Reliability of nasal auscultation and their relation to middle ear condition – a clinical interest to pediatrics respiratory physiotherapy

Background: Acute respiratory infections are usual in children under three years old occurring in upper respiratory tract, having an impact on child and caregiver’s quality of life predisposing to otitis media or bronchiolitis. There are few valid and reliable measures to determine the child’s respiratory condition and to guide the physiotherapy intervention. Aim: To assess the intra and inter rater reliability of nasal auscultation, to analyze the relation between sounds’ classification and middle ear’s pressure and compliance as well as with the Clinical Severity Score. Methods: A cross-sectional observational study was composed by 125 nursery children aged up to three years old. Tympanometry, pulmonary and nasal auscultation and application of Clinical Severity Score were performed to each child. Nasal auscultation sounds’ were recorded and sent to 3 blinded experts, that classified, as “obstructed” and “unobstructed”, with a 48 hours interval, in order to analyze inter and intra rater reliability. Results: Nasal auscultation revealed a substantial inter and intra rater reliability (=0,749 and evaluator A - K= 0,691; evaluator B - K= 0,605 and evaluator C - K= 0,724, respectively). Both ears’ pressure was significantly lower in children with an "unobstructed" nasal sound when compared with an “obstructed” nasal sound (t=-3,599, p<0,001 in left ear; t=-2,258, p=0,026 in right ear). Compliance in both ears was significantly lower in children with an "obstructed" nasal sound when compared with “unobstructed” nasal sound (t=-2,728, p=0,007 in left ear; t=-3,830, p<0,001 in right ear). There was a statistically significant association between sounds’ classification and tympanograms types in both ear’s (=11,437, p=0,003 in left ear; =13,535, p=0,001 in right ear). There was a trend to children with an "unobstructed" nasal sound that had a lower clinical severity score when compared with “obstructed” children. Conclusion: It was observed a good intra and substantial inter reliability for nasal auscultation. Nasal auscultation sounds’ classification was related to middle ears’ pressure and compliance.

A influência da massagem na sensação retardada de desconforto muscular

Introdução: Apesar dos muitos estudos sobre a temática da sensação retardada de desconforto muscular, atualmente, ainda se discute a explicação dos mecanismos subjacentes a esta condição clínica, bem como, a sua prevenção e tratamento. A literatura sugere a massagem como uma das formas de terapia, contudo, os estudos têm mostrado resultados controversos. Objetivo: Verificar se a massagem aplicada 2 horas após um protocolo de exercício excêntrico tem influência na sensação retardada de desconforto muscular, bem como, se o seu efeito varia dependendo do tempo de aplicação. Métodos: 21 participantes (23,62±1,32 anos; 76,95±12,17 kg; 174,71±4,78 cm; 25,25±4,26 Kg/m 2) foram divididos em três grupos. Foi avaliada a dor, força muscular e a perimetria antes, e 2h, 24h, 48h, e 72h após um protocolo de exercício constituído por três séries de dez repetições de contrações excêntricas dos isquiotibiais do membro dominante, com 80% da força máxima, a uma velocidade constante de 60º/s, numa amplitude entre 0º e 80º, utilizando o dinamómetro isocinético Biodex System 4. A massagem foi efetuada 2 horas após o exercício em dois grupos experimentais com durações diferentes, sendo o terceiro grupo de controlo. Para identificar diferenças entre os grupos no momento inicial e na variável diferença entre o momento inicial e os restantes momentos, recorreu-se ao teste de Kruskal-Wallis, seguido de uma análise Post-Hoc através do teste de Dunn com um nível de significância de 0,05. Resultados: Verificou-se que a massagem teve efeito na redução da dor e na perimetria. Relativamente à força não foram encontradas alterações significativas. Conclusão: Os resultados mostraram que a massagem aplicada 2 horas após o exercício excêntrico, independentemente da duração utilizada, teve efeito na redução da dor, mas não na força muscular. Na perimetria apesar de haver alterações, estas não foram consideradas relevantes.

La condition de la femme dans le cid

La tragi-comédie de Corneille, «Le Cid» (1636-7), est davantage une pièce d‘amour qui illustre bien la condition de la femme au XVIIème siècle. Le triangle amoureux constitué par l‘Infante, Chimène et Rodrigue est l‘un des fondements de la pièce. Cependant, comme les personnages sont insérés dans un système féodal basé sur une idéologie aristocratique, l‘amour ne se présente pas comme une jouissance paisible. De cette façon, il y a une lutte acharnée entre l‘amour, le devoir et l‘honneur, ce qui est frappant au niveau lexical. Les personnages les plus jeunes utilisent beaucoup de mots associés au thème de l‘amour et qui ont le radical amour-, tandis que les plus âgés emploient très souvent des mots qui appartiennent au champ lexical de l‘honneur et de la gloire. Selon D. Diègue, l‘honneur a plus de puissance que l‘amour, et il trouve que l‘homme qui s‘endort dans l‘amour oublie ses devoirs. Pour l‘Infante, Chimène et Rodrigue, l‘amour est lié à la souffrance. L‘Infante souffre, mais elle se conforme, parce qu‘étant donné qu‘elle est fille de roi, elle ne peut pas aimer Rodrigue qui appartient à un rang inférieur. Chimène est le revers de l‘Infante, c‘est une femme rebelle qui veut mouler sa destinée. Cependant, tout au long de la pièce, l‘héroïne est assujettie à une force mâle: si parfois l‘amour entre elle et Rodrigue ressemble à l‘amour courtois du Moyen âge quand il se met à la disposition de sa maîtresse et la place au-dessus de lui, la plupart du temps il met la passion en dessous de l‘honneur, parce que c‘est un homme et descend d‘une famille de guerriers vaillants. Selon le code chevaleresque dans lequel il est inséré la femme est inférieure à l‘homme. À la fin de la pièce, il y a une victoire de l‘amour sur l‘honneur et le devoir : Chimène abdique de son honneur en pardonnant et en prenant pour mari l‘assassin de son père. Le monde de l‘élément masculin triomphe et elle devient le prix de la victoire de Rodrigue. Mais si son statut de femme l‘empêche de sortir victorieuse, elle ne se conforme pas et dans sa dernière tirade elle met en question la justice et défie la société féodale.

Using remote experimentation in a large undergraduate course: initial findings

The use of remote labs in undergraduate courses has been reported in literature several times since the mid 90's. Nevertheless, very few articles present results about the correspondent learning gains obtained by students, and in what conditions those systems can be more efficient, thus suggesting a lack of data concerning their pedagogical effectiveness. This paper addresses such a gap by presenting some initial findings concerning the use of a remote lab (VISIR), in a large undergraduate course on Physics, with over 550 students enrolled.

Numerical analysis of the initial conditions in fractional systems

Fractional dynamics is a growing topic in theoretical and experimental scientific research. A classical problem is the initialization required by fractional operators. While the problem is clear from the mathematical point of view, it constitutes a challenge in applied sciences. This paper addresses the problem of initialization and its effect upon dynamical system simulation when adopting numerical approximations. The results are compatible with system dynamics and clarify the formulation of adequate values for the initial conditions in numerical simulations.

A New Heuristic Providing an Effective Initial Solution for a Simulated Annealing approach to Energy Resource Scheduling in Smart Grids

An intensive use of dispersed energy resources is expected for future power systems, including distributed generation, especially based on renewable sources, and electric vehicles. The system operation methods and tool must be adapted to the increased complexity, especially the optimal resource scheduling problem. Therefore, the use of metaheuristics is required to obtain good solutions in a reasonable amount of time. This paper proposes two new heuristics, called naive electric vehicles charge and discharge allocation and generation tournament based on cost, developed to obtain an initial solution to be used in the energy resource scheduling methodology based on simulated annealing previously developed by the authors. The case study considers two scenarios with 1000 and 2000 electric vehicles connected in a distribution network. The proposed heuristics are compared with a deterministic approach and presenting a very small error concerning the objective function with a low execution time for the scenario with 2000 vehicles.

Numerical analysis of the initial conditions in fractional systems

Fractional dynamics is a growing topic in theoretical and experimental scientific research. A classical problem is the initialization required by fractional operators. While the problem is clear from the mathematical point of view, it constitutes a challenge in applied sciences. This paper addresses the problem of initialization and its effect upon dynamical system simulation when adopting numerical approximations. The results are compatible with system dynamics and clarify the formulation of adequate values for the initial conditions in numerical simulations.

Condition-Based Diagnosis of Mechatronic Systems Using a Fractional Calculus Approach

While fractional calculus (FC) is as old as integer calculus, its application has been mainly restricted to mathematics. However, many real systems are better described using FC equations than with integer models. FC is a suitable tool for describing systems characterised by their fractal nature, long-term memory and chaotic behaviour. It is a promising methodology for failure analysis and modelling, since the behaviour of a failing system depends on factors that increase the model’s complexity. This paper explores the proficiency of FC in modelling complex behaviour by tuning only a few parameters. This work proposes a novel two-step strategy for diagnosis, first modelling common failure conditions and, second, by comparing these models with real machine signals and using the difference to feed a computational classifier. Our proposal is validated using an electrical motor coupled with a mechanical gear reducer.

Maturity models in the hospital information systems management initial research

Os modelos de maturidade são instrumentos facilitadores da gestão das organizações, incluindo a gestão da sua função sistemas de informação, não sendo exceção as organizações hospitalares. Neste artigo apresenta-se uma investigação inicial que visa o desenvolvimento de um abrangente modelo de maturidade para a gestão dos sistemas de informação hospitalares. O desenvolvimento deste modelo justifica-se porque os modelos de maturidade atuais no domínio da gestão dos sistemas informação hospitalares ainda se encontram numa fase embrionária de desenvolvimento, sobretudo porque são pouco detalhados, não disponibilizam ferramentas para determinação da maturidade e não apresentam as características dos estágios de maturidade estruturadas por diferentes fatores de influência.

Initial dilemmas in IST research: design science and design research, a clarification of concepts

The inter-disciplinarity of information systems, applied discipline and activity of design, and the study from different paradigms perspectives explains the diversity of problems addressed. The context is broad and includes important issues beyond technology, as the application, use, effectiveness, efficiency and their organizational and social impacts. In design science, the research interest is in contributing to the improvement of the processes of the design activity itself. The relevance of research in design science is associated with the result obtained for the improvement of living conditions in organizational, inter-organizational and Society contexts. In the research whose results are artifacts, the adoption of design research as a process of research is crucial to ensure discipline, rigor and transparency. Based on a literature review, this paper clarifies the terms of design science and design research. This is the main motivation for presenting this paper, determinant for the phase in research in technologies and information systems which are the three research projects presented. As a result the three projects are discussed in relation to the concepts of design science and design research.