The importance of quality of life in patients with multiple sclerosis: do they need auxiliary walking devices?

Objective: To describe the importance of training multiple sclerosis (MS) patients with auxiliary walking devices (walking stick, crutch, or wheelchair) in a way that achieves a better quality of life (QOL). Design: Exploratory and descriptive. Setting: General hospital in Portugal.

Risk assessment of exposure to multiple mycotoxins in food

Moulds may produce a diversity of toxins such as aflatoxins, ochratoxins, trichothecenes, zearalenone, fumonisins and others. Although toxicological, environmental and epidemiological studies have addressed the problem of these toxins one by one, more than one mycotoxin are found usually in the same contaminated food. Risk assessment for humans potentially exposed to multimycotoxins suffers very much from the lack of adequate food consumption data. Furthermore, for a given mycotoxin, synergism and antagonism with other mycotoxins, found in the same food commodities, are not taken into account. Aflatoxin B1 and ochratoxin A belong to the most frequently occurring mycotoxins. This has repeatedly been demonstrated, however, normally, the risk resulting from their simultaneous occurrence is not considered. A descriptive study was developed to monitor air fungal contamination in one hospital food unit.

Non-selective optical wavelength-division multiplexing devices based on a-SiC:H multilayer heterostuctures

In this paper we present results on the optimization of multilayered a-SiC:H heterostructures for wavelength-division (de) multiplexing applications. The non selective WDM device is a double heterostructure in a glass/ITO/a-SiC:H (p-i-n) /a-SiC:H(-p) /a-Si:H(-i')/a-SiC:H (-n')/ITO configuration. The single or the multiple modulated wavelength channels are passed through the device, and absorbed accordingly to its wavelength, giving rise to a time dependent wavelength electrical field modulation across it. The effect of single or multiple input signals is converted to an electrical signal to regain the information (wavelength, intensity and frequency) of the incoming photogenerated carriers. Here, the (de) multiplexing of the channels is accomplished electronically, not optically. This approach offers advantages in terms of cost since several channels share the same optical components; and the electrical components are typically less expensive than the optical ones. An electrical model gives insight into the device operation.

New Steel Alloys for the Design of Heat Recovery Steam Generator Components of Combined Cycle Gas Plants

Demand for power is growing every day, mainly due to emerging economies in countries such as China, Russia, India, and Brazil. During the last 50 years steam pressure and temperature in power plants have been continuously raised to improve thermal efficiency. Recent efforts to improve efficiency leads to the development of a new generation of heat recovery steam generator, where the Benson once-through technology is applied to improve the thermal efficiency. The main purpose of this paper is to analyze the mechanical behavior of a high pressure superheater manifold by applying finite element modeling and a finite element analysis with the objective of analyzing stress propagation, leading to the study of damage mechanism, e.g., uniaxial fatigue, uniaxial creep for life prediction. The objective of this paper is also to analyze the mechanical properties of the new high temperature resistant materials in the market such as 2Cr Bainitic steels (T/P23 and T/P24) and also the 9-12Cr Martensitic steels (T/P91, T/P92, E911, and P/T122). For this study the design rules for construction of power boilers to define the geometry of the HPSH manifold were applied.

The importance of the program for the promotion of physical activity in perceived fatigue in people with multiple sclerosis

The aims of the study is to examine for intervention program of physical activity in the perception of fatigue, in patients with multiple sclerosis.

Implication of an intervention program for the promotion of physical activity in the quality of life of people with multiple sclerosis

The aims of this study is to examine the interest for quality of life of an implementation of program physical activity, with patients of multiple sclerosis.

Estudo da qualidade organizacional da unidade de rastreio da retinopatia diabética do Alentejo central: projecto de intervenção comunitária em saúde

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Gestão e Administração dos Serviços de Saúde.

Digital radiology and Picture Archiving and Communication System (PACS)

Plain radiography still accounts for the vast majority of imaging studies that are performed at multiple clinical instances. Digital detectors are now prominent in many imaging facilities and they are the main driving force towards filmless environments. There has been a working paradigm shift due to the functional separation of acquisition, visualization, and storage with deep impact in the imaging workflows. Moreover with direct digital detectors images are made available almost immediately. Digital radiology is now completely integrated in Picture Archiving and Communication System (PACS) environments governed by the Digital Imaging and Communications in Medicine (DICOM) standard. In this chapter a brief overview of PACS architectures and components is presented together with a necessarily brief account of the DICOM standard. Special focus is given to the DICOM digital radiology objects and how specific attributes may now be used to improve and increase the metadata repository associated with image data. Regular scrutiny of the metadata repository may serve as a valuable tool for improved, cost-effective, and multidimensional quality control procedures.

Augmented LDPC Graph for Distributed Video Coding with Multiple Side Information

The advances made in channel-capacity codes, such as turbo codes and low-density parity-check (LDPC) codes, have played a major role in the emerging distributed source coding paradigm. LDPC codes can be easily adapted to new source coding strategies due to their natural representation as bipartite graphs and the use of quasi-optimal decoding algorithms, such as belief propagation. This paper tackles a relevant scenario in distributedvideo coding: lossy source coding when multiple side information (SI) hypotheses are available at the decoder, each one correlated with the source according to different correlation noise channels. Thus, it is proposed to exploit multiple SI hypotheses through an efficient joint decoding technique withmultiple LDPC syndrome decoders that exchange information to obtain coding efficiency improvements. At the decoder side, the multiple SI hypotheses are created with motion compensated frame interpolation and fused together in a novel iterative LDPC based Slepian-Wolf decoding algorithm. With the creation of multiple SI hypotheses and the proposed decoding algorithm, bitrate savings up to 8.0% are obtained for similar decoded quality.

Environmental and track perturbations on multiple pantograph interaction with catenaries in high-speed trains

The top velocity of high-speed trains is generally limited by the ability to supply the proper amount of energy through the pantograph-catenary interface. The deterioration of this interaction can lead to the loss of contact, which interrupts the energy supply and originates arcing between the pantograph and the catenary, or to excessive contact forces that promote wear between the contacting elements. Another important issue is assessing on how the front pantograph influences the dynamic performance of the rear one in trainsets with two pantographs. In this work, the track and environmental conditions influence on the pantograph-catenary is addressed, with particular emphasis in the multiple pantograph operations. These studies are performed for high speed trains running at 300 km/h with relation to the separation between pantographs. Such studies contribute to identify the service conditions and the external factors influencing the contact quality on the overhead system. (C) 2013 Elsevier Ltd. All rights reserved.

Decisions with multiple simultaneous goals and uncertain causal effects

A key aspect of decision-making in a disaster response scenario is the capability to evaluate multiple and simultaneously perceived goals. Current competing approaches to build decision-making agents are either mental-state based as BDI, or founded on decision-theoretic models as MDP. The BDI chooses heuristically among several goals and the MDP searches for a policy to achieve a specific goal. In this paper we develop a preferences model to decide among multiple simultaneous goals. We propose a pattern, which follows a decision-theoretic approach, to evaluate the expected causal effects of the observable and non-observable aspects that inform each decision. We focus on yes-or-no (i.e., pursue or ignore a goal) decisions and illustrate the proposal using the RoboCupRescue simulation environment.

Implications of the Intervention Program for Physical Activity (IPPA) in the perception of illness and wellbeing in people with Multiple Sclerosis (MS)

The aim of this study is to examine the implications of the IPPA in the perception of illness and wellbeing in MS patients. Methods - This is a quasi experimental study non-randomized study with 24 MS patients diagnosed at least 1 year before, and with an EDSS score of under 7. We used the IPPA in 3 groups of eight people in 3 Portuguese hospitals (Lisbon, Coimbra, and Porto). The sessions were held once a week for 90 minutes, over a period of 7 weeks. The instruments used were: We asked the subjects the question “Please classify the severity of your disease?” and used the Personal Wellbeing Scale (PWS) at the beginning (time A) and end (time B) of the IPPA. We used the SPSS version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. Results – The results suggest that there are differences between time A and B, the perception of illness decreased (p<0.08), while wellbeing increased (p<0.01). Conclusions: The IPPA can play an important role in modifying the perception of disease severity and personal wellbeing.

Coletores de distribuição e sua otimização hidráulica, aplicados a uma instalação de produção de água arrefecida em sistemas de AVAC ( Fórum Picoas)

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

O impacto das perceções de justiça organizacional no sistema de recompensas sobre a satisfação no trabalho

Mestrado em Contabilidade e Gestão das Instituições Financeiras

Factores psicossociais preditivos de ajustamento à vida de pessoas com doenças crónicas

Doenças crónicas são de longa duração, de progressão lenta e induzem alterações na vida das pessoas, que são confrontadas com um conjunto de fatores que exercem um impacto negativo na sua qualidade de vida (QdV). A QdV é um conceito envolvendo componentes essenciais da qualidade humana: físicas, psicológicas, sociais, culturais e espirituais. Após o diagnóstico e com a doença estabilizada, os doentes procuram novas formas de lidar com esta. Este estudo teve como objetivo identificar fatores psicossociais preditivos (otimismo, afeto positivo e negativo, adesão aos tratamentos, suporte social e espiritualidade) da QdV (bem-estar geral, saúde física, saúde mental) e bem-estar subjetivo (BES) em pessoas com doenças crónicas. Amostra constituída por 774 indivíduos [30% diabetes, 27,1% cancro, 17,2% diabetes, 12% epilepsia, 11,5% esclerose múltipla e 2,2% miastenia, 70,5% do sexo feminino, idade M(DP)=42,9(11,6), educação M(DP)=9,6(4,7), anos diagnóstico M(DP)=12,8(9,7), classificação da doença M(DP)=6,6 (2,8)], recrutados nos hospitais centrais portugueses. Aplicando Modelos de Equações Estruturais e ajustando para variáveis sociodemográficas e clínicas, verificou-se que, pessoas mais otimistas, mais ativas e com uma melhor adesão aos tratamentos apresentam um melhor bem-estar geral, uma melhor saúde mental e um melhor bem-estar subjetivo; uma melhor adesão aos tratamentos contribui para uma melhor saúde física; melhor suporte social reflete-se numa melhor saúde mental; pessoas com mais espiritualidade apresentam uma melhor saúde física e uma melhor saúde mental. Estas conclusões contribuem para a definição de uma terapia que pode ajudar a uma melhor adaptação dos protocolos de tratamento para atender às necessidades dos doentes.