significativa com a idade. Conclusões: Os dados demonstram que quase 8 em cada 10 ETTs foram considerados adequados e que 4 em cada 10 exames não apresentaram alteração ativa dos cuidados.

US fiscal dynamics in political perspective

Given the importance of fiscal balance for ensuring a sustainable fiscal policy, we conduct an empirical examination of fiscal dynamics in the United States in response to unsustainable budget deviations. We concentrate on the role of political factors, namely the Republican - Democrat presidential divide, in determining the fiscal response to budget disequilibria. Making use of an asymmetric cointegration framework, we explore politically motivated fiscal asymmetries in the US, from Eisenhower to Obama. We conclude that political factors such as the government’s political quadrant and the timing of elections are important determinants of the fiscal response to unsustainable budget deviations.

Paving the way? Female leadership and attitudes toward gender

In a male dominant political world, the cases of female leadership are still a novelty. Looking at the episodes where a woman was head of state or government, the impact on attitudes and perceptions toward gender equality is evaluated. By instrumenting the presence of a female in government with the proportion of female seats in parliament, the results seem to suggest that individuals, when exposed to a woman as an executive political leader, report a higher tendency to agree with statements of gender discrimination.

New insights on nevirapine use: A mechanistic perspective of its toxic events

Introdução: A nevirapina (NVP) é um fármaco amplamente utilizado para o tratamento da infecção pelo vírus da imunodeficiência humana de tipo 1 (VIH-1), no entanto, a sua utilização na terapêutica crónica tem sido associada à toxicidade hepática e cutânea. O sexo feminino é um factor de risco para o desenvolvimento destes eventos tóxicos, mas as razões para essa diferença entre o sexo feminino e masculino não estão completamente esclarecidas. Diferenças na biotransformação da NVP e na formação de metabolitos tóxicos podem ser as causas subjacentes. O presente trabalho teve como objectivo explorar as diferenças entre homens e mulheres na biotransformação da NVP, como um potencial factor de toxicidade induzida por este fármaco anti-retroviral. Materiais e Métodos: Todos os indivíduos incluídos no presente estudo eram adultos com infecção por VIH-1 confirmada, tratados com 400 mg de NVP uma vez ao dia, durante pelo menos 1 mês. Foram colhidas amostras de sangue e os níveis de NVP e dos metabolitos de fase I foram determinados por cromatografia líquida de alta performance. Os dados antropométricos e clínicos e os perfis de metabolitos foram avaliados de forma a averiguar possíveis diferenças relacionadas com o sexo dos indivíduos. Resultados: Foram incluídos 52 doentes (63% do sexo masculino). O peso corporal foi inferior nas mulheres (p = 0.028) e o sexo feminino foi associado a maiores níveis de fosfatase alcalina (p = 0.036) e lactato desidrogenase (p = 0.037). Os níveis plasmáticos de NVP (p = 0.030) e 3-hidroxi-NVP (p = 0.035), assim como as proporções de 12-hidroxi-NVP (p = 0.037) e 3-hidroxi-NVP (p = 0.001) foram maiores nas mulheres, quando ajustados pelo peso corporal dos indivíduos. Discussão: Existem diferenças na biotransformação da NVP entre homens e mulheres, particularmente na formação de 12-hidroxi-NVP e 3-hidroxi-NVP. Estes resultados apontam para uma formação de metabolitos reactivos, que é dependente do sexo e que pode contribuir para o perfil de dimorfismo sexual associado às reacções tóxicas induzidas pela NVP.

The effect of music marketing: A consumer perspective

The purpose of this thesis is to get a consumer perspective regarding event marketing in music festivals. Event marketing is a tool used by marketers that evolved out of philanthropy and commercial sponsorship. Brands are more and more using music or other entertainment moments to create a strong relationship with their clients, and the target group at these events, the millennial generation. Brands use sponsoring and therefore event marketing for several reasons as: increase brand awareness; create brand image; re-position the brand/product in the minds of consumers; increase profit over a short period; and, achieve larger market share. Nonetheless, we wonder how is this tool seen by consumers? To understand this, a preliminary research with nine interviews was conducted to obtain basic ideas about event marketing. Afterwards the main research was developed, also using interviews, to get deeper insights. With this thesis, it is possible to conclude that some brands are able to create brand awareness on attendees through brand sponsorship. Moreover, entertainment activities in festivals are well seen by consumers, they like it and are able to describe it well, even though it is more about the activity itself than the brand promoting it. Furthermore, it was possible to understand that experiential marketing in a festival might have a positive effect on consumers as it might create a link between the event and the brand. Finally, we recommend some actions, for brands to develop in future music festivals.

A behavioral perspective on the effects of using performance measurement systems in the companies: Evidence from a case study

The effects of PMSs on the people’s behaviour represent a high degree of relevance in the context of an organization performance and success. Thus, motivational and behavioural consequences of performance measurements are far from being totally understood (Franco-Santos et al., 2012). This work project (WP) purposes going further regarding the consequences/effects on people’s behaviour of using PMSs in organizations. The researcher conducted 11 interviews to managers during a nine-month internship as a controller in a Portuguese multi-national company. The evidence from this WP suggests that the way how managers understand a PMS determines a lot the way how they behave. Data also supports that PMSs influences in several ways motivation, perceptions, participation and job-related stress of managers.

The global shopper & brands communication at airports

This project aims to illuminate two perspectives on travel retail. On the one hand, it describes the main character of the shopping scenario at airports, namely the Global Shopper. It covers the entire profile of the referred character, the main nationalities that represent him and the current shopping trends of the passenger. Also estimates of the booming nationalities and the future purchasing trends are accurately presented. On the other hand, the travel retail market is analyzed from the airport brands’ perspective. It is described what is currently done in terms of brands communication in the top ten airports around the world and the expected future market retail trends. To accurately explore the Global Shopper behavior and purchasing preferences, a market research was conducted with a sample of 128 respondents, male and female, from different nationalities, age groups, occupation and education backgrounds. The essay tests hypothesis regarding the relevance of several variables in the purchasing process of the Global Shopper in order to understand the most pleasant way to approach consumers in travel retail. The main variables studied concern the reasons to shop at airports, to whom the passenger shops, the preferred category and brand of purchase, feelings while shopping abroad, impulsive buying behavior, brand loyalty, the use of mobile devices in the shopping process, brands communication at airports, pre-ordering online and the attitude towards self-service stores. Some findings were in accordance with expectations, while others were a surprise and may produce valuable recommendations for future travel retail practices. 4 The main relevant results concern two areas, namely pre-ordering online and self-service stores. Results showed a certain stress about not having enough time to choose between the various offerings in travel retail, as well as difficulty in dealing with crowed stores. However, pre-ordering online was not common, which would be an initiative that could solve the discomfort at airport’s stores. Moreover, self-service would promote efficiency in stores allowing passengers to save time if they already know how to go through the shopping process by themselves. Another possible recommendation concerns differentiating the strategy in travel retail for the two genders. Some differences were found in the categories bought by male and female, as well as to how brands should shape their approach concerning the demands of each gender.

Audit quality: does gender composition of audit firms matter?

Using a sample of Portuguese audit firms and their client companies, this study examines the association between gender composition of the partnership structure oaudit firms and audit quality. Audit quality is measured through the earnings quality of audit clients. We find that gender diversity in the partnership structure of audit firms, per se, has no association with audit quality. In turn, we find significant evidence that a predominant presence of female Certified Public Accountants (CPAs) in partner positions in audit firms is associated with higher audit quality. In particular, the results indicate that audit firms with female-dominated partnership structures are negatively related with aggressive accounting practices in audit clients.

Gender norms in Portuguese college sudents' judgments in familial homicides: bad men and mad women

The gender of the offender has been proved to be an important factor in judicial sentencing. In this study, we analyze the judgments of College students regarding perpetrators of familial homicides to evaluate the presence of these gender norms and biases in the larger society. The sample included 303 college students (54.8% female) enrolled in several social sciences and engineering courses. Participants were asked to read 12 vignettes based on real crimes taken from Portuguese newspapers. Half were related to infanticide, and half were related to intimate partner homicide. The sex of the offender was orthogonally manipulated to the type of crime. The results show that gender had an important impact on sentences, with males being more harshly penalized by reasons of perversity and women less penalized by reason of mental disorders. In addition, filicide was more heavily penalized than was intimate partner homicide. The results also revealed a tendency toward a retributive conception of punishment. We discuss how gender norms in justice seem to be embedded in society as well as the need for intervention against the punitive tendency of this population.

Caught between changing tides: Gender and kinship in Cape Verde

Gender ideologies in Cape Verde are shifting. Individuals find themselves caught between changing tides, pushed and pulled in opposite directions by divergent gendered expectations. The article examines the different ways in which young women and men take recourse to tactics in response to the tensions that arise as they deal with changing gender ascriptions in the midst of their relations with community and kin. Women, in particular, are unevenly affected by traditional demands and expectations whilst they cross the boundaries of traditional gender roles in their pursuit of enhanced education and more sexual freedom. Yet, their actions are not characterized by an outright rejection of traditional gender ideologies, but rather by piecemeal tactical manoeuvres to plot a route through the centrifugal forces at play. keywords

Para cá e para lá dos muros: relações familiares na interface entre o interior e o exterior da prisão

Tese de Doutoramento em Sociologia