A productivity dashboard for hospitals: An empirical study

Health units are institutions which require accurate, updated information to support managerial decisions for thriving in such a critical industry. Thus, health information systems have been developed to help hospital managers steer daily operations. These systems provide not only operational support, but also key performance indicators (KPI’s) to monitor relevant areas at a time-aggregated basis. Despite the recognized value of dashboards in helping decision-makers, the literature shows a lack of proposals of productivity dashboards to assist Hospitals stakeholders. The thesis focuses on two problems: Hospital organizations need access to production and productivity information to improve access to services. Managers need production and productivity information to optimize resource allocation. The importance of addressing these issues lies in the fact that to monitor production and productivity information, is it possible to improve resource allocation. This dissertation consists of the development of dashboards to monitor information obtained from a hospital organization at the level of production and productivity, with the mission of supporting decision makers in the decision process. To properly develop the productivity dashboard, the Design Science Research (DSR) methodology was adopted to build and evaluate the artefact. It was ascertained that the production and productivity segment need more study and that the dashboards on these themes is an asset at the level of monitoring and analysis and subsequent decision-making process. The expected contribution of this research is to develop a dashboard recognized by health stakeholders as capable of better assisting them during their management duties.As unidades de saúde são instituições que requerem informações atualizadas e precisas para apoiar as decisões de gestão a fim de prosperarem numa indústria tão crítica. Assim, os sistemas de informação de saúde foram desenvolvidos para ajudar os gestores hospitalares a dirigir as operações diárias. Esses sistemas não fornecem só suporte operacional, mas também indicadores de desempenho chave (KPI’s) para monitorizar áreas relevantes numa base agregada no tempo. A tese concentra-se em dois problemas: As organizações hospitalares precisam de informações sobre produção e produtividade para melhorar o acesso aos serviços. Os gestores precisam de informações de produção e produtividade para otimizar a alocação de recursos. A importância da resolução destas questões prende-se com o facto de que ao monitorizar a informação de produção e produtividade é possível melhorar a alocação de recursos. A pesquisa consiste no desenvolvimento de painel de controlo para monitorar as informações obtidas numa organização hospitalar ao nível da produção e produtividade, com a missão de apoiar os decisores no processo de decisão. Para desenvolver adequadamente o painel de controlo de produtividade, adotou-se a metodologia Design Science Research (DSR) para construir e avaliar o artefato. Verificou-se que o segmento de produção e produtividade necessita de mais estudo e que o painel de controlo sobre estas temáticas é uma mais-valia ao nível da monotorização e análise e posterior processo de tomada de decisão. O contributo esperado é melhorar o processo de tomada de decisão nas Organizações de saúde, podendo ser útil para alertar de factos que a própria organização possa ainda desconhecer relativamente à sua operacionalidade

Persistence in Airline Accidents

This paper analyses airline accident data from 1927-2006, through fractional integration. It is shown that airline accidents are persistent and (fractionally) cointegrated with airline traffic. There exists a negative relation between air accidents and airline traffic, with the effect of the shocks to that relationship disappearing in the long run. Policy implications are derived for countering accident events.Accidents; airline; Time series; Persistence; Long memory; Cointegration.

Brazilian Land Tenure and Conflicts: The Landless Peasants' Movement

This paper analyzes conflicts and violence in Brazil involving landless peasants occupying privately-owned land, for the period 2000-2008. It is the first study to be undertaken at a national level, with a contemporary data span, using a count data model that allows for heterogeneity, endogeneity and dynamics. Results from the estimated model show that the violent land occupation grows with left-wing political support for land occupation, rural population density, and agricultural credit, and decreases with poverty, agricultural productivity. The study discusses the interconnection of land reform, poverty and conflict.Land occupation, land reform, Brazil, poverty, conflict.

Myofascial release effects in teachers' posture, muscle tension and voice quality: a randomized controlled trial

Summary: Objective. Myofascial release (MFR) comprises a set of manual therapeutic techniques applied to many conditions, but specific evidence concerning its effects on body posture, muscle tension and voice has been lacking. Thus, the aim of this study was to verify the effects of MFR in teachers’ posture, muscular tension and voice quality. Study Design. Randomized controlled trial − crossover. Methods. Twenty-four teachers, after completing a Sociodemographic and Clinical Questionnaire and providing written informed consent, were randomly distributed into two groups designated Group 1 (G1; n = 12; received MFR first) and Group 2 (G2; n = 12; belong to control group first). All participants received treatment and were into control group, since, after a 14 day period, procedures were switched between groups. Photogrammetry, muscle tension assessed through palpation, algometry, aerodynamic assessment of voice, acoustic and auditory-perceptual analysis of voice were performed before and after interventions. Results. Regarding voice, statistically significant differences were found when intervention was applied to both groups for maximum phonation time (MPT) (G1 P = 0.019; G2 P = 0.004). The acoustic variables did not differ. Concerning the auditory-perceptual analysis of voice statistically significant differences were found when intervention was applied in both groups for Grade in G2 (P = 0.046) and for Roughness in G1 (P = 0.025). Regarding the photogrammetry assessment statistically significant differences were found when intervention was applied to both groups in many parameters while as control group they did not. Concerning the algometry and muscle tension assessed through palpation statistically significant differences were found when intervention was applied in all muscles. Conclusions. Findings indicated that MFR seems to be an effective therapy in improving MPT, two subscales (Grade and Roughness) of the GRABASH scale, muscle tension assessed through palpation and algometry. Regarding photogrammetry, MFR had an immediately effect in improvement of the posture, especially related with head.info:eu-repo/semantics/publishedVersio

A responsabilidade pela gestão dos riscos de negócio

Dissertação de Mestrado Apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação do Dr. Carlos MendesA temática da Gestão dos Riscos de Negócio tem tido uma grande importância ao longo dos últimos anos, protegendo e acrescentando valor às organizações e aos “stakeholders”, motivado pelas grandes crises económicas. A Gestão dos Riscos de Negócio permite aos gestores identificar, avaliar e gerir os riscos de acordo com as incertezas, focando-se nos riscos com maior impacto e probabilidade. Este trabalho tem como principal objetivo apurar como as organizações atribuem a responsabilidade na Gestão dos Riscos de Negócio. Em Portugal, as sociedades emitentes de ações admitidas à negociação em mercado regulamentado, são obrigadas a disponibilizar anualmente informação sobre o grau de acolhimento do Código de Governo das Sociedades, o qual consiste num conjunto de recomendações elaboradas, onde parte dessas recomendações são referentes a Gestão dos Riscos de Negócio. Para o efeito analisámos os últimos relatórios de gestão, na sua componente de governo das sociedades das empresas que integram o índice do PSI-20 da Euronext de Lisboa, de modo a apurar e a concluir quais são as áreas das empresas responsáveis pela Gestão dos Riscos de Negócio.Enterprise Risk Management subject has a greater importance over the last years, protecting and adding value to the organizations and to the stakeholders, motivated by the great economic crisis. Enterprise Risk Management allows managers to identify, assess and manage the risks according to the uncertainty level, focusing on the risks with bigger impact and probability. The main goal of this work is to ascertain how the organizations assign the responsibility on Enterprise Risk Management. In Portugal, the societies that issue shares admitted to the negotiation in a regulated market, are yearly obliged to make available information about the Corporate Governance Code compliance degree, which consists in a joint of produced recommendations, where part of these recommendations are regarded to Enterprise Risk Management. For this purpose, we analyzed the last management reports, in its governance component of the companies that integrate the index of the PSI-20 of Lisbon Euronext, to investigate which are the companies areas accountable for Enterprise Risk Management

Tarifação de seguros multirriscos habitação

Trabalho de projeto de mestrado em Matemática Aplicada à Economia e Gestão, Universidade de Lisboa, Faculdade de Ciências, 2020O presente trabalho, realizado no âmbito de um estágio profissional na Aegon Santander Portugal (ASP), visa resultar na criação de uma estrutura tarifária para o produto de seguros multirriscos habitação, estrutura essa obtida através do recurso a conjuntos de dados adequados e a modelos lineares generalizados, os quais representam opções viáveis para incorporar informação presente em covariáveis na modelação de riscos, ajudando a eliminar em grande parte qualquer possibilidade de seleção adversa. Neste sentido, será exemplificada a construção da tarifa pretendida, não sem antes serem introduzidos conceitos básicos sobre Seguros e Atuariado, sobre a ASP e sobre os seguros multirriscos habitação no geral. Apesar da natureza prática deste trabalho, decidiu-se também apresentar de forma breve a teoria dos modelos lineares generalizados, antes do uso dos mesmos na modelação tarifária em Atuariado. Por último, mas não menos importante, é dada alguma atenção à implementação dos modelos criados, com o intuito de avaliar a suficiência dos prémios cobrados.The present paper, carried out as part of a professional internship at Aegon Santander Portugal (ASP), has as its purpose the creation of a tariff structure for the multirisk home insurance product. This exact structure was obtained through the use of appropriate data sets and generalized linear models, which represent viable options to incorporate the information present in covariates in risk modeling, effectively eliminating, in large proportion, any possibility of adverse selection. The construction of the intended tariff will be explained, not without first introducing some basic concepts about Insurance and Actuarial Science, ASP and multirisk home insurance. Despite the practical nature of this paper, it is important to mention that the theory of generalized linear models will also be presented in a short but comprehensive way, before its use in tariff building. Last but not least, the implementation of the created models will be addressed with some emphasis. The goal is to evaluate if the premiums charged are adequate and reasonable

Comprehensive Assessment of TERT mRNA Expression across a Large Cohort of Benign and Malignant Thyroid Tumours

The presence of TERT promoter (TERTp) mutations in thyroid cancer have been associated with worse prognosis features, whereas the extent and meaning of the expression and activation of TERT in thyroid tumours is still largely unknown. We analysed frozen samples from a series of benign and malignant thyroid tumours, displaying non-aggressive features and low mutational burden in order to evaluate the presence of TERTp mutations and TERT mRNA expression in these settings. In this series, TERTp mutations were found in 2%, only in malignant cases, in larger cancers, and from older patients. TERT mRNA expression was detected in both benign and malignant tumours, with increased frequencies in the malignant tumours with aggressive histotypes, larger tumours, and from older patients. In benign tumours, TERT mRNA expression was found in 17% of the follicular thyroid adenoma (FTA) with increased levels of expression in smaller tumours and associated with the presence of thyroiditis. TERTp mutations and TERT mRNA expression are correlated with worse prognosis features in malignant thyroid tumours, whereas TERT mRNA expression in the benign tumours is associated with the presence of thyroiditis.info:eu-repo/semantics/publishedVersio

Peritoneal microbiome in end-stage renal disease patients and the impact of peritoneal dialysis therapy

The following are available online at http://www.mdpi.com/2076-2607/8/2/173/s1, Figure S1 (Rarefaction curves), Figure S2 (Relative proportion taxa for class, order, genus, and species), Figure S3 (Abundances of the genera and families between the ESRD-PD and ESRD-nonPD), Figure S4 (Alpha diversity of the peritoneum microbiome community at phylum, class, order, family, genus, species and OUT taxonomic levels calculated with Observed, Chao1, Shannon, Simpson, and Inverse Simpson indexes), Figure S5 (Beta-diversity of the peritoneum microbiome community at OTU level with Bray-Curtis, Jaccard, unweighted Unifrac, and Weighted Unifrac) and Figure S6 (Non-metric multidimensional scaling of blood and peritoneum microbiomes of non-PD and PD patients).Factors influencing the occurrence of peritoneal dialysis (PD)-related infections are still far from fully understood. Recent studies described the existence of specific microbiomes in body sites previously considered microbiome-free, unravelling new microbial pathways in the human body. In the present study, we analyzed the peritoneum of end-stage kidney disease (ESKD) patients to determine if they harbored a specific microbiome and if it is altered in patients on PD therapy. We conducted a cross-sectional study where the peritoneal microbiomes from ESKD patients with intact peritoneal cavities (ESKD non-PD, n = 11) and ESKD patients undergoing PD therapy (ESKD PD, n = 9) were analyzed with a 16S rRNA approach. Peritoneal tissue of ESKD patients contained characteristically low-abundance microbiomes dominated by Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. Patients undergoing PD therapy presented lower species richness, with dominance by the Pseudomonadaceae and Prevotelaceae families. This study provides the first characterization of the peritoneal microbiome in ESKD patients, bringing new insight to the human microbiome. Additionally, PD therapy may induce changes in this unique microbiome. The clinical relevance of these observations should be further explored to uncover the role of the peritoneal microbiome as a key element in the onset or aggravation of infection in ESKD patients, especially those undergoing PD.This research was funded by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT/MCTES in the framework of the project MicroMOB “POCI-01-0145-FEDER-029777 / PTDC/MEC-MCI/29777/2017”; and by a Research Grant 2014 by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) to I.S.-S. L.S.-S was supported by SFRH/BD/84837/2012 and I.S.-S was supported by SFRH/BPD/101016/2014 from FCT/QREN–POPH/FSE

IgA dominant glomerulonephritis associated to staphylococcus infection: a peculiar case report

IgA dominant glomerulonephritis associated to Staphylococcus infection is a rare clinical entity that has been described mainly in case reports. Biopsy features can resemble other disease entities mainly IgA nephropathy and Henoch‑Schönlein purpura nephritis. Treatment of IgA dominant glomerulonephritis associated to staphylococcal infection is based on antibiotics for the underlying infection, controlling hypertension and edema and may resort to concomitant use of steroids in selected cases. Prognosis markers such as hypertension, diabetes and interstitial fibrosis may influence treatment as they are associated with poor renal outcomes. We report a case of a 63‑year‑old man with known hypertension, pre‑diabetes and recent history of methicillin‐sensitive staphylococcus aureus bacteremia associated to prostatitis, who presented with a one‑month history of edema, arthralgia and foamy urine. Over this period he progressed to anasarca and nephrotic range proteinuria with concomitant rise in creatinine levels being documented. The renal biopsy showed segmental endocapillary proliferation and IgA segmental dominant staining associated to C3 and lambda in minor distribution. On completion of two months of steroid therapy the patient partially recovered his renal function and proteinuria. After nine months of tapering steroids, he presented with acute inflammatory arthritis supporting an inflammatory background disease. To our knowledge this case describes an unusual entity such as IgA dominant glomerulonephritis associated to staphylococcal infection co‑presenting with an associated reactive arthritis.info:eu-repo/semantics/publishedVersio

Reverse FDI in Europe : an analysis of Angola's FDI in Portugal

This paper analyses investment from Angola in Portugal. An open economy model with money laundering is proposed and then tested with a time series Bayesian regression. The result reveals that exports and corruption are the positive determinants of Angola FDI in Portugal. Policy implications are derived..info:eu-repo/semantics/publishedVersio