Universidade Lusíada de Lisboa

Ricardo A., Figueira J.R., Tavares L.V.

The Pairwise Comparison Table for the Deck of Cards Method enables the elicitation of preference parameters through an interactive process between an analyst and a Decision-Maker (DM). As in other preferences elicitation processes in Multiple Criteria Decision Aiding (MCDA) problems, this methodology can result in several inconsistent judgments. One way to address this concern is to use Linear Programming (LP) techniques to find solutions that minimize the number of initial inconsistent judgments that must be modified to restore consistency. However, since this approach does not allow further differentiating solutions, it can be inefficient in decision problems with multiple inconsistent information and several distinct solutions to overcome such inconsistencies. To enhance the decision-making process and to suggest solutions based on enriched information, we propose a new procedure for addressing inconsistent judgments based on two additional criteria to complement the minimum cardinality criterion. While the first additional criterion concerns the confidence level of the DM in their initial judgments, the second seeks to minimize the modifications made to the initial judgments to distort them as little as possible. Solving the three criteria in a specific LP-based lexicographic order defined by the DM makes it possible to determine a comprehensive ranking of eligible solutions to restore consistency. Proposing these solutions to the DM according to their position in the ranking enables revising the initial inconsistent judgments more efficiently. The new methodology also considers the possibility of missing confidence information, which can decrease the cognitive effort of the DM in real-world decision problems when eliciting preferences.

Abreu A., Dores H., Gonçalves L., Franco F., Silveira C., Proença G., Teresa Timóteo A., Cardim N., Pedro M., Fiuza M., Ferreira D., Bento L., Patrício L., Caldeira D., Bravo Baptista S., et. al.

Atherosclerotic cardiovascular disease (ASCVD) remains the major cause of premature death and disability; effective cardiovascular (CV) risk prevention is fundamental. The World Heart Federation (WHF) Cholesterol Roadmap provides a framework for national policy development and aims to achieve ASCVD prevention. At the invitation of the WHF, a group of experts from the Portuguese Society of Cardiology (SPC), addressed the cholesterol burden at nationally and discussed possible strategies to include in a Portuguese cholesterol roadmap. The literature review showed that the cholesterol burden in Portugal is high and especially uncontrolled in those with the highest CV risk. An infographic scorecard was built to include in the WHF collection, for a clear idea about CV risk and cholesterol burden in Portugal, which would also be useful for health policy advocacy. The expert discussion and preventive strategies proposal followed the five pillars of the WHF document: awareness improvement; population-based approaches for CV risk and cholesterol; risk assessment/population screening; system-level approaches; surveillance of cholesterol and ASCVD outcomes. These strategies were debated by all the expert participants, with the goal of creating a national cholesterol roadmap to be used for advocacy and as a guide for CV prevention. Several key recommendations were outlined: include all stakeholders in a multidisciplinary national program; create a structured activities plan to increase awareness in the population; improve the quality of continuous CV health education; increase the interaction between different health professionals and non-health professionals; increment the referral of patients to cardiac rehabilitation; screen cholesterol levels in the general population, especially high-risk groups; promote patient self-care, engage with patients' associations; use specific social networks to spread information widely; create a national database of cholesterol levels with systematic registry of CV events; redefine strategies based on the evaluation of results; create and involve more patients' associations – invert the pyramid order. In conclusion, ASCVD and the cholesterol burden remain a strong global issue in Portugal, requiring the involvement of multiple stakeholders in prevention. The Portuguese cholesterol roadmap can provide some solutions to help urgently mitigate the problem. Population-based approaches to improve awareness and CV risk assessment and surveillance of cholesterol and ASCVD outcomes are key factors in this change. A call to action is clearly needed to fight hypercholesterolemia and ASCVD burden. A doença aterosclerótica cardiovascular (DACV) mantém-se a maior causa de morte prematura e de incapacidade, sendo uma prevenção eficaz de risco cardiovascular (CV) fundamental. O WHF Cholesterol Roadmap fornece enquadramento para o desenvolvimento de políticas nacionais, tendo como objetivo a prevenção de DACV. A convite da WHF, um grupo de peritos da Sociedade Portuguesa de Cardiologia (SPC) avaliou a carga do colesterol a nível nacional e discutiu possíveis estratégias para um Roadmap português. A revisão da literatura mostrou uma carga elevada de colesterol em Portugal, sobretudo em pessoas de alto risco CV. Uma infografia, Scorecard, foi construída pela WHF, para mostrar claramente o risco CV e o peso do colesterol em Portugal, sendo útil para advocacia em políticas de saúde. A discussão de peritos e proposta das estratégias preventivas seguiram os cinco pilares do documento da WHF: Melhoria da consciencialização; Abordagens do risco CV e do colesterol nas populações; Avaliação de risco/screening das populações; abordagens a nível do sistema; Seguimento do colesterol e complicações da DACV. Várias recomendações chave foram definidas: incluir todos os stakeholders em programa multidisciplinar nacional; criar plano de atividades estruturadas para aumentar a consciencialização da população; aumentar qualidade da educação contínua em saúde CV; aumentar interação entre profissionais de saúde e outros profissionais; aumentar referenciação de doentes para reabilitação cardiovascular; avaliar níveis de colesterol na população geral, especialmente em alto risco; promover autocuidado dos doentes, envolvendo associações de doentes; usar redes sociais específicas para disseminar informação; criar base nacional de níveis de colesterol com registo sistemático de eventos CV; redefinir estratégias baseadas na avaliação de resultados; criar e envolver mais doentes em associações – inverter a ordem da pirâmide! Em conclusão, a DACV e o peso de colesterol permanecem uma questão global forte em Portugal, necessitando o envolvimento de múltiplos stakeholders na prevenção. O Roadmap de colesterol português pode fornecer algumas soluções para urgentemente mitigar o problema. Abordagens a nível das populações para melhorar a consciencialização e avaliar o risco CV, seguimento do colesterol e das complicações de DACV são fatores chave nesta mudança. Uma call to action é claramente necessária para combater a carga da hipercolesterolemia e DACV.

Gaspar T., Salado V., Faia-Correia M.

Abstract   The hospital health care professionals are the frontline fighting COVID-19 considering they are responsible for all the care provided to patients during all the time they spend at the hospital for diagnosis, treatment or recovering of the COVID-19 disease and other diseases. The purpose of this study was to determine the impact of COViD-19 at the hospital management level and, also, to understand how psychosocial environment, and satisfaction of Health Professionals were affected. A case study was performed in a Portuguese Hospital. Data were collected at one hospital under study at two different occasions: the first before the pandemic (November 2019) and the second almost two years after the pandemic started (November 2021). Regarding data collection, 37.0% of participants responded in the occasion 1 (n = 296) and 63.0% responded in the occasion 2 (n = 503). The instrument for the Assessment of Global Management of Health Organizations (AGMHO) Comparing timings pre and during pandemic COVID-19, it was found that the participants in the pre- COVID-19 era showed stronger organizational culture, higher quality of life, better psychosocial environment regarding content/leadership and higher job satisfaction when compared to the participants during pandemic COVID-19. On the other hand, participants in the second occasion were found to have higher psychosocial risks related to mental health when compared to participants in the pre- COVID-19 phase. The results obtained allow us to identify priorities in terms of promoting well-being and satisfaction of professionals and overall wellbeing of the health organization, namely intervention in leadership relationships and psychosocial risks at work related to the physical and psychological demands of work, stress management and a more active and involved role for the professional. Key messages • This knowledge facilitates labelling and prioritizing the promotion of well-being and satisfaction of professionals and overall wellbeing of the health organization. • The product is a comprehensive diagnostic model of the factors influencing the results in health organizations.

Fernandez M., Baptista N., Antão M.

The topic of sustainable management of gastronomic events is gaining increasing traction in the creation of sustainable practices that contribute to turning cities into more inclusive. Despite the great interest of academia, the literature is relatively dispersed, without unifying paradigms. There is also the need to define sustainable actions and policies that respond to the needs and expectations of the parties involved. To respond to the aforementioned research gap, this study aims to determine the factors associated with the sustainable management of gastronomic events through a scoping review of existing literature. In order to manage gastronomic events in a sustainable way, it is necessary to implement policies by developing practices that reduce the environmental impact of the events, encourage environmental education for those attending the events, promote the authenticity of local products and the sustainable management of the gastronomic events, contributing to visitor satisfaction and the well-being of local communities.

Choudhary W., Waqar Haider S., Raza A., Silva S.C., Carmo Dias J.

Gaspar T., Barata M., de Sousa S.B., Raimundo M., Cabrita T.

Background: Aging is a process inherent to the human condition that is characterized by various biological, psychological, and social changes that can lead to certain mental health problems. Objective: This study aimed to understand and characterize how biological, psychological, and social factors influence mental health symptoms and neuropsychological function in the aging process. Methods: A sample consisting of 616 participants (73.8% female) aged between 50 and 90 years, (mean [SD]: 69.6 [17.2] years). Data collection involved a neuropsychological assessment carried out by a psychologist in a clinical interview session and the self-completion of a questionnaire. Results: Regression models revealed that depressive symptoms are explained by anxiety, psychological and environmental quality of life, and sleep habits. Anxiety symptoms are explained by depression, physical quality of life, and sleep habits. Statistically significant differences were identified between participants with and without anxiety in neuropsychological terms at the level of agnosia and praxis. Statistically significant differences were identified between participants with and without depression in neuropsychological terms at the level of memory, language, agnosia and praxis, and executive function (eg, prefrontal tests). Conclusions: Depression and anxiety symptoms are associated and could negatively influence the aging process. Aging should be understood in an ecological way taking into account the action of biological, psychological, social, and environmental factors, as well as the relationship and influence between the different levels and factors. This knowledge is important for diagnosis, for clinical practice, and for the development and definition of public policies to promote healthy aging.

Castro S., Pereira V., Silva R.

Medical imaging is essential for pathology diagnosis and treatment, enhancing decision making and reducing costs, but despite various computational methodologies proposed to improve imaging modalities, further optimization is needed for broader acceptance. This study explores deep learning (DL) methodologies for classifying and segmenting pathological imaging data, optimizing models to accurately predict and generalize from training to new data. Different CNN and U-Net architectures are implemented for segmentation tasks, with their performance evaluated on histological image datasets using enhanced pre-processing techniques such as resizing, normalization, and data augmentation. These are trained, parameterized, and optimized using metrics such as accuracy, the DICE coefficient, and intersection over union (IoU). The experimental results show that the proposed method improves the efficiency of cell segmentation compared to networks, such as U-NET and W-UNET. The results show that the proposed pre-processing has improved the IoU from 0.9077 to 0.9675, about 7% better results; also, the values of the DICE coefficient obtained improved from 0.9215 to 0.9916, about 7% better results, surpassing the results reported in the literature.

Albuquerque F., Gomes dos Santos P.

Purpose: From an exploratory perspective, this paper aims to assess how well ChatGPT scores in an accounting proficiency exam in Portugal, as well as its overall understanding of the issues, purpose and context underlying the questions under assessment. Design/methodology/approach: A quasi-experimental method is used in this study. The questions from an exam by the Portuguese Order of Chartered Accountants (OCC, in the Portuguese acronym) served as input queries, while the responses (outputs) from ChatGPT were compared with those from the OCC. Findings: The findings indicate that ChatGPT’s responses were able to deduce the primary issue underlying the matters assessed, although some responses were inaccurate or imprecise. Also, the tool did not have the same score in all matters, being less accurate in those requiring more professional judgment. The findings also show that the ChatGPT did not pass the exam, although it was close to doing so. Originality: To the best of the authors’ knowledge, there is little research on ChatGPT accuracy in accounting proficiency exams, this being the first such study in Portugal. Practical implications: The findings from this research can be useful to accounting professionals to understand how ChatGPT may be used for practitioners, stressing that it could assist them and improve efficiency, but cannot, at least for now, replace the human professional. It also highlights the potential use of ChatGPT as an additional resource in the classroom, encouraging students to engage in critical thinking and facilitating open discussion with the guidance of teachers. Consequently, it can also prove beneficial for academic purposes, aiding in the learning process.

Gavina C., Carvalho D.S., Afonso-Silva M., Abreu D.B., Canelas-Pais M., Taveira-Gomes T., Araújo F.

AbstractBackground Cardiovascular (CV) risk scores identify individuals at higher long-term risk of CV events that may benefit from more aggressive preventive interventions. Objective To assess the association of CV-risk categories and criteria with long-term CV events. Methods Observational cohort study between 2000-2019 on patients aged 40-80 years, followed by 14 primary care centers assisted by 1 hospital in Portugal. Follow-up began when electronic health records data allowed for CV-risk classification and dynamic reassessment per 2019 ESC/EAS Guidelines. Inclusion criteria required at least one appointment with a primary care physician within three years before follow-up initiation. We assessed the 10-year adjusted hazard-ratio of combined CV death and non-fatal Atherosclerotic Cardiovascular Disease (ASCVD) hospitalization, across SCORE risk categories and criteria, using Cox proportional hazards models adjusted for sex, age, competing comorbidities, and medication. Results The study included 161 681 observations from 87 035 unique patients. During the observation period, 71 787 patients were classified as low/moderate, 51 476 as high and 38 418 as very-high CV-risk categories. In the very-high group, prevalent comorbidities were hypertension (69%), hypercholesterolemia (69%) and type 2 diabetes (61%), and 13% were hospitalized for ASCVD. The adjusted 10-year hazard ratio of the composite of CV death or ASCVD hospitalization was 2.10 (95% CI: 1.91-2.32) for high-risk and 3.56 (95% CI: 3.21-3.96) for very-high-risk patients (low-risk as reference). Conclusion Our study reinforces the prognostic relevance of CV-risk stratification for long-term prediction of CV death and ASCVD hospitalization in an unselected cohort, independently of sex, age, competing comorbidities and medication.

Caramelo Gomes C.

The progression of technology continues to shape our access to information, activities, and interactions within our physical and social environments. This radical transformation challenges traditional boundaries, as technology now extends beyond mechanical tasks to encompass intellectual pursuits previously exclusive to human cognition. Artificial intelligence, a pivotal technological innovation, has transitioned from merely supporting intellectual activities to actively engaging in creative endeavours, prompting various ethical and practical concerns. Central to creative work, colour serves as a compelling attribute, captivating attention, conveying information, reflecting social and cultural contexts, defining aesthetic values, and expressing emotional nuances. Among its manifold dimensions, the aesthetic aspect frequently takes precedence, raising fundamental questions about the ultimate purpose of communication. As artificial intelligence endeavours to partake in artistic creation through generative imagery, a critical inquiry emerges: how does this technology comprehend and employ colour to convey ideas? This article seeks to address this question. Does artificial intelligence possess a nuanced understanding of colour’s multifaceted dimensions, and does it leverage this comprehension in image generation? Alternatively, does it rely exclusively on pre-existing image datasets available on the internet? To unravel these queries, our investigation involved querying ChatGPT, a free version, which demonstrated that artificial intelligence can discern the various dimensions of colour. Additionally, utilizing the Stable Diffusion, free version, we generated images to visually elucidate the application of this knowledge. Our findings revealed that while the theoretical knowledge is discerning, the visual output disproportionately emphasizes aesthetic values, potentially overshadowing other dimensions of colour. This apparent discrepancy underscores the necessity for human intervention and collaboration to bridge this perceptible gap and fully leverage the symbiosis between technology and human creativity.

Ricardo A.V., Costa A.S., Figueira J.R.

The healthcare policy reforms implemented in Portugal in recent years significantly impacted the quality of health care provided to Portuguese citizens. Since public hospitals play a pivotal role as secondary care providers within the National Health Service (NHS), it is essential to assess their quality. However, a generalized assessment of this multidimensional concept is insufficient to differentiate hospitals across different quality dimensions, limiting the efficiency of benchmarking processes. The conjoint use of the Electre Tri-nC method with the Multiple Criteria Hierarchy Process (MCHP) allowed us to assess quality in Portuguese public hospitals by encompassing dimension-based analysis and a holistic perspective. Electre Tri-nC is a multiple criteria sorting method that categorizes each alternative (in this case, a public hospital in Portugal) into pre-defined and ordered categories representing quality levels. The hospitals are assessed based on four non-elementary criteria (Timeliness, Effectiveness, Safety and Efficiency) structured hierarchically in logical subsets of elementary criteria, allowing MCHP to evaluate each hospital based on specific criteria subsets or the comprehensive level. The sample size is 25 hospitals, and the analysis period includes the years from 2019 to 2022. The results evidence a general downward trend in quality, culminating in poor quality levels in most public hospitals in 2022, particularly in the Effectiveness dimension. A robustness analysis was conducted to examine the resilience and reliability of the model. By establishing a framework for assessing quality assessment across different critical dimensions, this work provides an enhanced hospital benchmarking process for healthcare policymakers. This process can serve as a reference for implementing new hospital reforms based on replicating the successful practices adopted by the healthcare facilities that demonstrate superior quality results in specific dimensions or even allocating resources more efficiently across the entire network by identifying dimensions in which hospitals are performing poorly.

Correia J.C., Dias M.C., Coelho D.M.

Since the beginning of the twenty-first century, small and medium-sized enterprises (SMEs) have been operating in the context of an economic crisis, with the added effect of the pandemic crisis, leading them to rethink how to act in the markets in which they operate. SMEs have assumed a relevant role in national economies, in terms of employment, production, and turnover, with the assimilation of new information and communication technologies (ICT) becoming increasingly important, with a view to adopting e-commerce. Given the fact that SMEs represent a considerable segment of the companies in Europe, European entities (European Commission and European Parliament) proceeded to redefine their concept and sought to enable them to enjoy the economic and social benefits provided by ICT, through the adoption of e-commerce, in order to ensure a more active and influential presence with their customers. When inquiring about this matter, we came across the fact that most of the existing studies, within the scope of the adoption of electronic commerce, refer to its application in the context of large companies, in nonagricultural activities, therefore the need to carry out scientific research on this issue, which allowed us to determine the factors that influence the adoption of electronic commerce on agricultural SMEs. In this study, the factors that stood out to the acceptance/adoption of electronic commerce by agricultural SMEs are as follows: perceived utility, risk perception/intent-adoption of e-commerce, perceived ease of use, and perception of social influence.

Correia J.C., Dias M.C., Coelho D.M.

The age of digital transformation is upon us, characterized by the demands of the markets in which companies operate, with a view of responding more efficiently and effectively to customer requests, where companies are encouraged to adopt new business models based on digital platforms. In the current context of uncertainty and risk, in which companies operate, it is important to question the contribution of digital platforms. This investigation stems from the need to validate the contribution of digital platforms in the process of adopting electronic commerce by small and medium-sized enterprises, considering that these platforms ended up being intrinsically linked to the business models of these companies. In this sense, the methodology employed included the realization of interviews, with the aim of validating the selection of constructs made from the existing e-commerce acceptance models in the literature. The present study focused on small and medium-sized enterprises in the agricultural sector in Portugal, with a view to the business sustainability of the primary sector in Portugal.

Luís C., James T.S., Garnett H.A.

Duarte P., e Silva S.C., Mangei I., Dias J.C.

This research assesses how adult consumers perceive and behave concerning ethical practices, aiming to comprehend the obstacles that hinder ethical and sustainable consumption. Employing a modified version of the Theory of Planned Behavior (TPB) alongside the Ethically Minded Consumer Behavior-Scale (EMCB), a survey was conducted with 372 participants from Germany, young and educated, to reveal and compare the factors influencing ethical consumption, including both determinants and barriers. The results indicate positive correlations between attitudes toward ethical consumption, ethical obligation, self-identity, and the intention to engage in ethical consumption, while this intention is negatively associated with price. Additionally, the study validates the explanatory power of the modified TPB within the EMCB context. Understanding the drivers and hindrances of ethical consumption is crucial for companies and decision-makers, allowing them to prioritize these factors and refine strategies for promoting ethical consumption. This insight aids marketers in tailoring campaigns to reach this specific market effectively. Given the growing significance of ethical and sustainable consumption, this research provides valuable insights into the motivations and constraints shaping consumer behavior in this domain, contributing to both theoretical understanding and managerial decision-making for those targeting this consumer segment.