A demonstração dos fluxos de caixa nas instituições particulares de solidariedade social

Dada a atual conjuntura económica internacional, a Economia Social tem vindo a aumentar consideravelmente a sua importância. Desta forma, torna-se importante conhecer o normativo contabilístico que é aplicado em Portugal. No caso concreto das Entidades do Setor Não Lucrativo, surgiu a necessidade de se encontrarem formas mais eficientes de gerir os recursos para dar resposta às necessidades sociais emergentes, e por isso, estas entidades foram, em 2011, enquadradas num novo contexto legal. O sucesso, o crescimento e a sobrevivência de uma entidade dependem da sua capacidade para gerar fluxos de caixa e/ou obter os recursos financeiros necessários ao desenvolvimento da sua atividade. Neste sentido, é a Demonstração de Fluxos de Caixa (DFC) que fornece aos seus utilizadores uma base para avaliar a capacidade da entidade gerar e utilizar os seus fluxos de caixa. Esta dissertação aborda uma área de estudo, ainda pouco investigada, a Economia Social e, em particular, as Instituições Particulares de Solidariedade Social (IPSS), sendo notório que o interesse por esta área tem vindo a acentuar-se nos últimos anos. Assim, fazendo o respetivo enquadramento teórico e normativo, avalia-se a importância da DFC, mais especificamente, a importância do relato dos fluxos nas IPSS. Para a realização desta dissertação, foi feita a análise em profundidade do relato da DFC nas IPSS, recorrendo à metodologia qualitativa, nomeadamente, à investigação descritiva, aos métodos e técnicas de recolha de dados, e, por último, à análise de conteúdo para tratar os dados qualitativos, tais como, as entrevistas. Para tratar alguns dados estatísticos foi utilizado o Microsoft Excel do Microsoft Office. A presente dissertação demonstra que o relato dos fluxos da DFC é extremamente importante, pois proporciona informação financeira que é importante no processo de tomada de decisão e na avaliação do desempenho financeiro das IPSS.

Os Factores Genéticos na Perda Gestacional

Pregnancy loss is the most common obstetric complication. Multiple factors have been associated with recurrent or sporadic pregnancy loss, and genetic factors, particularly at earlier gestational ages, are the most important ones. The proportion of miscarriages due to chromosomal factors decreases with increasing gestational age. The most common chromosomal abnormalities in early losses are autosomal trisomies, monosomy X and polyploidy. In later losses, aneuploidies are similar to those found in live newborns (trisomies 21,18 and 13, X monosomy and polysomy of sex chromosomes. In cases of recurrent miscarriage the most common cytogenetic changes are trisomies, polyploidy, monosomy X and unbalanced translocations. Identification of the causes of pregnancy loss facilitates the families’ grief and may indicate if there is the risk of repetition, in order to reduce recurrence. The investigation recommended in each case is far from consensual, and the cost/benefit analysis of diagnostic exams is essential. The determination of the karyotype of the products of conception is indicated in cases of fetal loss and recurrent miscarriage, while the parental karyotypes should be performed only in selected cases. Couples with identified genetic conditions should be counseled about reproductive options, including prenatal or pre-implantation diagnosis. Surveillance of a future pregnancy should be multidisciplinary and adjusted in each case. The cytogenetic factors, due to their high prevalence and complexity, have a fundamental, but still not completely clear, role in pregnancy loss.

Characterizing the Risk Profiles of Intensive Care Units

OBJECTIVE: To develop a new method to evaluate the performance of individual ICUs through the calculation and visualisation of risk profiles. METHODS: The study included 102,561 patients consecutively admitted to 77 ICUs in Austria. We customized the function which predicts hospital mortality (using SAPS II) for each ICU. We then compared the risks of hospital mortality resulting from this function with the risks which would be obtained using the original function. The derived risk ratio was then plotted together with point-wise confidence intervals in order to visualise the individual risk profile of each ICU over the whole spectrum of expected hospital mortality. MAIN MEASUREMENTS AND RESULTS: We calculated risk profiles for all ICUs in the ASDI data set according to the proposed method. We show examples how the clinical performance of ICUs may depend on the severity of illness of their patients. Both the distribution of the Hosmer-Lemeshow goodness-of-fit test statistics and the histogram of the corresponding P values demonstrated a good fit of the individual risk models. CONCLUSIONS: Our risk profile model makes it possible to evaluate ICUs on the basis of the specific risk for patients to die compared to a reference sample over the whole spectrum of hospital mortality. Thus, ICUs at different levels of severity of illness can be directly compared, giving a clear advantage over the use of the conventional single point estimate of the overall observed-to-expected mortality ratio.

MOLECULAR TYPING OF Candida albicans ISOLATES FROM HOSPITALIZED PATIENTS

SUMMARYIntroduction: The majority of nosocomial fungal infections are caused by Candida spp. where C. albicans is the species most commonly identified. Molecular methods are important tools for assessing the origin of the yeasts isolated in hospitals.Methods: This is a study on the genetic profifiles of 39 nosocomial clinical isolates of C. albicans using two typing methods: random amplifified polymorphic DNA (RAPD) and microsatellite, two different primers for each technique were used.Results: RAPD provided 10 and 11 different profiles with values for SAB of 0.84 ± 0.126 and 0.88 ± 0.08 for primers M2 and P4, respectively. Microsatellite using two markers, CDC3 and HIS3, allowed the observation of six and seven different alleles, respectively, with combined discriminatory power of 0.91.Conclusions: Although genetic variability is clear, it was possible to identify high similarity, suggesting a common origin for at least a part of isolates. It is important to emphasize that common origin was proven from yeasts isolated from colonization (urine, catheter or endotracheal secretions) and blood culture from the same patient, indicating that the candidemia must have started from a site of colonization. The combination of RAPD and microsatellite provides a quick and efficient analysis for investigation of similarity among nosocomial isolates of C. albicans.

MOLECULAR TYPING OF Giardia duodenalisISOLATES FROM NONHUMAN PRIMATES HOUSED IN A BRAZILIAN ZOO

Giardia infections in captive nonhuman primates (NHP) housed at a Brazilian zoo were investigated in order to address their zoonotic potential. Fresh fecal samples were collected from the floors of 22 enclosures where 47 primates of 18 different species were housed. The diagnosis of intestinal parasites after concentration by sedimentation and flotation methods revealed the following parasites and their frequencies: Giardia (18%); Entamoebaspp. (18%); Endolimax nana(4.5%); Iodamoeba spp. (4.5%); Oxyurid (4.5%) and Strongylid (4.5%). Genomic DNA extracted from all samples was processed by PCR methods in order to amplify fragments of gdh and tpi genes of Giardia. Amplicons were obtained from samples of Ateles belzebuth, Alouatta caraya, Alouatta fusca and Alouatta seniculus. Clear sequences were only obtained for the isolates from Ateles belzebuth (BA1), Alouatta fusca(BA2) and Alouatta caraya (BA3). According to the phenetic analyses of these sequences, all were classified as assemblage A. For the tpi gene, all three isolates were grouped into sub-assemblage AII (BA1, BA2 and BA3) whereas for the gdh gene, only BA3 was sub-assemblage AII, and the BA1 and BA2 were sub-assemblage AI. Considering the zoonotic potential of the assemblage A, and that the animals of the present study show no clinical signs of infection, the data obtained here stresses that regular coproparasitological surveys are necessary to implement preventive measures and safeguard the health of the captive animals, of their caretakers and of people visiting the zoological gardens.

EVIDENCE OF Leishmania (Leishmania) infantum INFECTION IN DOGS FROM JUIZ DE FORA, MINAS GERAIS STATE, BRAZIL, BASED ON IMMUNOCHROMATOGRAPHIC DUAL-PATH PLATFORM (DPP®) AND PCR ASSAYS

In Brazil, domestic dogs are branded as the primary reservoir for zoonotic visceral leishmaniasis, due to the clear positive correlation observed between human and canine infection rates. This study aimed to carry out a serological survey of canine visceral leishmaniasis (CVL) in dogs housed at a public kennel in the municipality of Juiz de Fora, Minas Gerais State, Brazil, using the immunochromatographic TR DPP® CVL rapid test. Additionally, conventional and/or real time PCR assay was used to detect and confirm L. infantum infection in the DPP positive dogs only. Of the 400 dogs studied, most did not present clinical signs for CVL (p < 0.05), and fifteen (3.8%) were seropositive in the DPP test. There was no statistically significant difference between the DPP seropositive dogs and the clinical signs of the disease (p > 0.05). Both conventional and real time PCR tests confirmed L. infantum infection in nine (75.0%) of the twelve DPP seropositive dogs that remained alive during the follow-up period. This study is the first seroepidemiologic survey of CVL held in the city of Juiz de Fora, and the results reinforce the idea that this disease is currently in a process of expansion and urbanization in Brazil. Furthermore, this study highlights the use of the DPP test as an alternative for diagnosing CVL in large and mid-sized cities, due to its ease of implementation.

Construção de um sensor eletroquímico molecularmente impresso para monitorização do cancro da mama

O Cancro da mama é uma doença cuja incidência tem vindo a aumentar de ano para ano e além disso é responsável por um grande número de mortes em todo mundo. De modo a combater esta doença têm sido propostos e utilizados biomarcadores tumorais que permitem o diagnóstico precoce, o acompanhamento do tratamento e/ou a orientação do tipo tratamento a adotar. Atualmente, os biomarcadores circulantes no sangue periférico recomendados pela Associação Americana de Oncologia Clinica (ASCO) para monitorizar os pacientes durante o tratamento são o cancer antigen 15-3 (CA 15-3), o cancer antigen 27.29 (CA 27.29) e o cancer embryobic antigen (CEA). Neste trabalho foi desenvolvido um sensor eletroquímico (voltamétrico) para monitorizar o cancro da mama através da análise do biomarcador CA 15-3. Inicialmente realizou-se o estudo da adsorção da proteína na superfície do elétrodo para compreender o comportamento do sensor para diferentes concentrações. De seguida, estudaram-se três polímeros (poliaminofenol, polifenol e polifenilenodiamina) e selecionou-se o poliaminofenol como o polímero a utilizar, pois possuía a melhor percentagem de alteração de sinal. Após a seleção do polímero, este foi depositado na superfície do elétrodo por eletropolimerização, formando um filme polimérico molecularmente impresso (MIP) à volta da proteína (molde). Posteriormente, foram analisados cinco solventes (água, mistura de dodecil sulfato de sódio e ácido acético, ácido oxálico, guanidina e proteinase K) e o ácido oxálico revelou ser mais eficaz na extração da proteína. Por último, procedeu-se à caraterização do sensor e analisou-se a resposta analítica para diferentes concentrações de CA 15-3 revelando diferenças claras entre o NIP (polímero não impresso) e o MIP.

PREVALENCE OF Entamoeba histolytica/Entamoeba dispar IN THE CITY OF CAMPINA GRANDE, IN NORTHEASTERN BRAZIL

There is a clear need to perform epidemiological studies to find the true prevalence of Entamoeba histolytica around the world. The evaluation of this prevalence has been hindered by the existence of two different species which are morphologically identical, but genetically different, namely E. histolytica, which causes amebiasis, and E. dispar, which is non-pathogenic. In Brazil, the E. dispar has been detected in communities in the Southeastern (SE) and Northeastern (NE) regions with poor sanitation. However, individuals infected with E. histolytica have been identified in other regions. There is an absence of reports on the prevalence of these parasites in the state of Paraíba, which also has areas with poor sanitary conditions where a high prevalence of the E. histolytica/E. dispar complex has been detected in children from urban slums. The present study evaluated the prevalence of E. histolytica and E. dispar in 1,195 asymptomatic children between two and 10 years of age, living in a sprawling urban slum in Campina Grande, in the state of Paraíba, in Northeastern Brazil. These children were examined and their feces samples were analyzed microscopically. A total of 553 children tested positive for the E. histolytica/E. dispar complex, and 456 of the positive samples were tested with the E. histolytica II® ELISA kit. All 456 samples were negative for the presence of the adhesin E. histolytica specific antigen. The evidence suggests that in this community E. histolytica is absent and E. dispar is the dominant species.

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.

Anti-Tumor Necrosis Factor Alpha-Induced Drug Eruptions: One Patient, More Than a Pattern

Background: Tumor necrosis factor alpha (TNFα) antagonists are effective in treating several immune-inflammatory diseases, including psoriasis and inflammatory bowel disease. The paradoxical and unpredictable induction of psoriasis and psoriasiform skin lesions is a recognized adverse event, although of unclear aetiology. However, histological analysis of these eruptions remains insufficient, yet suggesting that some might constitute a new pattern of adverse drug reaction, rather than true psoriasis. Case report: The authors report the case of a 43-year-old woman with severe recalcitrant Crohn disease who started treatment with infliximab. There was also a personal history of mild plaque psoriasis without clinical expression for the past eight years. She developed a heterogeneous cutaneous eruption of psoriasiform morphology with pustules and crusts after the third infliximab infusion. The histopathological diagnosis was of a Sweet-like dermatosis. The patient was successfully treated with cyclosporine in association with both topical corticosteroid and vitamin D3 analogue. Three weeks after switching to adalimumab a new psoriasiform eruption was observed, histologically compatible with a psoriasiform drug eruption. Despite this, and considering the beneficial effect on the inflammatory bowel disease, it was decided to maintain treatment with adalimumab and to treat through with topicals, with progressive control of skin disease. Discussion: Not much is known about the pathogenesis of psoriasiform eruptions induced by biological therapies, but genetic predisposition and Koebner phenomenon may contribute to it. Histopathology can add new facets to the comprehension of psoriasiform reactions. In fact, histopathologic patterns of such skin lesions appear to be varied, in a clear asymmetry with clinical findings. Conclusion: The sequential identification in the same patient of two clinical and histopathologic patterns of drug reaction to TNFα antagonists is rare. Additionally, to the authors’ knowledge, there is only one other description in literature of a TNFα antagonist-induced Sweet-like dermatosis, emphasizing the singularity of this case report.

SPATIOTEMPORAL TRENDS OF CASES OF PANDEMIC INFLUENZA A(H1N1)PDM09 IN ARGENTINA, 2009-2012

The aim of this paper was to analyze the spatiotemporal variations of cases of influenza A(H1N1)pdm09 in Argentina. A space-time permutation scan statistic was performed to test the non-randomness in the interaction between space and time in reported influenza A(H1N1)pdm09 cases. In 2009, two clusters were recorded in the east of Buenos Aires Province (May and June) and in the central and northern part of Argentina (July and August). Between 2011 and 2012, clusters near areas bordering other countries were registered. Within the clusters, in 2009, the high notification rates were first observed in the school-age population and then extended to the older population (15-59 years). From 2011 onwards, higher rates of reported cases of influenza A(H1N1)pdm09 occurred in children under five years in center of the country. Two stages of transmission of influenza A(H1N1)pdm09 can be characterized. The first stage had high rates of notification and a possible interaction with individuals from other countries in the major cities of Argentina (pattern of hierarchy), and the second stage had an increased interaction in some border areas without a clear pattern of hierarchy. These results suggest the need for greater coordination in the Southern Cone countries, in order to implement joint prevention and vaccination policies.

Estudo e Avaliação de Plataformas de Business Intelligence em contexto empresarial

O crescente interesse pela área de Business Intelligence (BI) tem origem no reconhecimento da sua importância pelas organizações, como poderoso aliado dos processos de tomada de decisão. O BI é um conceito dinâmico, que se amplia à medida que são integradas novas ferramentas, em resposta a necessidades emergentes dos mercados. O BI não constitui, ainda, uma realidade nas pequenas e médias empresas, sendo, até, desconhecido para muitas. São, essencialmente, as empresas de maior dimensão, com presença em diferentes mercados e/ou áreas de negócio mais abrangentes, que recorrem a estas soluções. A implementação de ferramentas BI nas organizações depende, pois, das especificidades destas, sendo fundamental que a informação sobre as plataformas disponíveis e suas funcionalidades seja objetiva e inequívoca. Só uma escolha correta, que responda às necessidades da área de negócio desenvolvida, permitirá obter dados que resultem em ganhos, potenciando a vantagem competitiva empresarial. Com este propósito, efectua-se, na presente dissertação, uma análise comparativa das funcionalidades existentes em diversas ferramentas BI, que se pretende que venha auxiliar os processos de seleção da plataforma BI mais adaptada a cada organização e/ou negócio. As plataformas BI enquadram-se em duas grandes vertentes, as que implicam custos de aquisição, de índole comercial, e as disponibilizadas de forma livre, ou em código aberto, designadas open source. Neste sentido, equaciona-se se estas últimas podem constituir uma opção válida para as empresas com recursos mais escassos. Num primeiro momento, procede-se à implementação de tecnologias BI numa organização concreta, a operar na indústria de componentes automóveis, a Yazaki Saltano de Ovar Produtos Eléctricos, Ltd., implantada em Portugal há mais de 25 anos. Para esta empresa, o desenvolvimento de soluções com recurso a ferramentas BI afigura-se como um meio adequado de melhorar o acompanhamento aos seus indicadores de performance. Este processo concretizou-se a partir da stack tecnológica pré-existente na organização, a plataforma BI comercial da Microsoft. Com o objetivo de, por um lado, reunir contributos que possibilitem elucidar as organizações na escolha da plataforma BI mais adequada e, por outro, compreender se as plataformas open source podem constituir uma alternativa credível às plataformas comerciais, procedeu-se a uma pesquisa comparativa das funcionalidades das várias plataformas BI open source. Em resultado desta análise, foram selecionadas duas plataformas, a SpagoBI e a PentahoBI, utilizadas na verificação do potencial alternativo das open source face às plataformas comerciais. Com base nessas plataformas, reproduziu-se os processos e procedimentos desenvolvidos no âmbito do projeto de implementação BI realizado na empresa Yazaki Saltano.

Analysis of the EEG Dynamics of Epileptic Activity in Gelastic Seizures Using Decomposition in Independent Components

Objective: Gelastic seizures are a frequent and well established manifestation of the epilepsy associated with hypothalamic hamartomas. The scalp EEG recordings very seldom demonstrate clear spike activity and the information about the ictal epilepsy dynamics is limited. In this work, we try to isolate epileptic rhythms in gelastic seizures and study their generators. Methods: We extracted rhythmic activity from EEG scalp recordings of gelastic seizures using decomposition in independent components (ICA) in three patients, two with hypothalamic hamartomas and one with no hypothalamic lesion. Time analysis of these rhythms and inverse source analysis was done to recover their foci of origin and temporal dynamics. Results: In the two patients with hypothalamic hamartomas consistent ictal delta (2–3 Hz) rhythms were present, with subcortical generators in both and a superficial one in a single patient. The latter pattern was observed in the patient with no hypothalamic hamartoma visible in MRI. The deep generators activated earlier than the superficial ones, suggesting a consistent sub-cortical origin of the rhythmical activity. Conclusions: Our data is compatible with early and brief epileptic generators in deep sub-cortical regions and more superficial ones activating later. Significance: Gelastic seizures express rhythms on scalp EEG compatible with epileptic activity originating in sub-cortical generators and secondarily involving cortical ones.

Development Process and Cognitive Testing of CARATkids - Control of Allergic Rhinitis and Asthma Test for Children

Background: Allergic rhinitis and asthma (ARA) are chronic inflammatory diseases of the airways that often coexist in children. The only tool to assess the ARA control, the Control of Allergic Rhinitis and Asthma Test (CARAT) is to be used by adults. We aimed to develop the Pediatric version of Control of Allergic Rhinitis and Asthma Test (CARATkids) and to test its comprehensibility in children with 4 to 12 years of age. Methods: The questionnaire development included a literature review of pediatric questionnaires on asthma and/or rhinitis control and two consensus meetings of a multidisciplinary group. Cognitive testing was carried out in a cross-sectional qualitative study using cognitive interviews. Results: Four questionnaires to assess asthma and none to assess rhinitis control in children were identified. The multidisciplinary group produced a questionnaire version for children with 17 questions with illustrations and dichotomous (yes/no) response format. The version for caregivers had 4-points and dichotomous scales. Twenty-nine children, 4 to 12 years old, and their caregivers were interviewed. Only children over 6 years old could adequately answer the questionnaire. A few words/expressions were not fully understood by children of 6 to 8 years old. The drawings illustrating the questions were considered helpful by children and caregivers. Caregivers considered the questionnaire complete and clear and preferred dichotomous over the 4-points scales. The proportion of agreement between children and their caregivers was 61%. The words/expressions that were difficult to understand were amended. Conclusion: CARATkids, the first questionnaire to assess a child’s asthma and rhinitis control was developed and its content validity was assured. Cognitive testing showed that CARATKids is well-understood by children 6 to 12 years old. The questionnaire’s measurement properties can now be assessed in a validation study.

Efeitos especiais mediados por Kinect em contexto de espetáculo de dança ao vivo

A dança e os espetáculos foram atividades desenvolvidas e praticadas pelo homem desde praticamente a sua existência. Ao longo de todo esse período de tempo e até aos dias atuais estas atividades foram sofrendo evoluções que as fizeram manterem-se relevantes e de grande importância na sociedade humana e na sua cultura. A evolução não se fez sentir apenas no estilo das danças e espetáculos mas também nos acessórios e efeitos que estas implementam de forma a torna-las mais atrativas para quem as vê. Apesar desta evolução, a maioria dos efeitos não permite um nível de interação com a dança ou espetáculo, fazendo com que exista uma clara separação entre a componente pura da dança e o cenário do espetáculo no que diz respeito á componente acessória de efeitos. Com o intuito de colmatar esta clara divisão de componentes, iniciamos um estudo no sentido de criar um sistema que permitisse derrubar essa barreira e juntar as duas componentes com o intuito de criar efeitos que interajam com a própria dança tornando o espetáculo mais interativo, e que não seja apenas mais um componente acessório, isto ao mesmo tempo torna todo o espetáculo mais apelativo para o público em geral. Para conseguir criar tal sistema, recorremos às tecnologias de sensores de movimento atuais para que a ponte de ligação entre o artista e os efeitos fosse conseguida. No mercado existem diversas ofertas de sensores de movimentos que serviriam para criar o sistema, mas apenas um poderia ser escolhido, então para tal numa primeira parte foi feito um estudo para determinar qual destes sensores seria o mais adequado para ser utilizado no sistema, tendo em conta uma diversidade de fatores. Após a escolha do sensor foi então desenvolvido o sistema MoveU e tendo no final sido feitos uma série de testes que permitiram validar o protótipo e verificar se os objetivos propostos foram atingidos. Por fim, o MoveU foi demonstrado a uma série de pessoas (dançarinos e espectadores), para que pudessem opinar sobre ele e indicar possíveis melhoramentos. Foram também criados uma série de questionários para que o público a quem foi demonstrado o protótipo, com a finalidade de realizar uma análise estatística para determinar se este sistema seria do agrado das pessoas e também permitir retirar conclusões sobre este trabalho.