Controlo de gestão nas instituições públicas de cuidados primários: estudo de caso

7º Congresso Nacional da Administração Pública: “Estado e Administração na Resposta à Crise” FIL, Lisboa, Portugal 10 e 11 de Novembro de 2009

Dispositional optimism is unidimensional or bidimensional? The Portuguese Revised Life Orientation Test

The aim of the study is to adapt and then discuss the appropriateness of the Life Orientation Test as a one or two dimension scale. The research includes two studies; one is composed of a sequential sample of 280 people with multiple sclerosis, 71% female, and another includes a convenience sample of 615 individuals from the community, 51.1% female. Because the construct is built upon a theoretical assumption that has one dimension, we examine the hypothesis of one or two factor solutions through confirmatory factor analysis, and the two-dimension solution premise demonstrates better adjustment for both samples. The other psychometric properties explored show appropriate results for the Portuguese sample, and similar to the original ones; the Test therefore seems appropriate for use in cross cultural studies. Based on our results, we discuss whether the questionnaire is a one or two dimension instrument, concluding that it appears appropriate to accept the recommendations of the original authors to use it as a one-dimensional tool and, when necessary, to use both dimensions. - RESUMO: El objetivo del estudio es adaptar y discutir la adecuación de la prueba de Orientación de la Vida en una o dos escalas de dimensión. La investigación engloba dos estudios, uno constituido por una muestra secuencial de 280 personas con esclerosis múltiple, 71% mujeres y otro con una muestra de conveniencia de la comunidad de 615 individuos, 51,1% del sexo femenino. Como el constructo se asienta sobre la presunción teórica de que tiene una dimensión, inspeccionamos la hipótesis de una o dos soluciones de factor a través del análisis factorial confirmatorio y la hipótesis de dos dimensiones manifiesta un mejor ajuste para ambas muestras. Las otras propiedades psicométricas exploradas muestran los resultados apropiados para la muestra portuguesa, y semejantes a los originales. Parece apropiado para los estudios culturales transversales. Basándonos en nuestros resultados, discutimos si el cuestionario es un instrumento de una o dos dimensiones, concluyéndose que parece conveniente seguir las recomendaciones de los autores originales, para utilizarlo como un instrumento unidimensional y, si fuera necesario necesario, utilizar cada una de las dimensiones.

Inexact restoration approaches to solve mathematical program with complementarity constraints

Mathematical Program with Complementarity Constraints (MPCC) finds applica- tion in many fields. As the complementarity constraints fail the standard Linear In- dependence Constraint Qualification (LICQ) or the Mangasarian-Fromovitz constraint qualification (MFCQ), at any feasible point, the nonlinear programming theory may not be directly applied to MPCC. However, the MPCC can be reformulated as NLP problem and solved by nonlinear programming techniques. One of them, the Inexact Restoration (IR) approach, performs two independent phases in each iteration - the feasibility and the optimality phases. This work presents two versions of an IR algorithm to solve MPCC. In the feasibility phase two strategies were implemented, depending on the constraints features. One gives more importance to the complementarity constraints, while the other considers the priority of equality and inequality constraints neglecting the complementarity ones. The optimality phase uses the same approach for both algorithm versions. The algorithms were implemented in MATLAB and the test problems are from MACMPEC collection.

Analysis of functionally graded sandwich plate structures with piezoelectric skins, using B-spline finite strip method

Functionally graded materials are composite materials wherein the composition of the constituent phases can vary in a smooth continuous way with a gradation which is function of its spatial coordinates. This characteristic proves to be an important issue as it can minimize abrupt variations of the material properties which are usually responsible for localized high values of stresses, and simultaneously providing an effective thermal barrier in specific applications. In the present work, it is studied the static and free vibration behaviour of functionally graded sandwich plate type structures, using B-spline finite strip element models based on different shear deformation theories. The effective properties of functionally graded materials are estimated according to Mori-Tanaka homogenization scheme. These sandwich structures can also consider the existence of outer skins of piezoelectric materials, thus achieving them adaptive characteristics. The performance of the models, are illustrated through a set of test cases. (C) 2012 Elsevier Ltd. All rights reserved.

Hay vida más allá del trabajo: la relación entre la recuperación de recursos y el desempeño en el trabajo

En los últimos años presenciamos profundas alteraciones en la relación trabajo/ tiempo libre. El proceso de globalización, las alteraciones económicas y sociales produjeron cambios en las estructuras sociales, en el trabajo y en la forma como los individuos ocupan su tiempo libre. Estas transformaciones tuvieron un impacto indeleble en la organización del trabajo, con consecuencias a nivel de las exigencias colocadas a los trabajadores; éstos se vieron obligados a adaptarse a medios cada vez más exigentes, estresantes y en constante mutación. Al mismo tiempo, muchos trabajadores vieron que aumentaba su jornada de trabajo y disminuían los períodos de descanso, dejando poco tiempo para la recuperación de las presiones a que estuvieron sujetos a lo largo de la jornada laboral.

Improvement of a filters method in a derivative free optimization

Constraints nonlinear optimization problems can be solved using penalty or barrier functions. This strategy, based on solving the problems without constraints obtained from the original problem, have shown to be e ective, particularly when used with direct search methods. An alternative to solve the previous problems is the lters method. The lters method introduced by Fletcher and Ley er in 2002, , has been widely used to solve problems of the type mentioned above. These methods use a strategy di erent from the barrier or penalty functions. The previous functions de ne a new one that combine the objective function and the constraints, while the lters method treat optimization problems as a bi-objective problems that minimize the objective function and a function that aggregates the constraints. Motivated by the work of Audet and Dennis in 2004, using lters method with derivative-free algorithms, the authors developed works where other direct search meth- ods were used, combining their potential with the lters method. More recently. In a new variant of these methods was presented, where it some alternative aggregation restrictions for the construction of lters were proposed. This paper presents a variant of the lters method, more robust than the previous ones, that has been implemented with a safeguard procedure where values of the function and constraints are interlinked and not treated completely independently.

On the ranks of certain monoids of transformations that preserve a uniform partition

The rank of a semigroup, an important and relevant concept in Semigroup Theory, is the cardinality of a least-size generating set. Semigroups of transformations that preserve or reverse the order or the orientation as well as semigroups of transformations preserving an equivalence relation have been widely studied over the past decades by many authors. The purpose of this article is to compute the ranks of the monoid

A relação entre a preparação para a parentalidade no terceiro trimestre de gravidez e os níveis de atividade física das gestantes

Introdução: A atividade física (AF) parece ter um impacto positivo na saúde física e mental durante a gravidez, nascimento e puerpério, sendo que os programas de preparação para a parentalidade (PPP) poderão ser fundamentais para o seu suporte e estimulação. Objetivos: O objetivo do presente estudo foi avaliar a relação entre a preparação para a parentalidade no 3º trimestre de gravidez e os níveis de AF da gestante. Especificamente pretendeu-se verificar a relação entre as caraterísticas sociodemográficas das gestantes, os níveis de ansiedade e o PPP. Métodos: Efetuou-se um estudo transversal analítico onde se utilizaram duas amostras. Uma constituída por 42 gestantes que frequentaram o PPP no CHTS (GPP) e outra por 41 gestantes do HSJ que não frequentou (GNPP). A cada gestante foi pedido que preenchessem 3 questionários (caraterização sociodemográfica e saúde obstétrica, Questionário de Atividade Física para gestantes-PPAQ e Escala de ansiedade de Zung), administrados, individualmente, por um Fisioterapeuta. Resultados: Não se verificaram diferenças entre os grupos relativamente ao score da AF total (p=0,615), contudo, o GPP apresentou um número superior de gestantes que praticava desporto organizado durante a gravidez (p=0,016) comparativamente ao GNPP. Relativamente à intensidade da AF, verificou-se que o GPP apresentava uma prática maior de AF vigorosa (p=0,023). No que diz respeito ao tipo de AF, o GPP apresentou um número superior de gestantes a praticar AF desportiva (p<0,001) enquanto no GNPP se verificou uma maior AF ocupacional (p=0,002). Relativamente às caraterísticas sociodemográficas verificaram-se diferenças estatisticamente significativas entre os dois grupos relativamente à idade (p<0,001), paridade (p<0,001) e nível educacional (p<0,001). No que respeita aos níveis de ansiedade não se verificaram diferenças estatisticamente significativas entre os grupos (GPP vs GNPP p=0,916). Conclusão: No GPP um maior número de gestantes praticava atividade física desportiva e de intensidade vigorosa. Verificaram-se diferenças entre os dois grupos no que diz respeito à idade, paridade e nível educacional. Não se verificou associação entre o PPP e os níveis de ansiedade durante este período.

Avaliação funcional ventilatória e dos músculos respiratórios em doentes com artrite reumatóide e sem compromisso clínico pulmonar

Arquivos de Medicina, 1994, 8 (4): 199-202

Parasitological and serological studies on Amoebiasis and other intestinal parasitic infections in Recife and its suburban area, northeast Brazil

Parasitological examinations were carried out during April to August, 1987, with 187 out-patients of the IMIP hospital, located in the center of Recife City, and 464 inhabitants of several villages around Cabo City, 50 Km southeast of Recife, Pernambuco, Brazil. Approximately 71% of the IMIP patients and 92% of the Cabo inhabitants were infected with at least one species of intestinal parasite. There was minimum difference in the prevalence rate of Trichuris trichiura between two areas, whereas the prevalence rates of Ascaris lumbricoides, hookworms, Strongyloides stercoralis, Schistosoma mansoni and Entamoeba histolytica were higher in the inhabitants of the Cabo City area. Only Giardia lamblia was more prevalent in the out-patients of IMIP hospital. Test tube cultivation revealed that the prevalence rate of Necator americanus in both areas was much higher than that of Ancylostoma duodenale , and also that the prevalence rate of S. stercoralis of the IMIP patients and Cabo inhabitants were 4.5% and 9.6%, respectively. Six hundred and fifteen sera were serologically examined for amoebiasis by the gel diffusion precipitation test (GDP) and enzyme linked immunosorbent assay (ELISA) using the antigen prepared from axenically cultured trophozoite of E. histolytica (strain HM-ITMSS). No positive reaction was observed in all of the sera as examined by GDP, while 32 out of 615 sera were positive on ELISA.

Microsoft excel 2013

O Microsoft Excel é uma ferramenta incontornável, quer seja utilizado em ambiente profissional, académico ou a título pessoal, sendo a folha de cálculo dominante no mercado. O novo Excel 2013 funciona em diversas plataformas: computadores, smartphones, tablets, na nuvem (cloud), e até mesmo em computadores que não têm o Office instalado, através do Office 365. Com uma ligação à Internet é agora possível aceder às suas folhas de cálculo independentemente da sua localização ou do tipo de dispositivo que estiver a utilizar. Poderá ainda trabalhar em modo off-line, sincronizando os seus dados com a sua pasta na Cloud quando tiver acesso à Internet. Este livro propõe-se contribuir para um maior conhecimento das potencialidades do novo Excel, destinando-se a todos aqueles que pretendam iniciar-se nas folhas de cálculo ou ampliar os seus conhecimentos sobre o Excel 2013. Mesmo aqueles que já utilizam o Excel há alguns anos poderão encontrar neste livro inúmeras dicas que os ajudarão a otimizar o seu trabalho e a executar algumas tarefas de forma mais rápida e eficiente! O livro baseia-se em exemplos passo-a-passo, ilustrados a cores, que guiam o utilizador na execução decifrada de cada procedimento. Ao longo deste livro são abordados diversos temas, tais como: • Formatar dados e tabelas • Gerir, configurar e imprimir folhas de dados • Elaborar gráficos • Utilizar fórmulas de cálculo e funções incorporadas • Gerir e organizar listas de dados: filtrar, agrupar, importar e exportar dados • Elaborar tabelas e gráficos dinâmicos • Análise de hipóteses: tabelas de simulação, gerir cenários, atingir objetivo • Análise de dados com a ferramenta Solver • Rever, comentar e registar alterações em folhas de cálculo • Proteger dados e partilhar folhas de cálculo • Adicionar e utilizar serviços Cloud: SkyDrive, Google Drive, Dropbox • Partilhar em redes sociais • Apps para o Excel: a Office Store

Promotion of gender equality and social inclusion of unemployed groups in Portuguese European Founds Frameworks (1990-2007): overview and critical reflection

Comunicação apresentada no 38º Congresso Mundial do Instituto Internacional de Sociologia, em Budapeste, Hungria, de 26 a 30 de Junho de 2008.

Sucesso terapêutico no controlo da tuberculose em Portugal : determinantes do resultado do tratamento e a sua capacidade preditiva

RESUMO - Enquadramento/objectivos: Apesar do elevado nível de comprometimento em estratégias eficazes para o controlo da tuberculose, em todo o mundo, esta constitui ainda um sério problema de Saúde Pública, com uma estimativa global de 9,4milhões de casos novos em 2008 e 1,8milhões de mortes/ano. O reduzido conhecimento das barreiras e facilitadores para o sucesso terapêutico constitui um importante obstáculo na procura de soluções eficazes de melhoramento da qualidade dos programas de controlo da tuberculose. Este estudo procura contribuir para a identificação atempada de doentes com perfis preditivos de insucesso terapêutico, através da identificação inicial de potenciais determinantes do resultado, com base num modelo epidemiológico e estatístico. Métodos: Foi desenvolvido um estudo de caso-controlo para a população de casos notificados ao Programa Nacional de Controlo da Tuberculose (n=24491), entre 2000-2007. Os factores preditivos de insucesso terapêutico foram identificados na análise bivariada e multivariada, com um nível de significância de 5%; a regressão logística foi utilizada para estimar a odds ratio de insucesso terapêutico, em comparação com o sucesso terapêutico, para diversos factores identificados na literatura, e para os quais os dados se encontravam disponíveis. Resultados: A dependência alcoólica (OR=2,889), o país de origem (OR=3,910), a situação sem-abrigo (OR=3.919), a co-infecção pelo VIH (OR=5,173), a interrupção (OR=60.615) ou falha terapêutica no tratamento anterior (OR=67.345) e a duração do tratamento inferior a 165 dias (OR=1930,133) foram identificados como factores preditivos de insucesso terapêutico. A duração do tratamento inferior a 165 dias provou ser o mais importante determinante do resultado terapêutico. Conclusões: Os resultados sugerem que um doente imigrante, em situação de sem-abrigo, dependente alcoólico, com tratamentos anteriores para a tuberculose e co-infectado pelo VIH apresenta uma elevada probabilidade de insucesso terapêutico. Assim, deverão ser definidas estratégias específicas, centradas no doente por forma a impedir este resultado. A base de dados (SVIG-TB), provou ser uma ferramenta de qualidade para a investigação sobre diversos aspectos do controlo da tuberculose. ------------------------------- ABSTRACT - Background/Objective: Despite the high commitment in good strategies for tuberculosis control worldwide, this is still a serious Public Health problem, with global estimates of 9,4million new cases in 2008 and 1,8million deaths/year. The poor understanding of the barriers and facilitators to treatment success is a major obstacle to find effective solutions to improve the quality of tuberculosis programs. This study tries to contribute to the timely identification of patients with predictive profiles of unsuccessful treatment outcomes, through the initial identification of characteristics probably affecting treatment outcome, found on the basis of an epidemiological and statistical model. Methods: A case-control study was conducted for the population of cases notified to the National Program for Tuberculosis Control (n=24 491), between 2000-2007. Predictive factors for unsuccessful outcome were assessed in a bivariate and multivariate analysis, using a significance level of 5%; a logistic regression was used to estimate the odds-ratio of unsuccessful, as compared to successful outcome, for several factors identified in the literature and to which data was available. Results: Alcohol abuse (OR=2,889), patient´s foreign origin (OR=3,910), homelessness (OR=3,919), HIV co-infection (OR=5,173), interruption (OR=60,615) or unsuccessful outcome in the previous treatment (OR=67,345) and treatment duration below 165 days (OR=1930,133) were identified as predictive of unsuccessful outcomes. A low treatment duration proved to be the most powerful factor affecting treatment outcome. Conclusions: Results suggest that a foreign-born patient, alcohol abuser, who has had a previous treatment for tuberculosis and is co-infected with HIV is very likely to have an unsuccessful outcome. Therefore, specific, patient-centered strategies should be taken to prevent an unsuccessful outcome. The database (SVIG-TB), has proved to be a quality tool on research of various aspects of tuberculosis control.

Age-related seroprevalence study for St. Louis encephalitis in a population from Cordoba, Argentina

A serological screening was performed in 615 individuals aged 0-87 years, living in the city of Cordoba, Argentina to study the relationship between antibody prevalence for the SLE virus and age. A 13.98% prevalence of neutralizing antibodies was obtained and its relation to age was significantly high (p = 0.045). The highest seroprevalence was noted on individuals over 60 years old (>20%), whereas no subject under 10 was seropositive for this virus. Our results confirm that the agent is endemic in this area and neurological pathology studies should be performed on those individuals aged 60 since they represent the most susceptible group to SLE virus.

A framework for using real data with distributed low cost sensors

Currently, due to the widespread use of computers and the internet, students are trading libraries for the World Wide Web and laboratories with simulation programs. In most courses, simulators are made available to students and can be used to proof theoretical results or to test a developing hardware/product. Although this is an interesting solution: low cost, easy and fast way to perform some courses work, it has indeed major disadvantages. As everything is currently being done with/in a computer, the students are loosing the “feel” of the real values of the magnitudes. For instance in engineering studies, and mainly in the first years, students need to learn electronics, algorithmic, mathematics and physics. All of these areas can use numerical analysis software, simulation software or spreadsheets and in the majority of the cases data used is either simulated or random numbers, but real data could be used instead. For example, if a course uses numerical analysis software and needs a dataset, the students can learn to manipulate arrays. Also, when using the spreadsheets to build graphics, instead of using a random table, students could use a real dataset based, for instance, in the room temperature and its variation across the day. In this work we present a framework which uses a simple interface allowing it to be used by different courses where the computers are the teaching/learning process in order to give a more realistic feeling to students by using real data. A framework is proposed based on a set of low cost sensors for different physical magnitudes, e.g. temperature, light, wind speed, which are connected to a central server, that the students have access with an Ethernet protocol or are connected directly to the student computer/laptop. These sensors use the communication ports available such as: serial ports, parallel ports, Ethernet or Universal Serial Bus (USB). Since a central server is used, the students are encouraged to use sensor values results in their different courses and consequently in different types of software such as: numerical analysis tools, spreadsheets or simply inside any programming language when a dataset is needed. In order to do this, small pieces of hardware were developed containing at least one sensor using different types of computer communication. As long as the sensors are attached in a server connected to the internet, these tools can also be shared between different schools. This allows sensors that aren't available in a determined school to be used by getting the values from other places that are sharing them. Another remark is that students in the more advanced years and (theoretically) more know how, can use the courses that have some affinities with electronic development to build new sensor pieces and expand the framework further. The final solution provided is very interesting, low cost, simple to develop, allowing flexibility of resources by using the same materials in several courses bringing real world data into the students computer works.