Estudo descritivo do perfil de utilizador da linha Saúde 24 com análise de impacto ao nível da eficiência, equidade e empowerment em comparação com o modelo inglês NHS Direct

RESUMO - A 8 de Maio de 2008 surgiu o centro de atendimento “Linha Saúde24” (S24) no sentido de modernizar o SNS, aproximando-o do cidadão. O serviço surge baseado no modelo inglês – o NHS Direct – que pode ser encarado como um serviço de informação telefónico apoiado por enfermeiros, disponível 24h por dia, concebido para expandir os serviços púbicos de acesso à rede prestadora de cuidados com intuito de aliviar a pressão da procura na rede de urgências hospitalares e médicos de família, assim como diluir as iniquidades regionais na prestação de serviços. A S24 assenta na perspectiva de ser um ponto de contacto inicial do utente com a rede de prestação de cuidados de saúde com capacidade de orientação. O objectivo da linha está na tentativa mais eficiente no uso dos recursos disponíveis, ao mesmo tempo que delega responsabilidade no cidadão na forma como este utiliza os recursos disponíveis, com melhor racionalização financeira na área da saúde aliada a uma melhor qualidade de serviço prestada e adequada, colocando os cidadãos no mesmo patamar, diluindo as dificuldades de acesso a aqueles que necessitam na tentativa de harmonizar e racionalizar o consumo de serviços de saúde. Esta estrutura permite ao cidadão conhecer melhor o seu estado de saúde e decidir mais acertadamente quanto à decisão a tomar. Com este estudo, e com base na literatura nacional e internacional, pretende-se descrever o perfil de utilizador que acede à S24 – definir o tipo de utilizador, disposição geográfica, motivos pelo qual acede ao serviço e qual o seu destino final, fazendo comparação com o perfil do NHS Direct. Assim, e com os dados obtidos, far-se-á uma avaliação preliminar em termos do contributo da linha S24 no que concerne à sua eficiência, equidade e empowerment dado ao utilizador. --- ------------------------------ABSTRACT - Saúde 24 (S24) is a national 24-hour health line initiated in May 2008 aiming at modernizing the Portuguese NHS by bringing it closer to the citizen. Indeed, S24 be seen as an initial contact point between the patient and the healthcare network, facilitating a better a management of health care demand. The service is inspired on the UK NHS Direct – a nurse-led telephone line to provide easier and faster advice information to people about health, illness and NHS services. It is expected to provide information so that people can deal with their health problems or their families´ on their own, with the purpose of reducing demand to A&E department and out-of-hours GP services. Additionally it can contribute to a reduction in regional inequities in healthcare provision through bringing health care advice to remote areas. The purpose of S24 is to handle more efficiently the available resources by enabling responsibilities in citizens. By doing so, S24 encourages a more appropriate use of available resources, with better financial outcomes and a better quality of care. It is meant, in terms of empowerment, to help people to be in control of their health and healthcare interactions by participating in the final decision. Based on quantitative data, this study defines the S24 caller user profile in terms of type, geographical reference, reasons for calling and outcome. This analysis allows us to perform a preliminary evaluation of the S24 in terms of its contribution to efficiency, equity and empowerment. Then the S24 is compared to

Pliocene-quaternary upwelling in the SoutheasternAtlantic may reflect changes in water mass production

Proceedings of tile 1" R.C.A.N.S. Congress, Lisboa, October 1992

Modulation of parasitemia and antibody responce to Trypanosoma cruzy by cyclophosphamide in Calomys callosus (Rodentia, Cricetidae)

Calomys callosus a wild rodent, previously described as harboring Trypanosoma cruzi, has a low susceptibility to infection by this protozoan. Experiments were designed to evaluate the contribution of the immune response to the resistance to T. cruzi infection exhibited by C. calossus. Animals were submitted to injections of high (200 mg/kg body weight) and low (20 mg/kg body weight) doses of cyclophosphamide on days -1 or -1 and +5, and inoculated with 4 x 10³ T. cruzi on day O. Parasitemia, mortality and antibody response as measured by direct agglutination of trypomastigotes were observed. Two hundred mg doses of cyclophosphamide resulted in higher parasitemia and mortality as well as in suppression of the antibody response. A single dose of 20 mg enhanced antibody levels on the 20th day after infection, while an additional dose did not further increase antibody production. Parasitemia levels were not depressed, but rather increased in both these groups as compared to untreated controls. Passive transfer of hyperimmune C. callosus anti-T. cruzi serum to cyclophosphamide immunosuppressed animals resulted in lower parasitemia and mortality rates. These results indicate that the immune response plays an important role in the resistance of C. callossus to T. cruzi.

Biomass production of four Cynara cardunculus clones and lignin composition analysis

Four Cynara cardunculus clones, two from Portugal and two from Spain were studied for biomass production and their lignin was characterized. The clones differed in biomass partitioning: Spanish clones produced more capitula (54.5% vs. 43.9%), and Portuguese clones more stalks (37.2% vs. 25.6%). The heating values (HHV0) of the stalks were similar, ranging from 17.1 to 18.4 MJ/kg. Lignin was studied by analytical pyrolysis (Py-GC/MS(FID)), separately in depithed stalks (stalksDP) and pith. StalksDP had in average higher relative proportions of lignin derived compounds than pith (23.9% vs. 21.8%) with slightly different lignin monomeric composition: pith samples were richer in syringyl units as compared to stalksDP (64% vs. 53%), with S/G ratios of 2.1 and 1.3, respectively. The H:G:S composition was 7:40:53 in stalksDP and 7:29:64 in pith. The lignin content ranged from 18.8% to 25.5%, enabling a differentiation between clones and provenances. © 2015 Elsevier Ltd. All rights reserved.

Preliminary study of synthesis gas production from water electrolysis, using the ELECTROFUEL (R) concept

This paper describes preliminary work on the generation of synthesis gas from water electrolysis using graphite electrodes without the separation of the generated gases. This is an innovative process, that has no similar work been done earlier. Preliminary tests allowed to establish correlations between the applied current to the electrolyser and flow rate and composition of the generated syngas, as well as a characterisation of generated carbon nanoparticles. The obtained syngas can further be used to produce synthetic liquid fuels, for example, methane, methanol or DME (dimethyl ether) in a catalytic reactor, in further stages of a present ongoing project, using the ELECTROFUEL® concept. The main competitive advantage of this project lies in the built-in of an innovative technology product, from RE (renewable energy) power in remote locations, for example, islands, villages in mountains as an alternative for energy storage for mobility constraints.

An uncertainty and sensitivity analysis applied to the prioritisation of pharmaceuticals as surface water contaminants from wastewater treatment plant direct emissions

In this study, the concentration probability distributions of 82 pharmaceutical compounds detected in the effluents of 179 European wastewater treatment plants were computed and inserted into a multimedia fate model. The comparative ecotoxicological impact of the direct emission of these compounds from wastewater treatment plants on freshwater ecosystems, based on a potentially affected fraction (PAF) of species approach, was assessed to rank compounds based on priority. As many pharmaceuticals are acids or bases, the multimedia fate model accounts for regressions to estimate pH-dependent fate parameters. An uncertainty analysis was performed by means of Monte Carlo analysis, which included the uncertainty of fate and ecotoxicity model input variables, as well as the spatial variability of landscape characteristics on the European continental scale. Several pharmaceutical compounds were identified as being of greatest concern, including 7 analgesics/anti-inflammatories, 3 β-blockers, 3 psychiatric drugs, and 1 each of 6 other therapeutic classes. The fate and impact modelling relied extensively on estimated data, given that most of these compounds have little or no experimental fate or ecotoxicity data available, as well as a limited reported occurrence in effluents. The contribution of estimated model input variables to the variance of freshwater ecotoxicity impact, as well as the lack of experimental abiotic degradation data for most compounds, helped in establishing priorities for further testing. Generally, the effluent concentration and the ecotoxicity effect factor were the model input variables with the most significant effect on the uncertainty of output results.

Utilization of food industry wastes for the production of zero-valent iron nanoparticles

The proper disposal of the several types of wastes produced in industrial activities increases production costs. As a consequence, it is common to develop strategies to reuse these wastes in the same process and in different processes or to transform them for use in other processes. This work combines the needs for new synthesis methods of nanomaterials and the reduction of production cost using wastes from citrine juice (orange, lime, lemon and mandarin) to produce a new added value product, green zero-valent iron nanoparticles that can be used in several applications, including environmental remediation. The results indicate that extracts of the tested fruit wastes (peel, albedo and pulp fractions) can be used to produce zero-valent iron nanoparticles (nZVIs). This shows that these wastes can be an added value product. The resulting nZVIs had sizes ranging from 3 up to 300 nm and distinct reactivities (pulp > peel > albedo extracts). All the studied nanoparticles did not present a significant agglomeration/settling tendency when compared to similar nanoparticles, which indicates that they remain in suspension and retain their reactivity.

Supply chain optimization of residual forestry biomass for bioenergy production: the case study of Portugal

Within a large set of renewable energies being explored to tackle energy sourcing problems, bioenergy can represent an attractive solution if effectively managed. The supply chain design supported by mathematical programming can be used as a decision support tool to the successful bioenergy production systems establishment. This strategic decision problem is addressed in this paper where we intent to study the design of the residual forestry biomass to bioelectricity production in the Portuguese context. In order to contribute to attain better solutions a mixed integer linear programming (MILP) model is developed and applied in order to optimize the design and planning of the bioenergy supply chain. While minimizing the total supply chain cost the production energy facilities capacity and location are defined. The model also includes the optimal selection of biomass amounts and sources, the transportation modes selection, and links that must be established for biomass transportation and products delivers to markets. Results illustrate the positive contribution of the mathematical programming approach to achieve viable economic solutions. Sensitivity analysis on the most uncertain parameters was performed: biomass availability, transportation costs, fixed operating costs and investment costs. (C) 2015 Elsevier Ltd. All rights reserved.

Siderophore Production by Bacillus megaterium: Effect of Growth Phase and Cultural Conditions

Siderophore production by Bacillus megaterium was detected, in an iron-deficient culture medium, during the exponential growth phase, prior to the sporulation, in the presence of glucose; these results suggested that the onset of siderophore production did not require glucose depletion and was not related with the sporulation. The siderophore production by B. megaterium was affected by the carbon source used. The growth on glycerol promoted the very high siderophore production (1,182 μmol g−1 dry weight biomass); the opposite effect was observed in the presence of mannose (251 μmol g−1 dry weight biomass). The growth in the presence of fructose, galactose, glucose, lactose, maltose or sucrose, originated similar concentrations of siderophore (546–842 μmol g−1 dry weight biomass). Aeration had a positive effect on the production of siderophore. Incubation of B. megaterium under static conditions delayed and reduced the growth and the production of siderophore, compared with the incubation in stirred conditions.

Preliminary study on the production of functionally graded materials by friction stir processing

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

Acompanhamento da construção do edifício Focus Lx na Avenida António Augusto de Aguiar

Relatório de Estágio para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Edificações

Matrix converter as unified power flow controller: design and implementation of decoupled direct power controllers

This paper presents the design and implementation of direct power controllers for three-phase matrix converters (MC) operating as Unified Power Flow Controllers (UPFC). Theoretical principles of the decoupled linear power controllers of the MC-UPFC to minimize the cross-coupling between active and reactive power control are established. From the matrix converter based UPFC model with a modified Venturini high frequency PWM modulator, decoupled controllers for the transmission line active (P) and reactive (Q) power direct control are synthesized. Simulation results, obtained from Matlab/Simulink, are presented in order to confirm the proposed approach. Results obtained show decoupled power control, zero error tracking, and fast responses with no overshoot and no steady-state error.

GLODS: Global and Local Optimization using Direct Search

Locating and identifying points as global minimizers is, in general, a hard and time-consuming task. Difficulties increase in the impossibility of using the derivatives of the functions defining the problem. In this work, we propose a new class of methods suited for global derivative-free constrained optimization. Using direct search of directional type, the algorithm alternates between a search step, where potentially good regions are located, and a poll step where the previously located promising regions are explored. This exploitation is made through the launching of several instances of directional direct searches, one in each of the regions of interest. Differently from a simple multistart strategy, direct searches will merge when sufficiently close. The goal is to end with as many direct searches as the number of local minimizers, which would easily allow locating the global extreme value. We describe the algorithmic structure considered, present the corresponding convergence analysis and report numerical results, showing that the proposed method is competitive with currently commonly used global derivative-free optimization solvers.

Materials selection for a set of multiple parts considering manufacturing costs and weight reduction with structural isoperformance using direct multisearch optimization

Materials selection is a matter of great importance to engineering design and software tools are valuable to inform decisions in the early stages of product development. However, when a set of alternative materials is available for the different parts a product is made of, the question of what optimal material mix to choose for a group of parts is not trivial. The engineer/designer therefore goes about this in a part-by-part procedure. Optimizing each part per se can lead to a global sub-optimal solution from the product point of view. An optimization procedure to deal with products with multiple parts, each with discrete design variables, and able to determine the optimal solution assuming different objectives is therefore needed. To solve this multiobjective optimization problem, a new routine based on Direct MultiSearch (DMS) algorithm is created. Results from the Pareto front can help the designer to align his/hers materials selection for a complete set of materials with product attribute objectives, depending on the relative importance of each objective.

Multiobjective optimization of viscoelastic laminated sandwich structures using the Direct MultiSearch method

A multiobjective approach for optimization of passive damping for vibration reduction in sandwich structures is presented in this paper. Constrained optimization is conducted for maximization of modal loss factors and minimization of weight of sandwich beams and plates with elastic laminated constraining layers and a viscoelastic core, with layer thickness and material and laminate layer ply orientation angles as design variables. The problem is solved using the Direct MultiSearch (DMS) solver for derivative-free multiobjective optimization and solutions are compared with alternative ones obtained using genetic algorithms.