Economic Analysis of Portuguese Public Hospitals Through the Construction of Quality, Efficiency, Access, and Financial Related Composite Indicators

Hospitals consume most of the health systems’ fnancial resources. In Portugal, for instance, public hospitals represent more than half of the National Health Service debt and are decisive in their fnancial insufciency. Although proft is not the primary goal of hospitals, it is essential to guarantee their fnancial sustainability to ensure users’ health care and the necessary resources. An analysis of the existing literature shows that researches focus mainly on the hospital’s technical efciency. The literature has paid little or even no attention to the use of composite indicators in hospital benchmarking studies. This study uses the Beneft of Doubt methodology alongside recent data about Portuguese public hospitals (2013–2017) to understand the factors that contribute to low performance and high indebtedness levels. Our results suggest that hospitals perform better in terms of access (average score: 0.982). The group of criteria with the lowest performance was efciency and productivity (average score: 0.919), suggesting resources waste. Financial performance is, in general, higher than quality, raising social concerns about the way that public hospitals have been managed. Findings bring relevant implications. For example, the way hospitals are currently fnanced should consider efciency, productivity, quality, and access. Regulators should ensure that minimum performance levels are fulflled, applying preventive and corrective measures to avoid future low-performance levels. We suggest that hospital managers introduce satisfaction inquiries to improve quality. These improvements can attract more patients in the medium- or long-term; thus, our results are useful to citizens to make a better choice.info:eu-repo/semantics/publishedVersio

Contracting out public transit operation services: an incentive performance-based approach

The literature on public transit services contracting, emphasizes the need of efficient contracting designs to promote parties’ interest alignment. There is, however, limited research addressing specific incentive mechanisms. The paper contributes to that literature by developing a performance-based model with an embedded incentive bonus/malus (B/M) mechanism for contracting out transit services. Monte Carlo simulation documents that model’s performance appears sensitive to stochastic specification of some of the B/M drivers, and responsive to changes in the contractual performance factors out of the sub-concessionaire’s control. Evidence on the operation of a light-rail transit system designed based on a version of the model, document that it may contribute to promote ridership patronage, increase the average ride, and ultimately promote the economic operating efficiency of the system. Some policy implications are drawn, namely in terms of public funds allocative efficiency, and promotion of social welfare in contracting transit services.info:eu-repo/semantics/publishedVersio

Contracting out public transit services: a competitive performance-based approach

This paper develops a bonus / malus incentive model to contracting out public transit services, and provides evidence on performance measures of a lightrail transit system operation, procured with a contract designed based on our modeling approach. Empirical results document that the implementation of a performance-based contract with an embedded incentive bonus / malus mechanism, may contribute to promote ridership patronage, increase the average ride, and ultimately significantly improving the overall economic operating efficiency of the system, measured by a 40 percent increase in the operating costs coverage ratio during the contract term

Soft and transferable skills acquisition through organizing a doctoral conference

UIDB/00066/2020.This article presents a 10-year experience of soft and transferable skills acquisition through the involvement of PhD students in the organization of an international conference. Soft and transferable skills acquisition is currently perceived as a core component of doctoral studies. Examples include writing and communication, teamwork, time management, leadership, resource management, negotiation, problem solving, listening, planning, entrepreneurial spirit, mastering ethics awareness, etc. The need for such skills is due to the leading role that doctoral students are expected to play in society. As such, various organizations have issued recommendations for doctoral programs to include a formal component of soft skills training. In this article, an effective way of introducing soft and transferable skills acquisition in doctoral engineering education is introduced. Namely, a form of collaborative project-based learning is designed as a compulsory course. This includes a set of base lectures, a long period of parallel working groups focusing on the various aspects of organizing an international conference, running the actual conference, and performing a post-conference assessment. Results and lessons learned demonstrate the validity and effectiveness of the proposed approach.publishersversionpublishe

Performance-based contracting of urban transport operation services: evidence from Porto's light-rail

This paper develops a bonus/malus incentive model for contracting out the provision of urban railroad operation services, and testing parts of its performance using Monte Carlo methods. We also provide evidence on the performance measures of Metro do Porto's (MdP) light-rail network operation, during the 2010–2016 term of a bonus/malus-based contract, incorporating some features of our model. Results document that the implementation of a performance-based contract with an embedded incentive bonus/malus mechanism may contribute to promoting ridership patronage, increasing the average ride, and ultimately promoting the overall economic operating efficiency of the system. The comparative operating performance analysis of MdP versus Metropolitano de Lisboa, a vertically integrated, governmentally-owned metro network, shows that MdP exhibits higher revenue, cost, and operating efficiency in the 2010–2016 period, and that the bonus/malus mechanism induces the private sub-concessionaire to respond more efficiently to changes in demand.info:eu-repo/semantics/publishedVersio

Protein-biomembrane interactions as therapeutic targets

Biological membranes are dynamic structures essential for several cellular phenomena. The scope of the work of the Institute of Molecular Medicine (IMM) Biomembranes Unit is the study of biochemical and biophysical processes occurring at the membrane level on human cells and on their viral and bacterial pathogens. On the viral context, we are primarily interested on HIV and dengue virus, and particularly on the two steps of their life cycle involving their interaction with host cell membranes: the viral entry into target cells and the assembly of new viral particles. A special focus will be given to the study of the role of biological membranes on the mechanism of action of the HIV entry (membrane fusion) inhibitors enfuvirtide and T-1249. We are also involved in assessing the molecular basis of the activity of microbicides, such as rBPI21, that bind to specific components of bacterial membranes. Additionally, our line of work on the binding of fibrinogen to erythrocytes, and its relevance as a cardiovascular risk factor will be presented. An approach to the latter problem by single-molecule force spectroscopy, using an atomic force microscope (AFM), allowed the molecular recognition, characterization and partial identification of the human erythrocyte receptor for fibrinogen.These lines of work were supported by Fundação para a Ciência e a Tecnologia – Ministério da Ciência, Tecnologia e Ensino Superior (FCT-MCTES, Portugal; projects PTDC/SAU-OSM/73449/2006 and PTDC/ QUI-BIQ/104787/2008), by the FP7-PEOPLE IRSES (International Research Staff Exchange Scheme) project MEMPEPACROSS (EU), and by Fundação Calouste Gulbenkian (Portugal). MMD and PMM also thank FCT-MCTES for the PhD fellowships SFRH/BD/41750/2007 and SFRH/BD/42205/2007, respectively

Analysis of processing systems involving reaction and distillation : the synthesis of ethyl acetate

The integration of reaction and separation into a single process unit, i. e., reactive destillation, may offer several advantages over conventional systems that use a reactor followed by a distillation column. In this paper we explore the operational characteristics of reactive distillation and highlight some of this potential benefits, using the production of ethyl acetate as an illustrative example. With this aim, the two types of system are compared employing different reactor types and a number of performance indicators, such as yield, conversion, purity, specific energy consumption and residence time. A sensitivity analysis is carried out on some variables and parameters, in order to explore and define the distillation columns operating conditions. As expected, results point to a clear advantage of reactive distillation allowing for the azeotrope to be surpassed and for the overcoming of chemical equilibrium, favouring an increase in conversion and product purity, along with reduced operating costs

HIV-1 Fusion Inhibitor Peptides Enfuvirtide and T-1249 Interact with Erythrocyte and Lymphocyte Membranes

Enfuvirtide and T-1249 are two HIV-1 fusion inhibitor peptides that bind to gp41 and prevent its fusogenic conformation, inhibiting viral entry into host cells. Previous studies established the relative preferences of these peptides for membrane model systems of defined lipid compositions. We aimed to understand the interaction of these peptides with the membranes of erythrocytes and peripheral blood mononuclear cells. The peptide behavior toward cell membranes was followed by di-8-ANEPPS fluorescence, a lipophilic probe sensitive to the changes in membrane dipole potential. We observed a fusion inhibitor concentration-dependent decrease on the membrane dipole potential. Quantitative analysis showed that T-1249 has an approximately eight-fold higher affinity towards cells, when compared with enfuvirtide. We also compared the binding towards di-8-ANEPPS labeled lipid vesicles that model cell membranes and obtained concordant results. We demonstrated the distinct enfuvirtide and T-1249 membranotropism for circulating blood cells, which can be translated to a feasible in vivo scenario. The enhanced interaction of T-1249 with cell membranes correlates with its higher efficacy, as it can increase and accelerate the drug binding to gp41 in its pre-fusion state