Pandemia influenza A/H1N1 2009 em Portugal : estratégias de intervenção e saúde pública

RESUMO - Introdução: A necessidade de gestão da ameaça de uma pandemia obriga à gestão da incerteza absoluta. O desconhecimento científico quanto a uma série de factores tais como, as características dos vírus causadores de infecções, a efectividade das medidas de prevenção e de tratamento, contribuiu para a dificuldade de actuação a vários níveis. Face à evolução da situação epidemiológica mundial no campo da gripe, Portugal reviu e adaptou o seu plano de contingência para a gripe tendo sido homologado, em Janeiro de 2006, um novo plano – Plano de Contingência Nacional do Sector da Saúde para a Pandemia. Objectivos: O presente estudo apresenta como principais objectivos (1) a avaliação das estratégias de intervenção e respectiva implementação das medidas de saúde pública não farmacológicas, durante a pandemia da gripe de 2009; (2) a identificação dos pontos críticos na gestão das medidas de saúde pública não farmacológicas, para preparação e resposta a futuras pandemias da gripe e, por último, (3) a definição de um modelo de acompanhamento, de monitorização e de avaliação das medidas de saúde pública não farmacológicas, que permita identificar os pontos importantes a ter em conta na implementação de boas práticas de saúde pública, nos diferentes níveis de prestação de cuidados de saúde, tendo como limitação o estado da arte dos sistemas de informação e avaliação, nacionais e internacionais, existentes. Material e Métodos: Para a avaliação das estratégias de intervenção e respectiva implementação das medidas de saúde pública não farmacológicas bem como, para a identificação dos pontos críticos na gestão das respectivas medidas foram consideradas duas perspectivas: a avaliação dos resultados através do Relatório da Pandemia da Gripe e a avaliação dos resultados através das avaliações da OMS e da Euro OMS. É apresentado um modelo de acompanhamento, de monitorização e de avaliação das medidas de saúde pública não farmacológicas, a implementar na classe médica que esteve na “linha da frente”, durante a pandemia H1N1 2009 em Portugal, nos cuidados primários, hospitalares e intensivos. Resultados: Deverá existir uma representação dos profissionais de saúde para suporte das decisões de forma a assegurar uma representação alargada não só na preparação mas também, na implementação e na aplicação do Plano de Contingência. O processo de planemanto deverá ter acesso público com possibilidade de participação activa do cidadão na sua implementação. O Plano deve ter a capacidade para se adaptar à situação epidemiológica e, no terreno os exercícios de simulações durante o processo de planeamento são importantes. As orientações técnicas devem ser dinâmicas, práticas, específicas e úteis e, dever-se investir numa cultura de confiança (“right people communicating to right people”). As alterações ao plano devem partir da coordenação, comando e controlo que, nos vários níveis de decisão, devem definir claramente quem toma as decisões. Conclusões: As estratégias para as intervenções ao nível da saúde pública, continuam, no mundo hodierno a desempenhar um papel fundamental e crucial na contenção das pandemias. O modelo apresentado neste estudo procura uma abordagem objectiva para destacar não só, os elementos essenciais de actividades bem-sucedidas, mas também as áreas em que a experiência pandémica sugere que o futuro planeamento deve dar maior ênfase.

Coronary Optical Coherence Tomography: A Practical Overview of Current Clinical Applications

Coronary optical coherence tomography has emerged as the most powerful in-vivo imaging modality to evaluate vessel structure in detail. It is a useful research tool that provides insights into the pathogenesis of coronary artery disease. This technology has an important clinical role that is still being developed. We review the evidence on the wide spectrum of potential clinical applications for coronary optical coherence tomography, which encompass the successive stages in coronary artery disease management: accurate lesion characterization and quantification of stenosis, guidance for the decision to perform percutaneous coronary intervention and subsequent planning, and evaluation of immediate and long-term results following intervention.

A communication strategy for Continente: Practical, low priced and healthy eating solutions

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Evidence of market anomalies in the Eurozone: A practical implementation

A Work Project, presented as part of the requirements for the Award of a Master’s Double Degree in Finance and Financial Economics from NOVA – School of Business and Economics and Maastricht University

The use of saliva as a practical and feasible alternative to urine in large-scale screening for congenital cytomegalovirus infection increasesinclusion and detection rates

INTRODUCTION: Although urine is considered the gold-standard material for the detection of congenital cytomegalovirus (CMV) infection, it can be difficult to obtain in newborns. The aim of this study was to compare the efficiency of detection of congenital CMV infection in saliva and urine samples. METHODS: One thousand newborns were included in the study. Congenital cytomegalovirus deoxyribonucleic acid (DNA) was detected by polymerase chain reaction (PCR). RESULTS: Saliva samples were obtained from all the newborns, whereas urine collection was successful in only 333 cases. There was no statistically significant difference between the use of saliva alone or saliva and urine collected simultaneously for the detection of CMV infection. CONCLUSIONS: Saliva samples can be used in large-scale neonatal screening for CMV infection.

Improving practical reasoning and argumentation

This thesis justifies the need for and develops a new integrated model of practical reasoning and argumentation. After framing the work in terms of what is reasonable rather than what is rational (chapter 1), I apply the model for practical argumentation analysis and evaluation provided by Fairclough and Fairclough (2012) to a paradigm case of unreasonable individual practical argumentation provided by mass murderer Anders Behring Breivik (chapter 2). The application shows that by following the model, Breivik is relatively easily able to conclude that his reasoning to mass murder is reasonable – which is understood to be an unacceptable result. Causes for the model to allow such a conclusion are identified as conceptual confusions ingrained in the model, a tension in how values function within the model, and a lack of creativity from Breivik. Distinguishing between dialectical and dialogical, reasoning and argumentation, for individual and multiple participants, chapter 3 addresses these conceptual confusions and helps lay the foundation for the design of a new integrated model for practical reasoning and argumentation (chapter 4). After laying out the theoretical aspects of the new model, it is then used to re-test Breivik’s reasoning in light of a developed discussion regarding the motivation for the new place and role of moral considerations (chapter 5). The application of the new model shows ways that Breivik could have been able to conclude that his practical argumentation was unreasonable and is thus argued to have improved upon the Fairclough and Fairclough model. It is acknowledged, however, that since the model cannot guarantee a reasonable conclusion, improving the critical creative capacity of the individual using it is also of paramount importance (chapter 6). The thesis concludes by discussing the contemporary importance of improving practical reasoning and by pointing to areas for further research (chapter 7).

A practical approach to execute and test a lean startup

This paper practically applies the “Lean Startup Approach” by identifying, analyzing and executing a newly developed web-based business idea. Hypotheses were designed and tested with the construction of a minimum viable product – i.e. a landing page. In-depth interviews allowed deciding either to pivot or persevere the initial launch strategy. Overall, the aim was to collect as much valuable response as possible from customers and ultimately decide for a superior strategy while devoting the smallest amount of time and money.

Dos reis da História aos reis das histórias: ficção para a infância e educação histórica no 4º ano do 1ºCEB

Relatório de estágio de mestrado em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico

Two practical approaches to monitoring the zooplanktonic community at Lago Grande do Curuai, Pará, Brazil

The use of substitute groups in biomonitoring programs has been proposed to minimize the high financial costs and time for samples processing. The objectives of this study were to evaluate the correlation between (i) the spatial distribution among the major zooplankton groups (cladocerans, copepods, rotifers, and testaceans protozoa), (ii) the data of density and presence/absence of species, and (iii) the data of species, genera, and families from samples collected in the Lago Grande do Curuai, Pará, Brazil. A total of 55 sample of the zooplanktonic community was collected, with 28 samples obtained in March and 27 in September, 2013. The agreement between the different sets of data was assessed using Mantel and Procrustes tests. Our results indicated high correlations between genus level and species level and high correlations between presence/absence of species and abundance, regardless of the seasonal period. These results suggest that zooplankton community could be incorporated in a long-term monitoring program at relatively low financial and time costs.

ADSNARK: Nearly practical and privacy-preserving proofs on authenticated data

We study the problem of privacy-preserving proofs on authenticated data, where a party receives data from a trusted source and is requested to prove computations over the data to third parties in a correct and private way, i.e., the third party learns no information on the data but is still assured that the claimed proof is valid. Our work particularly focuses on the challenging requirement that the third party should be able to verify the validity with respect to the specific data authenticated by the source — even without having access to that source. This problem is motivated by various scenarios emerging from several application areas such as wearable computing, smart metering, or general business-to-business interactions. Furthermore, these applications also demand any meaningful solution to satisfy additional properties related to usability and scalability. In this paper, we formalize the above three-party model, discuss concrete application scenarios, and then we design, build, and evaluate ADSNARK, a nearly practical system for proving arbitrary computations over authenticated data in a privacy-preserving manner. ADSNARK improves significantly over state-of-the-art solutions for this model. For instance, compared to corresponding solutions based on Pinocchio (Oakland’13), ADSNARK achieves up to 25× improvement in proof-computation time and a 20× reduction in prover storage space.

Introduction [to Food Safety in the Seafood Industry: A practical guide for ISO 22000 and FSSC 22000 implementation]

The prelims comprise: * Half-Title Page * Dedication Page * Title Page * Copyright Page * Table of Contents * Foreword * Acknowledgements * Disclaimer * Introduction

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

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The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

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The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

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