Determination of pharmocotherapeutical complexity in institutionalized elderly

The phenomenon of aging is nowadays society as acquired the status of a social problem, with growing attention and concern, leading to an increase number of studies dedicated to the elderly. The lack of domestic, familiar or social support often lead elderly to nursing homes. Institutionalization is in many cases the only opportunity to have access to health care and life quality. Aging is also associated with a higher prevalence of chronic diseases that require long term medication sometimes for life. Frequently the onset of multiple pathologies at the same time require different therapies and the phenomenon of polypharmacy (five ou more drugs daily) can occur. Even more, the slow down of physiological and cognitives mechanisms associated with these chronic diseases can interphere, in one hand, with the pharmacocinetic of many medications and, on the other hand, with the facility to accomplish the therapeutical regimen. All of these realities contribute to an increase of pharmacotherapeutical complexity, decreasing the adherence and effectiveness of treatment. The pharmacotherapeutical complexity of an individual is characterized by the conciliator element of different characteristics of their drug therapy, such as: the number of medications used; dosage forms; dosing frequency and additional indications. It can be measured by the Medication Regimen Complexity Index (MRCI), originally validated in English.

Drug therapy complexity: the importance of pharmacotherapeutic follow-up

Nowadays, the phenomenon of population ageing represents an worldwide problem, which assumes particular significance in Portugal. As they get older, individuals present more comorbidities and consequently consume an increasing number of drugs, which contributes to a growing drug therapy complexity. The institutionalized elders are particularly affected by this occurrence. Drug therapy complexity is defined as the conciliator of several characteristics of the pharmacotherapy and can affect patient’s safety and medication adherence. It can be measured with Medication Regimen Complexity Index (MRCI). This study aims to determine the drug therapy complexity of institutionalized elders in order to assess the need of pharmacotherapeutic follow-up.

On the Problem of Balancing the DC Capacitor Voltage Divider in Back-to-Back Multilevel Converters

This paper presents a new generalized solution for DC bus capacitors voltage balancing in back-to-back m level diode-clamped multilevel converters connecting AC networks. The solution is based on the DC bus average power flow and exploits the switching configuration redundancies. The proposed balancing solution is particularized for the back-to-back multilevel structure with m=5 levels. This back-to-back converter is studied working with bidirectional power flow, connecting an induction machine to the power grid.

Low Complexity Intra Mode Selection for Efficient Distributed Video Coding

Motion compensated frame interpolation (MCFI) is one of the most efficient solutions to generate side information (SI) in the context of distributed video coding. However, it creates SI with rather significant motion compensated errors for some frame regions while rather small for some other regions depending on the video content. In this paper, a low complexity Infra mode selection algorithm is proposed to select the most 'critical' blocks in the WZ frame and help the decoder with some reliable data for those blocks. For each block, the novel coding mode selection algorithm estimates the encoding rate for the Intra based and WZ coding modes and determines the best coding mode while maintaining a low encoder complexity. The proposed solution is evaluated in terms of rate-distortion performance with improvements up to 1.2 dB regarding a WZ coding mode only solution.

Formaldehyde in indoor air: a public health problem?

Formaldehyde was the first air pollutant, which already in the 1970s emerged as a specifically non-industrial indoor air quality problem. Yet formaldehyde remained an indoor air quality issue and the formaldehyde level in residential indoor air is among the highest of any indoor air contaminant. Formaldehyde concentrations in 4 different indoor settings (schools, office buildings, new dwellings and occupied dwellings) in Portugal were measured using Photo Ionization Detection (PID) equipment (11,7 eV lamps). All the settings presented results higher than the reference value proposed by Portuguese legislation. Furthermore, occupied dwellings showed 3 units with results above the reference. We could conclude that formaldehyde presence is a reality in monitored indoor settings. Concentration levels are higher than the Portuguese reference value for indoor settings and these can indicate health problems for occupants.

Advanced side information creation techniques and framework for Wyner-Ziv video coding

Recently, several distributed video coding (DVC) solutions based on the distributed source coding (DSC) paradigm have appeared in the literature. Wyner-Ziv (WZ) video coding, a particular case of DVC where side information is made available at the decoder, enable to achieve a flexible distribution of the computational complexity between the encoder and decoder, promising to fulfill novel requirements from applications such as video surveillance, sensor networks and mobile camera phones. The quality of the side information at the decoder has a critical role in determining the WZ video coding rate-distortion (RD) performance, notably to raise it to a level as close as possible to the RD performance of standard predictive video coding schemes. Towards this target, efficient motion search algorithms for powerful frame interpolation are much needed at the decoder. In this paper, the RD performance of a Wyner-Ziv video codec is improved by using novel, advanced motion compensated frame interpolation techniques to generate the side information. The development of these type of side information estimators is a difficult problem in WZ video coding, especially because the decoder only has available some reference, decoded frames. Based on the regularization of the motion field, novel side information creation techniques are proposed in this paper along with a new frame interpolation framework able to generate higher quality side information at the decoder. To illustrate the RD performance improvements, this novel side information creation framework has been integrated in a transform domain turbo coding based Wyner-Ziv video codec. Experimental results show that the novel side information creation solution leads to better RD performance than available state-of-the-art side information estimators, with improvements up to 2 dB: moreover, it allows outperforming H.264/AVC Intra by up to 3 dB with a lower encoding complexity.

The problem of estimating the volatility of zero coupon bond interest rate

Financial literature and financial industry use often zero coupon yield curves as input for testing hypotheses, pricing assets or managing risk. They assume this provided data as accurate. We analyse implications of the methodology and of the sample selection criteria used to estimate the zero coupon bond yield term structure on the resulting volatility of spot rates with different maturities. We obtain the volatility term structure using historical volatilities and Egarch volatilities. As input for these volatilities we consider our own spot rates estimation from GovPX bond data and three popular interest rates data sets: from the Federal Reserve Board, from the US Department of the Treasury (H15), and from Bloomberg. We find strong evidence that the resulting zero coupon bond yield volatility estimates as well as the correlation coefficients among spot and forward rates depend significantly on the data set. We observe relevant differences in economic terms when volatilities are used to price derivatives.

Fungal contamination of poultries litter: a public health problem

Exposure to certain fungi can cause human illness. Fungi cause adverse human health effects through three specific mechanisms: generation of a harmful immune response (e.g., allergy or hypersensitivity pneumonitis); direct infection by the fungal organism; by toxic-irritant effects from mold byproducts, such as mycotoxins. In Portugal there is an increasingly industry of large facilities that produce whole chickens for domestic consumption and only few investigations have reported on fungal contamination of the poultry litter. The material used for poultry litter is varied but normally can be constitute by: pine shavings; sawdust of eucalyptus; other types of wood; peanut; coffee; sugar cane; straw; hay; grass; paper processed. Litter is one of the most contributive factors to fungal contamination in poultries. Spreading litter is one of the tasks that normally involve higher exposure of the poultry workers to dust, fungi and their metabolites, such as VOC’s and mycotoxins. After being used and removed from poultries, litter is ploughed into agricultural soils, being this practice potentially dangerous for the soil environment, as well for both humans and animals. The goal of this study was to characterize litter’s fungal contamination and also to report the incidence of keratinophilic and toxigenic fungi.

Positive Solutions of the Dirichlet Problem for the One-dimensional Minkowski-Curvature Equation

We discuss existence and multiplicity of positive solutions of the Dirichlet problem for the quasilinear ordinary differential equation-(u' / root 1 - u'(2))' = f(t, u). Depending on the behaviour of f = f(t, s) near s = 0, we prove the existence of either one, or two, or three, or infinitely many positive solutions. In general, the positivity of f is not required. All results are obtained by reduction to an equivalent non-singular problem to which variational or topological methods apply in a classical fashion.

Fungal contamination of poultry litter: a public health problem

Although numerous studies have been conducted on microbial contaminants associated with various stages related to poultry and meat products processing, only a few reported on fungal contamination of poultry litter. The goals of this study were to (1) characterize litter fungal contamination and (2) report the incidence of keratinophilic and toxigenic fungi presence. Seven fresh and 14 aged litter samples were collected from 7 poultry farms. In addition, 27 air samples of 25 litters were also collected through impaction method, and after laboratory processing and incubation of collected samples, quantitative colony-forming units (CFU/m3) and qualitative results were obtained. Twelve different fungal species were detected in fresh litter and Penicillium was the most frequent genus found (59.9%), followed by Alternaria (17.8%), Cladosporium (7.1%), and Aspergillus (5.7%). With respect to aged litter, 19 different fungal species were detected, with Penicillium sp. the most frequently isolated (42.3%), followed by Scopulariopsis sp. (38.3%), Trichosporon sp. (8.8%), and Aspergillus sp. (5.5%). A significant positive correlation was found between litter fungal contamination (CFU/g) and air fungal contamination (CFU/m3). Litter fungal quantification and species identification have important implications in the evaluation of potential adverse health risks to exposed workers and animals. Spreading of poultry litter in agricultural fields is a potential public health concern, since keratinophilic (Scopulariopsis and Fusarium genus) as well as toxigenic fungi (Aspergillus, Fusarium, and Penicillium genus) were isolated.

Topological Complexity and Predictability in the Dynamics of a Tumor Growth Model with Shilnikov's Chaos

Dynamical systems modeling tumor growth have been investigated to determine the dynamics between tumor and healthy cells. Recent theoretical investigations indicate that these interactions may lead to different dynamical outcomes, in particular to homoclinic chaos. In the present study, we analyze both topological and dynamical properties of a recently characterized chaotic attractor governing the dynamics of tumor cells interacting with healthy tissue cells and effector cells of the immune system. By using the theory of symbolic dynamics, we first characterize the topological entropy and the parameter space ordering of kneading sequences from one-dimensional iterated maps identified in the dynamics, focusing on the effects of inactivation interactions between both effector and tumor cells. The previous analyses are complemented with the computation of the spectrum of Lyapunov exponents, the fractal dimension and the predictability of the chaotic attractors. Our results show that the inactivation rate of effector cells by the tumor cells has an important effect on the dynamics of the system. The increase of effector cells inactivation involves an inverse Feigenbaum (i.e. period-halving bifurcation) scenario, which results in the stabilization of the dynamics and in an increase of dynamics predictability. Our analyses also reveal that, at low inactivation rates of effector cells, tumor cells undergo strong, chaotic fluctuations, with the dynamics being highly unpredictable. Our findings are discussed in the context of tumor cells potential viability.

Contratualização na Administração Pública: o caso da descentralização de competências educacionais para os Municípios

A presente investigação procurou descrever, de forma exaustiva, o processo de previsão, negociação, implementação e avaliação do Contrato de Execução celebrado entre a Câmara Municipal de Sintra e o Ministério da Educação em 2009. Este contrato corresponde a um instrumento previsto na regulamentação do quadro de transferências de competências para os municípios em matéria de educação, de acordo com o regime previsto no Decreto-Lei n.º 144/2008, de 28 de julho. Definida a problemática e os objetivos, a investigação centrou-se num estudo de caso no qual foi feita a descrição e interpretação do processo e das ações desenvolvidas pelos intervenientes no período compreendido entre 2008 e 2011. Recorreu-se à confrontação dos dados obtidos através da análise das fontes documentais e do recurso às entrevistas realizadas aos responsáveis pelo Pelouro da Educação e diretores dos Agrupamentos de Escolas, à luz da revisão da literatura e do contributo de diferentes trabalhos de investigadores nesta matéria. A investigação permitiu concluir que o processo de contratualização foi algo complexo face à realidade deste Município e que o normativo apresenta várias lacunas no que diz respeito à contratualização da referida transferência de competências, designadamente porque procura generalizar algo que não é, de todo, generalizável – o campo da educação face à complexidade dos territórios educativos em causa e aos dos intervenientes envolvidos no mesmo.

Avaliação da intervenção socioeducativa sobre a violência na escola

A investigação desenvolvida no âmbito do projeto Estratégias de Intervenção socioeducativa em contextos sociais complexos enquadra-se na avaliação das políticas sociais e educativas, em particular no que diz respeito à segurança escolar em contextos marcados pela diversidade e complexidade social e cultural. O processo de avaliação centrou-se na análise das estratégias de intervenção socioeducativa relativas ao problema da violência na escola, desenvolvidas em três escolas de um concelho da Área Metropolitana de Lisboa. Partindo do pressuposto que a violência na escola é um fenómeno multideterminado e multifacetado, a pesquisa centrou-se numa abordagem que enquadra as esferas de intervenção/ação das instituições formais e dos agentes sociais enquanto mecanismos que estruturam e regulam as concepções e práticas de violência na escola. A recolha e sistematização de informação centrou-se, por um lado, nas estratégias de intervenção que têm vindo a ser desenvolvidas localmente pelas escolas, e, por outro, nas perspetivas dos diferentes intervenientes, considerando-se os alunos, osprofessores, as direções escolares e representantes das entidades e instituições locais. Metodologicamente, privilegiou-se o cruzamento de métodos de carácter extensivo e intensivo, combinando técnicas como a Observação Direta, a realização de Entrevistas, de Grupos Focais, de Questionários, e ainda, a Análise de Redes e a Análise Documental. Numa fase posterior, os diversos intervenientes participaram na discussão e análise dos resultados previamente recolhidos, e na validação conjunta de uma metodologia de intervenção que define um conjunto de estratégias gerais de combate às situações de violência na escola e nos territórios educativos. Esta metodologia é o principal produto do projeto e resulta de um processo de avaliação dinâmico e participado. A contribuição que se apresenta no VI Encontro do CIED ocupa-se dos procedimentos de avaliação desenvolvidos no âmbito deste projeto.

Fast growing fungi: a problem to be solved to achieve characterization of occupational exposure to fungi in cork industry

Chrysonilia sitophila is a common mould in cork industry and has been identified as a cause of IgE sensitization and occupational asthma. This fungal species have a fast growth rate that may inhibit others species’ growth causing underestimated data from characterization of occupational fungal exposure. Aiming to ascertain occupational exposure to fungi in cork industry, were analyzed papers from 2000 about the best air sampling method, to obtain quantification and identification of all airborne culturable fungi, besides the ones that have fast-growing rates. Impaction method don’t allows the collection of a representative air volume, because even with some media that restricts the growth of the colonies, in environments with higher fungal load, such as cork industry, the counting of the colonies is very difficult. Otherwise, impinger method permits the collection of a representative air volume, since we can make dilution of the collected volume. Besides culture methods that allows fungal identification trough macro- and micro-morphology, growth features, thermotolerance and ecological data, we can apply molecular biology with the impinger method, to detect the presence of non-viable particles and potential mycotoxin producers’ strains, and also to detect mycotoxins presence with ELISA or HPLC. Selection of the best air sampling method in each setting is crucial to achieve characterization of occupational exposure to fungi. Information about the prevalent fungal species in each setting and also the eventual fungal load it’s needed for a criterious selection.

Particularidades do ensino do canto a adolescentes no contexto da Escola de Música do Conservatório Nacional: relatório de estágio

Resumo I - O presente Relatório de Estágio foi elaborado no âmbito da Unidade Curricular (UC) de Estágio do Ensino Especializado (EEE) do Mestrado em Ensino da Música da Escola Superior de Música de Lisboa, ramo de especialização em Canto. Incide sobre a Prática Pedagógica desenvolvida com três alunos de Canto da Escola de Música do Conservatório Nacional (EMCN), no ano letivo de 2012/2013, em diferentes níveis de desenvolvimento vocal, adolescentes, ou tendo saído há pouco tempo da adolescência. Nesta secção, encontram-se enumeradas as principais linhas pedagógicas seguidas, assim como os principais motivos das opções tomadas. Descreve-se também a forma como foi organizado e planeado o trabalho técnico e musical desenvolvido com os alunos, adequado à fase de desenvolvimento físico e vocal de cada um, além do conjunto de atividades escolares realizadas, as quais tiveram como finalidade promover o seu desenvolvimento artístico.