Abstract
Background: The study of length of stay (LOS) outliers is important for the management and financing of hospitals. Our aim was to study variables associated with high LOS outliers and their evolution over time. Methods: We used hospital administrative data from inpatient episodes in public acute care hospitals in the Portuguese National Health Service (NHS), with discharges between years 2000 and 2009, together with some hospital characteristics. The dependent variable, LOS outliers, was calculated for each diagnosis related group (DRG) using a trim point defined for each year by the geometric mean plus two standard deviations. Hospitals were classified on the basis of administrative, economic and teaching characteristics. We also studied the influence of comorbidities and readmissions. Logistic regression models, including a multivariable logistic regression, were used in the analysis. All the logistic regressions were fitted using generalized estimating equations (GEE). Results: In near nine million inpatient episodes analysed we found a proportion of 3.9% high LOS outliers, accounting for 19.2% of total inpatient days. The number of hospital patient discharges increased between years 2000 and 2005 and slightly decreased after that. The proportion of outliers ranged between the lowest value of 3.6% (in years 2001 and 2002) and the highest value of 4.3% in 2009. Teaching hospitals with over 1,000 beds have significantly more outliers than other hospitals, even after adjustment to readmissions and several patient characteristics. Conclusions: In the last years both average LOS and high LOS outliers are increasing in Portuguese NHS hospitals. As high LOS outliers represent an important proportion in the total inpatient days, this should be seen as an important alert for the management of hospitals and for national health policies. As expected, age, type of admission, and hospital type were significantly associated with high LOS outliers. The proportion of high outliers does not seem to be related to their financial coverage; they should be studied in order to highlight areas for further investigation. The increasing complexity of both hospitals and patients may be the single most important determinant of high LOS outliers and must therefore be taken into account by health managers when considering hospital costs.

Abstract

Abstract
A spatial optical filter based on splice misalignment between optical fibers with different cladding dimensions is proposed for gas refractometry. The sensing head is formed by a 2 mm-long optical fiber with 50 mu m diameter spliced with a strong misalignment between two single mode fibers (SMF28) and interrogated in transmission. This fiber structure causes a Fabry-Perot-behavior along the reduced-size fiber giving at its output end a well defined spatial filtering selectivity. Depending on the misalignment position of the lead-out SMF28, it is possible to obtain two different spectral responses, namely, bandpass or band-rejection filters. It is shown that this filter device is highly sensitive to refractive index changes on a nitrogen (N-2) environment by means of the gas pressure variation. A maximum sensitivity of -1390 nm/RIU for the bandpass filter was achieved.

Abstract
Spatial data infrastructures (SDI) are extremely important in order to combine the technical and organizational elements required to promote the use of territory-based information in an interoperable way. In fact, geographic information has unique intrinsic features, which makes it a natural indexing mechanism for spatial data. Due to its high cost and upgrade dynamics, this information should be available for reuse and should be managed and maintained by those responsible for producing it as part of management interventions in the territory. Therefore, it is important that different spatial data infrastructures, developed at different hierarchical levels, coexist and communicate in an interoperable way so that they can constitute a spatial basis of reference that facilitates the integration with other sectorial applications. This ongoing work proposes the implementation of a regional spatial data infrastructure based on free software, in compliance with the principles of the EU INSPIRE Directive and with the OGC standards.

Abstract
A fiber-optic sensor for simultaneous measurement of refractive index and temperature is described. The refractive index measurement is based on the visibility variations of a Fabry-Perot interferometer. It is formed with the interfering waves generated from a low reflectivity Bragg grating inscribed on a Panda fiber and from the fiber end tip (Fresnel reflection) in contact with the liquid. The sensor is characterized by immersing the fiber tip in distilled water with different concentrations of ethylene glycol. A linear relation of the interferometer fringe visibility with refractive index variation is observed. The temperature is determined by the wavelength shift of the FBG peaks. Results show the feasibility of simultaneous measurement of refractive index and temperature and also the possibility of adjusting fringe visibility via polarization control.

Abstract
The new generation of e-learning, commonly nominated e-learning 2.0 or social e-learning, aims at eliminating physical, social and cultural barriers, allowing knowledge everywhere, whether being in the workplace or being at home. This allows a growth in the motivation and likeness for learning, shortening the distances between people by the creation of learning communities that share the same tastes and interests. This article proposes a model for e-Learning 2.0 that can be implemented on a social network, and discuss its advantages by supporting the education and training throughout life and in designing new models for distance learning.