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.

Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional study

Objective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.

Valorização dos trabalhos de auditoria interna através do CSA

Dissertação apresentada ao Instituto Superior de Contabilidade para a obtenção do Grau de Mestre em Auditoria Orientado por: Doutor Rodrigo Carvalho

O Contributo da auditoria interna para uma gestão eficaz

Com a globalização da economia e o crescimento dos mercados financeiros, surge cada vez mais a necessidade de obter informação útil e atempada, que permita aos gestores das organizações tomar as melhores decisões para a consecução dos objectivos e para o desenvolvimento de estratégias. É neste contexto que a auditoria interna assume um papel relevante, indo ao encontro dos interesses dos gestores, na medida em que audita não só os procedimentos relativos ao reporte financeiro, como também todos os outros procedimentos de controlo interno, contribuindo assim para um controlo mais amplo e completo em toda a organização. O presente trabalho tem como objectivo verificar até que ponto a auditoria interna contribui para uma gestão eficaz das organizações. Para tal, realizaram-se pesquisas sobre os principais conceitos, funções e procedimentos relacionados com auditoria interna e a sua relação com a gestão das organizações. Seguidamente, procedeu-se à explicação da metodologia praticada e à exposição do caso empírico, que teve como base a elaboração de dois questionários basicamente semelhantes, que foram enviados às 200 empresas que apresentaram maior Volume de Negócios, retiradas do universo das “1000 MAIORES EMPRESAS” a actuarem no mercado português durante o ano de 2010. Esses questionários tiveram como objectivo cruzar as opiniões de gestores e auditores, a fim de concluir se existe ou não um contributo da auditoria interna para uma gestão eficaz. Na posse da informação recolhida foi possível ressaltar o contributo da auditoria interna como ferramenta indispensável para uma gestão eficaz, no sentido que procura adequar os custos, aumentar a produtividade, auxiliar no processo de gestão dos riscos e no processo de tomada de decisão, de modo a tornar as organizações mais competitivas e garantindo-lhes um crescimento sustentado.

Acrescentar valor à organização com a auditoria interna

Dissertação de Mestrado Apresentado ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação de Doutora Alcina Portugal Dias

O Comportamento de consumo de Vinho do Porto dos portugueses – recomendações para o aumento da procura interna

Dissertação de Mestrado apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Marketing Digital, sob orientação de Doutor António Correia de Barros

A importância da auditoria interna e a avaliação do desempenho da organização: estudo de caso: empresas do sector do calçado

Dissertação de Mestrado apresentado ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação da Doutora Alcina Augusta de Sena Portugal Dias

Estratégias de comunicação interna

Dissertação apresentada ao Instituto Superior de Contabilidade e Administração do Porto para obtenção do Grau de Mestre em Assessoria de Administração Orientada pela professora Arminda Sá Sequeira

On the adaptation of broadcast transactions in token-passing fieldbus networks with heterogeneous transmission media

Broadcast networks that are characterised by having different physical layers (PhL) demand some kind of traffic adaptation between segments, in order to avoid traffic congestion in linking devices. In many LANs, this problem is solved by the actual linking devices, which use some kind of flow control mechanism that either tell transmitting stations to pause (the transmission) or just discard frames. In this paper, we address the case of token-passing fieldbus networks operating in a broadcast fashion and involving message transactions over heterogeneous (wired or wireless) physical layers. For the addressed case, real-time and reliability requirements demand a different solution to the traffic adaptation problem. Our approach relies on the insertion of an appropriate idle time before a station issuing a request frame. In this way, we guarantee that the linking devices’ queues do not increase in a way that the timeliness properties of the overall system turn out to be unsuitable for the targeted applications.

A proposal for media component brokerage

This paper describes how MPEG-4 object based video (obv) can be used to allow selected objects to be inserted into the play-out stream to a specific user based on a profile derived for that user. The application scenario described here is for personalized product placement, and considers the value of this application in the current and evolving commercial media distribution market given the huge emphasis media distributors are currently placing on targeted advertising. This level of application of video content requires a sophisticated content description and metadata system (e.g., MPEG-7). The scenario considers the requirement for global libraries to provide the objects to be inserted into the streams. The paper then considers the commercial trading of objects between the libraries, video service providers, advertising agencies and other parties involved in the service. Consequently a brokerage of video objects is proposed based on negotiation and trading using intelligent agents representing the various parties. The proposed Media Brokerage Platform is a multi-agent system structured in two layers. In the top layer, there is a collection of coarse grain agents representing the real world players – the providers and deliverers of media contents and the market regulator profiler – and, in the bottom layer, there is a set of finer grain agents constituting the marketplace – the delegate agents and the market agent. For knowledge representation (domain, strategic and negotiation protocols) we propose a Semantic Web approach based on ontologies. The media components contents should be represented in MPEG-7 and the metadata describing the objects to be traded should follow a specific ontology. The top layer content providers and deliverers are modelled by intelligent autonomous agents that express their will to transact – buy or sell – media components by registering at a service registry. The market regulator profiler creates, according to the selected profile, a market agent, which, in turn, checks the service registry for potential trading partners for a given component and invites them for the marketplace. The subsequent negotiation and actual transaction is performed by delegate agents in accordance with their profiles and the predefined rules of the market.

B2B platform for media content personalisation

This paper proposes a novel business model to support media content personalisation: an agent-based business-to-business (B2B) brokerage platform for media content producer and distributor businesses. Distributors aim to provide viewers with a personalised content experience and producers wish to en-sure that their media objects are watched by as many targeted viewers as possible. In this scenario viewers and media objects (main programmes and candidate objects for insertion) have profiles and, in the case of main programme objects, are annotated with placeholders representing personalisation opportunities, i.e., locations for insertion of personalised media objects. The MultiMedia Brokerage (MMB) platform is a multiagent multilayered brokerage composed by agents that act as sellers and buyers of viewer stream timeslots and/or media objects on behalf of the registered businesses. These agents engage in negotiations to select the media objects that best match the current programme and viewer profiles.

Engineering PROFIBUS networks with heterogeneous transmission media

A significant number of process control and factory automation systems use PROFIBUS as the underlying fieldbus communication network. The process of properly setting up a PROFIBUS network is not a straightforward task. In fact, a number of network parameters must be set for guaranteeing the required levels of timeliness and dependability. Engineering PROFIBUS networks is even more subtle when the network includes various physical segments exhibiting heterogeneous specifications, such as bus speed or frame formats, just to mention a few. In this paper we provide underlying theory and a methodology to guarantee the proper operation of such type of heterogeneous PROFIBUS networks. We additionally show how the methodology can be applied to the practical case of PROFIBUS networks containing simultaneously DP (Decentralised Periphery) and PA (Process Automation) segments, two of the most used commercial-off-the-shelf (COTS) PROFIBUS solutions. The importance of the findings is however not limited to this case. The proposed methodology can be generalised to cover other heterogeneous infrastructures. Hybrid wired/wireless solutions are just an example for which an enormous eagerness exists.

Otimização de uma cadeia de logística interna

Atualmente qualquer organização que se queira manter no ativo, tem que obrigatoriamente inovar, reduzir o desperdício associado ao processo produtivo e simultaneamente simplificar as tarefas diárias dos seus colaboradores. E é sobre estes princípios que este trabalho é baseado, ou seja, pretende-se através da aplicação de ferramentas Lean, a melhoria contínua do processo de produção da Schmitt Elevadores. Numa fase inicial foi necessário um estudo dos diferentes fluxos de materiais, que permitiu a conceção do VSM (Value Stream Mapping). O VSM juntamente com o diagrama de Spaghetti permitiram a identificação de algumas das fontes de desperdício, relacionadas essencialmente com o excesso de movimentações. Considerando o âmbito do estágio, logística interna, e reunidas as causas de desperdício verificadas nesta área, procedeu-se à criação de um ciclo de entrega de materiais, por parte do operador logístico, baseado no conceito de milk run. Verificaram-se também problemas ao nível da gestão de stocks, pelo que também foi necessária intervenção nesta área. A aplicação das medidas mencionadas anteriormente irá traduzir-se em ganhos para o processo produtivo, nomeadamente, na criação de rotinas para os operadores logísticos; evitar deslocações por parte dos operadores de cada processo e manter em supermercado a quantidade suficiente de cada artigo, para fazer face à variabilidade da procura.

O impacto da auditoria interna no desempenho organizacional – estudo de caso das 65 maiores empresas a atuarem em Portugal

Dissertação de Mestrado apresentado ao Instituto Superior de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação das docentes Doutora Alcina Dias e Doutora Ana Paula Lopes