Plataforma de apoio à decisão nos cuidados de ginecologia e obstetrícia

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Informática Médica)

Certificação ISO 9001 e Gestão de Recursos Humanos: precedentes e consequentes: estudo de caso das Unidades de Serviços Certificadas da Universidade do Minho

Dissertação de mestrado em Gestão de Recursos Humanos

Biocatalysis in micellar systems

[Excert] Biocatalysis and biotransformations are environmentally friendly, and allow the development of sustainable production processes on a large scale. Thus, these processes are becoming important alternatives to conventional chemistry in the drug, biochemical, and emerging biorenewable energy industries. Biocatalysts are required to function under non-conventional conditions, such as in organic solvents, being competitive in terms of cost and efficiency. In fact, the technological utility of enzymes can be enhanced greatly by using them in the presence of organic solvents, rather than in their natural aqueous reaction media. Multiphase systems are more complex but offer a new field of possibilities. The presence of hydrophobic solvents in biocatalysis allows the conversion of poorly water soluble substrates more efficiently. The accessibility of hydrophobic substrates to enzymes or whole cells presents an interesting challenge for researchers and technologists. In this context, microemulsions are a promising tool in enzyme technology. This chapter presents an overview of the characterization of biphasic and microemulsion systems and their applications in biotransformation processes (...).

Olive pomace pretreatments to enhance its valorisation by solid-state fermentation

Dissertação de mestrado em Bioengenharia

Predicting pre-triage waiting time in a maternity emergency room through data mining

An unsuitable patient flow as well as prolonged waiting lists in the emergency room of a maternity unit, regarding gynecology and obstetrics care, can affect the mother and child’s health, leading to adverse events and consequences regarding their safety and satisfaction. Predicting the patients’ waiting time in the emergency room is a means to avoid this problem. This study aims to predict the pre-triage waiting time in the emergency care of gynecology and obstetrics of Centro Materno Infantil do Norte (CMIN), the maternal and perinatal care unit of Centro Hospitalar of Oporto, situated in the north of Portugal. Data mining techniques were induced using information collected from the information systems and technologies available in CMIN. The models developed presented good results reaching accuracy and specificity values of approximately 74% and 94%, respectively. Additionally, the number of patients and triage professionals working in the emergency room, as well as some temporal variables were identified as direct enhancers to the pre-triage waiting time. The imp lementation of the attained knowledge in the decision support system and business intelligence platform, deployed in CMIN, leads to the optimization of the patient flow through the emergency room and improving the quality of services.

Communications with QoS in IoT&Cloud environment

Dissertação de mestrado integrado em Engenharia de Telecomunicações e Informática

Modelação de processos num serviço de uma organização de ensino superior

Dissertação de mestrado integrado em Engenharia e Gestão Industrial

Insertion dans les soins après une première hospitalisation dans un secteur pour psychose [Linkage to care after first hospitalisation for psychosis]

BACKGROUND: First hospitalisation for a psychotic episode causes intense distress to patients and families, but offers an opportunity to make a diagnosis and start treatment. However, linkage to outpatient psychiatric care remains a notoriously difficult step for young psychotic patients, who frequently interrupt treatment after hospitalisation. Persistence of symptoms, and untreated psychosis may therefore remain a problem despite hospitalisation and proper diagnosis. With persisting psychotic symptoms, numerous complications may arise: breakdown in relationships, loss of family and social support, loss of employment or study interruption, denial of disease, depression, suicide, substance abuse and violence. Understanding mechanisms that might promote linkage to outpatient psychiatric care is therefore a critical issue, especially in early intervention in psychotic disorders. OBJECTIVE: To study which factors hinder or promote linkage of young psychotic patients to outpatient psychiatric care after a first hospitalisation, in the absence of a vertically integrated program for early psychosis. Method. File audit study of all patients aged 18 to 30 who were admitted for the first time to the psychiatric University Hospital of Lausanne in the year 2000. For statistical analysis, chi2 tests were used for categorical variables and t-test for dimensional variables; p<0.05 was considered as statistically significant. RESULTS: 230 patients aged 18 to 30 were admitted to the Lausanne University psychiatric hospital for the first time during the year 2000, 52 of them with a diagnosis of psychosis (23%). Patients with psychosis were mostly male (83%) when compared with non-psychosis patients (49%). Furthermore, they had (1) 10 days longer mean duration of stay (24 vs 14 days), (2) a higher rate of compulsory admissions (53% vs 22%) and (3) were more often hospitalised by a psychiatrist rather than by a general practitioner (83% vs 53%). Other socio-demographic and clinical features at admission were similar in the two groups. Among the 52 psychotic patients, 10 did not stay in the catchment area for subsequent treatment. Among the 42 psychotic patients who remained in the catchment area after discharge, 20 (48%) did not attend the scheduled or rescheduled outpatient appointment. None of the socio demographic characteristics were associated with attendance to outpatient appointments. On the other hand, voluntary admission and suicidal ideation before admission were significantly related to attending the initial appointment. Moreover, some elements of treatment seemed to be associated with higher likelihood to attend outpatient treatment: (1) provision of information to the patient regarding diagnosis, (2) discussion about the treatment plan between in- and outpatient staff, (3) involvement of outpatient team during hospitalisation, and (4) elaboration of concrete strategies to face basic needs, organise daily activities or education and reach for help in case of need. CONCLUSION: As in other studies, half of the patients admitted for a first psychotic episode failed to link to outpatient psychiatric care. Our study suggests that treatment rather than patient's characteristics play a critical role in this phenomenon. Development of a partnership and involvement of patients in the decision process, provision of good information regarding the illness, clear definition of the treatment plan, development of concrete strategies to cope with the illness and its potential complications, and involvement of the outpatient treating team already during hospitalisation, all came out as critical strategies to facilitate adherence to outpatient care. While the current rate of disengagement after admission is highly concerning, our finding are encouraging since they constitute strategies that can easily be implemented. An open approach to psychosis, the development of partnership with patients and a better coordination between inpatient and outpatient teams should therefore be among the targets of early intervention programs. These observations might help setting up priorities when conceptualising new programs and facilitate the implementation of services that facilitate engagement of patients in treatment during the critical initial phase of psychotic disorders.

Physiotherapy practice in the private sector: organizational characteristics and models.

BACKGROUND: Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of this study was to: 1) describe characteristics of organizations where physiotherapists practice in the private sector, and 2) explore the existence of a taxonomy of organizational models. METHODS: This was a cross-sectional quantitative survey of 236 randomly-selected physiotherapists. Participants completed a purpose-designed questionnaire online or by telephone, covering organizational vision, resources, structures and practices. Organizational characteristics were analyzed descriptively, while organizational models were identified by multiple correspondence analyses. RESULTS: Most organizations were for-profit (93.2%), located in urban areas (91.5%), and within buildings containing multiple businesses/organizations (76.7%). The majority included multiple providers (89.8%) from diverse professions, mainly physiotherapy assistants (68.7%), massage therapists (67.3%) and osteopaths (50.2%). Four organizational models were identified: 1) solo practice, 2) middle-scale multiprovider, 3) large-scale multiprovider and 4) mixed. CONCLUSIONS: The results of this study provide a detailed description of the organizations where physiotherapists practice, and highlight the importance of human resources in differentiating organizational models. Further research examining the influences of these organizational characteristics and models on outcomes such as physiotherapists' professional practices and patient outcomes are needed.

La biblioteca recombinada: portals i persones

Aquest article explora el disseny i l'ús dels portals en un entorn bibliotecari. Tracta les motivacions per construir portals, així com l'estructura i la tipologia d'aquests. A més, examina l'entorn de l'usuari en què es desenvolupen aquests portals. També argumenta que aporten serveis útils d'integració i presentació, però que s'han de considerar com a component d'un conjunt de serveis més ampli que la biblioteca està construint per tal d'introduir aquests recursos útils als usuaris. Així mateix, considera breument els serveis que els portals ofereixen: consulta distribuïda o metacerca, personalització, demandes, resolució OpenURL, avisos, etc. També considera l'emergent necessitat de serveis de directori o de registre per a coses com la descripció de col·leccions i serveis, dades de drets i polítiques, etc. Tracta l'impacte dels serveis web i el canvi en els models d'investigació i aprenentatge en relació al subministrament i ús d'informació en xarxa. Finalment, considera els serveis bibliotecaris com a part d'un entorn de sistemes, cada vegada més ric, que inclou els sistemes de gestió d'aprenentatge i de programari educatiu, portals de campus, serveis compartits com l'autenticació, i altres sistemes i serveis.

Anàlisi i diagnosi ambiental dels refugis del PNAP

Els refugis de muntanya es troben situats en zones d’interès natural, sovint protegides, com és el cas dels deu refugis del Parc Natural de l’Alt Pirineu. En els darrers anys s’ha observat una diversificació en l’ús dels refugis de muntanya, originalment construïts per donar aixopluc als excursionistes, degut a l’augment del turisme i la popularització dels esports de neu i d’aventura. Els refugis estudiats es poden agrupar en tres tipologies diferents: refugis guardats, refugis alberg i refugis associats a pistes d’esquí, cadascuna de les quals presenta una realitat i unes problemàtiques diferents. Mitjançant una metodologia pròpia, es pretén fer una anàlisi i una diagnosi ambiental de cada cas d’estudi i de les diferents tipologies a partir dels vectors que poden generar un major impacte en l’entorn immediat dels refugis: aspectes socioeconòmics, arquitectura, paisatge i impacte visual, energia elèctrica i tèrmica, aigua potable i residual i residus sòlids. La diagnosi permet identificar els aspectes de cada refugi i tipologia que requereixen propostes de millora. Finalment es fa una proposta d’ecoetiqueta de serveis per a refugis guardats basada en el Distintiu de Garantia de Qualitat Ambiental de la Generalitat de Catalunya, ja aplicat amb èxit a altres establiments de serveis.

Factors explaining local privatization: A meta-regression analysis

Privatization of local public services has been implemented worldwide in the last decades. Why local governments privatize has been the subject of much discussion, and many empirical works have been devoted to analyzing the factors that explain local privatization. Such works have found a great diversity of motivations, and the variation among reported empirical results is large. To investigate this diversity we undertake a meta-regression analysis of the factors explaining the decision to privatize local services. Overall, our results indicate that significant relationships are very dependent upon the characteristics of the studies. Indeed, fiscal stress and political considerations have been found to contribute to local privatization specially in the studies of US cases published in the eighties that consider a broad range of services. Studies that focus on one service capture more accurately the influence of scale economies on privatization. Finally, governments of small towns are more affected by fiscal stress, political considerations and economic efficiency, while ideology seems to play a major role for large cities.

Agents mòbils en situacions d'emergència: gestió dinàmica de serveis

Aquest projecte consisteix en el disseny i desenvolupament d'una arquitectura de serveis sota el paradigma dels agents inteligents. El propòsit d'ADASMI (Architecture for Dynamic Agent Service Management and Interaction) és permetre la gestió i utilització de serveis per altres agents. L'arquitectura s'ha implementat utilitzant la plataforma d'agents de JADE i es pot utilitzar amb qualsevol altra plataforma que compleixi els estàndards d'IEEE FIPA. A més, és prou flexible com per adaptar-se en entorns dinàmics, com per exemple les xarxes ad-hoc en situacions d'emergència.

Human scFv antibody fragments specific for the epithelial tumour marker MUC-1, selected by phage display on living cells.

New anti-cancer agents are being developed that specifically recognise tumour cells. Recognition is dependent upon the enhanced expression of antigenic determinants on the surface of tumour cells. The tumour exposure and the extracellular accessibility of the mucin MUC-1 make this marker a suitable target for tumour diagnosis and therapy. We isolated and characterised six human scFv antibody fragments that bound to the MUC-1 core protein, by selecting a large naive human phage display library directly on a MUC-1-expressing breast carcinoma cell line. Their binding characteristics have been studied by ELISA, FACS and indirect immunofluorescence. The human scFv antibody fragments were specific for the tandem repeat region of MUC-1 and their binding is inhibited by soluble antigen. Four human scFv antibody fragments (M2, M3, M8, M12) recognised the hydrophilic PDTRP region of the MUC-1 core protein, which is thought to be an immunodominant region. The human scFv antibody fragments were stable in human serum at 37 degrees C and retained their binding specificity. For imaging or targeting to tumours over-expressing MUC-1, it might be feasible to use these human scFv, or multivalent derivatives, as vehicles to deliver anti-cancer agents.

Les symbioses industrielles : une nouvelle stratégie pour l'amélioration de l'utilisation des ressources matérielles et énergétiques par les activités économiques

RésuméCette thèse traite d'un domaine d'application de l'écologie industrielle, les symbioses industrielles, comme stratégie d'amélioration de la consommation des ressources matérielles et énergétiques et de la gestion des déchets par les activités économiques. Les symbioses industrielles cherchent à créer de nouvelles collaborations directement entre les acteurs économiques d'un territoire dans le but d'échanger de l'information, des matières premières et des déchets, et d'intensifier les mutualisations de services et d'infrastructures possibles entre entreprises voisines. Ces quatre types de collaboration sont représentés schématiquement dans la figure ci-dessous.Dans ce travail, la détection et la mise en oeuvre de symbioses industrielles sont abordées sous plusieurs angles. Les recherches réalisées concernent le développement de procédures de mise en oeuvre s'adressant aux collectivités publiques, aux institutions académiques et aux bureaux de conseil dans le domaine de l'environnement. Les objectifs des procédures sont de créer une dynamique de collaboration et de confiance entre les acteurs économiques et l'administration publique d'un territoire afin de détecter des symbioses industrielles potentielles. Ces procédures requièrent la gestion de grandes quantités d'informations relatives aux flux de matière et d'énergie.Un travail de terrain, réalisé sur les territoires du canton de Genève et de Lausanne Région et utilisé comme études de cas, a permis de mettre en évidence un grand nombre de symbioses industrielles qui existent déjà en Suisse romande. Plusieurs dizaines d'exemples ont été identifiés principalement dans lesdomaines de la gestion de l'eau, de l'énergie, des produits chimiques et des matériaux de construction. La législation suisse autoriserait cependant la concrétisation de nombreuses autres opportunités. Dans cette recherche, celles-ci sont évaluées techniquement, légalement, économiquement et environnementalement. La création d'un référentiel d'évaluation des opportunités permet de déterminer quelles sont les symbioses industrielles techniquement réalisables et pertinentes dans le contexte suisse et dans quels cas celles-ci représenteraient une réelle plus-value par rapport à l'utilisation actuelle de la ressource et aux filières existantes de collecte et de valorisation des déchets.Finalement, un logiciel, SymbioGIS, destiné à soutenir la détection et l'évaluation de symbioses industrielles potentielles a été développé. Il s'agit d'une interface web accessible pour de nombreux utilisateurs, couplée à une interface de systèmes d'information géographique. En plus de la détection de symbioses industrielles, plusieurs fonctionnalités sont proposées pour faciliter la prise en compte des flux de matière et d'énergie dans les problématiques liées à l'aménagement du territoire et au positionnement des activités économiques.En conclusion, cette recherche met en évidence la nécessité de rapprocher les institutions publiques en charge de la protection de l'environnement, de la promotion économique et de l'aménagement du territoire pour favoriser l'essor des symbioses industrielles comme stratégie pour la gestion des ressources matérielles et énergétiques. Elle propose des pistes pour intensifier les collaborations entre ces domaines et accélérer le partage des connaissances liées aux flux de matière et d'énergie et à leur cheminement au sein des activités économiques afin de rendre le système industriel existant en Suisse romande viable à long terme. Parallèlement, elle étudie les possibilités de transposer ces considérations et les procédures et outils développés dans le contexte économique et social de la région Asie-Pacifique, où se trouvent aujourd'hui de nombreuses activités de production.SummaryIndustrial symbioses: A new strategy for improving how economic activities use material and energy resourcesThis thesis focuses on one application of industrial ecology, industrial symbioses, as a strategy for improving how economic activities consume material and energy resources. Industrial symbioses seek to create new collaborations among economic players with the goal of exchanging information, raw materials, and waste directly among area businesses, and to step up the potential pooling of services and infrastructure among neighboring companies.The identification and implementation of industrial symbioses are studied from several angles. The research first examines the development of implementation procedures for government bodies, academic institutions, and environmental consulting services. The purpose of the procedures is to create a dynamic of collaboration and trust between the economic players and the public officials in a region in order to identify potential industrial symbioses. The procedures necessitate managing large amounts of information about material and energy flows.Fieldwork conducted in the canton of Geneva and the Lausanne region, and used as case studies for the research, highlights a great number of industrial symbioses that already exist in French-speaking Switzerland. Several dozen examples are identified, primarily in the areas of water management, energy, chemical products, and building materials; however, Swiss law would permit many others. The research evaluates these opportunities from a technical, legal, economic, and environmental standpoint. By developing an assessment framework it is possible to determine which industrial symbioses are technically feasible and pertinent in Switzerland, and under what circumstances they would represent real added value compared to the current use of the resource and to existing systems for collecting and reusing waste.Lastly, SymbioGIS software was developed to help identify and assess potential industrial symbioses. The program's Web-based interface can be accessed by multiple users and is coupled with an interface that provides geographic information. In addition to identifying industrial symbioses, several program functionalities make it easier to consider material and energy flows with regard to local development issues and siting economic activities.In conclusion, the research highlights the need to bring together public institutions charged with protecting the environment, promoting economic activity, and overseeing development in order to foster the expansion of industrial symbioses as a strategy for managing material and energy resources. It proposes solutions for stepping up collaboration among these players and accelerating the sharing of knowledge about material and energy flows and their paths within economic activities with the goal of making theexisting industrial system in French-speaking Switzerland viable long-term. Also examined were thepossibilities of transposing these considerations and the study's findings about Switzerland to the economic and social context of the Asia-Pacific region, where much production is now located.