A intervenção privada na prestação pública : da expansão do Estado às parcerias público-privadas

Durante séculos o papel do Estado na vida económica e social das nações foi crescendo, atingindo um desenvolvimento assinalável a partir da segunga guerra mundial, em execução do novo paradigma que dela resultou. Desenvolvimento que conheceu fortes críticas com paragem e posterior inversão de sentido durante a década de 80 em que se gerou alguma diluição da intervenção do Estado, criando-se um movimento de relativo cepticismo relativamente à bondade, à eficiência e aos custos daquela intervenção. Foi nesse contexto e paralelamente com o aumento da vontade de intervir do sector privado que surgiram as chamadas três «vagas» de intervenção privada, sucessivamente dirigidas às actividades públicas (i) em sectores industriais, comerciais ou de serviços não estratégicos, (ii) no domínio das infra-estruturas e, finalmente, (iii) na área social, recorrendo com diferentes níveis de sucesso, a diversos processos, da privatização às parcerias público-privadas (PPP), passando pela empresarialização. O movimento de reforma nascido de reservas quanto à eficiência do sector público não passou ao lado da saúde, particularmente do hospital público, em que assumiu objectivos e modos específicos, das «reformas de gestão» às «reformas de financiamento» e às «reformas organizacionais », para, na sequência do movimento anteriormente ocorrido noutros domínios, também recorrer às parcerias público-privadas. Depois de situar estas iniciativas no contexto do movimento que rodeou o aumento da intervenção privada na produção e na prestação pública, o artigo procura identificar os requisitos de compatibilidade das parcerias público-privadas com sistemas de saúde organizados e que perseguem a universalidade da cobertura, a acessibilidade e compreensividade dos cuidados e a equidade do acesso, com especial atenção ao facto de (designadamente em Portugal) a partilha de riscos e tarefas poder atribuir ao sector privado a gestão das dimensões clínicas da prestação.

A onda de calor de Agosto de 2003 e os seus efeitos sobre a mortalidade da população portuguesa

RESUMO - Portugal continental, como outros países europeus, foi afectado por uma onda de calor de grande intensidade no Verão de 2003, com efeitos na mortalidade da população. O excesso de óbitos associados à onda de calor foi estimado pela comparação do número de óbitos observados entre 30 de Julho e 15 de Agosto de 2003 e o número de óbitos esperados se a população tivesse estado exposta às taxas de mortalidade médias do biénio 2000-2001 no respectivo período homólogo. Os óbitos esperados foram calculados com ajustamento para a idade. O número de óbitos observados (O) foi superior ao número esperado (E) em todos os dias do período estudado e o seu excesso global foi estimado em 1953 óbitos (excesso relativo de 43%), dos quais 1317 (61%) ocorreram no sexo feminino e 1742 no grupo de 75 e + anos (89%). A nível distrital, Portalegre teve o maior aumento relativo do número de óbitos (+89%) e Aveiro o menor (+18%). Numa área geográfica contínua do interior do território (Guarda, Castelo Branco, Portalegre e Évora) houve aumentos relativos superiores a 80%. Em termos absolutos, o maior excesso de óbitos ocorreu no distrito de Lisboa (mais cerca de 396) e no do Porto (mais cerca de 183). As causas de morte «golpe de calor» e «desidratação e outros distúrbios metabólicos» tiveram os aumentos relativos mais elevados (razões O/E de, respectivamente, 70 e 8,65). Os maiores aumentos absolutos do número de óbitos ocorreram no grupo das «doenças do aparelho circulatório» (mais 758), nas «doenças do aparelho respiratório» (mais 255) e no conjunto de «todas as neoplasias malignas» (mais 131). No período da onda de calor e no período de comparação, a percentagem dos óbitos que ocorreu nos hospitais (52% e 56%), no domicílio (32 e 33%) e em «outros locais» foi semelhante. A discussão sobre os factores que condicionaram a obtenção dos valores apresentados, relativos ao excesso de óbitos por sexo, grupo etário, distrito, causa e local da morte, permite concluir que os mesmos se afiguram adequados para medir a ordem de grandeza e caracterizar o efeito da onda de calor na mortalidade. O erro aleatório, medido pelos intervalos de confiança, e alguns possíveis erros sistemáticos associados ao período de comparação escolhido não deverão afectar de modo relevante as estimativas.

Determinants for the subcellular localization of the inner and outer spore coat hubs in Bacillus subtilis

Endospores, or spores for simplicity, are a highly resistant cell type produced by some bacterial species under adverse conditions. Two main protective layers contribute to the resilience of spores: the cortex, composed of peptidoglycan, and the outermost proteinaceous coat. In Bacillus subtilis, the coat comprises up to 80 different proteins, organized into four sublayers: the basement layer, the inner coat, the outer coat and the crust. These proteins are synthesized at different times during sporulation and deposited at the spore surface in multiple coordinated waves. Central to coat formation is a group of morphogenetic proteins that guide the assembly of the coat components. Targeting of the coat proteins to the surface of the developing spore is mainly controlled by the SpoIVA morphogenetic ATPase. In a second stage, the coat proteins fully encircle the spore, a process termed encasement that requires the morphogenetic protein SpoVID. Assembly of the inner coat requires SafA, whereas formation of the outer coat and the crust requires CotE. SafA interacts directly with the N terminus of SpoVID. (...)

Application of wavelets to the study of political history

\The idea that social processes develop in a cyclical manner is somewhat like a `Lorelei'. Researchers are lured to it because of its theoretical promise, only to become entangled in (if not wrecked by) messy problems of empirical inference. The reasoning leading to hypotheses of some kind of cycle is often elegant enough, yet the data from repeated observations rarely display the supposed cyclical pattern. (...) In addition, various `schools' seem to exist which frequently arrive at di erent conclusions on the basis of the same data." (van der Eijk and Weber 1987:271). Much of the empirical controversies around these issues arise because of three distinct problems: the coexistence of cycles of di erent periodicities, the possibility of transient cycles and the existence of cycles without xed periodicity. In some cases, there are no reasons to expect any of these phenomena to be relevant. Seasonality caused by Christmas is one such example (Wen 2002). In such cases, researchers mostly rely on spectral analysis and Auto-Regressive Moving-Average (ARMA) models to estimate the periodicity of cycles.1 However, and this is particularly true in social sciences, sometimes there are good theoretical reasons to expect irregular cycles. In such cases, \the identi cation of periodic movement in something like the vote is a daunting task all by itself. When a pendulum swings with an irregular beat (frequency), and the extent of the swing (amplitude) is not constant, mathematical functions like sine-waves are of no use."(Lebo and Norpoth 2007:73) In the past, this di culty has led to two di erent approaches. On the one hand, some researchers dismissed these methods altogether, relying on informal alternatives that do not meet rigorous standards of statistical inference. Goldstein (1985 and 1988), studying the severity of Great power wars is one such example. On the other hand, there are authors who transfer the assumptions of spectral analysis (and ARMA models) into fundamental assumptions about the nature of social phenomena. This type of argument was produced by Beck (1991) who, in a reply to Goldstein (1988), claimed that only \ xed period models are meaningful models of cyclic phenomena".We argue that wavelet analysis|a mathematical framework developed in the mid-1980s (Grossman and Morlet 1984; Goupillaud et al. 1984) | is a very viable alternative to study cycles in political time-series. It has the advantage of staying close to the frequency domain approach of spectral analysis while addressing its main limitations. Its principal contribution comes from estimating the spectral characteristics of a time-series as a function of time, thus revealing how its di erent periodic components may change over time. The rest of article proceeds as follows. In the section \Time-frequency Analysis", we study in some detail the continuous wavelet transform and compare its time-frequency properties with the more standard tool for that purpose, the windowed Fourier transform. In the section \The British Political Pendulum", we apply wavelet analysis to essentially the same data analyzed by Lebo and Norpoth (2007) and Merrill, Grofman and Brunell (2011) and try to provide a more nuanced answer to the same question discussed by these authors: do British electoral politics exhibit cycles? Finally, in the last section, we present a concise list of future directions.

Electromagnetic fields and environmental noise: human health impacts in Serzedelo, Guimarães (Portugal)

The present paper investigates the risks that arise from exposure to noise from powerpoles and powerlines in Serzedelo, in the municipality of Guimarães, in Portugal. This research focused on four guiding questions: Can powerlines cause noise? Do powerlines cause discomfort? Do powerlines cause discomfort due to noise? And can powerlines effect human health? Two groups were the basis of the study: people that were exposed to electromagnetic waves and people that were not. the research pointed to the harmful influence of the presence of powerlines and high-voltage masts in residential areas and the damage to the cells in the human body. This type of environmental noise, which has the spectral content of a low frequency, typically tonal noise and a very high speed of propagation, is a complex source to explain in terms of the health profiles of the human population living in Serzedelo, located in an area that is densely occupied by high voltage powerlines and powerpole.

Cidadania, imigração e nacionalidade na União Europeia

Projeto de mestrado em Políticas Comunitárias e Cooperação Territorial

Effect of the acoustic impedance in ultrasonic emitter transducers using digital modulations

In an underwater environment it is difficult to implement solutions for wireless communications. The existing technologies using electromagnetic waves or lasers are not very efficient due to the large attenuation in the aquatic environment. Ultrasound reveals a lower attenuation, and thus has been used in underwater long-distance communications. The much slower speed of acoustic propagation in water (about 1500 m/s) compared with that of electromagnetic and optical waves, is another limiting factor for efficient communication and networking. For high data-rates and real-time applications it is necessary to use frequencies in the MHz range, allowing communication distances of hundreds of meters with a delay of milliseconds. To achieve this goal, it is necessary to develop ultrasound transducers able to work at high frequencies and wideband, with suitable responses to digital modulations. This work shows how the acoustic impedance influences the performance of an ultrasonic emitter transducer when digital modulations are used and operating at frequencies between 100 kHz and 1 MHz. The study includes a Finite Element Method (FEM) and a MATLAB/Simulink simulation with an experimental validation to evaluate two types of piezoelectric materials: one based on ceramics (high acoustic impedance) with a resonance design and the other based in polymer (low acoustic impedance) designed to optimize the performance when digital modulations are used. The transducers performance for Binary Amplitude Shift Keying (BASK), On-Off Keying (OOK), Binary Phase Shift Keying (BPSK) and Binary Frequency Shift Keying (BFSK) modulations with a 1 MHz carrier at 125 kbps baud rate are compared.

Simulation of OWES with five-Level converter linked to the grid: Harmonic assessment

This paper deals with a computing simulation for an offshore wind energy system taking into account the influence of the marine waves action throughout the floating platform. The wind energy system has a variable-speed turbine equipped with a permanent magnet synchronous generator and a full-power five level converter, injecting energy into the electric grid through a high voltage alternate current link. A reduction on the unbalance of the voltage in the DC-link capacitors of the five-level converter is proposed by a strategic selection of the output voltage vectors. The model for the drive train of the wind energy system is a two mass model, including the dynamics of the floating platform. A case study is presented and the assessment of the quality of the energy injected into the electric grid is discussed.

Firm innovation and co-location in Portugal

This paper investigates the geographical distribution and concentration of firms’ innovation persistence and innovation type (product and process) based on three waves of the Portuguese Community Innovation Survey data covering the period 1998–2006. The main findings are: 1) both innovation persistence and innovation type are asymmetrically distributed across Portuguese regions, 2) the degree of correlation between geographical location and innovative output varies with the innovation type, and 3) the correlation between geographical unit and innovation increases when the spatial unit of analysis is narrower. The results suggest that the firms’ choices of geographical location have a long-lasting effect, engendering no equal probabilities of being persistently innovative.

Cylindrically symmetric models of gravitational collapse to black holes: a short review

We survey results about exact cylindrically symmetric models of gravitational collapse in General Relativity. We focus on models which result from the matching of two spacetimes having collapsing interiors which develop trapped surfaces and vacuum exteriors containing gravitational waves. We collect some theorems from the literature which help to decide a priori about eventual spacetime matchings. We revise, in more detail, some toy models which include some of the main mathematical and physical issues that arise in this context, and compute the gravitational energy flux through the matching boundary of a particular collapsing region. Along the way, we point out several interesting open problems.

Graphene-based nanostructures: Plasmonics in the THz range

The properties of surface plasmon-polaritons (SPPs) in graphene are discussed and several possible ways of coupling electromagnetic radiation in the terahertz (THz) spectral range to this type of surface waves are described: (i) the attenuated total reflection (ATR) method employing a prism, (ii) graphene-based gratings or graphene monolayers with modulated conductivity, (iii) a metal stripe on top of the graphene layer, and (iv) a nanoparticle located above it. Potentially interesting for applications SPP effects, such as switching, modulation and polarization of THz radiation, as well as its enhanced absorption in graphene, are considered. The discussion also concerns the impact of the nonlinear properties of graphene, such as optical bistability.

Identificação de fendilhamento de pavimentos e propriedades volumétricas das misturas betuminosas utilizando um Georadar

Dissertação de mestrado integrado em Engenharia Civil

Modelação, simulação e implementação de agitação acústica para aplicações em microfluídica

Tese de Doutoramento (Programa Doutoral em Engenharia Biomédica)

Detection of the viable myocardium. A perfusion scintigraphic study, before and after coronary bypass surgery in myocardial infarction patients

OBJECTIVE: To compare single-photon-emission computed tomography (SPECT) imaging scans using 201Tl and 99mTc-MIBI in detection of viable myocardium, in regions compromised by infarction. METHODS: Thirty-two (59.3±9.8 years old and 87% male) myocardial infarction patients were studied. All had Q waves on the ECG and left ventricle ejection fraction of <50%. They underwent coronary and left ventricle angiographies and SPECT before (including 201Tl reinjection) and after coronary artery bypass surgery (CABG). Improvement in perfusion observed after surgery was considered the gold standard for myocardial viability. RESULTS: Among 102 studied regions of the heart, there were 40 (39.2%) areas of transient perfusion defects in the conventional protocol with 201Tl and 52 (51.0%) after reinjection. Therefore, 12/62 (19.4%) more viable regions were identified by reinjection. Using 99mTc-MIBI, only 14 (13.7%) regions with transient defects were identified, all of which were seen also in 201Tl protocols. After surgery, 49 of a total of 93 regions analyzed (52.7%) were viable. Sensitivity, specificity, accuracy, positive and negative prediction values were, respectively, 201Tl SPECT scans - 65.3%, 90.9%, 77.4%, 88.9% and 70.2%, reinjection protocol with 201Tl scans - 81.6%, 81.8%, 81.7%, 83.3% and 80.0%; 99mTc-MIBI SPECT scans - 20.4%, 90.9%, 53.8%, 71.4% and 50.6%. Logistic regression demonstrated that the reinjection protocol with 201Tl was the best predictor of viability (P<0.001). CONCLUSION: Our data suggest the election of 201Tl for viability studies, especially when using the reinjection protocol.

Analysis of the effects of the continuous electrode paste band on precordial leads of the electrocardiogram

OBJECTIVE - To determine if the application of a continuous electrode paste band on precordial leads results in alteration of the electrocardiographic tracing as compared with an adequate amount of electrode paste, and if the former condition does not cause uniform morphologies from V1 to V6. METHODS - The amplitude and morphology of the electrocardiographic waves on the precordial leads in electrocardiographic tracings, which were performed with standard (control group) or excessive (continuous band) application of the electrode paste, were compared. RESULTS - None of the 106 patients studied showed uniformity of the QRS morphology from V1 to V6. The eletrocardiographic alterations identified in the tracings performed with a continuous electrode paste band that showed statistical significance in relation to the control group were the following: inversion of the P wave in V1; inversion of the T wave in V1, V2, and V3; appearance of R' waves in V1 and V2; disappearance of S waves in V1; appearance of S waves in V5 and V6; alterations in the amplitude of almost all waves, in all leads. CONCLUSION - Application of a continuous electrode paste band in the precordial leads may cause significant alterations in the electrocardiographic tracing obtained.