Customer satisfaction and its relationship with a positive NPS

This thesis, which follows the structure of an in-company project, was developed based on problems observed in the stores of EDP company. With the decline of customer traffic in the physical stores and with the increase in the use of the Net Promoter Score indicator, there was a need to better understand the customer profile, what conditions his satisfaction and the reasons that lead to visit a physical store of EDP, relating all these aspects with the NPS indicator. To formulate the project, a study was developed based on direct observations in certain stores, answers to questionnaires and registration in evaluation tables, based on two analyses with different objectives. A first analysis aimed at evaluating the team and its performance as a whole and another in which the main focus was the assistants with good and bad NPS value. With the observations made, the main conclusions drawn are related to the factors that influence customer satisfaction, which are directly related to the store experience and the way he is handled throughout the attendance. Thus, with the main factors identified, it was possible to define a set of strategies based on three distinct pillars, which are the reformulation of the teams, training and improvement of store strategies and experience. The implementation of these actions in EDP stores, and later in other contact channels, will maximize customer satisfaction and, consequently, improve the company's NPS indicator.Esta tese, que segue a estrutura de um projeto empresa, foi desenvolvida com base em problemas observados nas lojas da empresa EDP. Com o declínio do tráfego de clientes nas lojas físicas e com o aumento da utilização e importância do indicador Net Promoter Score, surgiu a necessidade de perceber melhor o tipo de cliente da empresa, o que condiciona a sua satisfação e os motivos que o levam a visitar uma loja física da EDP, relacionando todos estes aspetos com o indicador NPS. Para a elaboração do projeto, desenvolveu-se um estudo com base em observações diretas em determinadas lojas, respostas a questionários e preenchimento de tabelas de avaliação, assentes em duas análises com objetivos distintos. Uma primeira análise que visava avaliar a equipa e a sua performance como um todo e uma outra em que o principal foco era os assistentes com bom e mau valor de NPS. Com as observações feitas, as principais conclusões retiradas relacionam-se com os fatores que influenciam a satisfação do cliente, que estão diretamente relacionados com a experiência que este tem em loja e a forma como é tratado durante todo o atendimento. Assim, com os principais fatores identificados, foi possível definir um conjunto de estratégias assentes em três pilares distintos, que são a reformulação das equipas, formações e melhoria das estratégias e experiência em loja. A implementação destas ações nas lojas da EDP, e posteriormente noutros canais de contacto, irá maximizar a satisfação dos clientes e, consequentemente, melhorar o indicador NPS da empresa

Quem Cuida de Quem Cuida? Um estudo exploratório sobre o perfil dos cuidadores informais e o suporte online e offline

O cuidador informal é toda a pessoa, não remunerada economicamente, que assume a função de prestar cuidados a uma outra pessoa dependente ou com alguma incapacidade e que não esteja capaz de realizar determinada tarefa sem a ajuda de outra. O principal objetivo desta dissertação foi compreender que recursos online e offline mobilizam os cuidadores informais para consolidar o seu suporte social. Para obter essa informação foi desenvolvido um estudo exploratório que permitiu traçar o perfil dos cuidadores informais através da análise do tipo de suporte social (online e offline) que têm e do tipo de apoio que procuram, das alterações na sua vida a partir desta condição, do tipo de formação que possuem para cuidar de quem cuidam, da avaliação da sobrecarga física, emocional e social dos cuidadores informais com o auxílio do instrumento QASCI, e da identificação da importância das tecnologias na vida dos cuidadores informais. Após a análise dos dados verificou-se que os cuidadores informais são predominantemente do sexo feminino, casados ou a viverem em união de facto, com uma idade média de 48. Estes cuidadores prestam, em média, cuidados há cerca de 5 anos e durante 11 horas diárias. Recorrem ao suporte informal (família, amigos e vizinhos) através da Internet para lidarem com as emoções sentidas e ainda para procurarem apoio específico/técnico relacionado com a doença do cuidado. As mudanças mais sentidas no ambiente familiar são o sentimento de solidão, o stress e a sobrecarga e a falta de apoio familiar. Na relação com os amigos verificase um afastamento e falta de tempo para estarem juntos. Os resultados permitem ainda verificar que as pontuações médias de sobrecarga física, emocional e social dos cuidadores informais do nosso estudo, em comparação com outras investigações, são significativamente mais baixas, o que nos leva a concluir que estas diferenças se devem às competências mobilizadas pela nossa amostra na utilização da Internet. Os resultados mostram também que os inquiridos que afirmam ter maior suporte familiar são os que consideram que a Internet não combate a solidão, já os cuidadores informais que se sentem sozinhos sustentam que a Internet pode ajudar a combater a solidão. / The informal caregiver is any person, not economically paid, who assumes the task of providing care to another dependent or disabled person and who is not able to perform one task without the help of another. The main objective of this dissertation was to understand what online and offline resources mobilize informal caregivers to consolidate their social support. In order to obtain this information, an exploratory study was developed that allowed the profile of informal caregivers to be traced through the analysis of the type of social support (online and offline) they have and the type of support they seek, changes in their life from this condition, the type of training they have to provide care, evaluation of physical, emotional and social burden on informal caregivers with the assistance of QASCI instrument, and the identification of the importance of technology in the lives of informal caregivers. After analysing the data, it was found that informal caregivers are predominantly female, married or living in union of fact, with a mean age of 48. These caregivers provided on average care for about 5 years and during 11 hours daily. They use informal support (family, friends and neighbours) over the Internet to deal with the emotions felt and still to seek specific / technical support related to the illness of the person whom they care. The most significant changes in the family environment are the feeling of loneliness, stress and burden and lack of family support. In the relationship with the friends there is a separation and lack of time to be together. The results allow us to verify that the average physical, emotional and social burden of the informal caregivers of our study, in comparison with other studies, are significantly lower, which leads us to conclude that these differences are due to the competences mobilized by our sample in the use of the Internet. The results also show that respondents who claim to have greater family support are those who consider that the Internet does not combat loneliness, while informal caretakers who feel alone hold that the Internet can help to combat loneliness

Dietary (poly)phenols in traumatic brain injury

© 2023 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 (https://creativecommons.org/licenses/by/4.0/).Traumatic brain injury (TBI) remains one of the leading causes of death and disability in young adults worldwide. Despite growing evidence and advances in our knowledge regarding the multifaceted pathophysiology of TBI, the underlying mechanisms, though, are still to be fully elucidated. Whereas initial brain insult involves acute and irreversible primary damage to the brain, the processes of subsequent secondary brain injury progress gradually over months to years, providing a window of opportunity for therapeutic interventions. To date, extensive research has been focused on the identification of druggable targets involved in these processes. Despite several decades of successful pre-clinical studies and very promising results, when transferred to clinics, these drugs showed, at best, modest beneficial effects, but more often, an absence of effects or even very harsh side effects in TBI patients. This reality has highlighted the need for novel approaches that will be able to respond to the complexity of the TBI and tackle TBI pathological processes on multiple levels. Recent evidence strongly indicates that nutritional interventions may provide a unique opportunity to enhance the repair processes after TBI. Dietary (poly)phenols, a big class of compounds abundantly found in fruits and vegetables, have emerged in the past few years as promising agents to be used in TBI settings due to their proven pleiotropic effects. Here, we give an overview of the pathophysiology of TBI and the underlying molecular mechanisms, followed by a state-of-the-art summary of the studies that have evaluated the efficacy of (poly)phenols administration to decrease TBI-associated damage in various animal TBI models and in a limited number of clinical trials. The current limitations on our knowledge concerning (poly)phenol effects in TBI in the pre-clinical studies are also discussed.This research was funded by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program under grant agreement No 804229. iNOVA4Health Research Unit (LISBOA-01-0145-FEDER-007344), which is co-funded by Fundação para a Ciência e Tecnologia (FCT)/Ministério da Ciência e do Ensino Superior, through national funds, and by FEDER under the PT2020 Partnership Agreement, is acknowledged (UIDB/04462/2020 and UIDP/04462/2020) as well LS4FUTURE Associated Laboratory (LA/P/0087/2020). The authors would like to acknowledge FCT for financial support: RC (PD/BD/135492/2018) DC (2020.04630.BD); IF (2022.00151.CEECIND).info:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Polymorphism of the predictive antigenic sites on the V3 loop of Brazilian HIV-1 subtype B strains. HEC/FIOCRUZ AIDS Clinical Research Group.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-08-18T13:56:06Z No. of bitstreams: 1 Morgado MG Polimorphisms....pdf: 103545 bytes, checksum: 495748426b112c480d261a89c05eb9ac (MD5)Made available in DSpace on 2014-08-18T13:56:06Z (GMT). No. of bitstreams: 1 Morgado MG Polimorphisms....pdf: 103545 bytes, checksum: 495748426b112c480d261a89c05eb9ac (MD5) Previous issue date: 1996Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Imunologia. Rio de Janeiro, RJ, BrasilHospital Evandro Chagas. Rio de Janeiro, RJ, BrasilHospital Evandro Chagas. Rio de Janeiro, RJ, BrasilHospital Evandro Chagas. Rio de Janeiro, RJ, BrasilHospital Evandro Chagas. Rio de Janeiro, RJ, BrasilHospital Evandro Chagas. Rio de Janeiro, RJ, BrasilAmbulatório da Previdência da Arquidiocese do Rio de Janeiro. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Imunologia. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Imunologia. Rio de Janeiro, RJ, Brasi