Fiscal Policy in a Monetary Union: Gains from Changing Institutions

In a Monetary Union where individual monetary instruments are lost, fiscal policy becomes more important as a national policy. The question addressed in this article is whether fiscal policy should be decided at the country level or by a central decision maker, being in any case the fiscal instruments specific to each country. To answer this question, the focus is on the quantitative effect, since there are costs of implementing a supranational decision maker. While discussing the methodologies used in literature, we hereby propose a different one for quantifying gains from cooperation. We conclude that gains from fiscal coordination are significative, but gains that result from policy changes as a reaction to shocks are, by nature, very small. We also show that, symmetric shocks lead to coordination gains of the same magnitude than asymmetric ones.Coordination, Fiscal Policy, Gains, Nash.

Coordination and Stabilization Gains of Fiscal Policy in a Monetary Union

The issue of fiscal coordination in a Monetary Union is recurrent as monetary policy can no longer be used as a national stabilization policy instrument. We measure the increase in welfare due to the coordination of fiscal policies in the typical Neo-Keynesian environment, where monetary policy would have significantive and persistent real effects. We propose a decomposition of coordination gains into a deterministic and a stochastic parcel. We show that the deterministic fiscal coordination gain is high but that the stochastic gain, often called stabilization gain, is very small generating, for our calibration, an increase of 0.0161 percentage points, measured in consumption equivalents.Coordination, Fiscal Policy, Gains, Nash.

Nowcasting an Economic Aggregate with Disaggregate Dynamic Factors: An Application to Portuguese GDP

This paper consists of an empirical study comparing a dynamic factor model approach to estimate the current quarter aggregate GDP with the alternative approach of aggregating the forecasts obtained from specific dynamic factor models for each major expenditure disaggregate. The out-of-sample forecasting performance results suggest that there is no advantage in aggregating the disaggregate forecasts.Forecasting; Dynamic Factor Model; Temporal Disaggregation

Industry similarities, comparative advantage and structural transformation : the case of Portugal, 2005

This paper provides an empirical assessment of the “sophistication” of the Portuguese pattern of trade in 2005 and its possible implications for the process of structural transformation. Using trade data at the product (NC4) level for 96 countries in 2005, we first compute a measure of sophistication for each product (PRODY), as a weighted average of the per capita incomes of countries that export it. Following Hausmann and Klinger (2006), we then use the structure of international trade in 2005 to assess the similarity between each pair of products, in terms of the capabilities they use. The method consists in estimating the extent to which a country having comparative advantage in one product increments the probability of the same country having comparative advantage in another product. Contrary to Hausmann and Klinger, our measure of “proximity” is subject to a statistical scrutiny. Implementing a probit model with robustness checks, we show that a large number of branches between products are not significant. For each product, we then explore some measures assessing how distant it is from products with higher income content. We then investigate the extent to which upscale products in which a country didn’t develop RCA are surrounded by products in which the country already has developed RCA. These measures are then aggregated at the country level to assess the opportunities of each country in the process of structural transformation

Struggling for Brazil: Dutch, Portuguese and Spaniards in the 1640 Naval Battle of Paraíba

Over the years the 1640 naval battle of Paraíba (Brazil) has attracted the attention of several historians, including F.A. Varnhagen, H. Wätjen and J.C. Warnsinck, who made extensive use of Dutch sources. By combining the Dutch and Portuguese accounts, C.R. Boxer and, more recently, M.J. Guedes shed new light on the episode. The Portuguese material comprises the original papers of Fernando Mascarenhas, the commander in-chief of the armada. These papers are gathered in four voluminous codices and record events concerning the armada between April 1638 and October 1640. Written in Portuguese and Spanish, they comprise various documents, including correspondence, as well as instructions, reports, and minutes of meetings of the Council of Captains. The documents in these codices constitute the bedrock of this article which focuses on the armada leaders’ perceptions of their opponent during their sojourn in Brazil, a topic still insufficiently explored in the literature. Given the goal of the expedition, gathering information on the Dutch military and naval power was crucial for defining a strategy to oust them from Pernambuco. How did the armada leaders acquire intelligence? How reliable was it when cross-checked against other sources and to what extent did the outcome of the battle depend on it

A educação na pessoa com diabetes tipo 2 para a adesão às atividades de autocuidado

A diabetes mellitus (DM) constitui um grave problema de saúde pública a nível mundial, não só pelo aumento da sua incidência, como também pela sua elevada morbilidade e mortalidade. No entanto, uma grande percentagem da mortalidade associada à diabetes pode ser prevenida através da normalização dos níveis de glicemia. A educação na diabetes é o pilar fundamental no tratamento desta patologia, pois os doentes diabéticos, com a ajuda dos profissionais de saúde, devem executar um complexo plano de ações de forma a desenvolver habilidades de autocuidado. O objetivo principal deste trabalho foi explicar a importância da educação na pessoa com diabetes tipo 2 para a sua adesão às atividades de autocuidado. Para tal foi realizado um estudo transversal de natureza exploratório-descritivo, com uma metodologia de caráter quantitativo. Para a recolha de dados foram utilizados dois questionários: um questionário para caraterização sociodemográfica, formação na diabetes e antecedentes pessoais; e outro questionário para a avaliação das atividades de autocuidado com a diabetes, tendo sido traduzido e adaptado para português por Bastos Severo & Lopes (2007). A amostra foi constituída por 100 indivíduos com diabetes tipo 2, pertencentes às freguesias de Atalaia do Campo, Castelo Novo, Póvoa de Atalaia e Soalheira. Os resultados obtidos com a realização deste trabalho demonstram que a formação na diabetes é importante para a adesão às atividades de autocuidado no diabético tipo 2, pois, no estudo efetuado, 51,8% da média de adesão às atividades de autocuidado na DM tipo 2 foi explicada pela formação que o inquirido referia apresentar em relação à diabetes.Diabetes mellitus (DM) is a serious public health problem worldwide, not only for its rising caseness, but also for its high morbidity and mortality. However, a large percentage of the mortality associated with diabetes can be prevented through the normalization of blood glucose levels. The education in diabetes is the cornerstone in the treatment of this disease, because patients with diabetes, with the help of health professionals, must perform a complex action plan in order to develop self-care skills. The main objective of this work was to explain the importance of education in people with type 2 diabetes for their adherence to self-care activities. To do so, we used a cross-sectional study of exploratory-descriptive nature with a quantitative character methodology. To collect data we used two questionnaires: a questionnaire for socio-demographic characterization, training in diabetes and personal history, and another questionnaire for the assessment of self-care activities with diabetes, which was translated and adapted to Portuguese by Bastos, Severo & Lopes (2007). The sample comprised 100 individuals with type 2 diabetes, who came from Atalaia do Campo, Castelo Novo, Póvoa de Atalaia and Soalheira. The results obtained in this work show that the training in diabetes is important for the adherence to the self-care in type 2 diabetes, because in the study, 51.8% of the average adherence to the self-care in type 2 DM was explained by the training that the respondent claimed to have on diabetes

Avaliação do desenvolvimento infantil em contexto de cuidados de saúde primários - intervenção do enfermeiro

Mestrado, Enfermagem Saúde Infantil e Pediatria, 2013, Escola Superior de Enfermagem de LisboaCom o presente relatório pretende-se revelar e analisar o trabalho realizado durante o estágio no âmbito da frequência do Curso de Mestrado na área de Especialização em Enfermagem de Saúde Infantil e Pediatria. O tema que serviu de fio condutor ao seu planeamento e concretização, foi a intervenção do enfermeiro na avaliação do desenvolvimento infantil. Essa avaliação, é uma das actividades que integram um conjunto de cuidados promotores do desenvolvimento infantil e da saúde, no âmbito das consultas de vigilância de saúde infantil ao nível dos cuidados de saúde primários. A sua importância justifica-se, por proporcionar uma base objectiva de informação sobre a criança, que serve de orientação na identificação dos cuidados adequados à estimulação do máximo potencial do desenvolvimento da criança. Por outro lado, é a forma mais eficaz de detectar precocemente alterações no desenvolvimento e assim poder intervir o mais precocemente possível, quer nas funções afectadas quer nos factores de risco, aumentando as probabilidades de sucesso dessas mesmas intervenções. A avaliação do desenvolvimento deve ser realizada tanto pelos enfermeiros generalistas como pelos enfermeiros especialistas, cabendo aos últimos, a responsabilidade de assumir a liderança desses cuidados e assegurarem a sua qualidade. Foram identificadas, em contexto profissional, lacunas ao nível dessa mesma avaliação, sobretudo por necessidade de clarificação do papel do enfermeiro e por alguma insuficiência de conhecimentos consistentes neste âmbito. Assim, o delinear de um programa para a promoção do desenvolvimento infantil pela equipa de enfermagem, constituía-se como uma prioridade. No percurso em análise, desenvolveram-se as competências consideradas determinantes para a intervenção do Enfermeiro Especialista de SIP, num programa de assessoria que visa a boa prática no âmbito dos cuidados promotores do desenvolvimento infantil, com especial atenção na implementação de práticas de avaliação do desenvolvimento com recurso a um teste validado. As competências que se desenvolveram dizem sobretudo respeito à promoção e avaliação do desenvolvimento infantil, à comunicação com a criança e à gestão dos cuidados. É feita a discussão sobre o percurso realizado para o seu desenvolvimento e de que forma estas contribuíram efectivamente para a implementação do programa delineado

Prática autoreportada da fisioterapia em utentes com dor lombar

Relatório do Projeto de Investigação apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Fisioterapia, área de especialização em Fisioterapia em Condições Músculo-‐ EsqueléticasEnquadramento: A dor lombar aguda/subaguda tem uma prevalência ao longo da vida de 60 a 80% e é a primeira causa de incapacidade a nível mundial. Em 85% a 90% dos casos, a dor lombar é de origem não específica, e os utentes procuram a fisioterapia para aliviar a sua dor, melhorar a sua capacidade funcional e retornar ao trabalho. Esta condição apresenta um tempo de recuperação médio de 2 semanas, podendo chegar, no máximo, a 6 semanas. Apesar do prognóstico favorável, a literatura mostra que são mantidos valores mínimos a moderados de dor e incapacidade após 1 ano, atribuível à prática não estar a ser concordante com as recomendações. A investigação realizada noutros países confirma a presença de uma lacuna entre a evidência e a prática, mas ainda não se sabe como se caracteriza a prática da fisioterapia em Portugal. Objetivo: Este estudo tem como objetivo caracterizar a prática (autoreportada) dos fisioterapeutas em utentes com dor lombar aguda/subaguda em Portugal e identificar as barreiras e elementos facilitadores para a implementação de uma prática informada pela evidência. Metodologia: Realizou-se um estudo transversal com 123 fisioterapeutas que trabalham em Portugal. O instrumento utilizado foi um questionário online e os participantes foram contactados via email. Resultados: A maioria das red flags não é avaliada de forma consistente. As modalidades mais utilizadas são o exercício (95,1%), a terapia manual (92,7%) e a educação (88,6%), mas a eletroterapia é utilizada por 35,8%. A educação sobre a causa não específica da dor é feita por 67,5%, mas as explicações baseadas em alterações posturais (63,4%) e em alterações biomecânicas (65,0%) também são usadas consistentemente. Maioritariamente, os participantes não fornecem informação específica sobre o prognóstico da condição. Conclusões: Apesar da amostra reduzida, verificou-se que a prática da fisioterapia não é feita de acordo com as recomendações.Background: Acute/subacute low back pain has a lifetime prevalence of 60 to 80% and is the leading cause of disability worldwide. In 85% to 90% of cases, low back pain has non-specific origin, and the patients seek physiotherapy to relieve their pain, improve their functional capacity, and return to work. This condition has an average recovery time of 2 weeks, and can reach a maximum of 6 weeks. Despite the favorable prognosis, the literature shows that minimum to moderate values of pain and disability are maintained after 1 year, due to the fact that practice is not being in line with the recommendations. Research carried out in other countries confirms the existence of a gap between evidence and practice, but it is not yet known how the practice of physiotherapy in Portugal is characterized. Objective: This study aims to characterize the (self-reported) practice of physiotherapists in patients with acute/subacute low back pain in Portugal and to identify the barriers as well as facilitating elements for the implementation of a practice informed by the evidence. Methodology: A cross-sectional study was carried out with 123 physiotherapists working in Portugal. The instrument used was an online questionnaire and the participants were contacted via email. Results: Most red flags are not evaluated consistently. The most used modalities are exercise (95.1%), manual therapy (92.7%) and education (88.6%), but electrotherapy is used by 35.8%. Education of the non-specific cause of pain is done by 67.5%, but explanations based on postural changes (63.4%) and on biomechanical changes (65.0%) are also used consistently. Mostly, participants do not provide specific information on the prognosis of the condition. Conclusions: Despite the reduced sample of this study, it was verified that the practice of physiotherapy is not being done according to the recommendations

Productive experience and specialization opportunities for Portugal : an empirical assessment

Following Hidalgo et al. (Sci Mag 317: 482–487, 2007), we use the structure of international trade to estimate a measure of “revealed relatedness” for each pair of internationally traded products, which intends to capture similarities in terms of the endowments or capabilities they use in production. Our method departs from the original one, in that we run statistical tests of equality in probabilities, instead of computing conditional probabilities. We estimate a matrix of “Revealed Relatedness Indexes” using 2005 data and we then investigate which “upscale” products in which Portugal didn’t develop comparative advantage are more related to products in which the country is currently specialized. The analysis suggests that more than 60 % of Portugal’s “upscale opportunities” lie in non-traditional sectors, such as “machinery” and “chemicals”.info:eu-repo/semantics/publishedVersio

Lifestyles, arterial aging, and its relationship with the intestinal and oral microbiota (MIVAS III study): a research protocol for a cross-sectional multicenter study

The microbiota is increasingly recognized as a significant factor in the pathophysiology of many diseases, including cardiometabolic diseases, with lifestyles probably exerting the greatest influence on the composition of the human microbiome. The main objectives of the study are to analyze the association of lifestyles (diet, physical activity, tobacco, and alcohol) with the gut and oral microbiota, arterial aging, and cognitive function in subjects without cardiovascular disease in the Iberian Peninsula. In addition, the study will examine the mediating role of the microbiome in mediating the association between lifestyles and arterial aging as well as cognitive function.Methods and analysisMIVAS III is a multicenter cross-sectional study that will take place in the Iberian Peninsula. One thousand subjects aged between 45 and 74 years without cardiovascular disease will be selected. The main variables are demographic information, anthropometric measurements, and habits (tobacco and alcohol). Dietary patterns will be assessed using a frequency consumption questionnaire (FFQ) and the Mediterranean diet adherence questionnaire. Physical activity levels will be evaluated using the International Physical Activity Questionnaire (IPAQ), Marshall Questionnaire, and an Accelerometer (Actigraph). Body composition will be measured using the Inbody 230 impedance meter. Arterial aging will be assessed through various means, including measuring medium intimate carotid thickness using the Sonosite Micromax, conducting analysis with pulse wave velocity (PWA), and measuring pulse wave velocity (cf-PWV) using the Sphygmocor System. Additional cardiovascular indicators such as Cardio Ankle Vascular Index (CAVI), ba-PWV, and ankle-brachial index (Vasera VS-2000®) will also be examined. The study will analyze the intestinal microbiota using the OMNIgene GUT kit (OMR−200) and profile the microbiome through massive sequencing of the 16S rRNA gene. Linear discriminant analysis (LDA), effect size (LEfSe), and compositional analysis, such as ANCOM-BC, will be used to identify differentially abundant taxa between groups. After rarefying the samples, further analyses will be conducted using MicrobiomeAnalyst and R v.4.2.1 software. These analyses will include various aspects, such as assessing α and β diversity, conducting abundance profiling, and performing clustering analysis.DiscussionLifestyle acts as a modifier of microbiota composition. However, there are no conclusive results demonstrating the mediating effect of the microbiota in the relationship between lifestyles and cardiovascular diseases. Understanding this relationship may facilitate the implementation of strategies for improving population health by modifying the gut and oral microbiota