Comparação entre sistemas de saúde oral de 8 países da união europeia e intervenções por estes desenvolvidas no seguimento das linhas de atuação definidas pela Organização Mundial de Saúde para o ano 2020

RESUMO - Hoje, facilmente se poderá constatar que as doenças orais possuem uma expressiva influência perante a saúde geral, não apenas pela presença da condição por si só, mas também a nível pessoal, social e económico. O seu reflexo traduz-se em parte, no absentismo escolar e laboral, diminuição considerável de produtividade e eficiência, falta de atenção e objetividade. Pelo que é então considerado, um grave problema de saúde pública, afetando de forma mais expressiva, grupos socioeconomicamente desfavorecidos. O acompanhamento e análise do desenvolvimento de iniciativas internacionais, no que ao seguimento das recomendações da Organização Mundial de Saúde diz respeito, poderá ser um ótimo beneficio e impulso para a identificação e aplicação de novos planos de ação. O presente projeto, pretendeu contribuir para a identificação de duas propostas de intervenção em saúde oral ajustadas ao alcance das recomendações da OMS que simultaneamente possam sejam proveitosas para a resolução dos problemas de saúde oral nacionais. Foi realizado um estudo observacional, descritivo e retrospetivo onde foram recolhidos dados acerca de 8 Sistemas de Saúde Oral europeus, previamente selecionados segundo critérios específicos, e iniciativas de saúde oral por eles desenvolvidas. Por fim, foram eleitas duas iniciativas de interesse, possíveis de aplicação futura. Os resultados do estudo apontam para a existência de diferentes iniciativas, enquadradas com as recomendações da OMS. De entre as mesmas, destaca-se uma implementada em 2009, na Suécia, que estando essencialmente assente num acessível subsidio anual fixo pago por cada indivíduo adulto, procura fundamentalmente preservar os esforços de prevenção aplicados nas últimas décadas.

A afirmação do direito de águas

This thesis aims at demonstrating the dogmatic autonomy of Water Law. It also intends to clarify that this branch of law must not be confused with other similar subjects of law. To accomplish this task, the thesis justifies the dogmatic autonomy of Water Law beginning by discussing the emergence of this branch of law both at international and regional levels. The thesis analyses the emergence of International Water Law, discussing the reasons of its existence, its subject and importance. It also explains the relationship between international watercourses and the need to regulate them, considering that rules related to the use and management of such resources, although created at international level, are meant to be applied at regional and local levels. The thesis demonstrates that the fact that some waters are international, because they cross different states or serve as border between two or more states, justifies the existence of international water law rules aplicable to the region and to the watercourse they are supposed to regulate. For this reason, this thesis considers not only international water law in relation with the aplicable regional water law, but also the regional law in relation with the rules aplicable to the water basins and particularly with the concerned water basin states. This relationship between rules leads us to discuss how these three spectrums of rules are conciliated, namely international or universal, regional and water basin rules. To demonstrate how all this works we chose SADC for our case study. The thesis also studies the States who benefit from rules of international water law, and all other subjects who directly use water from international watercourses, and the conclusion we reach is that who really benefits are the population of such states whose rights of access, use and management are regulated by international, regional and basin rules As we can imagine, it is not easy to concile so many different rules, applicable to a scarce resource to which many subjects in many states compete for. And the interaction of the different interests, which is done under different spectrum of rules, is what guided our study, in which we analyse how all this process functions. And the main reason of all the discussion is to conclude that there is, in fact, a dogmatic autonomy of water law. To reach such a conclusion, the thesis begins by studying how international water law is applied at local level. Considering that international watercourses usually have different regimes adopted by the basin states, which difference may cause conflicts, the thesis discusses how water law may contribute to solve possible conflicts. To do this, the thesis studies and compares rules of international water law with rules of water law applicable to SADC states, and figures out the level of interaction between such rules. Considering that basin states have to obey to local rules, first of all, and after that to international and basin level rules, the thesis studies how the differents interests at stake are managed by riparian states, who act on behalf of their population. SADC appeared to provide an excellent case study to reach this goal. And the thesis discusses all these matters, the rules and principles applicable, and provides solutions where applicable, always considering water as subject of our study. Accordingly, we discuss the right to water, its nature and how it functions, considering the facts mentioned previously. And, as we conclude, all these legal discussions over water are a clear sign of the dogmatic autonomy of water

Anti-HBs levels among children and adolescents with complete immunization schedule against hepatitis B virus. A cross-sectional study in Blumenau, State of Santa Catarina, Brazil, 2007-2008

INTRODUCTION: Vaccination is the main tool for preventing hepatitis B virus (HBV) infection; however, following the completion of the vaccination series, the concentrations of anti-HBs can decline over the years and reach levels less than 10mIU/mL. The persistence of protection in these individuals is still unknown. The present study aimed to determine the anti-HBs antibody levels among children and adolescents who had received a complete vaccination course for hepatitis B. METHODS: Antibodies against HBV surface antigen (anti-HBs) were tested in 371 individuals aged 10 to 15 years-old. RESULTS: Volunteers who showed undetectable quantities of anti-HBs accounted for 10.2% of the population studied and 39.9% presented antibody titers of less than 10mIU/mL. Anti-HBs > 10mIU/mL were verified in 49.9%. CONCLUSIONS: These results corroborate other studies indicating levels of anti-HBs below 10mIU/mL in vaccinated individuals. Additional studies are required to assess whether this indicates susceptibility to HBV infection and the need and age for booster doses.

Health systems efficiency after the crisis in the OECD

This work evaluates the efficiency position of the health system of each OECD country. It identifies whether, or not, health systems changed in terms of quality and performance after the financial crisis. The health systems performance was calculated by fixed-effects estimator and by stochastic frontier analysis. The results suggest that many of those countries that the crisis affected the most are more efficient than the OECD average. In addition, some of those countries even managed to reach the top decile in the efficiency ranking. Finally, we analyze the stochastic frontier efficiency scores together with other health indicators to evaluate the health systems’ overall adjustments derived from the crisis.

What hides behind the fixed-term contracts wage gap?

In Portugal, about 20% of full-time workers are employed under a fixed-term contract. Using a rich longitudinal matched employer-employee dataset for Portugal, with more than 20 million observations and covering the 2002-2012 period, we confirm the common idea that fixed-term contracts are not desirable when compared to permanent ones, by estimating a conditional wage gap of -1.7 log points. Then, we evaluate the sources of that wage penalty by combining a three way high-dimensional fixed effects model with the decomposition of Gelbach (2014), in which the three dimensions considered are the worker’s unobserved ability, the firm’s compensation wage policy and the job title effect. It is shown that the average worker with a fixed-term contract is less productive than his/her permanent counterparts, explaining -3.92 log points of the FTC wage penalty. Additionally, the sorting of workers into lower-paid job titles is also responsible for -0.59 log points of the wage gap. Surprisingly, we found that the allocation of workers among firms mitigates the existing wage penalty (in 4.23 log points), as fixed-term workers are concentrated into firms with a more generous compensation policy. Finally, following Figueiredo et al. (2014), we further control for the worker-firm match characteristics and reach the conclusion that fixed-term employment relationships have an overrepresentation of low quality worker-firm matches, explaining 0.65 log points of the FTC wage penalty.

Da valoração de gravações e fotografias obtidas por particulares no processo penal

Recordings and photographs obtained by private individuals can be two of the most relevant evidences in helping finding the truth; however, they can also conflict with fundamental rights such as privacy, spoken word or image of the targets. It is not enough that only the violation of the right to privacy is withdrawn because rights to spoken word or image, unattached from the first one, show up independently as the main violated rights and are criminally protected in article 199º of the criminal code. Its use as evidence is, on a first moment, dependent on the private's conduct lawfulness, as it is stated in article 167º of the criminal procedure code. In order to consider its lawfulness, and accept its use as evidence, portuguese higher courts have been defending constructions mostly based on legal causes of defense. Although agreeing with a more flexible position of weighing all the interests at stake instead of denying its use as evidence, we believe notwithstanding that some of these solutions are misleading and shall not be spared from critics. Lastly, even if we reach a positive conclusion about the lawfulness of obtaining and using recordings and photogtaphs carried out to court by private individuals, they must not be however automatically admitted as evidence, still being necessary to proceed to a separate weighting, within the criminal procedure and its own legal rules, about their real purposes in the case.

Rifampicin fails to eradicate mature biofilm formed by methicillin-resistant Staphylococcus aureus

INTRODUCTION: Antimicrobial activity on biofilms depends on their molecular size, positive charges, permeability coefficient, and bactericidal activity. Vancomycin is the primary choice for methicillin-resistant Staphylococcus aureus (MRSA) infection treatment; rifampicin has interesting antibiofilm properties, but its effectivity remains poorly defined. METHODS: Rifampicin activity alone and in combination with vancomycin against biofilm-forming MRSA was investigated, using a twofold serial broth microtiter method, biofilm challenge, and bacterial count recovery. RESULTS: Minimal inhibitory concentration (MIC) and minimal bactericidal concentration for vancomycin and rifampicin ranged from 0.5 to 1mg/l and 0.008 to 4mg/l, and from 1 to 4mg/l and 0.06 to 32mg/l, respectively. Mature biofilms were submitted to rifampicin and vancomycin exposure, and minimum biofilm eradication concentration ranged from 64 to 32,000 folds and from 32 to 512 folds higher than those for planktonic cells, respectively. Vancomycin (15mg/l) in combination with rifampicin at 6 dilutions higher each isolate MIC did not reach in vitro biofilm eradication but showed biofilm inhibitory capacity (1.43 and 0.56log10 CFU/ml reduction for weak and strong biofilm producers, respectively; p<0.05). CONCLUSIONS: In our setting, rifampicin alone failed to effectively kill biofilm-forming MRSA, demonstrating stronger inability to eradicate mature biofilm compared with vancomycin.

Assessing the community needs of mental health residential care service users in Republic of Moldova

RESUMO: Background: Problemas de saúde mental são um grande problema clínico e social na República da Moldávia, representando uma quota significante de deficiência, sendo classificada no top cinco das dez linhas na hierarquia das condições. A taxa de incidência tem sido crescente na República da Moldávia, atingindo cerca de 15.000 por ano (14,655 em 2011), ou seja, 411,4 por 100 mil habitantes, e uma taxa de prevalência de 97.525 pessoas em 2011, ou seja, 2,737.9 por 100 mil habitantes. Sistema de atendimento psiquiátrico fornece serviços de saúde mental escassos a nível da comunidade, visando principalmente terapia hospitalar, centralizada, através de uma rede de três hospitais psiquiátricos, com 1.860 camas e 4 sanatórios psico- neurológicos com 1890 camas, assim alimentando-se a estigmatização do paciente. Objetivos: O objetivo deste estudo foi a avaliação das necessidades individuais dos beneficiários e do seu nível de autonomia dentro de cuidados residenciais, para o planeamento de reformas de saúde mental e desinstitucionalização na República da Moldávia. Este estudo foi encomendado pelo Ministério do Trabalho, Proteção Social e da Família e pelo Ministério da Saúde, com o apoio da Organização Mundial da Saúde, para determinar o cumprimento eficaz do artigo 19 da Convenção da ONU. O estudo tem os seguintes objetivos: Avaliar o nível de autonomia dos residentes nos hospitais psiquiátricos e sanatórios psico-neurológico, usando uma amostra representativa de 10 por ce nto do número total de pacientes/residentes e comparação cruzada; Para avaliar quatro sanatórios psico-neurológicos para adultos e três hospitais psiquiátricos; Para desenvolver recomendações para o planeamento da desinstitucionalização das pessoas com problemas de saúde mental e colocação na comunidade com base nos resultados do estudo. Metodologia e resultados: O estudo fez uso de duas ferramentas globais: questionário para a avaliação individual dos residentes do estabelecimento de saúde mental, e questionário de avaliação institucional. Todos os entrevistados foram divididos em quatro categorias conforme com o grau de dependência e preparação de viver de forma independente na comunidade. Apenas 1,2% dos entrevistados de PNHB eram totalmente dependentes de terceiros ou serviços especializados, tornando-se a categoria 4, que necessitam de cuidados e apoio contínuo. No PH esta categoria de pessoas é ausente. Conclusões: A condição dos entrevistados foi pior em PNBH que em PH. No entanto, ainda, aqueles que estão prontos para ser desinstitucionalizados correspondem com a maior parte dos entrevistados. Todos os hospitais tinham o consentimento do utente para admissão e tratamento, enquanto não houve consentimento qualquer em PNBH. É bastante óbvio que tanto os hospitais como também a sistema de assistência residencial não atingem a sua finalidade, o que significa que a maioria dos utentes pode ser desinstitucionalizados, sem qualquer terapia de suporte.------------------ABSTRACT: Background: Mental health problems are a major clinical and social issue in the Republic of Moldova,accounting for a significant share of disability and ranking in top five of the ten lines in the hierarchy of conditions. The incidence rate has been growing in the Republic of Moldova to reach approximately 15 thousand a year (14,655 in 2011), i.e. 411.4 per 100 thousand population, and a prevalence rate of 97,525 thousand people in 2011, i.e. 2,737.9 per 100 thousand population. Psychiatric care system provides for scanty mental health services at community level, aiming mainly at centralized hospital-based therapy through a network of three psychiatric hospitals tallying up 1,860 beds and 4 psycho-neurological boarding houses with 1,890 beds, thus fuelling up patient stigmatization. Objectives: The purpose of this study was to assess the individual needs of beneficiaries and their level of autonomy within residential care for the planning of mental health system reforms and deinstitutionalization in the Republic of Moldova. This study was commissioned by the Ministry of Labour, Social Protection and Family and by the Ministry of Health, with the World Health Organization support, to provide for effective enforcement of article 19 of the UN CRPD. The study pursued the following goals: To evaluate the level of autonomy of the psychiatric hospital and psycho-neurological boarding house residents by using a representative sample of 10 per cent of the total number of patients / residents and cross-comparison; To evaluate four psycho-neurological boarding houses for adults and three psychiatric hospitals; To develop recommendations for planning the deinstitutionalization of people with mental health problems and community placement based on the study findings.Methodology and results: The study made use of two global tools: questionnaire for individual assessment of mental health facility residents, and institutional assessment questionnaire. All interviewees were divided into four categories by one’s degree of dependence and readiness to live independently in the community. Only 1.2% of respondents from PNHB were fully dependent on a third party or specialized services, making up category 4, requiring continuous care and support. In PH this category of people is absent.Conclusions: The condition of respondents was worse in PNBH than in PH. However, yet, those ready to be deinstitutionalized accounted for most of respondents there. All hospitals had the resident’s consent to admission and treatment, whereas there was no consent in PNBH whatsoever. It is quite obvious that both the hospitals and residential care system do not achieve their intended purpose, meaning that the majority of residents may be deinstitutionalized without any support therapy.

How to increase and attract more tourists into Kenya throught experiental marketing

This marketing plan project is a culmination of extensive strategies with the use of experiential marketing to address issues confronting the Kenyan tourism industry in order to have a sustainable tourism sector. Following the terrorist attack carried out by Islamist militants’ belonging to al-Shabaab terrorist organization on Nairobi’s Westgate shopping mall in September 2013, tourist forecast has gone down sharply with an average of 20% fall in tourists’ arrivals which is likely to have an impact on the tourism sector in Kenya. Even before the deadly attack on Westgate, the most lethal attack by Islamist terrorists in 15 years in Kenya, the government through the Kenya tourist board had announced that in 2013 tourist arrivals were down by 12%, at 495,978, according to an October 2013 report by Bloomberg. Tourism revenues were also down by 7.4%, over FY12/13 (July-June) to reach KES96.24bn, according to a September 2013 report on the local Capital FM website. Beyond 2013, much will depend on how quickly the Kenya tourist board can regain control of the situation. The Kenyan government believes that the Westgate mall attack was a 'one-off' incident, with a low probability of a similar event happening again over the short term period. Germany, United States, United Kingdom, Australia, Italy, France and Canada continue to be the key source market however; the Kenya tourist board can make continued growth stronger from new emerging markets in order to increase new arrivals into the country. The marketing plan outlines the objectives to be implemented and provides the implementation strategy, activity plans, monitoring and evaluation plans, financial requirements projections and proposes a new structure of experiential marketing. A number of regional forces are identified that will impact tourism into the country including global, social and economic forces, emerging trends in visitor motivations and behavior, emerging forces in experiential marketing. A major component of the strategy identifies target markets for Kenya to commensurate with the level of resources that will be available for marketing and promotion, in keeping with the forces and trends identified and the nature of the Kenya tourism environment. The agreed upon target market segments are: generic/mass travel, experiential travel, creative travel, adventure seeking travel, senior/extended/long stay travel, and business related travel. The strategy phases the development of the target markets over the years of the marketing strategies in order to yield the best opportunity for results. A core activity in developing a marketing strategy is determining the nature of experiences Kenya offers in tourism. The strategy’s experience development process will continue to develop within the context of the products identified which will be promoted regionally: culture/heritage, nature, community-based. Each county in the country has a significant number of attractions and experiences and the challenge of the country is to bring these together in a creative and innovative way in order to encourage tourists to visit more than one county in Kenya.

Cabelte restructuring by OxyCapital

This case study describes OxyCapital’s intervention in Cabelte’s operational and financial restructuring. Despite Cabelte’s strong debt burden, OxyCapital believed that the Group’s financial difficulties were temporary and that it had growth potential if the said restructuring would be implemented. Hence, while striving for an operational turnaround, OxyCapital managed to reach an agreement among not only the several banks but also the Group’s shareholder for the financial restructuring. The transaction included the acquisition of a majority stake on the Group’s share capital and of a significant part of Cabelte’s bank debt by OxyCapital’s Corporate Restructuring Fund.

Characterization of an OPCPA laser amplifier based on the nonlinear crystal YCOB

The work described in this thesis was performed at the Laboratory for Intense Lasers (L2I) of Instituto Superior Técnico, University of Lisbon (IST-UL). Its main contribution consists in the feasibility study of the broadband dispersive stages for an optical parametric chirped pulse amplifier based on the nonlinear crystal yttrium calcium oxi-borate (YCOB). In particular, the main goal of this work consisted in the characterization and implementation of the several optical devices involved in pulse expansion and compression of the amplified pulses to durations of the order of a few optical cycles (20 fs). This type of laser systems find application in fields such as medicine, telecommunications and machining, which require high energy, ultrashort (sub-100 fs) pulses. The main challenges consisted in the preliminary study of the performance of the broadband amplifier, which is essential for successfully handling pulses with bandwidths exceeding 100 nm when amplified from the μJ to 20 mJ per pulse. In general, the control, manipulation and characterization of optical phenomena on the scale of a few tens of fs and powers that can reach the PW level are extremely difficult and challenging due to the complexity of the phenomena of radiation-matter interaction and their nonlinearities, observed at this time scale and power level. For this purpose the main dispersive components were characterized in detail, specifically addressing the demonstration of pulse expansion and compression. The tested bandwidths are narrower than the final ones, in order to confirm the parameters of these elements and predict the performance for the broadband pulses. The work performed led to additional tasks such as a detailed characterization of laser oscillator seeding the laser chain and the detection and cancelling of additional sources of dispersion.

Augmenting spaces and creating interactive experiences using video camera networks

This research addresses the problem of creating interactive experiences to encourage people to explore spaces. Besides the obvious spaces to visit, such as museums or art galleries, spaces that people visit can be, for example, a supermarket or a restaurant. As technology evolves, people become more demanding in the way they use it and expect better forms of interaction with the space that surrounds them. Interaction with the space allows information to be transmitted to the visitors in a friendly way, leading visitors to explore it and gain knowledge. Systems to provide better experiences while exploring spaces demand hardware and software that is not in the reach of every space owner either because of the cost or inconvenience of the installation, that can damage artefacts or the space environment. We propose a system adaptable to the spaces, that uses a video camera network and a wi-fi network present at the space (or that can be installed) to provide means to support interactive experiences using the visitor’s mobile device. The system is composed of an infrastructure (called vuSpot), a language grammar used to describe interactions at a space (called XploreDescription), a visual tool used to design interactive experiences (called XploreBuilder) and a tool used to create interactive experiences (called urSpace). By using XploreBuilder, a tool built of top of vuSpot, a user with little or no experience in programming can define a space and design interactive experiences. This tool generates a description of the space and of the interactions at that space (that complies with the XploreDescription grammar). These descriptions can be given to urSpace, another tool built of top of vuSpot, that creates the interactive experience application. With this system we explore new forms of interaction and use mobile devices and pico projectors to deliver additional information to the users leading to the creation of interactive experiences. The several components are presented as well as the results of the respective user tests, which were positive. The design and implementation becomes cheaper, faster, more flexible and, since it does not depend on the knowledge of a programming language, accessible for the general public.

A função continente como capacidade de transformação para uma melhor expressão da criatividade

Dissertação de Mestrado apresentada ao ISPA - Instituto Universitário

How to engage low category users through social media- The case of the make-up sector in Portugal

Purpose: This work project should be inevitably deemed as a practical approach to a marketing problem; “How to engage low category users through the social media – the case of the make-up sector in Portugal”. Design/methodology/approach: Online structured questionnaires and in-depth interviews were used. The questionnaire was answered by 110 women aged from 15 to 45 years old and the interviews were conducted with 14 women of the same age. The interviews provided key insights for the questionnaire formulation. Findings: Women are poorly informed on make-up properties and characteristics, feeling a genuine concern in regard to this subject. Lack of time, occasional usage and skin damage are the main barriers for make-up usage by low category users. Overcoming these aspects pass by demystifying the association of make-up with skin damage and emphasise the functional and emotional benefits of make-up. Further, brands need to create contents more consumer-oriented and ask directly to fans/followers suggestions and other insights. Resort to Portuguese “common” women for greater empathy in campaigns, promote online meetings between followers and make-up professionals on social media; and finally take advantage of the hybrid condition of Facebook, which incorporates multiple forms of content presentation, including videos, the most appealing format of make-up presentation for women. Research limitations/implications: Further studies addressing this topic, by using larger samples and study of specific make-up brands and campaign programs, over social media to reach a solid growth potential of make-up market evidences in Portugal. Originality/ value: Make-up brands are emphasising their interest in linking social media and marketing their promotional mix around social marketing.

Ser lean project- Internship at Millennium BCP

Financial institutions are turning their attentions to lean methodology. Strong competitive financial markets demand that organizations search for new ways to achieve competitive advantage. Lean thinking proposes a new method to reach high efficiency: the kaizen approach, which advocates a change in the mind set of all stakeholders towards continuous improvement. In this work project is represented the lean methodology applied at the bank, from a bottom-up spirit, as well as the evaluation of the benefits and the achievement of the proposed goals.