Is There Sufficient Training of Health Care Staff on Noise Reduction in Neonatal Intensive Care Units? a Pilot Study From NeoNoise Project

Evidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement and evaluate the effectiveness of a training program (TP) on noise reduction in a Neonatal Intensive Care Units (NICU) by comparing the noise levels before and after the implementation of the program. A total of 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and location of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly following implementation of the training program noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However a significant difference was found for Lp, Cpeak, before and after training staff, suggesting greater care by healthcare professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.

Coalition of distributed generation units to Virtual Power Players - a game theory approach

Smart Grids (SGs) have emerged as the new paradigm for power system operation and management, being designed to include large amounts of distributed energy resources. This new paradigm requires new Energy Resource Management (ERM) methodologies considering different operation strategies and the existence of new management players such as several types of aggregators. This paper proposes a methodology to facilitate the coalition between distributed generation units originating Virtual Power Players (VPP) considering a game theory approach. The proposed approach consists in the analysis of the classifications that were attributed by each VPP to the distributed generation units, as well as in the analysis of the previous established contracts by each player. The proposed classification model is based in fourteen parameters including technical, economical and behavioural ones. Depending of the VPP strategies, size and goals, each parameter has different importance. VPP can also manage other type of energy resources, like storage units, electric vehicles, demand response programs or even parts of the MV and LV distribution network. A case study with twelve VPPs with different characteristics and one hundred and fifty real distributed generation units is included in the paper.

Sectorization: measures and an electromagnetism based approach

Sectorization means dividing a set of basic units into sectors or parts, a procedure that occurs in several contexts, such as political, health and school districting, social networks and sales territory or airspace assignment, to achieve some goal or to facilitate an activity. This presentation will focus on three main issues: Measures, a new approach to sectorization problems and an application in waste collection. When designing or comparing sectors different characteristics are usually taken into account. Some are commonly used, and they are related to the concepts of contiguity, equilibrium and compactness. These fundamental characteristics will be addressed, by defining new generic measures and by proposing a new measure, desirability, connected with the idea of preference. A new approach to sectorization inspired in Coulomb’s Law, which establishes a relation of force between electrically charged points, will be proposed. A charged point represents a small region with specific characteristics/values creating relations of attraction/repulsion with the others (two by two), proportional to the charges and inversely proportional to their distance. Finally, a real case about sectorization and vehicle routing in solid waste collection will be mentioned.

Speech as the basic interface for assistive technology

Speech interfaces for Assistive Technologies are not common and are usually replaced by others. The market they are targeting is not considered attractive and speech technologies are still not well spread. Industry still thinks they present some performance risks, especially Speech Recognition systems. As speech is the most elemental and natural way for communication, it has strong potential for enhancing inclusion and quality of life for broader groups of users with special needs, such as people with cerebral palsy and elderly staying at their homes. This work is a position paper in which the authors argue for the need to make speech become the basic interface in assistive technologies. Among the main arguments, we can state: speech is the easiest way to interact with machines; there is a growing market for embedded speech in assistive technologies, since the number of disabled and elderly people is expanding; speech technology is already mature to be used but needs adaptation to people with special needs; there is still a lot of R&D to be done in this area, especially when thinking about the Portuguese market. The main challenges are presented and future directions are proposed.

Perspetivas interdisciplinares na planificação didática de Línguas e Culturas Estrangeiras

O presente Relatório Final de Estágio concretiza-se num trabalho de reflexão crítica sobre as práticas realizadas como professora estagiária de Inglês e de Espanhol no âmbito das Unidades Curriculares de Prática Educativa I, II e III, do Curso de Mestrado em Ensino de Inglês e Francês ou Espanhol, da Escola Superior de Educação, do Instituto Politécnico do Porto. A problemática que se apresenta decorre da perspetiva de que o ensino e aprendizagem de uma língua estrangeira baseados na articulação entre disciplinas do currículo contribui para uma aprendizagem holística, desenvolvendo competências que permitem um entendimento geral e global dos fenómenos humanos proporcionando aos alunos a compreensão do saber escolar como um todo articulável, contribuindo para uma leitura lógica e completa da realidade. A sua concretização na sala de aula impõe que o professor planifique atividades e opte por estratégias de ensino e de aprendizagem diversificadas, onde convergem finalidades, conceitos e metodologias de diversas disciplinas do currículo. Assim, este trabalho descreve a planificação de práticas de ensino e aprendizagem de Inglês e Espanhol em articulação com os conteúdos e os objetivos da disciplina de Estudo do Meio no Primeiro Ciclo. A planificação de práticas de Inglês no Segundo Ciclo foi realizada em articulação com a disciplina de História e Geografia de Portugal, com base na metodologia de projeto. As opções adotadas na planificação didática são consideradas estratégicas para uma aprendizagem significativa. Palavras-chave: perspetiva interdisciplinar do ensino; planificação didática de línguas estrangeiras; compreensão integrada do saber escolar; aprendizagem por projeto

HRM specificities’ on Portugal hotel units

This paper presents the main Human Resources Management (HRM) specificities’ on Portuguese hotel units. We try to understand the role of HRM on behavior of co-workers and quality service in hotel units and to know the future tendency of human capital profile on Portuguese hotel units and the role of HRM function on management of their staff. We, also, try to explore if Portuguese culture has influence on HRM specificities’ of hotel units. This phenomenon has a special relevance in the Portuguese context, because this country is known a growing process of tourism industry in recent years. Furthermore, little is known about HRM department’ contributions to their human capital management and development. This paper is one of the first to focus specifically on Portuguese hotel units and it also seeks to present findings that stem from the Human Resources Managers’ perspective. The paper is based on qualitative case studies. The data were collected through semi-structured interviews of 12 human resource managers from 12 hotel units located in Portugal. The results show that although there is not an effective HRM, current HRM practices are enough to encouraging pro-environmental behavior in their staff and they have a direct effect on customer satisfaction and competitiveness of sector. However, managers recognize there is need introduce some change on short-term to promote a better performance of staff with effect on customers satisfaction and competitiveness on sector in Portugal. According to these results, the paper discusses the major theoretical and practical implications.

Modeling in-Hospital Patient Survival During the First 28 Days After Intensive Care Unit Admission: a Prognostic Model for Clinical Trials in General Critically Ill Patients

OBJECTIVE: The objective of the study was to develop a model for estimating patient 28-day in-hospital mortality using 2 different statistical approaches. DESIGN: The study was designed to develop an outcome prediction model for 28-day in-hospital mortality using (a) logistic regression with random effects and (b) a multilevel Cox proportional hazards model. SETTING: The study involved 305 intensive care units (ICUs) from the basic Simplified Acute Physiology Score (SAPS) 3 cohort. PATIENTS AND PARTICIPANTS: Patients (n = 17138) were from the SAPS 3 database with follow-up data pertaining to the first 28 days in hospital after ICU admission. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The database was divided randomly into 5 roughly equal-sized parts (at the ICU level). It was thus possible to run the model-building procedure 5 times, each time taking four fifths of the sample as a development set and the remaining fifth as the validation set. At 28 days after ICU admission, 19.98% of the patients were still in the hospital. Because of the different sampling space and outcome variables, both models presented a better fit in this sample than did the SAPS 3 admission score calibrated to vital status at hospital discharge, both on the general population and in major subgroups. CONCLUSIONS: Both statistical methods can be used to model the 28-day in-hospital mortality better than the SAPS 3 admission model. However, because the logistic regression approach is specifically designed to forecast 28-day mortality, and given the high uncertainty associated with the assumption of the proportionality of risks in the Cox model, the logistic regression approach proved to be superior.

Characterizing the Risk Profiles of Intensive Care Units

OBJECTIVE: To develop a new method to evaluate the performance of individual ICUs through the calculation and visualisation of risk profiles. METHODS: The study included 102,561 patients consecutively admitted to 77 ICUs in Austria. We customized the function which predicts hospital mortality (using SAPS II) for each ICU. We then compared the risks of hospital mortality resulting from this function with the risks which would be obtained using the original function. The derived risk ratio was then plotted together with point-wise confidence intervals in order to visualise the individual risk profile of each ICU over the whole spectrum of expected hospital mortality. MAIN MEASUREMENTS AND RESULTS: We calculated risk profiles for all ICUs in the ASDI data set according to the proposed method. We show examples how the clinical performance of ICUs may depend on the severity of illness of their patients. Both the distribution of the Hosmer-Lemeshow goodness-of-fit test statistics and the histogram of the corresponding P values demonstrated a good fit of the individual risk models. CONCLUSIONS: Our risk profile model makes it possible to evaluate ICUs on the basis of the specific risk for patients to die compared to a reference sample over the whole spectrum of hospital mortality. Thus, ICUs at different levels of severity of illness can be directly compared, giving a clear advantage over the use of the conventional single point estimate of the overall observed-to-expected mortality ratio.

POLYCLONAL OUTBREAK OF BLOODSTREAM INFECTIONS CAUSED BY Burkholderia cepacia COMPLEX IN HEMATOLOGY AND BONE MARROW TRANSPLANT OUTPATIENT UNITS

Aim: The objective was to describe an outbreak of bloodstream infections by Burkholderia cepacia complex (Bcc) in bone marrow transplant and hematology outpatients.Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases were identified. Demographic and clinical data were evaluated. Environment and healthcare workers' (HCW) hands were cultured. Species were determined and typed. Reinforcement of hand hygiene, central venous catheter (CVC) care, infusion therapy, and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared for the CVCs. Multi-dose heparin and saline were prepared on counter common to both units.Findings: 14 patients had B. multivorans(one patient had also B. cenopacia), six non-multivorans Bcc and one did not belong to Bcc. Clone A B. multivorans occurred in 12 patients (from Hematology); in 10 their CVC had been used on February 11/12. Environmental and HCW cultures were negative. All patients were treated with meropenem, and ceftazidime lock-therapy. Eight patients (30%) were hospitalized. No deaths occurred. After control measures (multidose vial for single patient; CVC lock with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of cabinet to store prepared medication), no new cases occurred.Conclusions: This polyclonal outbreak may be explained by a common source containing multiple species of Bcc, maybe the laminar flow cabinet common to both units. There may have been contamination by B. multivorans (clone A) of multi-dose vials.

Ventiladores pulmonares: definição do método de calibração / ensaio, aplicação regulamentar e estudo da situação atual

A crescente incorporação das evoluções tecnológicas nos equipamentos médicos modernos, além de os tornar mais compactos e precisos, proporciona igualmente ganhos de outros benefícios importantes, especialmente ao nível da eficiência das terapias prescritas aos pacientes. Os sofisticados ventiladores pulmonares de cuidados intensivos do presente espelham perfeitamente esta realidade e por isso necessitam de procedimentos técnicos de verificação metrológica – calibrações, também eles mais exatos e rastreáveis, de modo a fornecerem informações corretas sobre se o estado de funcionamento de um determinado ventilador cumpre ou não as tolerâncias declaradas pelo seu fabricante. Através da presente dissertação pretendeu-se desenvolver um procedimento técnico de calibração dos ventiladores de cuidados intensivos tendo-se estudado, para esta finalidade, os equipamentos de calibração específicos disponíveis no mercado, a normalização e o enquadramento regulamentar do controlo metrológico aplicáveis, bem como o princípio de funcionamento do ventilador pulmonar e a evolução da ventilação mecânica ocorrida. No domínio da abordagem efetuada sobre o âmbito da metrologia, implementou-se a determinação das incertezas dos resultados das calibrações efetuadas pelo procedimento técnico desenvolvido, de acordo com a metodologia constante do GUM1. Considerando ainda os défices significativos de conhecimento da metrologia e da prática do controlo metrológico no setor da saúde, a par dos riscos inerentes para os próprios pacientes, procura-se contribuir com este trabalho, de uma forma transversal e ampla, para uma maior consciencialização, quer dos profissionais de saúde, quer dos gestores envolvidos, para a relevância da realização das calibrações periódicas dos complexos equipamentos de suporte de vida que são os ventiladores pulmonares de cuidados intensivos.

TOXOPLASMOSIS-RELATED KNOWLEDGE AMONG PREGNANT AND POSTPARTUM WOMEN ATTENDED IN PUBLIC HEALTH UNITS IN NITERÓI, RIO DE JANEIRO, BRAZIL

The present study conducted a toxoplasmosis-related knowledge level survey with 400 pregnant and puerperal women attended in public health units in the municipality of Niterói, Rio de Janeiro. Only 111 (27.8%) women claimed to know about the disease. Most of them (n = 289; 72.2%) had never heard about toxoplasmosis nor knew how to prevent the infection by Toxoplasma gondii. A significant difference (p = 0.013) regarding the presence of anti-T. gondii IgG was observed between women who claimed to know about the disease and those who had never heard about it. These results highlight the importance of a systematic serological screening process for toxoplasmosis, as well as the importance of primary prevention by accurate information during prenatal care, an important Public Health action to be implemented.

INVENTORY OF MOSQUITOES (DIPTERA: CULICIDAE) IN CONSERVATION UNITS IN BRAZILIAN TROPICAL DRY FORESTS

In Brazil, most studies of the Culicidae family are concentrated in rainforest regions. As such, there is a lack of knowledge regarding the diversity of Culicidae in regions with different climatic and vegetational characteristics. The aim of this study was to compile an inventory of Culicidae in protected areas of the semi-arid region of the state of Minas Gerais, Brazil, in order to better understand the diversity of the family within this region. The study was conducted across four protected areas in the northern region of the state, in tropical dry forest (TDF) fragments. Sampling methods included Shannon trap and CDC light trap, as well as active collection. A total of 11,219 mosquito specimens were collected between August 2008 and July 2012, belonging to 11 genera and 45 species; 15 new records for the state of Minas Gerais were registered, as well as 26 new records for semi-arid regions within the state. The high number of new Culicidae records in this region demonstrates the importance of inventory studies for increasing the knowledge of culicid biodiversity in Minas Gerais, and in particular within semi-arid regions of the state.

Relatório de estágio em Ensino do 1.º Ciclo do Ensino Básico

Relatório E1CEB - Relatório de estágio em Ensino do 1.º Ciclo do Ensino Básico: Atualmente, a sociedade encontra-se em constante mutação, pelo que urge formar profissionais de educação capazes de responder aos seus desafios, assim como formar cidadãos críticos e responsáveis e estimular a sua participação ativa na sociedade. Desta forma e, no âmbito das unidades curriculares (UC) de Prática Pedagógica Supervisionada na Educação Pré – Escolar e no 1º Ciclo do Ensino Básico (CEB), parte integrante dos 1.º e 2.º anos do Mestrado em Educação Pré-Escolar e Ensino do 1.º CEB, respetivamente, surge o presente relatório que apresenta o processo de desenvolvimento pessoal e profissional da mestranda. Assim, o presente documento pretende ser uma reflexão crítica sobre o processo formativo da formanda, revelando mobilização de conhecimentos teóricos e práticos e uma metodologia construtivista de Investigação – ação, que sustentou as práticas educativas e permitiu um conhecimento sólido e sustentável. Realça, ainda, o desenvolvimento da prática em díade de formação que estimulou o crescimento e a reconstrução de novos conhecimentos enriquecidos por uma reflexão sistemática e contínua. Este trabalho colaborativo promoveu um ambiente educativo profundo, significativo e agradável, contribuindo para a formação individual e coletiva dos vários intervenientes do contexto educativo. Acresce que, ao longo das práticas, a mestranda teve em consideração tudo o que foi aprendendo e desenvolvendo nas diversas UC’s, construindo a sua conceção de educadora e de professora, num contexto relacional e de consciência reflexiva que permitiu uma formação articulada com a ação pedagógica e organizacional, a partir da experiência e transformação dos saberes, eixos fundamentais para a profissionalidade docente.

Relatório de estágio

A realização do presente relatório está prevista no Complemento Regular Específico do Curso de Mestrado em Educação Pré-Escolar e Ensino do 1.º Ciclo do Ensino Básico da Escola Superior de Educação do Politécnico do Porto. Pretende espelhar os saberes adquiridos e vivenciados ao longo da Prática Pedagógica Supervisionada na Educação Pré-Escolar e no 1.º Ciclo do Ensino Básico e, também, os conhecimentos construídos ao longo da frequência das várias unidades curriculares do mestrado supramencionado, e da Licenciatura em Educação Básica. De facto, os conteúdos dos quais a mestranda se foi apropriando contribuíram para a construção do seu perfil enquanto futura profissional de educação, e para a criação da visão de educação que pretende assumir. O presente relatório demonstra, assim, a prática da mestranda, que se norteou pela metodologia de investigação-ação, considerando o ciclo observação-planificação-ação-reflexão-avaliação, atentando sempre na escuta ativa da voz das crianças, procurando compreender as suas características, necessidades e interesses. Para este delineamento constante, o papel da reflexão foi fulcral, essencialmente pelo seu culminar na elaboração de um portfólio, basilar para a criação do relatório que aqui se apresenta. Para esta construção do perfil profissional ressalva-se ainda o papel da supervisão e da colaboração propiciada pelo trabalho em díade com o par pedagógico, pela possibilidade de desenvolvimento e crescimento pessoal que oferecem através da partilha de saberes, opiniões e experiências, contribuindo, em larga escala, para a delineação do que é, de facto, ser educador e professor.