Da prova: na atuação policial e no âmbito da infração tributária

Relatório de atividade profissional de mestrado em Direito Judiciário

“It’s a complicated situation”. Harm in everyday experiences with technology. A qualitative study with school-aged children

Tese de Doutoramento em Ciências da Educação (Especialidade de Tecnologia Educativa)

Fathers’ emotional involvement with the neonate: impact of the umbilical cord cutting experience

Aims. This paper is a report on a study analysing the effect of the umbilical cord cutting experience on fathers’ emotional involvement with their infants. Background. Participation in childbirth offers an opportunity for father and mother to share the childbirth experience, so it is vital that midwives improve the fathers’ participation in this event. Design. A quasi-experimental study with a quantitative methodology was implemented. Methods. One hundred and five fathers were recruited as part of a convenience sample in a Maternity Public Hospital in a Metropolitan City in Portugal, between January and May of 2008. The Bonding Scale, the Portuguese version of the ‘Mother-to-Infant Bonding Scale’ was used to evaluate the fathers’ emotional involvement with the neonate at different moments: before childbirth, first day after childbirth and first month after childbirth. After childbirth, the fathers were divided into three separate groups depending on their umbilical cord cutting experience. Results. The results demonstrate that the emotional involvement between father and child tends to increase during the first days after childbirth and to decrease when evaluated 1 month after birth, for fathers who did not cut the umbilical cord. However, fathers who cut the umbilical cord demonstrate an improvement in emotional involvement 1 month later. Conclusion. Results suggest that the umbilical cord cutting experience benefits the father’s emotional involvement with the neonate, supporting the benefits of his participation and empowerment in childbirth.

Training and development in Irish technology companies

The sustained economic growth that has been experienced in the Irish economy in recent years has relied, to a large extent, on the contribution and performance of those industry sectors that possess the ability to provide high-value-added products and services to domestic and international markets. One such contributor has been the Technology sector. However, the performance of this sector relies upon the availability of the necessary capabilities and competencies for Technology companies to remain competitive. The Expert Group on Future Skills Needs have forecasted future skills shortages in this sector. The purpose of this research has been to examine the extent to which Irish Technology companies are taking measures to meet changing skills requirements, through training and development interventions. Survey research methods (in the form of a mail questionnaire, supported by a Web-based questionnaire) have been used to collect information on the expenditure on, and approach to, training and development in these companies, in addition to the methods, techniques and tools/aids that are used to support the delivery of these activities. The contribution of Government intervention has also been examined. The conclusions have been varied. When the activities of the responding companies are considered in isolation, the picture to emerge is primarily positive. Although the expenditure on training and development is slightly lower than that indicated in previous studies, the results vary by company size. Technical employees are clearly the key focus of training provision, while Senior Managers and Directors, Clerical and Administrative staff and Manual workers are a great deal more neglected in training provision. Expenditure on, and use of, computer-based training methods is high, as is the use of most of the specified techniques for facilitating learning. However, when one considers the extent to which external support (in the form of Government interventions and cooperation with other companies and with education and training providers) is integrated into the overall training practices of these companies, significant gaps in practice are identified. The thesis concludes by providing a framework to guide future training and development practices in the Technology sector.

The concept of risk management in the renewable sector.

This study explores the perception of risk and the level of risk management implementation in the renewable sector. Risk management is emerging as a key issue due to the loss of confidence amongst banks, causing the attainment of financing to be difficult over the next few years. To attract financing, there is a fundamental requirement to manage risk in a way that minimizes the probability of a negative financial impact on the project. Miller and Lessard (2001) argue that successful projects are not selected but shaped with risk resolution in mind. Rather than evaluating projects at the outset based on projections of the full set of benefits, costs and risks over their lifetime, successful developers start with project ideas that have the potential of becoming viable. Therefore, this study bridges the gap that exists within the renewable sector in relation to risk management literature. This study succeeds through a detailed comparative case study analysis where two developers and two financiers were questioned through qualitative semi-structured interviews on the concept of risk management and its level implementation within the industry. It is believed that the growth in financed renewable energy projects depends on the adequate design and implementation of risk management to mitigate inherent project risks. However, this study revealed that are certain types of developers in existence within the renewable sector, which underestimate the magnitude of risk and view the development of projects as a ‘money racket’. Therefore, it can be concluded that perception of risk will also differ, causing risk and uncertainty to vary from project to project, resulting in investment reluctance to be associated with certain projects. The study originality lies in how it demonstrates to developers the concept of risk management, outlining the simplicity and benefits of implementing it in project development. Finally, this study contributes to the knowledge by enhancing the awareness and understanding of the presence and nature of risk in a RE project environment.

Stroke

Stroke is a preventable and treatable disease. It can present with the sudden onset of any neurological disturbance, including limb weakness or numbness, speech disturbance, visual loss or disturbance of balance. Over the last two decades, a growing body of evidence has overturned the traditional perception that stroke is simply a consequence of aging which inevitably results in death or severe disability. Evidence is accumulating for more effective primary and secondary prevention strategies, better recognition of people at highest risk and thus most in need of active intervention, interventions that are effective so on after the onset of symptoms, and an understanding of the processes of care that contribute to a better outcome. In addition, there is now good evidence to support interventions and care processes in stroke rehabilitation. In the UK, the National Sentinel Stroke Audits 2,3 have documented changes in secondary care provision over the last 10 years, with increasing numbers of patients being treated in stroke units, more evidence-based practice, and reductions in mortality and length of stay. In order for evidence from research studies to improve outcomes for patients, it needs to be put into practice. National guidelines provide clinicians, managers and service users with summaries of evidence and recommendations for clinical practice. Implementation of guidelines in practice, supported by regular audit, improves the processes of care and clinical outcome. This guideline covers interventions in the acute stage of a stroke (‘acute stroke’) or transient ischaemic attack (TIA). Most of the evidence considered relates to interventions in the first 48 hours after onset of symptoms, although some interventions of up to 2 weeks are covered as well. This guideline is a stand-alone document, but is designed to be read alongside the Intercollegiate Stroke Working Party guideline ‘National clinical guideline for stroke’* which considers evidence for interventions from the acute stage into rehabilitation and life after stroke. The Intercollegiate Stroke Working Party guideline is an update of the 2004 2nd edition and includes all the recommendations contained within this guideline. This acute stroke and TIA guideline is also designed to be read alongside the Department of Health’s (DH) ‘National stroke strategy’ (NSS). Where there are differences between the recommendations made within this acute stroke and TIA guideline and the NSS, the Guideline Development Group (GDG) members feel that their recommendations are derived from systematic methodology to identify all of the relevant literature.

Ecological conflicts and valuation - mangroves vs. shrimp in the late 1990s

Shrimps are produced in two different ways. They are fished in the sea (sometimes at the cost of turtle destruction) or they are "farmed" in ponds in coastal areas. Such aquaculture is increasing around the world as shrimps become a valuable item of world trade. Mangrove forests are sacrificed for commercial shrimp farming. This paper considers the conflict between mangrove conservation and shrimp exports in different countries.Who has title to the mangroves, who wins and who loses in this tragedy of enclosures? Which languages of valuation are used by different actors in order to compare the increase in shrimp exports and the losses in livelihoods and in environmental services? The economic valuation of damages is only one of the possible languages of valuation which are relevant in practice. Who has the power to impose a particular language of valuation?

Constrained school choice

Recently, several school districts in the US have adopted or consider adopting the Student-Optimal Stable Mechanism or the Top Trading Cycles Mechanism to assign children to public schools. There is clear evidence that for school districts that employ (variants of) the so-called Boston Mechanism the transition would lead to efficiency gains. The first two mechanisms are strategy-proof, but in practice student assignment procedures impede students to submit a preference list that contains all their acceptable schools. Therefore, any desirable property of the mechanisms is likely toget distorted. We study the non trivial preference revelation game where students can only declare up to a fixed number (quota) of schools to be acceptable. We focus on the stability of the Nash equilibrium outcomes. Our main results identify rather stringent necessary and sufficient conditions on the priorities to guaranteestability. This stands in sharp contrast with the Boston Mechanism which yields stable Nash equilibrium outcomes, independently of the quota. Hence, the transition to any of the two mechanisms is likely to come with a higher risk that students seek legal actionas lower priority students may occupy more preferred schools.

L' Aprenentatge basat en problemes a través de casos clínics simulats. Una proposta metodològica de disseny i avaluació docent

RESUM Les exigències actuals de la professió de d’infermeria requereixen que la docència vagi orientada a interrelacionar els diferents rols a desenvolupar enla pràctica diària, per adquirir experiència en l’aprenentatge i així augmentar la qualitat de les cures d’infermeria. Per assolir aquest objectiu és important l’aprenentatge basat enproblemes. Aquest pretén en primer lloc que els estudiants aprenguin allò que permet desenvolupar-se enla vida professional de la manera més natural possible a partir d’una idea clara i profunda de l’evidència sobre la que s’ha d’actuar. Amb aquesta finalitat es vandissenyar casos clínics amb uns objectius que requerien la integració de coneixements, actituds i valors, en diferents fases a desenvolupar en un període de temps predeterminat. També ens vam proposar una estratègia docent que permetés a l’estudiant incorporar el coneixement científic que dóna suport a la pràctica assistencial per aproximar teoria i pràctica. Es pretén que els estudiants busquin una resposta basada en la millor evidència científica disponible, per prendre una decisió respecte a les cures del pacient. Els objectius de l’estudi són: Avaluar globalment l’aprenentatge basat en la simulació de casos Avaluar com els estudiants valoren la integració del model d’infermeria i del procés d’atenció en l’aprenentatge basat en la simulació de casos. Valorar les sensacions percebudes per l’estudiant durant la simulació del cas. Valorar l’actitud d el’estudiant en relació a la incorporació de l’evidència científica per una millora en la pràctica clínica. Avaluar el grau de dificultat manifestat per l’estudiant en relació al procés de documentació. Avaluar la idonietat de l’argumentació i la decisió de l’estudiant a la pregunta formulada en el cas clínic. Metodologia: L’assignatura d’Infermeria Medicoquirúrgica. Adult I del Departament d’Infermeria de la Universitat de Vic, va iniciar una experiència d’aprenentatge basat en la resolució de problemes, amb estudiants de 2on curs. Les professores responsables dels seminaris van realitzar una avaluació de l’experiència a través d’una enquesta. Aquesta es responia al cap d’un mes de la simulació al laboratori, quan es contrastaven els resultats obtinguts en aquesta entre professores i estudiants després de visualitzar la gravació feta durant el mateix. En el context del seminari de simulació de casos, es va introduir una pregunta/problema, a partir de la que els estudiants, en grup, havien de documentar-se amb el suport d’una guia. Per valorar l’actitud davant aquesta pregunta/problema es va dissenyar un qustionari tipus Likert. L’avaluació del grau de dificultat s’ha registrat a través d’unes escales de puntuació. Per a l’avaluació de la decisió presa, es van valorar les síntesis resum entregades en els treballs escrits pels diferents grups. Resultats: La realització de la simulació en el laboratori va ser avaluada per un alt percentatge d’estudiants (68,8%) amb puntuacions entre 6 i 8 mentre que un 26,6% la van situar en tre 9 i 10, només un 4,7 % la van puntuar amb 5. La integració del model d’infermeria va ser valorada pel 86% amb una puntuació entre 7 i 10. La valoració global de la simulació va ser qualificada pels estudiants amb una puntuació de 8 (34,4%) seguida d’un 28,1% amb una consideració de 7. Un 7,2% van puntuar entre 9 i 10. El 93,3% van assegurar que conèixer les fonts documentals els serviria per millorar l’assistència, el 86,7% esperen obtenir arguments sòlids respecte les seves desicions si la documentació consultada és de qualitat. Un 77,8% dels estudiants consideren estar més satisfets al saber incorporar la presa de decisions basada en evidències. Respecte el grau de dificultat en el procés de documentació la dificultat més gran la presenten en com buscar en les bases de dades de referències bibliogràfiques. Conclusions: L’aprenentatge dels estudiants a través de la simulació de casos és una estratègia vàlida que l’estudiant valora positivament al mateix temps que permet desenvolupar habilitats per a la pràctica professional. L’estratègia docent dissenyada per integrar les evidències en la presa de decisions es considera positiva, no obstant, després d’analitzar els resultats, s’han de modificar alguns aspectes per a la seva millora; tutoritzar per a millorar el procés de documentació i incidir més en la crítica i reflexió, de manera que les troballes de la investigació siguin canalitzades cap a la pràctica.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Weak recommendations (2) indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); and a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSIONS: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

The causal relationship between Individual’s choice behavior and self-reported satisfaction: the case of residential mobility in the EU

One of the most persistent and lasting debates in economic research refers to whether the answers to subjective questions can be used to explain individuals’ economic behavior. Using panel data for twelve EU countries, in the present study we analyze the causal relationship between self-reported housing satisfaction and residential mobility. Our results indicate that: i) households unsatisfied with their current housing situation are more likely to move; ii) housing satisfaction raises after a move, and; iii) housing satisfaction increases with the transition from being a renter to becoming a homeowner. Some interesting cross-country differences are observed. Our findings provide evidence in favor of use of subjective indicators of satisfaction with certain life domains in the analysis of individuals’ economic conduct.

Choice of Contracts in the British National Health Service: An Empirical Study

Following major reforms of the British National Health Service (NHS) in 1990, the roles of purchasing and providing health services were separated, with the relationship between purchasers and providers governed by contracts. Using a mixed multinomial logit analysis, we show how this policy shift led to a selection of contracts that is consistent with the predictions of a simple model, based on contract theory, in which the characteristics of the health services being purchased and of the contracting parties influence the choice of contract form. The paper thus provides evidence in support of the practical relevance of theory in understanding health care market reform.

Monetary Policy in Times of Financial Stress.

Some studies argue that the Fed reacts to financial market developments. Using data covering the period 1985:Q1 - 2008:Q4 and employing an augmented Taylor rule specification, we re-examine that conjecture. We find that evidence in favour of such a reaction is largely driven by the Fed’s behaviour during the 2007-2008 financial crisis.

Multilayer perceptron with local constraint as an emerging method in spatial data analysis

The use of Geographic Information Systems has revolutionalized the handling and the visualization of geo-referenced data and has underlined the critic role of spatial analysis. The usual tools for such a purpose are geostatistics which are widely used in Earth science. Geostatistics are based upon several hypothesis which are not always verified in practice. On the other hand, Artificial Neural Network (ANN) a priori can be used without special assumptions and are known to be flexible. This paper proposes to discuss the application of ANN in the case of the interpolation of a geo-referenced variable.

Public particiation and the legitimacy of intergovernmental decision-making : a focus on the World Trade Organization

The legitimacy of the WTO's decision-making process has always been questioned, and many have advocated public participation mechanisms as a remedy. The present study considers the limits and potential of these mechanisms by advancing a conceptual framework, which distinguishes the four 'implementation parameters' of public participation: the goal, the object, the modalities, and the actors. It addresses the issue of legitimacy by considering to what extent, and by virtue of which legal developments, one can see implementing the democratic principle as a goal for public participation in the context of the WTO. By analyzing the institutional structure of the WTO and its different types of decisions, it then outlines how this goal should influence the object and modalities of public participation, which decision-making procedures should be opened to public participation, and how the mechanisms should be implemented in practice. Finally, it suggests speciflrc amendments to existing WTO affangements on public participation