Outpatient health service utilization and associated factors: a population-based study

OBJECTIVE: To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups. METHODS: A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression. RESULTS: Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with self-reported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group. CONCLUSIONS: Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.

Ancillary service market simulation

Power systems operation in a liberalized environment requires that market players have access to adequate decision support tool, allowing them to consider all the business opportunities and take strategic decisions. Ancillary services represent a good negotiation opportunity that must be considered by market players. For this, decision support tools must include ancillary market simulation. This paper deals with ancillary services negotiation in electricity markets. The proposed concepts and methodologies are implemented in MASCEM, a multi-agent based electricity market simulator. A test case concerning the dispatch of ancillary services using two different methods (Linear Programming and Genetic Algorithm approaches) is included in the paper.

A probabilistic methodology for distributed generation location in isolated electrical service area

Distributed generation unlike centralized electrical generation aims to generate electrical energy on small scale as near as possible to load centers, interchanging electric power with the network. This work presents a probabilistic methodology conceived to assist the electric system planning engineers in the selection of the distributed generation location, taking into account the hourly load changes or the daily load cycle. The hourly load centers, for each of the different hourly load scenarios, are calculated deterministically. These location points, properly weighted according to their load magnitude, are used to calculate the best fit probability distribution. This distribution is used to determine the maximum likelihood perimeter of the area where each source distributed generation point should preferably be located by the planning engineers. This takes into account, for example, the availability and the cost of the land lots, which are factors of special relevance in urban areas, as well as several obstacles important for the final selection of the candidates of the distributed generation points. The proposed methodology has been applied to a real case, assuming three different bivariate probability distributions: the Gaussian distribution, a bivariate version of Freund’s exponential distribution and the Weibull probability distribution. The methodology algorithm has been programmed in MATLAB. Results are presented and discussed for the application of the methodology to a realistic case and demonstrate the ability of the proposed methodology for efficiently handling the determination of the best location of the distributed generation and their corresponding distribution networks.

Fatores de risco relacionados à perda de produtividade laboral e aumento dos custos ambulatoriais de pacientes atendidos por unidades básicas de saúde

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Determinants of vaccination after the Colombian health system reform

OBJECTIVE: To assess the effects of individual, household and healthcare system factors on poor children's use of vaccination after the reform of the Colombian health system. METHODS: A household survey was carried out in a random sample of insured poor population in Bogota, in 1999. The conceptual and analytical framework was based on the Andersen's Behavioral Model of Health Services Utilization. It considers two units of analysis for studying vaccination use and its determinants: the insured poor population, including the children and their families characteristics; and the health care system. Statistical analysis were carried out by chi-square test with 95% confidence intervals, multivariate regression models and Cronbach's alpha coefficient. RESULTS: The logistic regression analysis showed that vaccination use was related not only to population characteristics such as family size (OR=4.3), living area (OR=1.7), child's age (OR=0.7) and head-of-household's years of schooling (OR=0.5), but also strongly related to health care system features, such as having a regular health provider (OR=6.0) and information on providers' schedules and requirements for obtaining care services (OR=2.1). CONCLUSIONS: The low vaccination use and the relevant relationships to health care delivery systems characteristics show that there are barriers in the healthcare system, which should be assessed and eliminated. Non-availability of regular healthcare and deficient information to the population are factors that can limit service utilization.

Desperdícios na cadeia logística no âmbito industrial

Projecto apresentado ao Instituto Politécnico do Porto para obtenção do Grau de Mestre em Logística Orientada por Prof. Doutor Gouveia

A influência das tecnologias self-service bancárias no comportamento dos clientes residentes nos Açores

Dissertação de Mestrado em Ciências Económicas e Empresariais

GuideMe: service for consulting, publication and recommendation of touristic locations

Trabalho de Projeto realizado para obtenção do grau de Mestre em Engenharia Informática e de Computadores

Benchmarking de uma aproximação de ticketing as a service (Taas)

Dissertação de natureza científica realizada para obtenção do grau de Mestre em Engenharia de Redes de Computadores e Multimédia

Logistic optimization in tourism networks

55th European Regional Science Association Congress, Lisbon, Portugal (25-28 August 2015).

Public relations in part-time : full-time service: estratégia de comunicação para o lançamento de um novo modelo de negócio ds relações públicas em Portugal

O presente trabalho visa propor uma estratégia para a construção e lançamento de um novo modelo de negócio para a atuação das Relações Públicas em Portugal, numa proposta direcionada para as micro e pequenas empresas. Entre o serviço in house e a consultadoria clássica existe um espaço não coberto em Portugal: um serviço in house partilhado. Apresenta-se aqui este projeto de serviço de Relações Públicas para aqueles para quem é incomportável assumir nos seus quadros um Técnico de Comunicação.

E-Learning as a shared service in shared services centers

Book Subtitle International Conference, CENTERIS 2010, Viana do Castelo, Portugal, October 20-22, 2010, Proceedings, Part II

Risk factors for cesarean section by category of health service

OBJECTIVE: To analyze the rate of cesarean section and differences in risk factors by category of health service, either public or private. METHODS: A cross-sectional study was carried out including all pregnant women in labor admitted to hospitals in the city of Rio Grande, Southern Brazil, between January 1 and December 31, 2007. A pre-coded and pre-tested questionnaire was used to collect on social, demographic, obstetric and newborn care information. Two regression models were constructed: one for public users and the other one for private ones. Poisson regression was used in each model in the multivariate analysis. Prevalence rates and 95% confidence intervals were calculated for each adjusted factor. RESULTS: The rate of cesarean section was 43% and 86% among public and private users. Sociodemographic factors and twin births have a more significant impact among public users as well as number of pregnancies (25% vs. 13% reduction in public and private users, respectively) and previous cesarean section (86% vs. 24% increase in public and private users, respectively). Prenatal care visits and hospital admissions affected the outcome only in women users of public services. CONCLUSIONS: Cesarean section rates were high in both groups studied, but it was twice as high among women cared in the private sector. Associated factors differ in magnitude by category of service used.

Psychiatric patients' return for HIV/STI test results in mental health centers

OBJECTIVE: To assess individual and/or health service factors associated with patients returning for results of HIV or sexually transmitted infection (STI) tests in mental health centers. METHODS: Cross-sectional national multicenter study among 2,080 patients randomly selected from 26 Brazilian mental health centers in 2007. Multilevel logistic regression was used to assess the effect of individual (level 1) and mental health service characteristics (level 2) on receipt of test results. RESULTS: The rate of returning HIV/STI test results was 79.6%. Among health service characteristics examined, only condom distribution was associated with receiving HIV/STI test results, whereas several individual characteristics were independently associated including living in the same city where treatment centers are; being single; not having heard of AIDS; and not having been previously HIV tested. CONCLUSIONS: It is urgent to expand HIV/STI testing in health services which provide care for patients with potentially increased vulnerability to these conditions, and to promote better integration between mental health and health services.

QoS-based surrogates selection and service proposal formulation in offloading environments

Resource constraints are becoming a problem as many of the wireless mobile devices have increased generality. Our work tries to address this growing demand on resources and performance, by proposing the dynamic selection of neighbor nodes for cooperative service execution. This selection is in uenced by user's quality of service requirements expressed in his request, tailoring provided service to user's speci c needs. In this paper we improve our proposal's formulation algorithm with the ability to trade o time for the quality of the solution. At any given time, a complete solution for service execution exists, and the quality of that solution is expected to improve overtime.