Contributo para o desenvolvimento de um Instrumento de Investigação Neuropsicológica

Tese apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Doutor em Ciências Sociais, especialidade em Psicologia

Treatment of HIV/AIDS at South Africa's Largest Employers: Myth and Reality

Background: In the past three years, many large employers in South Africa have announced publicly their intention of making antiretroviral treatment (ART) available to employees. Reports of the scope and success of these programs have been mostly anecdotal. This study surveyed the largest private sector employers in South Africa to determine the proportion of employees with access to ART through employer-sponsored HIV/AIDS treatment programs. Methods: All 64 private sector and parastatal employers in South Africa with more than 6,000 employees were identified and contacted. Those that agreed to participate were interviewed by telephone using a structured questionnaire. Results: 52 companies agreed to participate. Among these companies, 63% of employees had access to employer-sponsored care and treatment for HIV/AIDS. Access varied widely by sector, however. Approximately 27% of suspected HIV-positive employees were enrolled in HIV/AIDS disease management programs, or 4.4% of the workforce overall. Fewer than 4,000 employees in the entire sample were receiving antiretroviral therapy. In-house (employer) disease management programs and independent disease management programs achieved higher uptake of services than did medical aid schemes. Conclusions: Publicity by large employers about their treatment programs should be interpreted cautiously. While there is a high level of access to treatment, uptake of services is low and only a small fraction of employees medically eligible for antiretroviral therapy are receiving it.

Determining WWW User's Next Access and Its Application to Pre-fetching

World-Wide Web (WWW) services have grown to levels where significant delays are expected to happen. Techniques like pre-fetching are likely to help users to personalize their needs, reducing their waiting times. However, pre-fetching is only effective if the right documents are identified and if user's move is correctly predicted. Otherwise, pre-fetching will only waste bandwidth. Therefore, it is productive to determine whether a revisit will occur or not, before starting pre-fetching. In this paper we develop two user models that help determining user's next move. One model uses Random Walk approximation and the other is based on Digital Signal Processing techniques. We also give hints on how to use such models with a simple pre-fetching technique that we are developing.

On the Performance and Robustness of Managing Reliable Transport Connections

We revisit the problem of connection management for reliable transport. At one extreme, a pure soft-state (SS) approach (as in Delta-t [9]) safely removes the state of a connection at the sender and receiver once the state timers expire without the need for explicit removal messages. And new connections are established without an explicit handshaking phase. On the other hand, a hybrid hard-state/soft-state (HS+SS) approach (as in TCP) uses both explicit handshaking as well as timer-based management of the connection’s state. In this paper, we consider the worst-case scenario of reliable single-message communication, and develop a common analytical model that can be instantiated to capture either the SS approach or the HS+SS approach. We compare the two approaches in terms of goodput, message and state overhead. We also use simulations to compare against other approaches, and evaluate them in terms of correctness (with respect to data loss and duplication) and robustness to bad network conditions (high message loss rate and variable channel delays). Our results show that the SS approach is more robust, and has lower message overhead. On the other hand, SS requires more memory to keep connection states, which reduces goodput. Given memories are getting bigger and cheaper, SS presents the best choice over bandwidth-constrained, error-prone networks.

A literary occupation: responses of German writers in service in occupied Europe

This thesis examines the literary output of German servicemen writers writing from the occupied territories of Europe in the period 1940-1944. Whereas literary-biographical studies and appraisals of the more significant individual writers have been written, and also a collective assessment of the Eastern front writers, this thesis addresses in addition the German literary responses in France and Greece, as being then theatres of particular cultural/ideological attention. Original papers of the writer Felix Hartlaub were consulted by the author at the Deutsches Literatur Archiv (DLA) at Marbach. Original imprints of the wartime works of the subject writers are referred to throughout, and citations are from these. As all the published works were written under conditions of wartime censorship and, even where unpublished, for fear of discovery written in oblique terms, the texts were here examined for subliminal authorial intention. The critical focus of the thesis is on literary quality: on aesthetic niveau, on applied literary form, and on integrity of authorial intention. The thesis sought to discover: (1) the extent of the literary output in book-length forms. (2) the auspices and conditions under which this literary output was produced. (3) the publication history and critical reception of the output. The thesis took into account, inter alia: (1) occupation policy as it pertained locally to the writers’ remit; (2) the ethical implications of this for the writers; (3) the writers’ literary stratagems for negotiating the constraints of censorship.

MyRoom: A user-centred model of affective responsive architecture

Can my immediate physical environment affect how I feel? The instinctive answer to this question must be a resounding “yes”. What might seem a throwaway remark is increasingly borne out by research in environmental and behavioural psychology, and in the more recent discipline of Evidence-Based Design. Research outcomes are beginning to converge with findings in neuroscience and neurophysiology, as we discover more about how the human brain and body functions, and reacts to environmental stimuli. What we see, hear, touch, and sense affects each of us psychologically and, by extension, physically, on a continual basis. The physical characteristics of our daily environment thus have the capacity to profoundly affect all aspects of our functioning, from biological systems to cognitive ability. This has long been understood on an intuitive basis, and utilised on a more conscious basis by architects and other designers. Recent research in evidence-based design, coupled with advances in neurophysiology, confirm what have been previously held as commonalities, but also illuminate an almost frightening potential to do enormous good, or alternatively, terrible harm, by virtue of how we make our everyday surroundings. The thesis adopts a design methodology in its approach to exploring the potential use of wireless sensor networks in environments for elderly people. Vitruvian principles of “commodity, firmness and delight” inform the research process and become embedded in the final design proposals and research conclusions. The issue of person-environment fit becomes a key principle in describing a model of continuously-evolving responsive architecture which makes the individual user its focus, with the intention of promoting wellbeing. The key research questions are: What are the key system characteristics of an adaptive therapeutic single-room environment? How can embedded technologies be utilised to maximise the adaptive and therapeutic aspects of the personal life-space of an elderly person with dementia?.

Optimizing perioperative analgesia for patients undergoing operative fixation of hip fractures

This PhD thesis describes work carried out on investigation of various interventions with the aim to optimise the anaesthetic management of patients scheduled to undergo operative fixation of hip fractures. We analysed the perioperative effects of continuous femoral nerve block, single preoperative dose of i.v. dexamethasone, the intention to deposit local anaesthetic in different locations around the femoral nerve during ultrasound guided femoral nerve block, continuous spinal anaesthesia and peri-surgical site infiltration with local anaesthetic after surgical fixation of hip fractures. Continuous femoral nerve block provided more effective preoperative analgesia six hours after the insertion of the perineural catheter compared to a standard opiate-based regimen in patients undergoing operative fixation of fractured hip. A single low dose of preoperative dexamethasone in the intervention group decreased pain scores by 75% six hours after the surgery. Both interventions had no major effect on the functional recovery in the first year after the surgical fixation of fractured hip. The results of the ultrasound guided femoral nerve block trial showed no clinical advantage of intending to deposit local anaesthetic circumferentially during performing femoral nerve block. Using the Dixon and Massey’s “up- and-down” method, we demonstrated that intrathecal 0.26 ml of 0.5% bupivacaine provided adequate surgical anaesthesia within 15 minutes in 50% of patients undergoing operative fixation of hip fracture. Finally, we demonstrated that local anaesthetic infiltration had no effect on pain scores 12 hours after the surgical fixation of fractured neck of femur. In addition to this original body of work, a review article was published on femoral nerve block highlighting the use of ultrasound guidance. In conclusion, the results of this thesis offer an insight into interventions aimed at optimising perioperative analgesia in patients scheduled to undergo operative fixation of hip fractures.

The human papillomavirus and cancer: a multiphase study investigating preventative behaviours in young males

Background: The Human Papillomavirus (HPV) is one of the world’s most common sexually transmitted infections, and a causative factor of oropharyngeal, anal and penile cancers in males. Worldwide, an estimated 39,000 HPV-associated cancers occur each year in men. The highest rates of HPV infection are found in adults aged 18 to 28 years. Clinical evidence indicates that use of a condom in addition to obtaining the HPV vaccine provides the greatest protection from HPV infections. Aim: To explore young men’s attitudes, beliefs, and behavioural intention in relation to receiving the HPV vaccine and using a condom correctly and consistently. Collectively, both behaviours are linked to the prevention of HPV transmission and associated infections with HPV. Method: A multi- phase study, underpinned by the Theory of Planned Behaviour, involving a qualitative belief elicitation, pilot, and quantitative cross-sectional study was conducted. A belief elicitation (n=12) phase was used to generate items to include in a newly developed research instrument. Post pilot the research instrument was utilised in a cross sectional online survey to explore the attitudes, beliefs, and behavioural intention of young men (n= 359) with regard to receiving the HPV vaccine, and using a condom correctly and consistently. Data Collection: Data collection took place over a three month time frame. Male participants were recruited from a university in Southern Ireland via a student email system, as well as posting advertisements on numerous health, social and sports websites. Sample: Three hundred and fifty nine male participants aged 18- 28 years completed the online questionnaire. Data Analysis: Data were analysed using SPSS. Descriptive, correlational, multiple and hierarchical regression analysis were performed on the indirect and direct variables of the Theory of Planned Behaviour i.e. attitude, subjective norm, perceived behavioural control, and intention. Status variables were also included in descriptive analysis and hierarchical regressions. Findings are presented through text and graphical representation. Results: Alarming sexual health statistics identified that only 44.3% of participants always used a condom, and 78.6% never used a condom for oral sex. Furthermore, findings reveal that the constructs of the Theory of Planned Behaviour adequately measure male’s attitudes, beliefs and behavioural intention with regard to both behaviours. The Theory of Planned Behaviour has assisted in identifying how social pressures play an influential role in relation to males receiving the HPV vaccine. Attitudes presented as the most significant predictor of male’s intentions to use a condom correctly and consistently. Intention to perform both behaviours was identified as moderate to high. Conclusion: This study has contributed to the field of HPV research, as it is the first piece of research to explore preventative HPV behaviours i.e. receiving the HPV vaccine, and condom use, amongst young males, utilising the Theory of Planned Behaviour. A deeper understanding of young male’s attitudes, beliefs, and behavioural intention on this topic has been achieved. Additionally, a new robust research instrument has been constructed. Findings from this study will undoubtedly help in the implementation of the HPV vaccine in Ireland, as well as influence health promotion campaigns aimed at young males, addressing the topic of condom use.

Creating religious place in Ireland: Hindu public places of worship and the Indian sculpture park

This paper examines the creation of religious place. It argues that the designation of a place as “religious” is a subjective and creative act which is dependent upon the perception and past, or memory, of the viewer. The paper focuses specifically on the creation of public places of worship by Hindu groups in the Dublin city area of Ireland and on the varied perceptions of the Indian Sculpture Park in County Wicklow. The creation of public places of worship results in places classified as “religious” due to the intention of the creator, the terminology used and the types of activities that take place in the space. This is in contrast to places such as the Indian Sculpture Park in County Wicklow which was created as a secular space but which is viewed by some Hindus as an outdoor temple due to the presence of sculptures of the Hindu deity Ganesh. Other Hindus do not view the space as having any religious significance and so its religiosity is contested. This points to the fact that the creation of religious place is a creative act of interpretation which is dependent upon the perception and past of the viewer and which changes over time.

A new proposition on the martingale representation theorem and on the approximate hedging of contingent claim in mean-variance criterion

In this work we revisit the problem of the hedging of contingent claim using mean-square criterion. We prove that in incomplete market, some probability measure can be identified so that becomes -martingale under .This is in fact a new proposition on the martingale representation theorem. The new results also identify a weight function that serves to be an approximation to the Radon-Nikodým derivative of the unique neutral martingale measure.

Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography.

BACKGROUND & AIMS: Prophylactic administration of interleukin (IL)-10 decreases the severity of experimental pancreatitis. Prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in humans is a unique model to study the potential role of IL-10 in this setting. METHODS: In a single-center, double-blind, randomized, placebo-controlled study, the effect of a single injection of 4 microg/kg (group 1) or 20 microg/kg (group 2) IL-10 was compared with that of placebo (group 0), all administered 30 minutes before therapeutic ERCP. The primary endpoint was the effect of IL-10 on serum levels of amylases and lipases measured 4, 24, and 48 hours after ERCP. The secondary objective was to evaluate changes in plasma cytokines (IL-6, IL-8, tumor necrosis factor) at the same time points and the incidence of acute pancreatitis in the 3 groups. Subjects undergoing a first therapeutic ERCP were eligible for inclusion. RESULTS: A total of 144 patients were included. Seven were excluded based on intention to treat (n = 1) or per protocol (n = 6). Forty-five, 48, and 44 patients remained in groups 0, 1, and 2, respectively. The 3 groups were comparable for age, sex, underlying disease, indication for treatment, type of treatment, and plasma levels of C-reactive protein (CRP), cytokines, and hydrolases at baseline. No significant difference was observed in CRP, cytokine, and hydrolase plasma levels after ERCP. Forty-three patients developed hyperhydrolasemia (18 in group 0, 14 in group 1, and 11 in group 2; P = 0.297), and 19 patients developed acute clinical pancreatitis (11 in group 0, 5 in group 1, 3 in group 2; P = 0.038). Two severe cases were observed in the placebo group. No mortality related to ERCP was observed. Logistic regression identified 3 independent risk factors for post-therapeutic ERCP pancreatitis: IL-10 administration (odds ratio [OR], 0.46; 95% confidence interval [95% CI], 0.22-0.96; P = 0.039), pancreatic sphincterotomy (OR, 5.04; 95% CI, 1.53-16.61; P = 0.008), and acinarization (OR, 8.19; 95% CI, 1.83-36.57; P = 0.006). CONCLUSIONS: A single intravenous dose of IL-10, given 30 minutes before the start of the procedure, independently reduces the incidence of post-therapeutic ERCP pancreatitis.

Sorting under partial information (without the ellipsoid algorithm)

We revisit the well-known problem of sorting under partial information: sort a finite set given the outcomes of comparisons between some pairs of elements. The input is a partially ordered set P, and solving the problem amounts to discovering an unknown linear extension of P, using pairwise comparisons. The information-theoretic lower bound on the number of comparisons needed in the worst case is log e(P), the binary logarithm of the number of linear extensions of P. In a breakthrough paper, Jeff Kahn and Jeong Han Kim (STOC 1992) showed that there exists a polynomial-time algorithm for the problem achieving this bound up to a constant factor. Their algorithm invokes the ellipsoid algorithm at each iteration for determining the next comparison, making it impractical. We develop efficient algorithms for sorting under partial information. Like Kahn and Kim, our approach relies on graph entropy. However, our algorithms differ in essential ways from theirs. Rather than resorting to convex programming for computing the entropy, we approximate the entropy, or make sure it is computed only once in a restricted class of graphs, permitting the use of a simpler algorithm. Specifically, we present: an O(n2) algorithm performing O(log n·log e(P)) comparisons; an O(n2.5) algorithm performing at most (1+ε) log e(P) + Oε(n) comparisons; an O(n2.5) algorithm performing O(log e(P)) comparisons. All our algorithms are simple to implement. © 2010 ACM.

Rent-seekers' lost El Dorado: Vietnam's financial turmoil, 2007-2013

In this investigation, we examined 256 cases of financial failure and fraud in Vietnam’s chaotic years from 2007 to 2013. Categorical data analyses suggest that the rent-seeking approach, or resource-based orientation, alone does not help explain the outcome of a business intention while the association between Orientation and Approach is the best-fit predictor. Rampant financial collapse not only increases the cost of funds but also erodes trust in the economy. Entrepreneurship development and creativity capacity building, in light of this, are necessary to improve socio-economic conditions and the environment. In this manuscript, we also introduce intuitive and cognitive factors to predict ex-ante outcome of a financing scheme.

Summer Sprite for Orchestra

Summer Sprite for Orchestra was completed in December, 2004. The piece originated from a singular encounter with little angels at Chang-Kyung Palace, which is the oldest and the most beautiful palace in Korea, and where the kings of the Chosun Dynasty (1393-1897) lived. This encounter was in the summer of 2002. I certainly could not prove that those angels I met were real. Possibly they were the reflection of drops of water after a sudden shower on that summer day. However, I definitely remember that short, unforgettable, and mysterious moment and the angels' beautiful dance-like celebration. Summer Sprite is based on these special memories and the encounter with the little angels that summer. Summer Sprite consists of 3 movements: "Greeting," "Encounter," and "Celebration." These follow the course of my encounter with the little angels. In Summer Sprite, I wished to describe the image of the angels as well as the progression of greeting, encounter, and celebration with them. The moods that follow in Summer Sprite are by turns lyrical, poetic, fantastic, mysterious, and dream-like. In each movement, I describe the meeting of angels and composer through the use of the soloists -- violin (sometimes viola) and cello. As suggested by the subtitle of the first movement, "Greeting" portrays the moment when a surprised I met the angels. It begins with tam-tam, marimba, harp, and piano and sets a mysterious and dark mood. The second movement, "Encounter," is shorter than the first movement. This movement provides a more tranquil mood as well as more unique timbres resulting from the use of mutes and special instruments (English horn, harp, crotales, suspended cymbal, and celesta). The delicate expression of the percussion is particularly important in establishing the static mood of this movement . The last movement, °?Celebration,°± is bright and energetic. It is also the longest. Here, I require the most delicate changes of dynamics and tempo, the most vigorous harmonies, and the fastest rhythmic figures, as well as the most independent, lyrical, and poetic melodies. For bright orchestral tone color, I used various kinds of percussion such as timpani, xylophone, marimba, vibraphone, cymbals, side drum, tambourine, triangle, and bass drum. This last movement is divided rondo-like into five sections: The first (mm.1-3), second (mm.4 - rehearsal number 1), third (rehearsal numbers 2-4), fourth (rehearsal numbers 5-7), and fifth, (rehearsal numbers 8 -18). To sum up, Summer Sprite describes an unforgettable and mysterious moment in a my life. My intention was to portray this through a concerto-like framework. A model for this would be Brahms°Ø °?Double Concerto°± in A minor, op.102, in which the solo cello stands for my angel and the solo violin (sometimes solo viola) for me.

Multi-touch accceptance: perceived disorientation and consequences on task engagement

The research project takes place within the technology acceptability framework which tries to understand the use made of new technologies, and concentrates more specifically on the factors that influence multi-touch devices’ (MTD) acceptance and intention to use. Why be interested in MTD? Nowadays, this technology is used in all kinds of human activities, e.g. leisure, study or work activities (Rogowski and Saeed, 2012). However, the handling or the data entry by means of gestures on multi-touch-sensitive screen imposes a number of constraints and consequences which remain mostly unknown (Park and Han, 2013). Currently, few researches in ergonomic psychology wonder about the implications of these new human-computer interactions on task fulfillment.This research project aims to investigate the cognitive, sensori-motor and motivational processes taking place during the use of those devices. The project will analyze the influences of the use of gestures and the type of gesture used: simple or complex gestures (Lao, Heng, Zhang, Ling, and Wang, 2009), as well as the personal self-efficacy feeling in the use of MTD on task engagement, attention mechanisms and perceived disorientation (Chen, Linen, Yen, and Linn, 2011) when confronted to the use of MTD. For that purpose, the various above-mentioned concepts will be measured within a usability laboratory (U-Lab) with self-reported methods (questionnaires) and objective indicators (physiological indicators, eye tracking). Globally, the whole research aims to understand the processes at stakes, as well as advantages and inconveniences of this new technology, to favor a better compatibility and adequacy between gestures, executed tasks and MTD. The conclusions will allow some recommendations for the use of the DMT in specific contexts (e.g. learning context).