41 resultados para collaborative medication review
em Instituto Politécnico do Porto, Portugal
Resumo:
Anxiety disorders are the most common psychiatric disorders observed currently. It is a normal adaptive response to stress that allows coping with adverse situations. Nevertheless, when anxiety becomes excessive or disproportional in relation to the situation that evokes it or when there is not any special object directed at it, such as an irrational dread of routine stimuli, it becomes a disabling disorder and is considered to be pathological. The traditional treatment used is medication and cognitive behavioral psychotherapy, however, last years the practice of physical exercise, specifically aerobic exercise, has been investigated as a new non-pharmacological therapy for anxiety disorders. Thus, the aim of this article was to provide information on research results and key chains related to the therapeutic effects of aerobic exercise compared with other types of interventions to treat anxiety, which may become a useful clinical application in a near future. Researches have shown the effectiveness of alternative treatments, such as physical exercise, minimizing high financial costs and minimizing side effects. The sample analyzed, 66.8% was composed of women and 80% with severity of symptoms anxiety as moderate to severe. The data analyzed in this review allows us to claim that alternative therapies like exercise are effective in controlling and reducing symptoms, as 91% of anxiety disorders surveys have shown effective results in treating. However, there is still disagreement regarding the effect of exercise compared to the use of antidepressant symptoms and cognitive function in anxiety, this suggests that there is no consensus on the correct intensity of aerobic exercise as to achieve the best dose-response, with intensities high to moderate or moderate to mild.
Resumo:
Introdução: Programas de self-management têm como objectivo habilitar os pacientes com estratégias necessárias para levar a cabo procedimentos específicos para a patologia. A última revisão sistemática sobre selfmanagament em DPOC foi realizada em 2007, concluindo-se que ainda não era possível fornecer dados claros e suficientes acerca de recomendações sobre a estrutura e conteúdo de programas de self-managament na DPOC. A presente revisão tem o intuito de complementar a análise da revisão anterior, numa tentativa de inferir a influência do ensino do self-management na DPOC. Objectivos: verificar a influência dos programas de self-management na DPOC, em diversos indicadores relacionados com o estado de saúde do paciente e na sua utilização dos serviços de saúde. Estratégia de busca: pesquisa efectuada nas bases de dados PubMed e Cochrane Collaboration (01/01/2007 – 31/08/2010). Palavras-chave: selfmanagement education, self-management program, COPD e pulmonary rehabilitation. Critérios de Selecção: estudos randomizados sobre programas de selfmanagement na DPOC. Extracção e Análise dos Dados: 2 investigadores realizaram, independentemente, a avaliação e extracção de dados de cada artigo. Resultados: foram considerados 4 estudos randomizados em selfmanagement na DPOC nos quais se verificaram benefícios destes programas em diversas variáveis: qualidade de vida a curto e médio prazo, utilização dos diferentes recursos de saúde, adesões a medicação de rotina, controle das exacerbações e diminuição da sintomatologia. Parece não ocorrer alteração na função pulmonar e no uso de medicação de emergência, sendo inconclusivo o seu efeito na capacidade de realização de exercício. Conclusões: programas de self-management aparentam ter impacto positivo na qualidade de vida, recurso a serviços de saúde, adesão à medicação, planos de acção e níveis de conhecimento da DPOC. Discrepâncias nos critérios de selecção das amostras utilizadas, períodos de seguimento desiguais, consistência das variáveis mensuradas, condicionam a informação disponibilizada sobre este assunto.
Resumo:
Introdução: O medicamento citotóxico é definido pelas suas características de genotoxicidade, mutagenicidade, carcinogenicidade, teratogenicidade, toxicidade reprodutiva e toxicidade orgânica em baixas doses. Deste modo, existe uma grande preocupação no que concerne ao manuseamento deste tipo de medicamentos, devido aos riscos ocupacionais que podem surtir da exposição a que os profissionais de farmácia envolvidos estão sujeitos. Objectivos: Analisar a realidade da farmácia hospitalar face ao cumprimento das normas e procedimentos preconizados pelas actuais guidelines para o manuseamento seguro de medicamentos citotóxicos, e identificar as lacunas existentes, conduzindo à promoção de práticas centradas na minimização do risco de exposição/contaminação dos profissionais e do ambiente. Material e Métodos: Foi realizada uma pesquisa bibliográfica sistemática sobre o tema, utilizando-se como instrumento de recolha de dados um inquérito por questionário, em que os TDT de Farmácia foram abordados sobre os procedimentos verificados no hospital onde exercem actividade profissional. Resultados: Face ao cumprimento das normas na recepção, armazenamento e transporte de medicamentos citotóxicos, verifica-se que todos os hospitais se encontram acima da média. Apesar desta evidência, é na fase de transporte que se verifica um menor cumprimento. As principais lacunas detectadas foram ao nível da não utilização de EPI nas fases de recepção e armazenamento; a recepção de medicamentos citotóxicos em conjunto com outros medicamentos; a falta de um sistema de ventilação no local de armazenamento e, ainda, ausência de portas de correr e/ou gavetas fechadas nos carros de transporte de medicamentos citotóxicos. Conclusões: Os resultados deste estudo revelam alguma heterogeneidade de procedimentos nos hospitais Portugueses, sugerindo a necessidade de intervenção e reformulação do programa de segurança e gestão de risco desenvolvidos para o manuseamento de citotóxicos.
Resumo:
Swarm Intelligence generally refers to a problem-solving ability that emerges from the interaction of simple information-processing units. The concept of Swarm suggests multiplicity, distribution, stochasticity, randomness, and messiness. The concept of Intelligence suggests that problem-solving approach is successful considering learning, creativity, cognition capabilities. This paper introduces some of the theoretical foundations, the biological motivation and fundamental aspects of swarm intelligence based optimization techniques such Particle Swarm Optimization (PSO), Ant Colony Optimization (ACO) and Artificial Bees Colony (ABC) algorithms for scheduling optimization.
Resumo:
The aim of this paper is to present an adaptation model for an Adaptive Educational Hypermedia System, PCMAT. The adaptation of the application is based on progressive self-assessment (exercises, tasks, and so on) and applies the constructivist learning theory and the learning styles theory. Our objective is the creation of a better, more adequate adaptation model that takes into account the complexities of different users.
Resumo:
Marine cyanobacteria have been considered a rich source of secondary metabolites with potential biotechnological applications, namely in the pharmacological field. Chemically diverse compounds were found to induce cytoxicity, anti-inflammatory and antibacterial activities. The potential of marine cyanobacteria as anticancer agents has however been the most explored and, besides cytotoxicity in tumor cell lines, several compounds have emerged as templates for the development of new anticancer drugs. The mechanisms implicated in the cytotoxicity of marine cyanobacteria compounds in tumor cell lines are still largely overlooked but several studies point to an implication in apoptosis. This association has been related to several apoptotic indicators such as cell cycle arrest, mitochondrial dysfunctions and oxidative damage, alterations in caspase cascade, alterations in specific proteins levels and alterations in the membrane sodium dynamics. In the present paper a compilation of the described marine cyanobacterial compounds with potential anticancer properties is presented and a review on the implication of apoptosis as the mechanism of cell death is discussed.
Resumo:
Purpose: Systematic review to identify the factors associated to the quality of life (QOL) of the caregivers of people with aphasia (PWA). Methods: Studies were searched using Medline, Pubmed, Cochrane Library, CINAHL, PsycINFO and Web of Science databases. Peer-reviewed papers that studied the QOL of PWA’s caregivers or the consequences of aphasia in caregivers’ life were included. Findings were extracted from the studies that met the inclusion criteria. Results: No data is available reporting particularly the QOL of PWA caregivers’ or their QOL predictors. Nevertheless, it was possible to extract aspects related to QOL from the studies that report the consequences of aphasia, and life changes in PWA’s caregivers. Nine (9) studies including PWA’s caregivers were found, but only 5 reported data separately on them. Methodological heterogeneity impedes cross-study comparisons, although some considerations can be made. PWA’s caregivers reported life changes such as: loss of freedom; social isolation; new responsibilities; anxiety; emotional loneliness; need for support and respite. Conclusions: Changes in social relationships, in emotional status, increased burden and need for support and respite were experienced by PWA’s caregivers. Stroke QOL studies need to include PWA caregivers’ and report separately on them. Further research is needed in this area in order to determine their QOL predictors and identify what interventions and referrals better suit their needs.
Motivations and management factors of volunteer work in nonprofit organisations: a literature review
Resumo:
The objective of this paper is to review and discuss the literature about volunteers’ motivations to donate their time to NPOs and the management factors that can influence volunteer work. Firstly, the paper illustrates and compares the different types of motivation followed by a presentation of a typology that organises the volunteers’ motivations into four types: (i) altruism, (ii) belonging, (iii) ego and social recognition and (iv) development and learning. Secondly we discuss the key management factors in volunteering: recruitment, training and rewarding. Finally, we present four gaps in the literature that justify the scope for further research: (i) omission of differences between motivations related to volunteers’ "Attraction" versus "Retention"; (ii) focus of the research on the USA, UK and Australia context; (iii) absence of comparative analyses that relate motivations by NPO types and (iv) comprehension of how management factors (recruitment, training and rewarding) influence volunteers’ satisfaction and retention.
Resumo:
The objective of this paper is to review and discuss the literature about the management factors that can influence volunteer work. First we present the different management factors. This discussion is followed by the identification of the key management factors in volunteering: recruitment, training and rewarding. Finally, we present two main gaps in the literature that justify the scope for further research: (i) how management factors (recruitment, training and rewarding) influence volunteers’ satisfaction and retention; and (ii) predominance of the investigations in the North American context, followed by English and Australian context.
Resumo:
Collaborative Work plays an important role in today’s organizations, especially in areas where decisions must be made. However, any decision that involves a collective or group of decision makers is, by itself complex, but is becoming recurrent in recent years. In this work we present the VirtualECare project, an intelligent multi-agent system able to monitor, interact and serve its customers, which are, normally, in need of care services. In last year’s there has been a substantially increase on the number of people needed of intensive care, especially among the elderly, a phenomenon that is related to population ageing. However, this is becoming not exclusive of the elderly, as diseases like obesity, diabetes and blood pressure have been increasing among young adults. This is a new reality that needs to be dealt by the health sector, particularly by the public one. Given this scenarios, the importance of finding new and cost effective ways for health care delivery are of particular importance, especially when we believe they should not to be removed from their natural “habitat”. Following this line of thinking, the VirtualECare project will be presented, like similar ones that preceded it. Recently we have also assisted to a growing interest in combining the advances in information society - computing, telecommunications and presentation – in order to create Group Decision Support Systems (GDSS). Indeed, the new economy, along with increased competition in today’s complex business environments, takes the companies to seek complementarities in order to increase competitiveness and reduce risks. Under these scenarios, planning takes a major role in a company life. However, effective planning depends on the generation and analysis of ideas (innovative or not) and, as a result, the idea generation and management processes are crucial. Our objective is to apply the above presented GDSS to a new area. We believe that the use of GDSS in the healthcare arena will allow professionals to achieve better results in the analysis of one’s Electronically Clinical Profile (ECP). This achievement is vital, regarding the explosion of knowledge and skills, together with the need to use limited resources and get better results.
Resumo:
Abstract Introduction: Exhaustive and/or unaccustomed exercise, mainly those involving eccentric muscle actions, induces temporary muscle damage, evidenced by Delayed Onset Muscle Soreness. Different strategies to recover the signs and symptoms of this myogenic condition have been studied by researchers, as a result a significant number of articles on this issue have been published. Purpose: A systematic review was conducted to assess the evidence of the physiotherapeutic interventions of exercise-induced muscle damage. Methods: The electronic data bases were searched, including MEDLINE (1996-2011), CINHAL (1982- 2011), EMBASE (1988-2011), PEDro (1950-2011), and SPORTDiscus (1985-2011). Systematic review was limited to randomized control trials (RCTs) studies, written in English or Portuguese, which included physiotherapeutic interventions, namely massage, cryotherapy, stretching and low-intensity exercise, on adult human subjects (18-60 years old) of either gender. Studies were excluded when the intervention could not be assessed independently. The methodological quality of RCTs was independently assessed with the PEDro Scale by three reviewers. Results: Thirty-three studies were included in the systematic review; eight analyzed the effects of the massage, ten analyzed the effects of the cryotherapy, eight the effect of stretching and seventeen focused low-intensity exercise intervention. The results suggest that massage is the most effective intervention and that there is inconclusive evidence to support the use of cryotherapy; whereas the other conventional, namely stretching and low-intensity exercise, there is no evidence to prove their efficacy. Conclusion: The results allow the conclusion that massage is the physiotherapeutic intervention that demonstrated to be the most effective in the relief of symptoms and signs of exercise-induced muscle damage, as a result, massage should still be used in the muscular recovery after sports activities.
Resumo:
No decorrer do projeto SELEAG foi desenvolvido um jogo de aventura gráfica educativo com o propósito de ensinar história, cultura e relações sociais aos alunos. Este jogo foi avaliado em contexto de sala de aula em diversos países, obtendo resultados positivos. No entanto, por motivos técnicos, alguns dos objetivos propostos pelo projeto não puderam ser devidamente explorados, como permitir que o jogo fosse extensível por outros educadores ou suportar a colaboração online entre os jogadores. Nomeadamente, as ferramentas utilizadas para desenvolver o jogo eram demasiado complicadas para serem utilizadas fora da equipa de desenvolvimento, o que limitou a extensibilidade do projeto, e tornou impossível que educadores sem conhecimentos de programação fossem também capazes de traduzir os seus conteúdos educativos para este formato. Além disso, apesar do jogo possuir algumas funcionalidades de colaboração online, toda a interação era efetuada externamente ao jogo, através de um fórum de mensagens, o que demonstrou ser pouco motivante para os jogadores, pois muitos deles nem se aperceberam que havia uma componente de colaboração no jogo. O objetivo desta tese incide sobre estes dois problemas, e consistiu em desenvolver um editor e motor de jogo com uma interface simples de utilizar, que não necessita de conhecimentos prévios de programação, e que permite criar jogos de aventura gráfica com uma componente de colaboração online verdadeiramente embebida na jogabilidade. A aplicação desenvolvida foi testada por um conjunto de utilizadores de diversas áreas, tendo-se obtido resultados que demonstram a acessibilidade e simplicidade da mesma, independentemente do nível de experiência prévio de programação do utilizador. A componente de colaboração online foi também muito bem recebida pelos utilizadores, os quais demonstraram bastante interesse em ver jogos de aventura gráfica com componente de colaboração online serem desenvolvidos no futuro.
Resumo:
Over the last two decades the research and development of legged locomotion robots has grown steadily. Legged systems present major advantages when compared with ‘traditional’ vehicles, because they allow locomotion in inaccessible terrain to vehicles with wheels and tracks. However, the robustness of legged robots, and especially their energy consumption, among other aspects, still lag behind mechanisms that use wheels and tracks. Therefore, in the present state of development, there are several aspects that need to be improved and optimized. Keeping these ideas in mind, this paper presents the review of the literature of different methods adopted for the optimization of the structure and locomotion gaits of walking robots. Among the distinct possible strategies often used for these tasks are referred approaches such as the mimicking of biological animals, the use of evolutionary schemes to find the optimal parameters and structures, the adoption of sound mechanical design rules, and the optimization of power-based indexes.
Resumo:
The remediation of contaminated sites supports the goal of sustainable development but may also have environmental impacts at a local, regional and global scale. Life cycle assessment (LCA) has increasingly been used in order to support site remediation decision-making. This review article discusses existing LCA methods and proposed models focusing on critical decisions and assumptions of the LCA application to site remediation activities. It is concluded that LCA has limitations as an adequate holistic decisionmaking tool since spatial and temporal differentiation of non-global impacts assessment is a major hurdle in site remediation LCA. Moreover, a consequential LCA perspective should be adopted when the different remediation services to be compared generate different site’s physical states, displacing alternative post-remediation scenarios. The environmental effects of the post-remediation stage of the site is generally disregarded in the past site remediation LCA studies and such exclusion may produce misleading conclusions and misdirected decision-making. In addition, clear guidance accepted by all stakeholders on remediation capital equipment exclusion and on dealing with multifunctional processes should be developed for site remediation LCA applications.
Resumo:
The development of new products or processes involves the creation, re-creation and integration of conceptual models from the related scientific and technical domains. Particularly, in the context of collaborative networks of organisations (CNO) (e.g. a multi-partner, international project) such developments can be seriously hindered by conceptual misunderstandings and misalignments, resulting from participants with different backgrounds or organisational cultures, for example. The research described in this article addresses this problem by proposing a method and the tools to support the collaborative development of shared conceptualisations in the context of a collaborative network of organisations. The theoretical model is based on a socio-semantic perspective, while the method is inspired by the conceptual integration theory from the cognitive semantics field. The modelling environment is built upon a semantic wiki platform. The majority of the article is devoted to developing an informal ontology in the context of a European R&D project, studied using action research. The case study results validated the logical structure of the method and showed the utility of the method.