Medical electronic prescription for home respiratory care services (PEM-CRD) at a Portuguese university tertiary care centre (2014–2018) : a case study

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.Home respiratory care (HRC) is the provision of healthcare services at the place of residence of patients or their families, with the aim of meeting needs mainly resulting from chronic respiratory conditions, permanent disability, or terminal illness. In 2016, an innovative electronic prescription system, PEM-CRD, was fully implemented for HRC services in Portugal. To date, no study has addressed the impact of the execution of this digital innovation. For this purpose, we carried out an analysis of the prevalence and number of prescriptions for people with chronic respiratory diseases receiving HRC in the Lisbon metropolitan area, during 2014–2018, using the information obtained from the PEM-CRD database. The data analysis shows that while the number of patients receiving HRC treatment with a prescription has remained stable over the last four years, the number of prescriptions has significantly dropped since 2016 (2016–2018), with consequent paper and processes efficiency. The implementation of the digital Medical Electronic Prescription for Home Respiratory Care tool (PEM-CRD) and consequent dematerialization of these processes has increased the efficiency of prescribing in HRC. Additionally, the possibility of obtaining data through the PEM-CRD allows the monitoring of the evolving prevalence of therapies, improving the health services optimization and allowing reporting on data other than medicines.info:eu-repo/semantics/publishedVersio

Integer programming model for ship loading management: a case study from cement industry

Industries only survive in the modern business world if they are prepared to improve processes whenever it is necessary. Therefore, companies need to adapt and/or modify processes to improve the level of service and reduce needless costs. In this article the logistics problem of planning a ship load operation of a Portuguese cement company is addressed. The objective is to determine the best way to transport the bagged cement from the warehouse to a ship reducing costs and optimizing forklifts operations. A mathematical programming model is proposed showing this methodology as a powerful tool to provide effective support to a more intelligent decision process.- (undefined

Influence of micro-aeration in the production of volatile fatty acids (VFA) from wastewaters with high salinity

Waste management and valorization are seen as pivotal drivers for adopting a circular economy. The production of volatile fatty acids (VFA) through anaerobic digestion (AD) fits perfectly into these emerging social and industrial dynamics, being the VFA considered valuable products, namely in chemical industries. Therefore, this work focuses on VFA production through AD, using wastes and wastewaters, with high salinity content (20 g/L) in continuous bioreactors. The effect of micro-aeration during acidogenesis of high-salinity wastes/wastewaters was accessed for more than 500 days, divided in 5 main periods, by analysing different physicochemical parameters like oxidationreduction potential (ORP), salinity, pH, COD, and VFA profile. Sludge properties were also analysed through quantitative image analysis (QIA) and integrating Principal Component Analysis (PCA). The results demonstrate that the high salinity does not appear as a limiting factor, with soluble COD (30 g/L) being constant through operation time in both reactors, as well as VFA/sCOD ratio (60 % 80 %). Due to micro-aeration, differences between anoxic (R1) and microaerophilic (R2) reactors were observed, with the second one presenting lower value of ORP in some periods during the assay. This indicates the presence of aerobic or facultative microorganisms, which have consumed oxygen. Also, higher concentrations of hexanoate in the microaerophilic reactor (R2) were obtained in those periods. The application of QIA combined with PCA has revealed that micro-aeration significantly impacts the morphology and size of aggregates.info:eu-repo/semantics/publishedVersio

rethinking the health technology assessment framework in Portugal

Funding Information: MEA and MIP. These methods might be a relevant mechanism to improve access. However, they should be supported by an improved registry database. Participants identified the possibility of these databases being (partially) funded by the pharmaceutical industry. MIP implementation must be assured by accurate prescription tracking. Publisher Copyright: © 2021 The Author(s). Published by S. Karger AG, Basel on behalf of NOVA National School of Public Health.Introduction: Health technology assessment (HTA) aims to provide decision makers with relevant data to make informed choices. Recent changes in the Portuguese HTA framework have altered substantially the assessment methodology with regard to economic evaluation, with potential impacts on access and process efficiency. The HTA Reshaping Project had as its main objective informing the debate on HTA in Portugal, thereby identifying improvement opportunities and solutions to the HTA framework that address future challenges. Methods: The project comprised several phases, i.e., (1) mapping and evaluation of different HTA frameworks across Europe, identifying best practices and key variables to consider in future frameworks; (2) conduction of in-depth interviews with relevant stakeholders (n = 11); and (3) development of 2 workshops - one with young professionals (n = 12) and another with relevant HTA stakeholders (n = 19) - to consolidate and further explore vital elements of HTA, aimed at brainstorming ideas and developing solutions to improve some of the most critical points, with a view to addressing future challenges. Results: The comparison of HTA frameworks showed that their purpose and sophistication vary across European countries. For example, the need for economic evidence is not unanimous, and reimbursement agreements vary considerably. Among the stakeholders interviewed there was a high level of agreement on priorities that should be addressed, e.g., expanding and creating national level registries and assuring patient participation throughout the HTA process. The possibility of using managed entry agreements to enhance patients' access, applying multi-indication pricing for medicines with different therapeutic values per indication, and improvement of registry/system interoperability gathered a moderate level of agreement. Conclusions: The Portuguese HTA framework might be further adapted to upcoming challenges and should evolve to improve access to innovative therapies. There is still a long path towards the convergence of HTA frameworks in EU member states.publishersversionpublishe

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Mechanical joining methods for additive manufactured assembly tools

The use of additive manufacturing (AM) processes is growing in the manufacturing industry. One application with great potential for using these processes is the manufacture of assembly tools for a high-ly competitive markets, such as the automotive industry. A critical aspect of the assembly tool design is its capability to incorporate modifications even at a late stage of its development in very short time. In many cases, these modifications are achieved using metal inserts in the polymeric tool, which allow to add new geometric features. This capability increases the usefulness and versatility of components produced by AM and compensate for potential shortcomings of using additive mate-rials. The purpose of this paper is to evaluate the potential use of accessories in additive manufactured com-ponents. In addition, the effect of different percentages of infill tool material on the joining quality of accesso-ries is evaluated. This is done by performing a screw pull-out test on a ABS ESD-7 part, produced by fused deposition modelling. The following different joining solutions were compared and studied in this work: em-bedded inserts, glue, heating processes, pressure (Tap-in) and creation of threads, such as, printing the thread directly and machining the thread onto the material.Programa Operacional Competitividade e Internacionalização - COMPETE 2020, Projeto nº 002814, Ref. POCI-01-0247-FEDER-002814 entre a Univ. do Minho e a Bosc

Presentation and validation of a new optical sensing concept based in a 3d-printing solution

In high competitive markets, such as the automotive industry, the better quality of products, reduction of manufacturing costs and the fulfilment of all delivery deadlines can only be achieved through continuous improvement of production capabilities. One current strategy is to develop and create smarter and adaptive assembly tools. Automation is a relevant area of development in the current industrial world and the baseline of the fourth industrial revolution (Industry 4.0). Namely, it is very important to use sensing components on jigs for assembly parts in the production line. The arrangement of sensing components on the assembly tools is very dependent of the product, making the project more complex and less flexible. This issue can penalise the productivity heavily, especially if a wide range of products and changeover operations are usual. The use of Additive Manufacturing (AM) is growing in the industry and offers a high potential for research and development in the present stage. The AM is advantageous in many areas, especially in the rapid construction of complex tools (RP). This paper presents a new optical sensing concept based on the 3D printing of internal circuits in the assembly tools. This solution can bring many advantages and increase tools flexibility.Programa Operacional de Competividade e Internacionalização - COMPETE 2020, Projeto nº 002814; Ref. POCI-01-0247-FEDER-002814, entre a Univ. Minho e a Bosc

Analysis of Average Temperatures And Trends In Brazil: Applying CUSUM Graphic from 2000 to 2014

In recent decades the temperature trends are being confirmed earlier. To determine the temperature changes in Brazil, analysis of annual trends and seasons was carried out based on daily data from 187 weather stations, covering the period from 2000 to 2014. Trends were confirmed using the Cumulative Sum Chart, a method that notices the changes in series faster than others. The modeling of temperature was obtained by Multiple Regression and using Cluster Analysis, and through this it was possible to group weather stations. The observed trends confirmed oscillations in cooling, heating and, in some cases, cooling followed by heating. These main trends presented during the study period were from -15 to 0 in latitude. The region with the highest confirmation of inversions in temperature was the North, then Northeast. Heights below 500 meters presented higher trends. Regarding the seasons, autumn contributed significantly to the trends.Nas últimas décadas as tendências de temperatura estão se confirmando mais rapidamente. Para determinar as mudanças de temperatura no Brasil foi realizada análise das tendências anuais e por estações do ano tendo por base dados diários de 187 estações meteorológicas, abrangendo o período de 2000 a 2014. As tendências foram confirmadas com a utilização do Gráfico de Soma Acumulativa, este método percebe as alterações em séries mais rápido que outros. A modelagem da temperatura foi obtida por Regressão Múltipla e com a Análise de Cluster foi possível agrupar Estações Meteorológicas. As tendências observadas confirmam oscilações de resfriamento, aquecimento e em alguns casos de resfriamento seguido de aquecimento. As principais tendências apresentadas no período estudado foram a partir de -15 até 0° na latitude. A região com maior confirmação de inversões na temperatura foi o Norte, seguida do Nordeste. Em altitude abaixo de 500 metros é onde apresentou maior tendência. Quanto às estações do ano, o outono contribuiu significativamente com as tendências

EDITORIAL

É com satisfação que nós editores organizamos e lançamos a presente edição da Revista Kínesis com o Número Especial temático “Epistemologia, Filosofia da Ciência e da Tecnologia”. Organizamos os artigos tomando como critério partir da reflexão sobre ciências mais abstratas às ciências mais aplicadas. Nesse sentido, os artigos perpassam pela Filosofia da Matemática, Teoria do Conhecimento, Epistemologia Social, Filosofia da Psicologia, Filosofia da Neurociência e, por fim, chegando à Filosofia da Tecnologia e a relação desta com a Educação