Autonomy of long-stay psychiatric inpatients

OBJECTIVE: To assess personal autonomy of long-stay psychiatric inpatients, to identify those patients who could be discharged and to evaluate the impact of sociodemographic variables, social functioning, and physical disabilities on their autonomy was also assessed. METHODS: A total of 584 long-stay individuals of a psychiatric hospital (96% of the hospital population) in Southern Brazil was assessed between July and August 2002. The following instruments, adapted to the Brazilian reality, were used: independent living skills survey, social behavioral schedule, and questionnaire for assessing physical disability. RESULTS: Patients showed severe impairment of their personal autonomy, especially concerning money management, work-related skills and leisure, food preparation, and use of transportation. Autonomy deterioration was associated with length of stay (OR=1.02), greater physical disability (OR=1.54; p=0.01), and male gender (OR=3.11; p<0.001). The risk estimate of autonomy deterioration was 23 times greater among those individuals with severe impairment of social functioning (95% CI: 10.67-49.24). CONCLUSIONS: In-patients studied showed serious impairment of autonomy. While planning these patients' discharge their deficits should be taken into consideration. Assessment of patients' ability to function and to be autonomous helps in identifying their needs for care and to evaluate their actual possibilities of social reinsertion.

Long-stay patients in a psychiatric hospital in Southern Brazil

OBJECTIVE: To describe the demographic profile, social functioning, and quality of life of a population of long-stay care patients in a psychiatric hospital. METHODS: A study was carried out in Porto Alegre, Southern Brazil, in 2002. A total of 584 (96%) long-stay patients were assessed by means of the following instruments: the World Health Organization Quality of Life, the Social Behavior Schedule, the Independent Living Skills Survey, the Brief Psychiatric Rating Scale and another instrument for assessing disability (Questionnaire for Assessing Physical Disability). RESULTS: The average hospital stay was 26 years (SD: 15.8) and 46.6% of inpatients had no physical disability. Patients had their social functioning skills and autonomy largely impaired. Few of them (27.7%) answered the instrument for assessing quality of life, and showed significant impairments in all domains. The Brief Psychiatric Rating Scale evidenced a low prevalence of positive symptoms in this population. CONCLUSIONS: The institutionalized population studied presented significantly impaired social functioning, autonomy, and quality of life. These aspects need to be taken into consideration while planning for their deinstitutionalization.

Comportamento das famílias em relação ao consumo de eletricidade: o caso dos Açores

Dissertação de Mestrado em Ciências Económicas e Empresariais

Ecotoxicity tests using the green algae chlorella vulgaris — a useful tool in hazardous effluents management

The treatment efficiency of laboratory wastewaters was evaluated and ecotoxicity tests with Chlorella vulgaris were performed on them to assess the safety of their environmental discharge. For chemical oxygen demand wastewaters, chromium (VI), mercury (II) and silver were efficiently removedby chemical treatments.Areduction of ecotoxicitywas achieved; nevertheless, an EC50 (effective concentration that causes a 50% inhibition in the algae growth) of 1.5% (v/v) indicated still high level of ecotoxicity. For chloride determination wastewaters, an efficient reduction of chromium and silver was achieved after treatment. Regarding the reduction of ecotoxicity observed, EC50 increased from 0.059% to 0.5%, only a 0.02% concentration in the aquatic environment would guarantee no effects. Wastewaters containing phenanthroline/iron (II) complex were treated by chemical oxidation. Treatmentwas satisfactory concerning chemical parameters, although an increase in ecotoxicitywas observed (EC50 reduced from 0.31% to 0.21%). The wastes from the kinetic study of persulphate and iodide reaction were treated with sodium bisulphite until colour was removed. Although they did not reveal significant ecotoxicity, only over 1% of the untreated waste produced observable effects over algae. Therefore, ecotoxicity tests could be considered a useful tool not only in laboratory effluents treatment, as shown, but also in hazardous wastewaters management.

Green production of zero-valent iron nanoparticles using tree leaf extracts

The interest in zero-valent iron nanoparticles has been increasing significantly since the development of a green production method in which extracts from natural products or wastes are used. However, this field of application is yet poorly studied and lacks knowledge that allows the full understanding of the production and application processes. The aim of the present work was to evaluate the viability of the utilization of several tree leaves to produce extracts which are capable of reducing iron(III) in aqueous solution to form nZVIs. The quality of the extracts was evaluated concerning their antioxidant capacity. The results show that: i) dried leaves produce extracts with higher antioxidant capacities than non-dried leaves, ii) the most favorable extraction conditions (temperature, contact time, and volume:mass ratio) were identified for each leaf, iii) with the aim of developing a green, but also low-cost,method waterwas chosen as solvent, iv) the extracts can be classified in three categories according to their antioxidant capacity (expressed as Fe(II) concentration): >40 mmol L−1; 20–40 mmol L−1; and 2–10 mmol L−1; with oak, pomegranate and green tea leaves producing the richest extracts, and v) TEManalysis proves that nZVIs (d=10–20 nm) can be produced using the tree leaf extracts.

Application of green zero-valent iron nanoparticles to the remediation of soils contaminated with ibuprofen

Zero-valent iron nanoparticles (nZVIs) are often used in environmental remediation. Their high surface area that is associated with their high reactivity makes them an excellent agent capable of transforming/degrading contaminants in soils and waters. Due to the recent development of green methods for the production of nZVIs, the use of this material became even more attractive. However, the knowledge of its capacity to degrade distinct types of contaminants is still scarce. The present work describes the study of the application of green nZVIs to the remediation of soils contaminated with a common anti-inflammatory drug, ibuprofen. The main objectives of this work were to produce nZVIs using extracts of grape marc, black tea and vine leaves, to verify the degradation of ibuprofen in aqueous solutions by the nZVIs, to study the remediation process of a sandy soil contaminated with ibuprofen using the nZVIs, and to compare the experiments with other common chemical oxidants. The produced nZVIs had nanometric sizes and were able to degrade ibuprofen (54 to 66% of the initial amount) in aqueous solutions. Similar remediation efficiencies were obtained in sandy soils. In this case the remediation could be enhanced (achieving degradation efficiencies above 95%) through the complementation of the process with a catalyzed nZVI Fenton-like reaction. These results indicate that this remediation technology represents a good alternative to traditional and more aggressive technologies.

Teste de Morisky-Green e Brief Medication Questionnaire para avaliar adesão a medicamentos

OBJETIVO: Analisar a confiabilidade e o desempenho da versão em português de instrumentos de avaliação da adesão ao tratamento anti-hipertensivo. MÉTODOS: Pacientes hipertensos atendidos de janeiro a setembro de 2010 em uma unidade de atenção primária em Porto Alegre, RS, foram selecionados aleatoriamente (n = 206). Na avaliação da adesão foram utilizadas versões em português do Teste de Morisky-Green (TMG) e do Brief Medication Questionnaire (BMQ). Foram analisados consistência interna, estabilidade temporal e desempenho com relação a três padrões-ouro: controle inadequado da pressão arterial (> 140/90 mmHg); taxa insuficiente de retirada de medicação na farmácia da Unidade Básica de Saúde (< 80%); e a combinação de ambos. RESULTADOS: Dos pacientes avaliados, 97 utilizavam medicamentos dispensados somente pela farmácia da Unidade Básica de Saúde. Os testes apresentaram boa consistência interna: BMQ α de Cronbach de 0,66 (IC95% 0,60;0,73) e o TMG 0,73 (IC95% 0,67;0,79). O desempenho do BMQ no domínio regime apresentou sensibilidade de 77%, especificidade de 58% e área sob a curva ROC de 0,70 (IC95% 0,55;0,86), e o TMG sensibilidade de 61%, especificidade de 36% e área sob a curva ROC de 0,46 (IC95% 0,30;0,62). A correlação entre o BMQ e o TMG foi de r = 0,28, p > 0,001. A baixa adesão ao BMQ está associada a maiores níveis tensionais quando comparada com pacientes aderentes (148,4 [dp 20,1] vs 128,8 [dp 17,8], p < 0,001), mas não para o TMG. CONCLUSÕES: O BMQ apresentou melhor desempenho que o TMG, com maiores sensibilidade e especificidade. A avaliação da adesão pode auxiliar o clinico na discriminação entre uso inadequado da medicação e esquema terapêutico insuficiente.

Impact of long-stay beds on the performance of a tertiary hospital in emergencies

ABSTRACT OBJECTIVE To assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital. METHODS For this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression. RESULTS Between September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index – 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) – the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days. CONCLUSIONS Implementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors.

A green integrated process for biodiesel production

Dissertation presented at Faculdade de Ciências e Tecnologia from Universidade Nova de Lisboa to obtain the degree of Master in Chemical and Biochemical Engineering

Biodiversity of cyanobacteria and green algae on monuments in the Mediterranean Basin: an overview

Microbiology (2009), 155, 3476–3490

Mapping and characterization of a green biofilm inside of Vilar de Frades Church (Portugal)

Vilar de Frades church is integrated in the Vilar de Frades Monastery, located in the North part of Portugal (Barcelos). The monastery, founded in 566, suffered several architectural modifications and restoration works, the most relevant was in the XVI century. The church, in granite, has one nave and six bays,holding ten chapels with vaults of crossed ribbings. Nowadays, the chapels present a severe biological colonization characterised by an intense green biofilm, which becoming apparent in other locations inside the church. In the course of a general survey concerning the conservation state of the church, an accurate campaign was planned in order to assess the main biodeterioration agents, map biological colonization and determine the environmental conditions. Laboratory analyses were accomplished with optical microscopy and spectrofluorometry. This study presents the results of this campaign. Details on conservation or preservation works that need to be implemented are also presented.

Volunteering for a Lifetime? Volunteers’ Intention to Stay in Portuguese Hospitals

The current study aims to study Hospital volunteers’ intention to stay in an organization through understanding motivation, management factors, and satisfaction. A total of 304 Hospital volunteers, mainly women, completed a questionnaire measuring motivations, management factors, satisfaction, and intention to stay. In this study, structural equation modeling was used. Results demonstrate that there is a positive relationship between (a) motivation and satisfaction, (b) management factors and satisfaction, (c) satisfaction and intention to stay, and (d) motivation and management factors. These results present important outcomes that should be reflected in the way organizations operate. This research indicates aspects which are most valued by volunteers and allows NPOs to design and establish appropriate and assertive management policies.

Auditorias energéticas em ambiente industrial

Gestão de Energia e Sustentabilidade são os pilares em que assenta esta dissertação, realizada no âmbito da Energia Elétrica em Ambiente Industrial. Neste sentido, deve entender-se “Gestão de Energia” como o planeamento de operações nas unidades de produção e de consumo. Tem como objetivos a conservação dos recursos, proteção climática e redução de custos, para que seja possível o acesso permanente à energia de que necessitamos. “Sustentabilidade”, por definição, é uma caraterística ou condição de um processo ou de um sistema que permite a sua permanência, até um determinado nível, por um determinado prazo. A Indústria Têxtil, da região do Vale do Ave, por ser extensa e muito heterogénea, quer na qualidade, quer na dimensão e nos recursos que utiliza, apresentou-se como uma oportunidade para aplicar os conhecimentos adquiridos, nas diversas disciplinas do Mestrado em Engenharia Electrotécnica - Área de Sistemas Eléctricos de Energia e como meio condutor à tentativa de optimização e racionalização do consumo de Energia Elétrica no Sector. O modelo encontrado para dar uma resposta satisfatória ao inicialmente proposto foi a Auditoria Energética. Neste sentido, foram realizadas visitas às instalações industriais, para o levantamento e recolha de informação, que posteriormente viria a ser analisada e, com base na mesma, tentou apresentar-se um conjunto de soluções que visassem a eficiência Energética do sector. Com o decorrer das visitas, surgiu a necessidade de criar um modelo, que servisse de guia da auditoria. Algo que seria um bloco de notas, mas específico, de forma a não perder a informação recolhida. Então foi desenvolvida uma aplicação para IPAD/IPHONE, o que permite também a recolha e armazenamento de fotografias, que aqui tem um papel fundamental. Salienta-se que as expectativas foram ao encontro do esperado, pois o que se encontrou foi um número significativo de empresas a precisar deste contributo. Atuando no “combate” ao consumo desnecessário e ao desperdício, é estar a contribuir ativa e positivamente, no desenvolvimento próspero da temática de Sustentabilidade Energética.

Prédios inteligentes. Green buildings

Este artigo apresenta alguns dos benefícios e a aplicabilidade da automação predial e residencial, cuja denominação atual e Domótica. Esta tecnologia permite a integração dos serviços e tecnologias, aplicados a residências, escritórios, flats, apartamentos e casas com o propósito de automatizá-los buscando sempre como resultado principal um maior conforto, economia de energia eletrica, redução no consumo de recursos hídricos, segurança dos usuários e um gerenciamento mais centralizado e efetivo, integrando todas as soluções de automação. Serão apresentadas as varias classes de aplicação para a criação dos chamados “prédios inteligentes”, assim como as diversas tecnologias desenvolvidas para esta finalidade

An information model for lean, agile, resilient and green supply chain management

Dissertação para a obtenção de Grau de Mestre em Engenharia e Gestão Industrial