Espectrometria de massa com modulação lock-in

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

A introdução de mecanismos de competição e o quadro legal básico do Sistema Nacional de Saúde português : a perspectiva hospitalar

RESUMO - O presente trabalho de projecto visa analisar a introdução de mecanismos de competição do ponto de vista do quadro legal básico – Constituição e Lei de Bases da Saúde – que enforma o sistema de saúde português e principalmente, o seu impacte ao nível do meio hospitalar. Pretende-se aferir se a implementação de ferramentas de mercado no meio em apreço encontra previsão naqueles diplomas legais, sendo por isso, permissivos quanto ao seu desenvolvimento ou se, por outro lado, o nosso enquadramento legal se revela hostil ao seu desenvolvimento. O estudo foi desenvolvido com recurso, essencialmente, à pesquisa e revisão bibliográficas que serão transversais aos capítulos que compõem o enquadramento conceptual, à hermenêutica para efeitos de aplicação à temática da descrição do quadro legal básico e à análise das hipóteses de trabalho apresentadas. Os resultados obtidos permitem concluir que, via de regra, o quadro legal básico do sistema de saúde português é permissivo à introdução de mecanismos de competição, encontrando mesmo, alguns deles, eco legal em disposições datadas de final da década de ’60. Este grau de permissividade tanto é comprovável através de estatuições que directamente prevêem determinada ferramenta, como através da ausência de previsão que no nosso ordenamento jurídico, não é sinónimo de proibição. ----------------------------------ABSTRACT - This essay analyses the existing relation between the introduction of competition tools in the Portuguese health care system and its basic legal framework – the Constitution and the Health Bases Law – particularly from the hospital’s point of view. We aim to assess if the use and implementation of those tools are permissible by law or if, on the other hand, our legal system is hostile towards that introduction. Preferably we used bibliographical research in almost every chapter and hermeneutics allowed us to perform a detailed analysis of the basic legal framework. We conclude that, most of the times, the Portuguese basic legal framework is permissible to the use of such tools and some of the legislative acts date from the late sixties. That can be encompassed by existing or non-existing statutes – since in our legal system what is not specifically foreseen is not, necessarily forbidden.

Fundamentos teóricos e objectivos estratégicos de uma unidade de ética em saúde pública : caso de estudo : o gabinete de ética e responsabilidade da Direcção-Geral da Saúde

RESUMO - Este trabalho de projecto visa responder à questão de saber como gerir uma unidade de ética num serviço público central de saúde pública, “de forma racional e informada”, definindo os seus objectivos estratégicos (Baranger, citando Drucker, 1990) utilizando como caso de estudo o Gabinete de Assuntos Jurídicos, Ética e Responsabilidade, adiante designado por Gabinete, da Direcção‐Geral da Saúde. Para o efeito, fez‐se, em primeiro lugar, uma abordagem teórica descritiva das bases filosóficas da ética realçando a sua aplicação prática na determinação das características dos sistemas de saúde. Em seguida, analisa‐se a utilização do conceito de ética no âmbito da Saúde Pública, no contexto da bioética, verificando‐se elementos distintivos que parecem justificar a autonomização do conceito de ‘Ética em Saúde Pública’. Para tal, foram consultadas as principais fontes de princípios éticos em saúde, tais como a Declaração Universal dos Direitos do Homem, a Declaração de Helsínquia, bem como a Constituição da República Portuguesa e os Códigos Deontológicos das profissões de saúde. Nesta fase do trabalho é pesquisada, nas perspectivas nacional e internacional, a existência de unidades de ética, congéneres ou de âmbito similar, bem como respectivas áreas e níveis de intervenção, tendo‐se nesse sentido auscultado as entidades idóneas dos Estados‐Membros da União Europeia. Na segunda parte do trabalho de projecto, desenvolveu‐se o planeamento estratégico através da aplicação da metodologia balanced scorecard, apresentando‐se uma proposta de objectivos estratégicos e iniciativas a serem desenvolvidas pelo gabinete de ética sub judice, para um horizonte temporal fixado em três anos. Da utilização desta metodologia resultaram doze objectivos estratégicos, dos quais se destacam: ‘fomentar a discussão ética’; ‘promover a igualdade dos utentes do SNS’; e ‘identificar prioridades de actuação’. Entre as iniciativas a desenvolver salienta‐se o desenho de um questionário, a aplicar às comissões de ética do sistema de saúde com o objectivo de identificar prioridades de actuação do Gabinete. O trabalho finaliza‐se com as conclusões, recomendações e linhas de investigação que se considera deverem ser desenvolvidas, num futuro próximo, para o aprofundamento da matéria alvo deste estudo. ------------------ABSTRACT - This research‐project aims to answer the question of how to manage a unit of ethics within the directorate‐general of public health in a "rational and informed” way, defining their strategic goals (Baranger, quoting Drucker, 1990) using as case study the Office of Legal Affairs, Ethics and Responsibility, hereinafter referred as the Office, of the Directorate‐General of Health. For this purpose, the first part of the study, includes a framework description of the main philosophical basis of ethics, emphasizing that its practical application determines the characteristics of health systems; the use of the concept of ethics of Public Health in the context of bioethics was analyzed, and distinctive elements were found that seem to justify the autonomy of the concept of 'Ethics of Public Health'. The main sources of this part were the fundamental ethical principles in health, such as the Universal Declaration of Human Rights, the Helsinki Declaration, and also the Constitution of the Portuguese Republic and the Codes of Ethics of the health professions. At this stage of the study a description is also made, at both a national and international perspective, on the existence of similar units of ethics or with similar scope, and their areas and levels of intervention. For the international dimension the appropriate bodies of the Member States the European Union were consulted. In the second part of the research‐project, a strategic planning for the Office was designed, using the balanced scorecard methodology, and a proposal of the strategic objectives and initiatives to be developed within a time schedule of three years are presented. The use of this method resulted in twelve strategic objectives, among which we note the following: 'to promote the ethical discussion'; 'to promote equality of users of the NHS'; and ‘to identify priorities for action’. The design of a questionnaire to be answered by the ethics committees for health of the Portuguese health system, in order to identify priorities for the Office’s activities is also presented in the study. The work ends with the conclusions and recommendations, as well as a suggestion of lines for future research to further investigate the subject of this study.

Day-ahead Resource Scheduling Including Demand Response for Electric Vehicles

The energy resource scheduling is becoming increasingly important, as the use of distributed resources is intensified and massive gridable vehicle (V2G) use is envisaged. This paper presents a methodology for day-ahead energy resource scheduling for smart grids considering the intensive use of distributed generation and V2G. The main focus is the comparison of different EV management approaches in the day-ahead energy resources management, namely uncontrolled charging, smart charging, V2G and Demand Response (DR) programs i n the V2G approach. Three different DR programs are designed and tested (trip reduce, shifting reduce and reduce+shifting). Othe r important contribution of the paper is the comparison between deterministic and computational intelligence techniques to reduce the execution time. The proposed scheduling is solved with a modified particle swarm optimization. Mixed integer non-linear programming is also used for comparison purposes. Full ac power flow calculation is included to allow taking into account the network constraints. A case study with a 33-bus distribution network and 2000 V2G resources is used to illustrate the performance of the proposed method.

Modified Particle Swarm Optimization Applied to Integrated Demand Response and DG Resources Scheduling

The elastic behavior of the demand consumption jointly used with other available resources such as distributed generation (DG) can play a crucial role for the success of smart grids. The intensive use of Distributed Energy Resources (DER) and the technical and contractual constraints result in large-scale non linear optimization problems that require computational intelligence methods to be solved. This paper proposes a Particle Swarm Optimization (PSO) based methodology to support the minimization of the operation costs of a virtual power player that manages the resources in a distribution network and the network itself. Resources include the DER available in the considered time period and the energy that can be bought from external energy suppliers. Network constraints are considered. The proposed approach uses Gaussian mutation of the strategic parameters and contextual self-parameterization of the maximum and minimum particle velocities. The case study considers a real 937 bus distribution network, with 20310 consumers and 548 distributed generators. The obtained solutions are compared with a deterministic approach and with PSO without mutation and Evolutionary PSO, both using self-parameterization.

Distributed, Agent-Based Intelligent System for Demand Response Program Simulation in Smart Grids

A distributed, agent-based intelligent system models and simulates a smart grid using physical players and computationally simulated agents. The proposed system can assess the impact of demand response programs.

Decision Support Concerning Demand Response Programs Design and Use – A Conceptual Framework and Simulation Tool

Demand response can play a very relevant role in the context of power systems with an intensive use of distributed energy resources, from which renewable intermittent sources are a significant part. More active consumers participation can help improving the system reliability and decrease or defer the required investments. Demand response adequate use and management is even more important in competitive electricity markets. However, experience shows difficulties to make demand response be adequately used in this context, showing the need of research work in this area. The most important difficulties seem to be caused by inadequate business models and by inadequate demand response programs management. This paper contributes to developing methodologies and a computational infrastructure able to provide the involved players with adequate decision support on demand response programs and contracts design and use. The presented work uses DemSi, a demand response simulator that has been developed by the authors to simulate demand response actions and programs, which includes realistic power system simulation. It includes an optimization module for the application of demand response programs and contracts using deterministic and metaheuristic approaches. The proposed methodology is an important improvement in the simulator while providing adequate tools for demand response programs adoption by the involved players. A machine learning method based on clustering and classification techniques, resulting in a rule base concerning DR programs and contracts use, is also used. A case study concerning the use of demand response in an incident situation is presented.

Distributed Generation and Demand Response Dispatch for a Virtual Power Player Energy and Reserve Provision

Recent changes in the operation and planning of power systems have been motivated by the introduction of Distributed Generation (DG) and Demand Response (DR) in the competitive electricity markets' environment, with deep concerns at the efficiency level. In this context, grid operators, market operators, utilities and consumers must adopt strategies and methods to take full advantage of demand response and distributed generation. This requires that all the involved players consider all the market opportunities, as the case of energy and reserve components of electricity markets. The present paper proposes a methodology which considers the joint dispatch of demand response and distributed generation in the context of a distribution network operated by a virtual power player. The resources' participation can be performed in both energy and reserve contexts. This methodology contemplates the probability of actually using the reserve and the distribution network constraints. Its application is illustrated in this paper using a 32-bus distribution network with 66 DG units and 218 consumers classified into 6 types of consumers.

Evaluation of the Electric Vehicle Impact in the Power Demand Curve in a Smart Grid Environment

Smart grids with an intensive penetration of distributed energy resources will play an important role in future power system scenarios. The intermittent nature of renewable energy sources brings new challenges, requiring an efficient management of those sources. Additional storage resources can be beneficially used to address this problem; the massive use of electric vehicles, particularly of vehicle-to-grid (usually referred as gridable vehicles or V2G), becomes a very relevant issue. This paper addresses the impact of Electric Vehicles (EVs) in system operation costs and in power demand curve for a distribution network with large penetration of Distributed Generation (DG) units. An efficient management methodology for EVs charging and discharging is proposed, considering a multi-objective optimization problem. The main goals of the proposed methodology are: to minimize the system operation costs and to minimize the difference between the minimum and maximum system demand (leveling the power demand curve). The proposed methodology perform the day-ahead scheduling of distributed energy resources in a distribution network with high penetration of DG and a large number of electric vehicles. It is used a 32-bus distribution network in the case study section considering different scenarios of EVs penetration to analyze their impact in the network and in the other energy resources management.

Slaughterhouses fungal burden assessment: a contribution for the pursuit of a better assessment strategy

In slaughterhouses, the biological risk is present not only from the direct or indirect contact with animal matter, but also from the exposure to bioaerosols. Fungal contamination was already reported from the floors and walls of slaughterhouses. This study intends to assess fungal contamination by cultural and molecular methods in poultry, swine/bovine and large animal slaughterhouses. Air samples were collected through an impaction method, while surface samples were collected by the swabbing method and subjected to further macro- and micro-scopic observations. In addition, we collected air samples using the impinger method in order to perform real-time quantitative PCR (qPCR) amplification of genes from specific fungal species, namely A. flavus, A. fumigatus and A. ochraceus complexes. Poultry and swine/bovine slaughterhouses presented each two sampling sites that surpass the guideline of 150 CFU/m3. Scopulariopsis candida was the most frequently isolated (59.5%) in poultry slaughterhouse air; Cladosporium sp. (45.7%) in the swine/bovine slaughterhouse; and Penicillium sp. (80.8%) in the large animal slaughterhouse. Molecular tools successfully amplified DNA from the A. fumigatus complex in six sampling sites where the presence of this fungal species was not identified by conventional methods. This study besides suggesting the indicators that are representative of harmful fungal contamination, also indicates a strategy as a protocol to ensure a proper characterization of fungal occupational exposure.

Persistent organic pollutant levels in human visceral and subcutaneous adipose tissue in obese individuals - Depot differences and dysmetabolism implications

Background: The role of persistent organic pollutants (POPs) with endocrine disrupting activity in the aetiology of obesity and other metabolic dysfunctions has been recently highlighted. Adipose tissue (AT) is a common site of POPs accumulation where they can induce adverse effects on human health. Objectives: To evaluate the presence of POPs in human visceral (vAT) and subcutaneous (scAT) adipose tissue in a sample of Portuguese obese patients that underwent bariatric surgery, and assess their putative association with metabolic disruption preoperatively, as well as with subsequent body mass index (BMI) reduction. Methods: AT samples (n=189) from obese patients (BMI ≥35) were collected and the levels of 13 POPs were determined by gas chromatography with electron-capture detection (GC-ECD). Anthropometric and biochemical data were collected at the time of surgery. BMI variation was evaluated after 12 months and adipocyte size was measured in AT samples. Results: Our data confirm that POPs are pervasive in this obese population (96.3% of detection on both tissues), their abundance increasing with age (RS=0.310, p<0.01) and duration of obesity (RS=0.170, p<0.05). We observed a difference in AT depot POPs storage capability, with higher levels of ΣPOPs in vAT (213.9±204.2 compared to 155.1±147.4 ng/g of fat, p<0.001), extremely relevant when evaluating their metabolic impact. Furthermore, there was a positive correlation between POP levels and the presence of metabolic syndrome components, namely dysglycaemia and hypertension, and more importantly with cardiovascular risk (RS=0.277, p<0.01), with relevance for vAT (RS=0.315, p<0.01). Finally, we observed an interesting relation of higher POP levels with lower weight loss in older patients. Conclusion: Our sample of obese subjects allowed us to highlight the importance of POPs stored in AT on the development of metabolic dysfunction in a context of obesity, shifting the focus to their metabolic effects and not only for their recognition as environmental obesogens.

Deficiência, autonomia e teatro: trabalho de projecto

Trabalho de Projeto submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro - especialização em Teatro e Comunidade.

Aplicação de ensaios não destrutivos por correntes induzidas à caracterização de propriedades eléctricas de materiais processados no estado sólido

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção de Grau de Mestre em Engenharia Mecânica

Levantamento planorbídico do Estado de São Paulo: 8ª Região Administrativa (grande área de São José do Rio Preto)

Para reconhecer a distribuição dos planorbídeos na 8ª Região Administrativa do Estado de São Paulo, 286 lotes de caramujos procedentes dos 85 municípios que a constituem foram examinados e identificados no Laboratório de Malacologia da SUCEN. Biomphalaria straminea, que ocorre em quatro criadouros - um em Altair e três em S. José do Rio Preto, foi a única espécie identificada capaz de vir a comportar-se naturalmente como hospedeira intermediária de S.mansoni. Isto demonstra que são mínimas as probabilidades da esquistossomose vir a instalar-se na área estudada.

Lagoquilascaríase humana: sobre três casos encontrados nos Distrito Federal, Brasil

Três novos casos humanos de infecção por Lagochilascaris minor são apresentados. Todos os pacientes eram oriundos do Estado do Pará, Brasil, e viviam em zona rural ou próximo à mata. As lesões, no momento da consulta, localizavam-se no pescoço, mastóide e ouvido, estando já fistulizadas; em dois casos havia também envolvimento do sistema nervoso central. Amostras de tecidos, retiradas das lesões, revelaram, ao exame histológico, ovos e vermes em vários estádios de sua evolução. A identificação da espécie foi confirmada através do estudo de larvas e adultos eliminados, pelas fístulas cutâneas, de mistura com pus. O tratamento consistiu em excisão cirúrgica das tumorações e administração de antihelmínticos, com bons resultados. Em dois pacientes, no entanto, houve recidiva das lesões, após cura aparente, indicando que as drogas utilizadas não destroem os ovos do parasito.