757 resultados para prerequisite
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As ciências são um elemento central da cultura contemporânea pelo que a educação científica tem de ser vista como um direito essencial dos cidadãos. A qualidade do ensino das ciências na escola torna-se, portanto, um especial foco de interesse, científico, político e social, ao nível local, nacional, e global. A investigação em educação em ciências tem produzido conhecimentos que permitem compreender os problemas e fundamentar decisões conducentes a um ensino de ciências ajustado aos desafios atuais. Por outro lado, várias organizações internacionais (UE, OCDE e UNESCO) também têm produzido documentos que visam regular as políticas globais de ensino de ciências, assumindo que a educação científica dos cidadãos é uma condição para a prosperidade económica e social de qualquer estado. Assim, atualmente, existe um acervo documental extenso e diverso relativo ao ensino de ciências, pelo que se impõe um exercício de análise e síntese que identifique quais as orientações-chave que devem ser consideradas. O ensino de nível secundário (ISCE2 e ISCE3), sendo uma etapa em que os jovens fazem escolhas pessoais e vocacionais importantes, merece particular atenção, pois diversos estudos revelam que regista níveis preocupantes de abandono e de desinteresse pelas áreas científicas e tecnológicas. Sendo as práticas dos professores um dos principais fatores de inovação e mudança importa sistematizar os conhecimentos científicos que explicam a sua complexidade e podem orientar a promoção da sua qualidade. O estudo que se apresenta situa-se na confluência de todos estes interesses e visou duas finalidades: delimitar um conceito unificador que permita estudar e desenvolver a qualidade das práticas dos professores de ciências de nível secundário; desenvolver um instrumento de inquérito que operacionalize esse conceito, numa perspetiva de investigação, formação e supervisão de práticas de ensino de ciências. O plano da investigação decorreu em duas fases. Na fase I foi delimitado o conceito perfil de ensino do professor de ciências (PEPC); este estrutura-se em três dimensões – didática, epistemológica e psicológica – cujos referenciais teórico-empíricos decorreram de revisão sistemática de literatura e de abordagem empírica de natureza exploratória e qualitativa, baseada em entrevistas a professores de ciências. Na fase II foi construído e validado o questionário do perfil de ensino do professor de ciências (QPEPC); este contém itens empiricamente situados, construídos a partir do discurso dos professores entrevistados na fase I e seguidamente validados. A validação de QPEPC envolveu dois processos de inquérito por questionário e uma metodologia mista de investigação (análise de conteúdo e análise estatística de dados): a primeira validação contou com um painel internacional de 12 especialistas em didática de ciências; a segunda validação envolveu 184 professores de ciências portugueses. Concluindo-se que QPEPC avalia duas dimensões de PEPC, construíram-se índices e modelos gráficos para facilitar a interpretação dos dados recolhidos. Analisaram-se limitações e potencialidades heurísticas de PEPC e QPEPC, enquanto produtos da investigação, perspetivando o seu uso em contextos diversos, nomeadamente futuras investigações e cenários de formação, reflexão e supervisão de professores de ciências.
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Dissertação mest., Observação e Análise da Relação Educativa, Universidade do Algarve, 2009
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Distribution systems are the first volunteers experiencing the benefits of smart grids. The smart grid concept impacts the internal legislation and standards in grid-connected and isolated distribution systems. Demand side management, the main feature of smart grids, acquires clear meaning in low voltage distribution systems. In these networks, various coordination procedures are required between domestic, commercial and industrial consumers, producers and the system operator. Obviously, the technical basis for bidirectional communication is the prerequisite of developing such a coordination procedure. The main coordination is required when the operator tries to dispatch the producers according to their own preferences without neglecting its inherent responsibility. Maintenance decisions are first determined by generating companies, and then the operator has to check and probably modify them for final approval. In this paper the generation scheduling from the viewpoint of a distribution system operator (DSO) is formulated. The traditional task of the DSO is securing network reliability and quality. The effectiveness of the proposed method is assessed by applying it to a 6-bus and 9-bus distribution system.
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Dissertação apresentada à Escola Superior de Educação de Lisboa para a obtenção de grau de Mestre em Didática da Língua Portuguesa no 1.º e 2.º Ciclos do Ensino Básico
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Projecto Final para obtenção do grau de Mestre em Engenharia Informática e de Computadores
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regula a posição do corpo no espaço, sendo um pré-requisito para o movimento. À periferia este processo de Controlo Postural pode ser identificado também através da variação do stiffness. O Acidente Vascular Encefálico apresenta-se como a patologia onde os sujeitos são referenciados como tendo alteração do stiffness, e poderão verificar-se modificações nesta variável no âmbito da reabilitação neuro-motora. Objetivo: Descrever o comportamento do stiffness da tibiotársica, nos dois membros inferiores, em indivíduos pós Acidente Vascular Encefálico, face a uma intervenção em fisioterapia baseada num processo de raciocínio clínico. Métodos: 5 sujeitos participaram no estudo, tendo sido implementado um programa de reabilitação para cada um dos sujeitos, por um período de 3 meses, com 2 momentos de avaliação (M0 e M1). O torque e a amplitude articular da tibiotársica foi monitorizada, através do dinamómetro isocinético, durante o movimento passivo de dorsiflexão, a diferentes velocidades (5º/s, 1º/s e 0,25º/s) A atividade eletromiográfica dos músculos Gastrocnémio Interno e Solear foi também recolhida. O valor de stiffness foi calculado através da relação torque/posição. Resultados: Em todos os sujeitos em estudo verificou-se que de uma forma geral o stiffness do membro contralateral à lesão apresentou uma modificação no sentido da diminuição em todas as amplitudes em M1. Nos sujeitos A e C, verificou-se que o stiffness do membro ipsilateral apresentou uma modificação no sentido da diminuição em M1 (em amplitudes intermédias). Nos sujeitos B, D e E o stiffness não apresentou modificações. O stiffness não variou com a velocidade. Conclusão: O stiffness apontou para uma diminuição, nos sujeitos em estudo no membro contralateral à lesão e no membro ipsilateral à lesão nos sujeitos A e C em amplitudes intermédias.
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This communication aims to present some reflections regarding the importance of information in organizational context, especially in business context. The ability to produce and to share expertise and knowledge among its employees is now a key factor in the success of any organization. However, it’s also true that workers are increasingly feeling that too much information can hurt their performance. The existence of skilled professionals able to organize, evaluate, select and disseminate information in organizations appears to be a prerequisite for success. The skills necessary for the formation of a professional devoted to the management of information and knowledge in the context of business organizations will be analysed. Then data collected in two focus group discussion with students from a graduate course in Business Information, from Polytechnic Institute of Porto, Portugal, a will be examined.
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Os sistemas de informação integrados contribuem para a gestão eficiente das empresas, seja na organização e funcionamento internos ou nas relações externas. O mercado deste software é dominado pelas empresas que criam e distribuem sistemas proprietários. Existe uma alternativa, software livre, que disponibiliza aplicações em código aberto e maioritariamente de licença gratuita, que pode ser adaptado às necessidades das empresas. O objetivo do presente trabalho é avaliar a viabilidade de plataformas livres, de natureza vertical – OFBiz – e horizontal – Spring – como opção na escolha de um sistema de informação nas Pequenas e Médias Empresas portuguesas. Das áreas de negócio principais das organizações, foi selecionada a área de Recursos Humanos para efeitos de adaptação na aplicação OFBiz, com incidência em dois casos de uso: uma opção essencial, mas que atualmente não está prevista – Processamento de vencimentos – e outra já existente e que é avaliada em termos de necessidades de adaptação – Recrutamento. Sendo o idioma um requisito indispensável à internacionalização da aplicação, foi também analisada a sua implementação. A metodologia de investigação utilizada foi o Design Science Research, tendo sido implementado um protótipo para efeitos de teste e avaliação do projeto, com a elaboração de dois modelos: configuração e desenvolvimento. Implementado o protótipo, verificou-se que a framework vertical apresenta-se como uma alternativa mais viável do que a horizontal, pelas funcionalidades já existentes e que facilitam a adequação às necessidades de informação das Pequenas e Médias Empresas. A sua base tecnológica e de estrutura permite que a aplicação possa ser adaptada por técnicos especialistas das próprias empresas.
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La douleur est fréquente en milieu de soins intensifs et sa gestion est l'une des missions des infirmières. Son évaluation est une prémisse indispensable à son soulagement. Cependant lorsque le patient est incapable de signaler sa douleur, les infirmières doivent se baser sur des signes externes pour l'évaluer. Les guides de bonne pratique recommandent chez les personnes non communicantes l'usage d'un instrument validé pour la population donnée et basé sur l'observation des comportements. A l'heure actuelle, les instruments d'évaluation de la douleur disponibles ne sont que partiellement adaptés aux personnes cérébrolésées dans la mesure où ces personnes présentent des comportements qui leur sont spécifiques. C'est pourquoi, cette étude vise à identifier, décrire et valider des indicateurs, et des descripteurs, de la douleur chez les personnes cérébrolésées. Un devis d'étude mixte multiphase avec une dominante quantitative a été choisi pour cette étude. Une première phase consistait à identifier des indicateurs et des descripteurs de la douleur chez les personnes cérébrolésées non communicantes aux soins intensifs en combinant trois sources de données : une revue intégrative des écrits, une démarche consultative utilisant la technique du groupe nominal auprès de 18 cliniciens expérimentés (6 médecins et 12 infirmières) et les résultats d'une étude pilote observationnelle réalisée auprès de 10 traumatisés crâniens. Les résultats ont permis d'identifier 6 indicateurs et 47 descripteurs comportementaux, vocaux et physiologiques susceptibles d'être inclus dans un instrument d'évaluation de la douleur destiné aux personnes cérébrolésées non- communicantes aux soins intensifs. Une deuxième phase séquentielle vérifiait les propriétés psychométriques des indicateurs et des descripteurs préalablement identifiés. La validation de contenu a été testée auprès de 10 experts cliniques et 4 experts scientifiques à l'aide d'un questionnaire structuré qui cherchait à évaluer la pertinence et la clarté/compréhensibilité de chaque descripteur. Cette démarche a permis de sélectionner 33 des 47 descripteurs et valider 6 indicateurs. Dans un deuxième temps, les propriétés psychométriques de ces indicateurs et descripteurs ont été étudiés au repos, lors de stimulation non nociceptive et lors d'une stimulation nociceptive (la latéralisation du patient) auprès de 116 personnes cérébrolésées aux soins intensifs hospitalisées dans deux centres hospitaliers universitaires. Les résultats montrent d'importantes variations dans les descripteurs observés lors de stimulation nociceptive probablement dues à l'hétérogénéité des patients au niveau de leur état de conscience. Dix descripteurs ont été éliminés, car leur fréquence lors de la stimulation nociceptive était inférieure à 5% ou leur fiabilité insuffisante. Les descripteurs physiologiques ont tous été supprimés en raison de leur faible variabilité et d'une fiabilité inter juge problématique. Les résultats montrent que la validité concomitante, c'est-à-dire la corrélation entre l'auto- évaluation du patient et les mesures réalisées avec les descripteurs, est satisfaisante lors de stimulation nociceptive {rs=0,527, p=0,003, n=30). Par contre la validité convergente, qui vérifiait l'association entre l'évaluation de la douleur par l'infirmière en charge du patient et les mesures réalisés avec les descripteurs, ainsi que la validité divergente, qui vérifiait si les indicateurs discriminent entre la stimulation nociceptive et le repos, mettent en évidence des résultats variables en fonction de l'état de conscience des patients. Ces résultats soulignent la nécessité d'étudier les descripteurs de la douleur chez des patients cérébrolésés en fonction du niveau de conscience et de considérer l'hétérogénéité de cette population dans la conception d'un instrument d'évaluation de la douleur pour les personnes cérébrolésées non communicantes aux soins intensifs. - Pain is frequent in the intensive care unit (ICU) and its management is a major issue for nurses. The assessment of pain is a prerequisite for appropriate pain management. However, pain assessment is difficult when patients are unable to communicate about their experience and nurses have to base their evaluation on external signs. Clinical practice guidelines highlight the need to use behavioral scales that have been validated for nonverbal patients. Current behavioral pain tools for ICU patients unable to communicate may not be appropriate for nonverbal brain-injured ICU patients, as they demonstrate specific responses to pain. This study aimed to identify, describe and validate pain indicators and descriptors in brain-injured ICU patients. A mixed multiphase method design with a quantitative dominant was chosen for this study. The first phase aimed to identify indicators and descriptors of pain for nonverbal brain- injured ICU patients using data from three sources: an integrative literature review, a consultation using the nominal group technique with 18 experienced clinicians (12 nurses and 6 physicians) and the results of an observational pilot study with 10 traumatic brain injured patients. The results of this first phase identified 6 indicators and 47 behavioral, vocal and physiological descriptors of pain that could be included in a pain assessment tool for this population. The sequential phase two tested the psychometric properties of the list of previously identified indicators and descriptors. Content validity was tested with 10 clinical and 4 scientific experts for pertinence and comprehensibility using a structured questionnaire. This process resulted in 33 descriptors to be selected out of 47 previously identified, and six validated indicators. Then, the psychometric properties of the descriptors and indicators were tested at rest, during non nociceptive stimulation and nociceptive stimulation (turning) in a sample of 116 brain-injured ICLI patients who were hospitalized in two university centers. Results showed important variations in the descriptors observed during the nociceptive stimulation, probably due to the heterogeneity of patients' level of consciousness. Ten descriptors were excluded, as they were observed less than 5% of the time or their reliability was insufficient. All physiologic descriptors were deleted as they showed little variability and inter observer reliability was lacking. Concomitant validity, testing the association between patients' self report of pain and measures performed using the descriptors, was acceptable during nociceptive stimulation (rs=0,527, p=0,003, n=30). However, convergent validity ( testing for an association between the nurses' pain assessment and measures done with descriptors) and divergent validity (testing for the ability of the indicators to discriminate between rest and a nociceptive stimulation) varied according to the level of consciousness These results highlight the need to study pain descriptors in brain-injured patients with different level of consciousness and to take into account the heterogeneity of this population forthe conception of a pain assessment tool for nonverbal brain-injured ICU patients.
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The mouse has emerged as an animal model for many diseases. At IRO, we have used this animal to understand the development of many eye diseases and treatment of some of them. Precise evaluation of vision is a prerequisite for both these approaches. In this unit we describe three ways to measure vision: testing the optokinetic response, and evaluating the fundus by direct observation and by fluorescent angiography.
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Parvalbumin-immunoreactive interneurons are surrounded by perineuronal nets, containing molecules of the extracellular matrix (e.g. tenascin-R). Furthermore, they seem to have a special cytoskeleton composed of, among others, ankyrinR and beta Rspectrin. In the present developmental study we showed that the intracellular markers parvalbumin, ankyrinR and beta Rspectrin as well as Vicia Villosa agglutinin, an extracellular marker for perineuronal nets, appeared in the second postnatal week. In the third postnatal week, ankyrinR and beta R spectrin were present in the parvalbumin-positive interneurons. Tenascin-R appeared in a similar topographic distribution as the intracellular markers. The adult pattern was established upon the end of the fourth postnatal week. Our results indicate that cytoskeletal maturity maybe a prerequisite for the organization of perineuronal nets of extracellular matrix.
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Many studies based on either an experimental or an epidemiological approach, have shown that the ability to drive is impaired when the driver is under the influence of cannabis. Baseline performances of heavy users remain impaired even after several weeks of abstinence. Symptoms of cannabis abuse and dependence are generally considered incompatible with safe driving. Recently, it has been shown that traffic safety can be increased by reporting the long-term unfit drivers to the driver licensing authorities and referring the cases for further medical assessment. Evaluation of the frequency of cannabis use is a prerequisite for a reliable medical assessment of the fitness to drive. In a previous paper we advocated the use of two thresholds based on 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THCCOOH) concentration in whole blood to help to distinguish occasional cannabis users (≤3μg/L) from heavy regular smokers (≥40μg/L). These criteria were established on the basis of results obtained in a controlled cannabis smoking study with placebo, carried out with two groups of young male volunteers; the first group was characterized by a heavy use (≥10 joints/month) while the second group was made up of occasional users smoking at most 1 joint/week. However, to date, these cutoffs have not been adequately assessed under real conditions. Their validity can now be evaluated and confirmed with 146 traffic offenders' real cases in which the whole blood cannabinoid concentrations and the frequency of cannabis use are known. The two thresholds were not challenged by the presence of ethanol (40% of cases) and of other therapeutic and illegal drugs (24%). Thus, we propose the following procedure that can be very useful in the Swiss context but also in other countries with similar traffic policies: if the whole blood THCCOOH concentration is higher than 40μg/L, traffic offenders must be directed first and foremost toward medical assessment of their fitness to drive. This evaluation is not recommended if the THCCOOH concentration is lower than 3μg/L and if the self-rated frequency of cannabis use is less than 1 time/week. A THCCOOH level between these two thresholds cannot be reliably interpreted. In such a case, further medical assessment and follow-up of the fitness to drive are also suggested, but with lower priority.
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The debate on the merits of observational studies as compared with randomized trials is ongoing. We will briefly touch on this subject, and demonstrate the role of cohort studies for the description of infectious disease patterns after transplantation. The potential benefits of cohort studies for the clinical management of patients outside of the expected gain in epidemiological knowledge are reviewed. The newly established Swiss Transplantation Cohort Study and in particular the part focusing on infectious diseases will serve as an illustration. A neglected area of research is the indirect value of large, multicenter cohort studies. These benefits can range from a deepened collaboration to the development of common definitions and guidelines. Unfortunately, very few data exist on the role of such indirect effects on improving quality of patient management. This review postulates an important role for cohort studies, which should not be viewed as inferior but complementary to established research tools, in particular randomized trials. Randomized trials remain the least bias-prone method to establish knowledge regarding the significance of diagnostic or therapeutic measures. Cohort studies have the power to reflect a real-world situation and to pinpoint areas of knowledge as well as of uncertainty. Prerequisite is a prospective design requiring a set of inclusive data coupled with the meticulous insistence on data retrieval and quality.
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OBJECTIVE: To determine the sensitivity of ultrasonography in screening for foetal malformations in the pregnant women of the Swiss Canton of Vaud. STUDY DESIGN: Retrospective study over a period of five years. METHOD: We focused our study on 512 major or minor clinically relevant malformations detectable by ultrasonography. We analysed the global sensitivity of the screening and compared the performance of the tertiary centre with that of practitioners working in private practice or regional hospitals. RESULTS: Among the 512 malformations, 181 (35%) involved the renal and urinary tract system, 137 (27%) the heart, 71 (14%) the central nervous system, 50 (10%) the digestive system, 42 (8%) the face and 31 (6%) the limbs. Global sensitivity was 54.5%. The lowest detection rate was observed for cardiac anomalies, with only 23% correct diagnoses. The tertiary centre achieved a 75% detection rate in its outpatient clinic and 83% in referred patients. Outside the referral centre, the diagnostic rate attained 47%. CONCLUSIONS: Routine foetal examination by ultrasonography in a low-risk population can detect foetal structural abnormalities. Apart from the diagnosis of cardiac abnormalities, the results in the Canton of Vaud are satisfactory and justify routine screening for malformations in a low-risk population. A prerequisite is continuing improvement in the skills of ultrasonographers through medical education.
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Early admission to hospital with minimum delay is a prerequisite for successful management of acute stroke. We sought to determine our local pre- and in-hospital factors influencing this delay. Time from onset of symptoms to admission (admission time) was prospectively documented during a 6-month period (December 2004 to May 2005) in patients consecutively admitted for an acute focal neurological deficit presented at arrival and of presumed vascular origin. Mode of transportation, patient's knowledge and correct recognition of stroke symptoms were assessed. Physicians contacted by the patients or their relatives were interviewed. The influence of referral patterns on in-hospital delays was further evaluated. Overall, 331 patients were included, 249 had an ischaemic and 37 a haemorrhagic stroke. Forty-five patients had a TIA with neurological symptoms subsiding within the first hours after admission. Median admission time was 3 hours 20 minutes. Transportation by ambulance significantly shortened admission delays in comparison with the patient's own means (HR 2.4, 95% CI 1.6-3.7). The only other factor associated with reduced delays was awareness of stroke (HR 1.9, 95% CI 1.3-2.9). Early in-hospital delays, specifically time to request CT-scan and time to call the neurologist, were shorter when the patient was referred by his family or to a lesser extent by an emergency physician than by the family physician (p < 0.04 and p < 0.01, respectively) and were shorter when he was transported by ambulance than by his own means (p < 0.01). Transportation by ambulance and referral by the patient or family significantly improved admission delays and early in-hospital management. Correct recognition of stroke symptoms further contributed to significant shortening of admission time. Educational programmes should take these findings into account.