Cost implications of outpatient teleneurology

A randomized controlled trial was conducted to compare the costs of realtime teleneurology with the cost of conventional neurological care. Two district hospitals in Northern Ireland were equipped with videoconferencing units and were connected to the regional neurological centre by ISDN at 384 kbit/s. Of 168 patients randomized to the study, 141 kept their appointments (76 male, 65 female). Sixty-five patients were randomized to a conventional consultation while 76 were randomized to a teleconsultation. The average age was 44 years of those seen conventionally and 42 years of those seen by telemedicine. The groups had similar diagnoses. The telemedicine group required more investigations and reviews than the conventional group. The average cost of the conventional consultation was pound 49 compared with pound 72 for the teleconsultation. Realtime teleneurology was not as cost-effective as conventional care.

Economic and environmental impacts of pollution control in a system of environment and economic interdependence

The importance of the rate of change of the pollution stock in determining the damage to the environment has been an issue of increasing concern in the literature. This paper uses a three-sector (economy, population and environment), non-linear, discrete time, calibrated model to examine pollution control. The model explicitly links economic growth to the health of the environment. The stock of natural resources is affected by the rate of pollution flows, through their impact on the regenerative capacity of the natural resource stock. This can shed useful insights into pollution control strategies, particularly in developing countries where environmental resources are crucial for production in many sectors of the economy. Simulation exercises suggested that, under plausible assumptions, it is possible to reverse undesirable transient dynamics through pollution control expenditure, but this is dependent upon the strategies used for control. The best strategy is to spend money fostering the development of production technologies that reduce pollution rather than spending money dealing with the effects of the pollution flow into the environment. (C) 2001 Elsevier Science Ltd. All rights reserved.

Optimising cleaning behaviour: minimising the costs and maximising ectoparasite removal

Little is known of how client fish minimise the costs of cleaning behaviour while maximising ectoparasite removal by cleaner fish. Previous studies have found that abundance on fish and infestation behaviour of gnathiid isopods, the main parasite eaten by cleaner fish, varies diurnally. We examined whether reduced foraging is a cost of cleaning behaviour in clients and whether the behaviour of the client fish, the thick-lipped wrasse Hemigymnus melapterus, towards the cleaner fish Labroides dimidiatus varied diurnally to maximise ectoparasite removal, possibly in response to the diurnal changes in the abundance and infestation patterns of gnathiids. We found that during the midday and afternoon, client foraging rates were negatively related to the duration and frequency of inspections, suggesting that cleaning may, at some times of the day, be energetically costly to the client in terms of reduced foraging opportunities. Surprisingly, we found that the duration and frequency of inspections of clients by cleaners did not vary among diel time periods. A model of gnathiid dynamics on individual fish is proposed. It shows that the observed diurnal pattern in gnathiid abundance on fish can be generated with the constant duration and frequency of inspections that was observed in this study. Thus clients would not have more gnathiids removed by modifying their cleaning behaviour.

Impact of osteoarthritis on individuals and society: how much disability? Social consequences and health economic implications

Osteoarthritis is a major cause of disability in both the developed and developing world. With the population aging, the prevalence of osteoarthritis is increasing and its consequences are impacting significantly on society. This is one of the reasons why osteoarthritis has been adopted as a major focus (along with osteoporosis, rheumatoid arthritis, back pain, and musculoskeletal trauma) by the global initiative-the Decade of Bone and Joint Disease. Adequate studies on the costs of osteoarthritis are urgently required so that cogent arguments can be made to governments to appropriately fund prevention and treatment programs for this condition. Its recognition as a major cause of disability, particularly in the aging population, should increase community focus on this important condition. (C) 2002 Lippincott Williams Wilkins, Inc.

Brazil and the institutionalization of South America: from hemispheric estrangement to cooperative hegemony

This article argues that Brazil went from a posture of estrangement in relation to the hemispheric project represented by the Free Trade Area of the Americas (FTAA) to a strategy of cooperative hegemony aimed at institutionalizing the South American space and increasing the costs of the FTAA for the United States. Although Brazil was initially isolated, US lack of leadership combined with events at the subregional level ended up turning the tide in the direction of Brazilian interests. These factors help to understand the current institutional configuration of South America.

Economic Analysis of Occupational Risk Prevention in the Construction Sector

The construction sector has one of the worst occupational safety and health records in Europe. The costs of this scenario are very high, namely costs for workers and their families, costs to organizations, resulting from the absence of workers due to illness, insurance premiums, costs resulting from reduced productivity, cost of replacement and training of workers, etc., and costs to society, which in turn increases the costs of health systems. This paper presents and discusses the development of a methodology for economic evaluation in the context of risk management, which will allow senior management to support decision making. The possible application of this methodology to the construction sector is discussed.

Desenvolvimento, testes e qualidade de software

RESUMO: Hoje em dia o software tornou-se num elemento útil na vida das pessoas e das empresas. Existe cada vez mais a necessidade de utilização de aplicações de qualidade, com o objectivo das empresas se diferenciarem no mercado. As empresas produtoras de software procuram aumentar a qualidade nos seus processos de desenvolvimento, com o objectivo de garantir a qualidade do produto final. A dimensão e complexidade do software aumentam a probabilidade do aparecimento de não-conformidades nestes produtos, resultando daí o interesse pela actividade de testes de software ao longo de todo o seu processo de concepção, desenvolvimento e manutenção. Muitos projectos de desenvolvimento de software são entregues com atraso por se verificar que na data prevista para a sua conclusão não têm um desempenho satisfatório ou por não serem confiáveis, ou ainda por serem difíceis de manter. Um bom planeamento das actividades de produção de software significa usualmente um aumento da eficiência de todo o processo produtivo, pois poderá diminuir a quantidade de defeitos e os custos que decorrem da sua correcção, aumentando a confiança na utilização do software e a facilidade da sua operação e manutenção. Assim se reconhece a importância da adopção de boas práticas no desenvolvimento do software. Para isso deve-se utilizar uma abordagem sistemática e organizada com o intuito de produzir software de qualidade. Esta tese descreve os principais modelos de desenvolvimento de software, a importância da engenharia dos requisitos, os processos de testes e principais validações da qualidade de software e como algumas empresas utilizam estes princípios no seu dia-a-dia, com o intuito de produzir um produto final mais fiável. Descreve ainda alguns exemplos como complemento ao contexto da tese. ABSTRACT: Nowadays the software has become a useful element in people's lives and it is increasingly a need for the use of quality applications from companies in order to differentiate in the market. The producers of software increase quality in their development processes, in order to ensuring final product quality. The complexity and size of software, increases the probability of the emergence of non-conformities in these products, this reason increases of interest in the business of testing software throughout the process design, development and maintenance. Many software development projects are postpone because in the date for delivered it’s has not performed satisfactorily, not to be trusted, or because it’s harder to maintain. A good planning of software production activities, usually means an increase in the efficiency of all production process, because it can decrease the number of defects and the costs of it’s correction, increasing the reliability of software in use, and make it easy to operate and maintenance. In this manner, it’s recognized the importance of adopting best practices in software development. To produce quality software, a systematic and organized approach must be used. This thesis describes the main models of software development, the importance of requirements engineering, testing processes and key validation of software quality and how some companies use these principles daily, in order to produce a final product more reliable. It also describes some examples in addition to the context of this thesis.

Elements of a methodology to assess the alignment of core-values in collaborative networks

Collaborative networks are typically formed by heterogeneous and autonomous entities, and thus it is natural that each member has its own set of core-values. Since these values somehow drive the behaviour of the involved entities, the ability to quickly identify partners with compatible or common core-values represents an important element for the success of collaborative networks. However, tools to assess or measure the level of alignment of core-values are lacking. Since the concept of 'alignment' in this context is still ill-defined and shows a multifaceted nature, three perspectives are discussed. The first one uses a causal maps approach in order to capture, structure, and represent the influence relationships among core-values. This representation provides the basis to measure the alignment in terms of the structural similarity and influence among value systems. The second perspective considers the compatibility and incompatibility among core-values in order to define the alignment level. Under this perspective we propose a fuzzy inference system to estimate the alignment level, since this approach allows dealing with variables that are vaguely defined, and whose inter-relationships are difficult to define. Another advantage provided by this method is the possibility to incorporate expert human judgment in the definition of the alignment level. The last perspective uses a belief Bayesian network method, and was selected in order to assess the alignment level based on members' past behaviour. An example of application is presented where the details of each method are discussed.

A importância da contabilidade analítica e o custeio direto e indireto numa microempresa do setor da cortiça

Dissertação para obtenção de Grau de Mestre em Contabilidade e Finanças Orientador: Mestre António Gonçalves da Silva

The influence of curing conditions on the mechanical performance of concrete made with recycled concrete waste

Research on the use of Construction and Demolition Waste (CDW) as recycled aggregate (in particular crushed concrete) for the production of new concrete has by now established the feasibility of this environmentally-friendly use of otherwise harmful waste. However, contrary to conventional concrete (CC), no large applications of concrete made with recycled concrete have been made and there is still a lack of knowledge in some areas of production and performance of recycled aggregate concrete (RAC). One issue concerns curing conditions: these greatly affect the performance of concrete made on site and some potential users of RAC wonder how RAC is affected by far-from-ideal curing conditions. This paper shows the main results of experiments to determine the influence of different curing conditions on the mechanical performance of concrete made with coarse recycled aggregate from crushed concrete. The properties analyzed include compressive strength, splitting tensile strength, modulus of elasticity, and abrasion resistance. The general conclusion in terms of mechanical performance is that RAC is affected by curing conditions roughly in the same way as CC. (C) 2011 Elsevier Ltd. All rights reserved.

Avaliação da rentabilidade económica dos sistemas de microgeração fotovoltaica em Portugal (1990-2010)

Dissertação para a obtenção do grau de Mestre em Engenharia Electrotécnica - ramo de Energia

Implementation of proton therapy in the portuguese context of radiotherapy

Cancer is a national and international health care concern. It’s important to find strategies for early diagnosis as well as for the optimization of the various therapeutic options currently existing in Portugal. Cancer is the second leading cause of death in Portugal, the choice of this study, is due to the importance of radiotherapy approach in cancer treatment and because is the therapy used in 40% of oncology patients. Radiation therapy has evolve data technological level, that allows new treatment techniques that are more efficient and that also promotes greater professional satisfaction. The hadrons are charged particles, used in cancer therapy. These particles can bring a paradigm shift regarding the therapeutic approach in radiotherapy. The technique used is proton therapy, that reveal to be more accurate, efficacious and less toxic to surrounding tissue. Proton therapy may be a promising development in the field of oncology and how the treatment is given in radiotherapy. Although there is awareness of the benefits of proton therapy in oncology it’s also important to take in consideration the costs of these therapy, because they are considerably higher than conventional treatments of radiotherapy. Given the lack of a proton therapy service in Portugal, this study aims to be a documentary analysis of clinical records that will achieve the following objectives: to identify the number of cancer patients diagnosed in 2010 in Portugal and to calculate the estimated number of patients that could have been treated with proton therapy according to the Health Council of the Netherlands registration document.

ß-Lactams: chemical structure, mode of action and mechanisms of resistance

This synopsis summarizes the key chemical and bacteriological characteristics of β-lactams, penicillins, cephalosporins, carbanpenems, monobactams and others. Particular notice is given to first-generation to fifth-generation cephalosporins. This review also summarizes the main resistance mechanism to antibiotics, focusing particular attention to those conferring resistance to broad-spectrum cephalosporins by means of production of emerging cephalosporinases (extended-spectrum β-lactamases and AmpC β-lactamases), target alteration (penicillin-binding proteins from methicillin-resistant Staphylococcus aureus) and membrane transporters that pump β-lactams out of the bacterial cell.

Monitorização integrada para sistemas de alimentação distribuídos

Mestrado em Engenharia Electrotécnica e de Computadores

Integration of biomonitoring and instrumental techniques to assess the air quality in an industrial area located in the coastal of Central Asturias, Spain

Throughout the world, epidemiological studies were established to examine the relationship between air pollution and mortality rates and adverse respiratory health effects. However, despite the years of discussion the correlation between adverse health effects and atmospheric pollution remains controversial, partly because these studies are frequently restricted to small and well-monitored areas. Monitoring air pollution is complex due to the large spatial and temporal variations of pollution phenomena, the high costs of recording instruments, and the low sampling density of a purely instrumental approach. Therefore, together with the traditional instrumental monitoring, bioindication techniques allow for the mapping of pollution effects over wide areas with a high sampling density. In this study, instrumental and biomonitoring techniques were integrated to support an epidemiological study that will be developed in an industrial area located in Gijon in the coastal of central Asturias, Spain. Three main objectives were proposed to (i) analyze temporal patterns of PM10 concentrations in order to apportion emissions sources, (ii) investigate spatial patterns of lichen conductivity to identify the impact of the studied industrial area in air quality, and (iii) establish relationships amongst lichen conductivity with some site-specific characteristics. Samples of the epiphytic lichen Parmelia sulcata were transplanted in a grid of 18 by 20 km with an industrial area in the center. Lichens were exposed for a 5-mo period starting in April 2010. After exposure, lichen samples were soaked in 18-MΩ water aimed at determination of water electrical conductivity and, consequently, lichen vitality and cell damage. A marked decreasing gradient of lichens conductivity relative to distance from the emitting sources was observed. Transplants from a sampling site proximal to the industrial area reached values 10-fold higher than levels far from it. This finding showed that lichens reacted physiologically in the polluted industrial area as evidenced by increased conductivity correlated to contamination level. The integration of temporal PM10 measurements and analysis of wind direction corroborated the importance of this industrialized region for air quality measurements and identified the relevance of traffic for the urban area.