Effects of an exercise training program in physical condition after liver transplantation in familial amyloidotic polyneuropathy: a case report

Introduction: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease that leads to sensory and motor polyneuropathies as well as functional limitations. So far, liver transplantation is the only treatment for FAP because the mutated protein causing the disease is mainly produced in the liver. With the increasing survival of transplant recipients, functional and cardiovascular problems as consequences of immunosuppressant side effects are increasing associated with sedentary lifestyles and/or retransplantation status. We sought to analyze the impact of exercise training programs on 1 FAP patient’s course long-term after liver transplantation. Methodology. A FAP patient (female; 49 years of age; body mass index 18.8 kg/m2) underwent a liver transplantation 133 months before assessment. She was assessed for body composition, isometric quadriceps muscle strength, functional capacity, fatigue, and levels of physical activity before and after a 6-month period of combined exercise training. Results: After the exercise training program, almost all variables were improved, namely, total body skeletal muscle mass, proximal femoral bone mineral density, quadriceps strength, maximal oxygen consumption on 6 minutes walk test (6mwt) or VO2peak, total ventilation on 6mwt, and fatigue. The improvement in distance on 6mwt (69.2 m) was clinically significant. Preintervention the levels of physical activity were below international recommendations for health; after the program they achieved the recommendations. Conclusion: The results showed an improvement in functional capacity with a decrease in future disability risk associated with a better lifestyle with respect to physical activity levels in 1 patient.

A practical approach for profit-based unit commitment with emission limitations

This paper proposes a practical approach for profit-based unit commitment (PBUC) with emission limitations. Under deregulation, unit commitment has evolved from a minimum-cost optimisation problem to a profit-based optimisation problem. However, as a consequence of growing environmental concern, the impact of fossil-fuelled power plants must be considered, giving rise to emission limitations. The simultaneous address of the profit with the emission is taken into account in our practical approach by a multiobjective optimisation (MO) problem. Hence, trade-off Curves between profit and emission are obtained for different energy price profiles, in a way to aid decision-makers concerning emission allowance trading. Moreover, a new parameter is presented, ratio of change, and the corresponding gradient angle, enabling the proper selection of a compromise commitment for the units. A case study based on the standard IEEE 30-bus system is presented to illustrate the proficiency Of Our practical approach for the new competitive and environmentally constrained electricity supply industry.

Practical insights into digital radiology

Digital radiography detectors—based on different technological solutions—are currently available for clinical applications and widespread in clinical practice. Computed radiography (CR) and digital radiology systems have been available for clinical applications and the trend over the last few years has become digital. Radiology departments have been changing from traditional screen–film technology to digital technology. This chapter is intended to give the reader a practical understanding about the key aspects concerning digital systems, related to the performance of different technologies, image quality, and dose and patient safety/protection. The discussion around an optimization framework for digital systems is provided.

O papel da supervisão na avaliação de desempenho docente

Com as várias reformulações do processo de avaliação de desempenho docente (ADD), passou-se de um processo de avaliação dos professores assente na autoavaliação do docente, para um sistema de heteroavaliação que visa a prestação de contas e a seleção, mas também a melhoria de práticas e o desenvolvimento profissional, através do acompanhamento supervisivo. No entanto, a conciliação entre estas duas perspetivas não é fácil e tem gerado perplexidades e inquietações entre os avaliadores e entre os avaliados. Com este estudo, pretendemos conhecer a perspetiva de avaliadores e avaliados sobre o papel que a Supervisão detém no processo de avaliação de desempenho do professor e o seu contributo para o desenvolvimento profissional do professor e melhoria das práticas. Assim desenhou-se um plano de estudo qualitativo, exploratório e descritivo procurando captar o ponto de vista dos principais intervenientes no processo. O principal meio de recolha de dados foi a entrevista semiestruturada a 4 professores avaliadores e 4 professores avaliados do Departamento de Matemática e Ciências Experimentais de um Agrupamento de Escolas. Os resultados mostram que os docentes discordam do modelo de ADD, mas que o processo vivenciado teve caraterísticas positivas, dando os avaliadores especial relevância à oportunidade de conhecer outros processos de trabalho, a partir da observação de aulas. Avaliadores e avaliados referem ainda o bom relacionamento estabelecido entre ambos, contradizendo as preocupações expressas quando se pronunciaram sobre os problemas do modelo de avaliação. No entanto, ambos os subgrupos focam a falta de formação e qualificação profissional dos avaliadores. Em termos gerais, é possível concluir que a maior parte das dificuldades atribuídas pelos docentes ao modelo de ADD não foi depois sentida na implementação prática. Por outro lado, na opinião dos docentes, o processo experienciado não teve verdadeiro impacto na melhoria das práticas ou no desenvolvimento profissional dos docentes envolvidos. - Abstract The several reformulations of the process of the teacher performance evaluation made the process of evaluating teachers, which was first based on a self-evaluation change into a straight assessment system, which aims not only accountability and selection, but also the improvement of the practice and professional development through the supervision of the teaching practice. However, the conciliation between these perspectives has not been easy and has generated anxieties and perplexities among evaluators and evaluated. With this study we intend to know the perspective of the evaluators and of the evaluated concerning the role supervision has hold in the process of evaluating a teacher’s performance and its contribution to the professional development of the teacher and to the improvement of his practices. Thus, a qualitative, exploratory and descriptive study plan was drawn to get to know the viewpoint of the intervening ones in the process. The main means for data collection was based on a semi structured interview, targeting 4 teacher evaluators and 4 evaluated teachers of the Experimental Sciences and Mathematics Department of a group of Schools. The results show that teachers disagree with the teacher’s evaluation model, but the experienced process had positive characteristics. Besides, evaluators have given special relevance to the opportunity of getting to know other working methods thanks to the lessons’ observations. Evaluators and evaluated also refer the good relationship between both parts contradicting the fears they had when they first pronounced themselves about this evaluation model. However, both subgroups focus the lack of training and professional qualifications of the evaluators. So it’s possible to conclude that most worries mentioned by the teachers when referring to this model of teacher performance evaluation were not verified during its practical implementation. On the other hand, in the opinion of the involved teachers, the experienced process had no real impact on their practice improvement or on their professional development.

Ética e responsabilidade social das organizações perante os Técnicos Oficiais de Contas

Mestrado em Contabilidade

The impact of exercise training on liver transplanted familial amyloidotic polyneuropathy (FAP) patients

Liver transplantation is nowadays the only effective answer to adjourn the outcome of functional limitations associated with familial amyloidotic polyneuropathy (FAP), a neurodegenerative disease characterized by sensory and motor polyneuropathies. Nevertheless, there is a detrimental impact associated with the after-surgery period on the fragile physical condition of these patients. Exercise training has been proven to be effective on reconditioning patients after transplantation. However, the effects of exercise training in liver transplanted FAP patients have not been scrutinized yet.

Radiographers and radiation protection: education, training and CPD

The increasing use of ionizing radiation for medical purposes emphasizes the concern about safety and justification of using ionizing radiation. This is linked with the use of new and high-dose X-ray technology (particularly CT). According to the UNSCEAR 2010 Report the total number of diagnostic medical examinations (both medical and dental) is estimated to have risen from 2.4 billion (period 1991–1996) to 3.6 billion (period 1997– 2008) - a marked increase in collective doses. An appropriate use of technology aiming diagnostic or therapy and respecting the ALARA principle is a mandatory requisite to safely perform any radiological procedure. Radiation protection is thus, a concern of all specialists in the radiology field ( radiologists, radiographers, medical physicists, among other professional groups). The importance of education and training of these professionals in reducing patients’ doses while maintaining the desired level of quality in medical exposures, as well as precise therapeutic treatments is well recognized. Education, training and continuing professional development (CPD) constitute a triad pointing towards the radiographers’ development of competences in the radiation protection field. This presentation excludes the radiographer role and competences in the fields of ultrasonography and MRI.

Avaliação do desempenho docente e supervisão pedagógica: implementação numa escola do ensino particular e cooperativo

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção do grau de Mestre em Educação - Especialização em Supervisão em Educação

Conceções e práticas de ciência de educadores de infância

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção do grau de Mestre em Ciências da Educação Especialidade em Didáctica das Ciências da Natureza

The influence of experience and training in a group of novice observers: a jackknife alternative free-response receiver operating characteristic analysis

Purpose - The study evaluates the pre- and post-training lesion localisation ability of a group of novice observers. Parallels are drawn with the performance of inexperienced radiographers taking part in preliminary clinical evaluation (PCE) and ‘red-dot’ systems, operating within radiography practice. Materials and methods - Thirty-four novice observers searched 92 images for simulated lesions. Pre-training and post-training evaluations were completed following the free-response the receiver operating characteristic (FROC) method. Training consisted of observer performance methodology, the characteristics of the simulated lesions and information on lesion frequency. Jackknife alternative FROC (JAFROC) and highest rating inferred ROC analyses were performed to evaluate performance difference on lesion-based and case-based decisions. The significance level of the test was set at 0.05 to control the probability of Type I error. Results - JAFROC analysis (F(3,33) = 26.34, p < 0.0001) and highest-rating inferred ROC analysis (F(3,33) = 10.65, p = 0.0026) revealed a statistically significant difference in lesion detection performance. The JAFROC figure-of-merit was 0.563 (95% CI 0.512,0.614) pre-training and 0.677 (95% CI 0.639,0.715) post-training. Highest rating inferred ROC figure-of-merit was 0.728 (95% CI 0.701,0.755) pre-training and 0.772 (95% CI 0.750,0.793) post-training. Conclusions - This study has demonstrated that novice observer performance can improve significantly. This study design may have relevance in the assessment of inexperienced radiographers taking part in PCE or commenting scheme for trauma.

Leitura à primeira vista ao piano: relatório de estágio

A frequência de um Estágio de Ensino Especializado proporciona uma oportunidade de proximidade entre futuro docente e aluno. A observação de metodologias e o envolvimento com a música e contexto musical das escolas e alunos é algo fundamental para a formação correcta de docentes. Devido ao carácter prático do ensino de um instrumento, esta interacção demonstra-se fundamental para a experiência pedagógica. Neste estágio pretendeu-se aumentar o grau de qualidade de ensino e o número de ferramentas pedagógicas, comparando-as com ferramentas aprendidas e articuladas por experiência pré-adquirida como docente. A pedagogia de ensino de piano tem vindo a sofrer várias modificações e adaptações, como reflexo do meio e dos recursos disponíveis. A existência de conservatórios onde os alunos podem frequentar um grande número de disciplinas trouxe vantagens significativas para a sua cultura musical. Embora o estudo do instrumento continue a ser a prática principal, a diminuição nos horários de estudo obriga a uma selecção criteriosa dos conteúdos programáticos deste instrumento, de modo a não por em causa o desenvolvimento técnico dos alunos. Uma área raramente encontrada nestes conteúdos é a leitura à primeira vista. A investigação aqui apresentada pretendeu compreender como se realiza a leitura à primeira vista de uma partitura ao piano e como se pode desenvolver esta competência. Recorrendo a fontes bibliográficas consultadas e à análise de métodos de ensino representativos, foram alvo de investigação a forma como um leitor lê à primeira vista uma partitura, qual a importância do tacto e da visão, e até que ponto esta competência pode ser estudada e desenvolvida. Quais são os factores-chave da leitura à primeira vista? Até que ponto a prática ao instrumento pode influenciar esta capacidade? Embora a leitura à primeira vista tenha sido retirada como disciplina e forma de avaliação em vários estabelecimentos de ensino, a realização de alguns inquéritos pretendeu avaliar a importância dada a esta disciplina, entre professores e alunos.

Teatro e igualdade de género : uma intervenção social e artística : relatório de estágio

O presente Relatório de Estágio tem como objecto de pesquisa a concepção e monitorização de duas Oficinas de Teatro dirigidas a dois grupos de mulheres constituídos, respectivamente, por estudantes universitárias e desempregadas. O estágio realizou-se entre Novembro/2013 e Junho/2014 na Quarta Parede - Associação de Artes Performativas da Covilhã e inseriu-se nos Empowerment Labs, laboratórios formativos que cruzam artes performativas e ciências sociais na reflexão e intervenção sobre a igualdade de género com foco no desemprego feminino. Este relatório expõe os três momentos do processo do estágio: pesquisa de referenciais teórico-práticos, concepção e monitorização das Oficinas de Teatro e reflexão a partir da prática laboratorial. Na pesquisa de referenciais, essencial para delinear a metodologia operacional e o programa de conteúdos, explorei dimensões como o feminismo e a igualdade de género, e procurei compreender de que forma o empowerment, a pedagogia de Paulo Freire e as metodologias do teatro aplicado serviam os objectivos do meu trabalho. A realização das oficinas foi o momento de experimentar as metodologias e o programa delineado. Tendo a igualdade de género como temática unificadora, o empowerment através da arte como objectivo maior e o teatro aplicado como base metodológica, as oficinas inserem-se nos processos de educação não-formal aplicados ao incremento de recursos intelectuais, emocionais, sociais, expressivos e criativos e, neste caso específico, à ampliação da consciência de género. Neste sentido, as oficinas desenvolveram uma abordagem metodológica processual, participativa e multidisciplinar, orientada para a pesquisa performativa, primeiro de uma dramaturgia individual, depois de uma dramaturgia do colectivo e, por fim, de uma dramaturgia orientada para a igualdade de género. O conceito de “dramaturgia” surge aqui no sentido metodológico do pachwork (trabalho com retalhos) e do sampling (recolha e transformação de materiais), relevante sobretudo na última fase, dedicada à construção colectiva de um exercício performativo apresentado publicamente.

OPTIMAX 2014 - Radiation dose and image quality optimisation in medical imaging

Medical imaging is a powerful diagnostic tool. Consequently, the number of medical images taken has increased vastly over the past few decades. The most common medical imaging techniques use X-radiation as the primary investigative tool. The main limitation of using X-radiation is associated with the risk of developing cancers. Alongside this, technology has advanced and more centres now use CT scanners; these can incur significant radiation burdens compared with traditional X-ray imaging systems. The net effect is that the population radiation burden is rising steadily. Risk arising from X-radiation for diagnostic medical purposes needs minimising and one way to achieve this is through reducing radiation dose whilst optimising image quality. All ages are affected by risk from X-radiation however the increasing population age highlights the elderly as a new group that may require consideration. Of greatest concern are paediatric patients: firstly they are more sensitive to radiation; secondly their younger age means that the potential detriment to this group is greater. Containment of radiation exposure falls to a number of professionals within medical fields, from those who request imaging to those who produce the image. These staff are supported in their radiation protection role by engineers, physicists and technicians. It is important to realise that radiation protection is currently a major European focus of interest and minimum competence levels in radiation protection for radiographers have been defined through the integrated activities of the EU consortium called MEDRAPET. The outcomes of this project have been used by the European Federation of Radiographer Societies to describe the European Qualifications Framework levels for radiographers in radiation protection. Though variations exist between European countries radiographers and nuclear medicine technologists are normally the professional groups who are responsible for exposing screening populations and patients to X-radiation. As part of their training they learn fundamental principles of radiation protection and theoretical and practical approaches to dose minimisation. However dose minimisation is complex – it is not simply about reducing X-radiation without taking into account major contextual factors. These factors relate to the real world of clinical imaging and include the need to measure clinical image quality and lesion visibility when applying X-radiation dose reduction strategies. This requires the use of validated psychological and physics techniques to measure clinical image quality and lesion perceptibility.

Projeto de estrutura variante de um edifício de habitação na zona de Lisboa

Trabalho de Projeto para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Estruturas

A interação entre Música e Dança na aula de Técnica de Dança Clássica : estratégias para o desenvolvimento da sensibilidade musical com alunas do 5º ano da Escola Vocacional de Dança da Sociedade Filarmónica Gualdim Pais

Relatório Final de Estágio apresentado à Escola Superior de Dança, com vista à obtenção do grau de Mestre em Ensino de Dança.