Dental caries experience in Indians of the Upper Xingu, Brazil

The present study describes the experience of dental caries in Indians communities of the Xingu, in order to supply parameters for further analysis of trends of the disease in Indians. We performed oral health examination in 288 Indians from four communities (Yawalapiti, Aweti, Mehinaku and Kamaiura) living in the southern part of the Xingu National Park, using international criteria defined by the World Health Organization. The outcome measures were the DMFT and dmft scores, and the care index. Indians of the Upper Xingu presented high levels of caries, in all age groups. The average DMFT for 11 to 13-year-old children - 5.93 - was lower than the index measured in 1993 for 12-year-old schoolchildren in nearby cities - 8.23 -, whose United Nations' human development index ranked medium. However, Indians presented a much lower care index, per age group, than these cities, and a high ratio of missing teeth for persons above 20 years old. These observations indicate low incorporation of dental care services. The irregularity of the services programmed for these communities, and the changing dietary and cultural patterns, mainly derived from their contact with the non-indigenous population of Brazil, reinforce the pressing need for health promotion initiatives aimed at these groups.

Platform for Smart Car to Car Content Delivery: Results of CISTER Research Centre within CarCoDe project

Poster presented in Redes de Veiculos nas sociedades do futuro (RVSF 2015). 3, Jun, 2015. Castelo Branco, Portugal.

Simple Kinematic Design for Evading the Forced Oscillation of a Car-Wheel Suspension System

An adaptive control damping the forced vibration of a car while passing along a bumpy road is investigated. It is based on a simple kinematic description of the desired behavior of the damped system. A modified PID controller containing an approximation of Caputo’s fractional derivative suppresses the high-frequency components related to the bumps and dips, while the low frequency part of passing hills/valleys are strictly traced. Neither a complete dynamic model of the car nor ’a priori’ information on the surface of the road is needed. The adaptive control realizes this kinematic design in spite of the existence of dynamically coupled, excitable internal degrees of freedom. The method is investigated via Scicos-based simulation in the case of a paradigm. It was found that both adaptivity and fractional order derivatives are essential parts of the control that can keep the vibration of the load at bay without directly controlling its motion.

Avaliação dos serviços de saúde mental em Moçambique

RESUMO: O instrumento de avaliação de sistemas de saúde mental da organização mundial de saúde (WHO-AIMS)foi usado para a recolha de informações sobre o Programa Nacional de Saúde Mental de Moçambique. O presente estudo tem como objectivo melhorar o Programa Nacional de Saúde Mental e fornecer um ponto de partida para a monitorização das mudanças. Os resultados do estudo permitirão a Moçambique fortalecer a sua capacidade para desenvolver planos de saúde mental baseados em informações com pontos de partida e metas bem definidos. O relatório será também útil para a monitorização do progresso da implementação de reformas nas políticas de saúde mental, na disponibilização de serviços de base comunitária, e no envolvimento dos utentes, seus familiares e outros actores na promoção, prevenção,cuidados e reabilitação em saúde mental. Tendo em conta os antecedentes históricos da saúde mental em Moçambique, a realidade actual clama por reformas profundas voltadas para uma intervenção mais humanizada e com enfoque nos cuidados primários. É nesse contexto que o estudo realizado apresenta resultados relacionados com as políticas, legislação, estratégias e planos de acção e financiamento para a saúde mental; serviços de saúde mental;cuidados primários; recursos humanos e ligação com outros sectores chave. A saúde mental foi avaliada desde o sistema de gestão até ao nível comunitário. Relativamente aos órgãos de gestão, a principal constatação é que existem instrumentos legais para sustentar as iniciativas desta área e influenciar os meios políticos em prol da saúde mental. Todavia, o caminho a percorrer ainda é longo uma vez que não está ainda aprovada nenhuma lei de saúde mental e os financiamentos para a área não permitem a implementação das reformas necessárias. Os serviços ao nível clínico debatem-se com a problemática dos recursos humanos (constituídos principalmente por técnicos de psiquiatria) e disponibilidade de psicofármacos. O modelo biopsicossocial ainda não é implementado integralmente uma vez que são poucos os serviços que oferecem apoio psicossocial (que inclui a reabilitação e reintegração) para além da intervenção farmacológica. Esta pode ser considerada uma das principais causas de recaídas identificadas em todas as províncias. Há uma necessidade urgente de se realizarem pesquisas e levantamentos epidemiológicos que possam servir de suporte para a advocacia em saúde mental com vista a melhoria dos cuidados a prestar aos pacientes e comunidade. Os instrumentos de recolha de informação de rotina não são adequados limitando a fidelidade dos dados recolhidos e a possibilidade de uma gestão dos serviços de saúde mental que responda as reais necessidades da população. Em suma, os resultados aqui apresentados mostram que Moçambique tem uma base que pode ser considerada uma mais valia para a reforma do sistema de saúde mental. Existem, ainda que escassos, recursos como humanos, infra-estruturas e legislação para a prestação dos serviços clínicos. É preciso investir na saúde mental para que os recursos existentes sejam melhorados e expandidos, apostando na criação de equipas multidisciplinares e qualificação das equipas de gestão e equipas clínicas. --------ABSTRACT: The World Health Organization Assessment Instrument for Mental Health Services (WHO-AIMS) was used to collect information about the National Mental Health Program of Mozambique. The present study aims to improve the National Mental Health Program and provide a starting point for monitoring change. The study results will allow Mozambique to strengthen its capacity to develop mental health plans based on information with starting points and well-defined goals. The report will also be useful for monitoring the progress of implementation of reforms in mental health policies, the provision of community-based services, and involvement of users, their families and other stakeholders in the promotion, prevention, care and rehabilitation in mental health. Given the historical background of mental health in Mozambique, the current situation calls for reforms aimed at a more humane intervention focused on primary care. In this context, the study presents results related to policies, legislation, strategies and action plans and funding for mental health; mental health services; primary care; human resources and liaison with other key sectors. Mental health was assessed from the management system to the community level. With regard to the management, the main observation is that there are legal instruments to support the initiatives in this area and to influence the political means on behalf of mental health. However, the pathway is still long as it is not yet approved any Mental Health Law and the funding for the area do not allow the implementation of necessary reforms. Services at the clinical level are struggling with the issue of human resources (consisting primarily of psychiatrist technicians) and availability of psychotropic drugs. The biopsychosocial model is not yet fully implemented since there are few services providing psychosocial support (including rehabilitation and reintegration) in addition to pharmacological intervention. This can be considered a major cause of relapse identified in all provinces. There is an urgent need to conduct research and epidemiological surveys which could provide support for advocacy in mental health in order to improve the mental health car for the patients and community. The routine data collection instruments are not appropriate limiting the fidelity of the data collected and the possibility of a management of mental health services that meets the real needs of the population. In summary, the results presented here show that Mozambique has a groundwork that can be considered an asset for the reform of mental health system. There are, though scarce, human resources, infrastructure and legislation for the provision of clinical services. It’s necessary to invest in mental health so that existing resources are improved and expanded, and to invest on the creation of multidisciplinary teams and qualification of management teams and clinical teams.

Dimensionar a logística interna da fábrica Toyota Ovar para a produção de nova viatura

O projeto foi realizado na Toyota (divisão fabril de Ovar), no ano letivo 2014/2015, teve por base um estágio extracurricular que foi realizado para que desta forma tomasse contacto com uma realidade concreta e absoluta no contexto empresarial. O estágio serviu, principalmente, como uma experiência na compreensão do funcionamento de uma indústria de automóveis. Este projeto desenvolve-se no âmbito do 2ºano do Mestrado de Logística e apresenta os contributos desenvolvidos no departamento de logística para a reorganização da mesma para a produção de um novo modelo automóvel. Atualmente, a Toyota, para os modelos de automóveis que produz, recebe os componentes em CKD (Completed Knocked Down) provenientes do Japão em lotes de cinco unidades. Estes lotes são armazenados no armazém, de onde só saem quando for dada ordem para serem produzidos. Cada lote tem várias caixas, que são colocadas à vez numa zona comum de abertura. São retidos os componentes das caixas CKD e colocados nos transportadores próprios dos postos correspondentes (supermercado de linha). Isto significa que sempre que é solicitado uma viatura de um determinado lote, são obrigados a produzir as cinco unidades. Isto significa que as restantes unidades do lote terão que ficar em parque aberto a aguardar venda futura, para além de ter um stock desnecessário, estas unidades ficam vulneráveis e sofrem desgaste, pois estão expostas à intempérie, causando graves problemas de qualidade e respetivos custos associados. Recentemente, foi decidida a produção do modelo Land Cruiser 70 na unidade industrial de Ovar, Portugal, o que obrigou a uma reorganização da produção e processos logísticos para a sua produção. Os objetivos que a empresa pretende com a entrada de um novo projeto Land Cruiser 70, são os seguintes: Alterar o sistema de abastecimento, implementando o abastecimento unitário em toda a fábrica para o novo modelo, garantindo o “one by one production”; Definir o funcionamento do processo logístico desde a chegada dos componentes até ficarem disponíveis no supermercado de linha. Para isso será necessário dimensionar armazém e zona de abertura, definir layouts e quantidade de stocks, bem como definir sistemas de comunicação entre abertura e supermercado; Verificar as peças que vão fazer parte do chassi por posto e contabilizar os dolly´s1 necessários; Fazer o layout de abastecimento da linha do chassi; Calcular o tempo de abertura, de abastecimento e de picking do chassi e de triming. Este projeto tem em conta a política de melhoria contínua de forma a conseguir satisfazer o cliente (ser eficaz) utilizando cada vez menos recursos quer físicos quer humanos (ser eficiente, detetar e eliminar os desperdícios). O presente projeto foi inserido na equipa de melhoria contínua da logística, maioritariamente no chassi. Em termos globais, os objetivos propostos neste estágio foram atingidos com êxito.

The words about a “sea of trees”. Colonial and post-colonial narratives about Gorongosa (Mozambique)

8º Congresso Ibérico de Estudos Africanos (CIEA8). Madrid, 2012

Contributo dos sistemas de informação geográfica para a mobilidade elétrica : localização de áreas ótimas para Park&Ride baseadas na rede do metro do Porto

Dissertação de mestrado em Gestão do Território na especialidade de Deteção Remota e Sistemas de Informação Geográfica

Pulmonary Hypertension in Portugal: First Data from a Nationwide Registry

Introduction. Pulmonary arterial hypertension (PAH) is a rare disease that must be managed in specialized centers; therefore, the availability of epidemiological national data is critical. Methods. We conducted a prospective, observational, and multicenter registry with a joint collaboration from five centers from Portugal and included adult incident patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH). Results. Of the 79 patients enrolled in this study, 46 (58.2%) were classified as PAH and 33 patients (41.8%) as CTEPH. PAH patients had a mean age of 43.4 ± 16.4 years. Idiopathic PAH was the most common etiology (37%). At presentation, PAH patients had elevated right atrial pressure (RAP) (7.7 ± 5.9mmHg) and mean pulmonary vascular resistance (11.4 ± 6.5 Wood units), with a low cardiac index (2.7 ± 1.1 L⋅min−1 m−2); no patient was under selective pulmonary vasodilators; however, at follow-up, most patients were on single (50%), double (28%), or triple (9%) combination vasodilator therapy. One-year survival was 93.5%, similar to CTEPH patients (93.9%), that were older (60.0 ± 12.5 years) and had higher RAP (11.0 ± 5.2mmHg,

Analysis of the pathway of developing a national mental health plan for Suriname

ABSTRACT: The aim of this analysis was to analyze and describe the steps that have been taken in the development of the mental health policy in Suriname after the WHO AIMS. The objectives are: 1.To review the steps to be taken in developing a mental health policy and plan for a country 2.To gather information and data concerning mental health policy and plan development in Suriname 3.To draw conclusion from the experience gained that can be applied to other countries. In general, the information that was gathered from the four countries Guyana, Barbados, Trinidad & Tobago and Suriname, was compared with the WHO steps for developing a mental health policy and plan. Were these steps taken into consideration, when developing their mental health policy and plan? If not, what were the reasons why it did not happen? The checklist for evaluating a mental health plan was used in Suriname. This checklist assisted to see if the results of the recommendations given by the WHO AIMS to develop a effective and balanced mental health plan were taken into consideration. The mayor findings of the analysis are that Suriname as well as Guyana used the steps in developing their mental health policy and plan. Barbados and Trinidad & Tobago did not develop a mental health policy and plan. Suriname and Guyana have a mental health coordinating body at the Ministry of Health. Trinidad & Tobago as well as Barbados have a mental health focal person at the Ministry of Health of the respective countries. It can be concluded that successfully improving of health systems and services for mental health is combining theoretical concepts, expert knowledge and cooperation of many stakeholders. The appointment of a mental health coordinating unit at the Ministry of Health is crucial for the development of mental health in a country. Furthermore, mental health is everyone’s business and responsibility. Implementing the steps to be taken when developing a mental health policy and plan as recommended by WHO may be a slow process requiring the mobilization of political will. That’s why it is crucial that persons responsible for this process work close with all stakeholders in relevant sectors, taking their needs into consideration and try to translate that in clear objectives. It is common knowledge that improving the quality of mental health must be accompanied by the availability of financial and human resources. Finally, a mental health policy and plan should be one document tackling all aspects of mental health of a community.

A Review of National Guidelines for Management of COPD in Europe

The quality of care can be improved by the development and implementation of evidence-based treatment guidelines. Different national guidelines for chronic obstructive pulmonary disease (COPD) exist in Europe and relevant differences may exist among them.This was an evaluation of COPD treatment guidelines published in Europe and Russia in the past 7 years. Each guideline was reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardised process. Guidelines were available from the Czech Republic, England and Wales, Finland, France, Germany, Italy, Poland, Portugal, Russia, Spain and Sweden. The treatment goals, criteria for COPD diagnosis, consideration of comorbidities in treatment selection and support for use of long-acting bronchodilators, were similar across treatment guidelines. There were differences in measures used for stratification of disease severity, consideration of patient phenotypes, criteria for the use of inhaled corticosteroids and recommendations for other medications (e.g. theophylline and mucolytics) in addition to bronchodilators.There is generally good agreement on treatment goals, criteria for diagnosis of COPD and use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management in Europe and Russia. However, there are differences in the definitions of patient subgroups and other recommended treatments.

Validation of Two US Risk Scores for Percutaneous Coronary Intervention in a Single-Center Portuguese Population of Patients with Acute Coronary Syndrome

INTRODUCTION: New scores have been developed and validated in the US for in-hospital mortality risk stratification in patients undergoing coronary angioplasty: the National Cardiovascular Data Registry (NCDR) risk score and the Mayo Clinic Risk Score (MCRS). We sought to validate these scores in a European population with acute coronary syndrome (ACS) and to compare their predictive accuracy with that of the GRACE risk score. METHODS: In a single-center ACS registry of patients undergoing coronary angioplasty, we used the area under the receiver operating characteristic curve (AUC), a graphical representation of observed vs. expected mortality, and net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analysis to compare the scores. RESULTS: A total of 2148 consecutive patients were included, mean age 63 years (SD 13), 74% male and 71% with ST-segment elevation ACS. In-hospital mortality was 4.5%. The GRACE score showed the best AUC (0.94, 95% CI 0.91-0.96) compared with NCDR (0.87, 95% CI 0.83-0.91, p=0.0003) and MCRS (0.85, 95% CI 0.81-0.90, p=0.0003). In model calibration analysis, GRACE showed the best predictive power. With GRACE, patients were more often correctly classified than with MCRS (NRI 78.7, 95% CI 59.6-97.7; IDI 0.136, 95% CI 0.073-0.199) or NCDR (NRI 79.2, 95% CI 60.2-98.2; IDI 0.148, 95% CI 0.087-0.209). CONCLUSION: The NCDR and Mayo Clinic risk scores are useful for risk stratification of in-hospital mortality in a European population of patients with ACS undergoing coronary angioplasty. However, the GRACE score is still to be preferred.

The national physics and chemistry exams and the learning of sciences

Dissertação apresentada para obtenção do Grau de Doutor em Ciências da Educação, pela Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa

Differential exploitation of cashew - a low conflict crop - by sympatric humans and chimpanzees

Modification of natural areas by human activities mostly has a negative impact on wildlife by increasing the geographical and ecological overlap between people and animals. This can result in escalating levels of competition and conflict between humans and wildlife, for example over crops. However, data on specific crops and crop parts that are unattractive to wildlife yet important for human livelihoods are surprisingly scarce, especially considering their potential application to reducing crop damage by wildlife. Here we examine the co-utilization of a nationally important and spatially abundant cash crop, cashew Anacardium occidentalis, by people and chimpanzees Pan troglodytes verus inhabiting a forested–agricultural matrix in Cantanhez National Park in Guinea-Bissau. In this Park people predominantly harvest the marketable cashew nut and discard the unprofitable fruit whereas chimpanzees only consume the fruit. Local farmers generally perceive a benefit of raiding by chimpanzees as they reportedly pile the nuts, making harvesting easier. By ensuring that conflict levels over crops, especially those with high economic importance, remain low, the costs of living in proximity to wildlife can potentially be reduced. Despite high levels of deforestation associated with cashew farming, these findings point to the importance of cashew as a low-conflict crop in this area.

Regional growth in Europe: The role of European and national policies

We conduct a systematic study of the impact of European Union (EU) regional policies on regional economic growth that controls for national policies and geographic characteristics. Special care is taken in distinguishing between the impact of EU policies and of national policies on economic growth. Our empirical study tries to answer two different questions. First, is there convergence across EU regions, and if so, do regions converge to a common European steady-state or to a national one? Second, how do European and national policies affect regional growth? We find evidence of regional convergence at the national level but not at the European level. In addition we find that trade openness at the national level is associated with regional convergence while European regional policies contribute, though weakly, to regional convergence. Our results suggest that policies that foster market integration – and convergence to a common steady-state - such as the promotion of labour and capital movements across countries and common regulatory policies are as important for European-wide regional convergence as regional structural funds.