11 resultados para Clinical Assessment Tools

em Universidade do Minho


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Nowadays, the sustainability of buildings has an extreme importance. This concept goes towards the European aims of the Program Horizon 2020, which concerns about the reduction of the environmental impacts through such aspects as the energy efficiency and renewable technologies, among others. Sustainability is an extremely broad concept but, in this work, it is intended to include the concept of sustainability in buildings. Within the concept that aims the integration of environmental, social and economic levels towards the preservation of the planet and the integrity of the users, there are, currently, several types of tools of environmental certification that are applicable to the construction industry (LEED, BREEAM, DGNB, SBTool, among others). Within this context, it is highlighted the tool SBTool (Sustainable Building Tool) that is employed in several countries and can be subject to review in institutions of basic education, which are the base for the formation of the critical masses and for the development of a country. The main aim of this research is to select indicators that can be used in a methodology for sustainability assessment (SBTool) of school buildings in Portugal and in Brazil. In order to achieve it, it will also be analyzed other methodologies that already incorporate parameters directly related with the schools environment, such as BREEAM or LEED.

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AIM To evaluate mucosal healing in patients with small bowel plus colonic Crohn's disease (CD) with a single non-invasive examination, by using PillCam COLON 2 (PCC2). METHODS Patients with non-stricturing nonpenetrating small bowel plus colonic CD in sustained corticosteroid-free remission were included. At diagnosis, patients had undergone ileocolonoscopy to identify active CD lesions, such as ulcers and erosions, and small bowel capsule endoscopy to assess the Lewis Score (LS). After = 1 year of follow-up, patients underwent entire gastrointestinal tract evaluation with PCC2. The primary endpoint was assessment of CD mucosal healing, defined as no active colonic CD lesions and LS < 135. RESULTS Twelve patients were included (7 male; mean age: 32 years), and mean follow-up was 38 mo. The majority of patients (83.3%) received immunosuppressive therapy. Three patients (25%) achieved mucosal healing in both the small bowel and the colon, while disease activity was limited to either the small bowel or the colon in 5 patients (42%). It was possible to observe the entire gastrointestinal tract in 10 of the 12 patients (83%) who underwent PCC2. CONCLUSION Only three patients in sustained corticosteroid-free clinical remission achieved mucosal healing in both the small bowel and the colon, highlighting the limitations of clinical assessment when stratifying disease activity, and the need for pan-enteric endoscopy to guide therapeutic modification.

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The healthcare project design requires a several number of concerns with the satisfaction and well‐being of the working team, patient and administrators, has a strong social responsibility and impact on the city. Due to various design requirements, these buildings are not designed and used in a sustainable way, because there are still no effective methods to support designers in this context. Consequently, they do not know what the best criteria to be followed and their managers are not aware of the measuresthatshould be adopted for efficient use. Furthermore, the aim of this study is to present a proposal for a Healthcare Building Sustainability Assessment (HBSA) method adapted for the Portuguese context and considering the work developed so far in the standardization bodies (CEN and ISO). For this, the chosen methodology is analysed and compared the most relevant building sustainability assessment tools in the context of healthcare buildings.  

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Nowadays the main honey producing countries require accurate labeling of honey before commercialization, including floral classification. Traditionally, this classification is made by melissopalynology analysis, an accurate but time-consuming task requiring laborious sample pre-treatment and high-skilled technicians. In this work the potential use of a potentiometric electronic tongue for pollinic assessment is evaluated, using monofloral and polyfloral honeys. The results showed that after splitting honeys according to color (white, amber and dark), the novel methodology enabled quantifying the relative percentage of the main pollens (Castanea sp., Echium sp., Erica sp., Eucaliptus sp., Lavandula sp., Prunus sp., Rubus sp. and Trifolium sp.). Multiple linear regression models were established for each type of pollen, based on the best sensors sub-sets selected using the simulated annealing algorithm. To minimize the overfitting risk, a repeated K-fold cross-validation procedure was implemented, ensuring that at least 10-20% of the honeys were used for internal validation. With this approach, a minimum average determination coefficient of 0.91 ± 0.15 was obtained. Also, the proposed technique enabled the correct classification of 92% and 100% of monofloral and polyfloral honeys, respectively. The quite satisfactory performance of the novel procedure for quantifying the relative pollen frequency may envisage its applicability for honey labeling and geographical origin identification. Nevertheless, this approach is not a full alternative to the traditional melissopalynologic analysis; it may be seen as a practical complementary tool for preliminary honey floral classification, leaving only problematic cases for pollinic evaluation.

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Although most of the accidents occurred in Olive Oil Mill (OOM) resulted from “basic” risks, there is a need to apply adequate tools to support risk decisions that can meet the specificities of this sector. This study aims to analyse the views of Occupational, Safety & Health (OSH) practitioners about the risk assessment process in OOM, identifying the key difficulties inherent to the risk assessment process in these sector, as well as identifying some improvements to the current practice. This analysis was based on a questionnaire that was developed and applied to 13 OSH practitioners working at OOM. The results showed that the time available to perform the risk assessment is the more frequent limitation. They believe that the methodologies available are not an important limitation to this process. However, a specific risk assessment methodology, that includes acceptance criteria adjusted to the OOM reality, using risk metrics supported on the frequency of accidents and workdays lost, were indicated as being also an important contributions improve the process. A semi-quantitative approach, complemented with the use of the sector accident statistics, can be a good solution for this sector. However, further strategies should also be adopted, mainly those that can lead to an easy application of the risk assessment process.

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Maturity models are adopted to minimise our complexity perception over a truly complex phenomenon. In this sense, maturity models are tools that enable the assessment of the most relevant variables that impact on the outputs of a specific system. Ideally a maturity model should provide information concerning the qualitative and quantitative relationships between variables and how they affect the latent variable, that is, the maturity level. Management systems (MSs) are implemented worldwide and by an increasing number of companies. Integrated management systems (IMSs) consider the implementation of one or several MSs usually coexisting with the quality management subsystem (QMS). It is intended in this chapter to report a model based on two components that enables the assessment of the IMS maturity, considering the key process agents (KPAs) identified through a systematic literature review and the results collected from two surveys.

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Kidney renal failure means that one’s kidney have unexpectedlystoppedfunctioning,i.e.,oncechronicdiseaseis exposed, the presence or degree of kidney dysfunction and its progression must be assessed, and the underlying syndrome has to be diagnosed. Although the patient’s history and physical examination may denote good practice, some key information has to be obtained from valuation of the glomerular filtration rate, and the analysis of serum biomarkers. Indeed, chronic kidney sickness depicts anomalous kidney function and/or its makeup, i.e., there is evidence that treatment may avoid or delay its progression, either by reducing and prevent the development of some associated complications, namely hypertension, obesity, diabetes mellitus, and cardiovascular complications. Acute kidney injury appears abruptly, with a rapiddeteriorationoftherenalfunction,butisoftenreversible if it is recognized early and treated promptly. In both situations, i.e., acute kidney injury and chronic kidney disease, an early intervention can significantly improve the prognosis. The assessment of these pathologies is therefore mandatory, although it is hard to do it with traditional methodologies and existing tools for problem solving. Hence, in this work, we will focus on the development of a hybrid decision support system, in terms of its knowledge representation and reasoning procedures based on Logic Programming, that will allow onetoconsiderincomplete,unknown,and evencontradictory information, complemented with an approach to computing centered on Artificial Neural Networks, in order to weigh the Degree-of-Confidence that one has on such a happening. The present study involved 558 patients with an age average of 51.7 years and the chronic kidney disease was observed in 175 cases. The dataset comprise twenty four variables, grouped into five main categories. The proposed model showed a good performance in the diagnosis of chronic kidney disease, since the sensitivity and the specificity exhibited values range between 93.1 and 94.9 and 91.9–94.2 %, respectively.

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The nitrogen dioxide is a primary pollutant, regarded for the estimation of the air quality index, whose excessive presence may cause significant environmental and health problems. In the current work, we suggest characterizing the evolution of NO2 levels, by using geostatisti- cal approaches that deal with both the space and time coordinates. To develop our proposal, a first exploratory analysis was carried out on daily values of the target variable, daily measured in Portugal from 2004 to 2012, which led to identify three influential covariates (type of site, environment and month of measurement). In a second step, appropriate geostatistical tools were applied to model the trend and the space-time variability, thus enabling us to use the kriging techniques for prediction, without requiring data from a dense monitoring network. This method- ology has valuable applications, as it can provide accurate assessment of the nitrogen dioxide concentrations at sites where either data have been lost or there is no monitoring station nearby.

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Assessment of prognosis of patients with stage II colon cancer.

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The Symbol Digit Modalities Test (SDMT) is a widely used instrument to assess information processing speed, attention, visual scanning, and tracking. Considering that repeated evaluations are a common need in neuropsychological assessment routines, we explored test–retest reliability and practice effects of two alternate SDMT forms with a short inter-assessment interval. A total of 123 university students completed the written SDMT version in two different time points separated by a 150-min interval. Half of the participants accomplished the same form in both occasions, while the other half filled different forms. Overall, reasonable test–retest reliabilities were found (r = .70), and the subjects that completed the same form revealed significant practice effects (p < .001, dz = 1.61), which were almost non-existent in those filling different forms. These forms were found to be moderately reliable and to elicit a similar performance across participants, suggesting their utility in repeated cognitive assessments when brief inter-assessment intervals are required.

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Tese de Doutoramento em Psicologia Aplicada.