Parasitological stool sample exam by spontaneous sedimentation method using conical tubes: effectiveness, practice, and biosafety

INTRODUCTION: Spontaneous sedimentation is an important procedure for stool examination. A modification of this technique using conical tubes was performed and evaluated. METHODS: Fifty fecal samples were processed in sedimentation glass and in polypropylene conical tubes. Another 50 samples were used for quantitative evaluation of protozoan cysts. RESULTS: Although no significant differences occurred in the frequency of protozoa and helminths detected, significant differences in protozoan cyst counts did occur. CONCLUSIONS: The use of tube predicts a shorter path in the sedimentation of the sample, increases concentration of parasites for microscopy analysis, minimizes the risks of contamination, reduces the odor, and optimizes the workspace.

Clinical practice guidelines in Portugal : quantitative and qualitative evaluation

RESUMO: Introdução As normas de orientação clínica são ferramentas úteis na translação de conhecimentos desde a investigação para a prática clínica diária. Estratégias ativas de implementação de normas de orientação clínica requerem elevado esforço organizacional e financeiro. Quando os recursos são escassos, as estratégias passivas podem ser a única opção de disseminação. Desde 2011 a Direção Geral da Saúde publicou cento e cinquenta e nove normas de orientação clínica. Nesta Tese é feita uma avaliação do impacto que estratégias de disseminação de normas de orientação clínica têm no padrão de prescrição dos médicos e uma avaliação qualitativa do processo das normas de orientação clínica em Portugal. Métodos: O primeiro artigo é um estudo quasi experimental usando uma série de análises temporais interrompida para comparar os níveis observados e esperados de prescrição de inibidores da ciclooxigenasa-2, antes e depois da publicação da norma de orientação clínica sobre a utilização de anti-inflamatórios não esteroides. O segundo estudo é um artigo de opinião e debate no qual numa primeira parte contextualiza o processo das normas da Direcção Geral da Saúde, na segunda parte aponta virtudes e defeitos no processo e a terceira parte constitui uma contribuição com vista à melhoria do processo. Discussão A produção de normas de orientação clínica requer metodologia rigorosa e complexa. A literatura médica revela que a translação de conhecimento é uma tarefa árdua. Estratégias de implementação ativas requerem recursos financeiros e organizacionais sólidos. Estratégias de implementação passivas podem representar uma solução aceitável se os recursos financeiros e organizacionais escasseiam. Pouco é conhecido sobre a eficácia destas estratégias fora do contexto de investigação. Com esta Tese pretendo contribuir para a clarificação desta resposta, outros países e instituições podem ver utilidade nesta informação, bem como pretendo contribuir para a discussão e melhoria do processo das normas de orientação clínica em Portugal. ------------------ ABSTRACT: Introduction Clinical practice guidelines can help address the failure to translate research findings into clinical practice. Active clinical practice guidelines implementation strategies require active efforts from organizations and are resource and financially demanding. Passive implementation strategies may represent the only option if resources are scarce. Out of research environment, real world efficacy of passive implementation strategies is still undetermined. Since 2011 the Portuguese General Health Directorate published one hundred and fifty nine guidelines. In this Thesis I evaluate the impact of passive dissemination of clinical practice guideline in clinician’s prescription behavior and review, from a qualitative point of view, the Portuguese clinical practice guideline process. Methods The first study is a quasi-experimental study using a retrospective interrupted time-series analysis design to compare the observed and expected prescription of cyclooxygenase-2 before and after the non steroidal antiinflammatory guideline publication. The second study is an opinion and debate article in which I firstly review the General Health Directorate guideline process. The second part states positive and negative aspects in the process and the third part is a contribution aimed at improving the process in the future. Discussion Clinical practice guidelines production demands a rigorous and complex methodology. medical iterature reveals that knowledge translation is a difficult task. Active implementation strategies demand solid financial and organizational resources. Passive implementation strategies may represent an acceptable solution if financial and organizational resources are scarce. Little is known about the efficacy of these strategies out of the research context. With this Thesis I intend to contribute to clarify this question, other countries and institutions with similar conditions may find this information useful, and also to contribute for the discussion and general improvement of national clinical practice guidelines process.

Quality assessment of clinical practice guidelinesfor Chagas disease

INTRODUCTION: The development of clinical practice guidelines (CPGs) has increased; this study aimed to assess the quality of CPGs for the management of Chagas disease. METHODS: Following a systematic search of the scientific literature, two reviewers assessed the eligible guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) II instrument. RESULTS: Five CPGs were included. The AGREE domains of scope/purpose, stakeholder involvement, and clarity of presentation were rated well, and the domains of applicability and editorial independence received poor ratings. CONCLUSIONS: The quality of CPGs for Chagas disease is poor, and significant work is required to develop high-quality guidelines.

VO2 thin films and nanoparticles for energy-saving applications in architectural elements

Vanadium dioxide (VO2) is a promising material with large interest in construction industry and architecture, due to its thermochromic properties. This material may be used to create "smart" coatings that result in improvements in the buildings energy efficiency, by reducing heat exchanges and, consequently, the need for acclimatization. In this work, VO2 thin films and coatings were produced and tested in laboratory, to apply in architectural elements, such as glass, rooftop tiles and exterior paints. Thin films were produced by RF magnetron sputtering and VO2 nanoparticles were obtained through hydrothermal synthesis, aiming to create "smart" windows and tiles, respectively. These coatings have demonstrated the capability to modulate the transmittance of infrared radiation by around 20%. The VO2 nanoparticle coatings were successfully applied on ceramic tiles. The critical temperature was reduced to around 40ºC by tungsten doping. Ultimately, two identical house models were built, in order to test the VO2 coatings, in real atmospheric conditions during one of the hottest months of the year, in Portugal – August.

Practice variations in the production of health

This study investigates three questions related to medical practice variation. First, it tests whether average length of stay across Portuguese National Health Service hospitals varies when controlling for differences in patients’ characteristics. Second, it looks at hospital-level characteristics in order to find out whether these are able to explain differences in average length of stay across hospitals. Finally, it proposes a best practice average length of stay for each of the six episodes of care analyzed. To perform the analysis, administrative data from the Diagnosis-Related groups’ data set for the year of 2012 was used. A replication of a hierarchical two-stage model with hospital fixed effects was carried out. The results show that after taking patients’ characteristics into account, variation in average length of stay across hospitals exists. This variation cannot be explained by hospital-level characteristics.

O início da 3.ª série da revista arquitectura em 1957 a influência das leituras de casabella‑continuità e architectural review

A revista Arquitectura foi criada em Portugal em 1927 e publicou‑se até 1939. Em 1948 foi comprada por um grupo de arquitectos denominado ICAT (Iniciativas Culturais Arte e Técnica) que, até 1957, a edita como um meio de divulgação da arquitectura moderna, sob a orientação decisiva de Francisco Keil do Amaral. O número 57/58, de Janeiro/Fevereiro de 1957, é o primeiro a ser editado por uma nova geração de arquitectos, que procurava exprimir as tendências de revisão do Movimento Moderno que começavam a dominar o debate internacional, e o número seguinte é o primeiro da 3.ª série. Na viragem dos anos 50 para os anos 60 as revistas Architectural Review e Casabella protagonizavam o debate arquitectónico na Europa. Neste artigo, a partir da leitura de alguns textos chave de Carlos Duarte e Nuno Portas publicados nos primeiros números da 3.ª série da revista portuguesa, é analisada a influência que tiveram as duas principais publicações internacionais sobre os editores de Arquitectura.

The names of things: terminology and the practice of art history

This paper aims to explore the ways in which standard art history terminology shapes the practice of art history by conditioning the interpretation of specific works of art and, in certain cases, the definition of a research subject (especially where questions of genre and periodization are concerned). Taking as a case study a painting by Georges de La Tour, the Peasant Couple Eating, I will argue that terms such as realism, realistic, naturalistic etc. used for its description and/or interpretation, far from constituting objective stylistic characterizations, shape our perception of the work in question. Bringing the question of social class to the center of the discourse on realism, I propose to show how the social divide between the painter and his subject matter (in this case, the peasants) is internalized in the painting’s style and meaning, and how it is fundamental for the understanding of its intentionality and function.

Revolution in Crisis: The Ruptures of Revolution and Ruptured Revolutions Through the Ruptures of Artistic Practice

This article proposes an investigation of the history and memory of the Carnation Revolution through the lens of contemporary art. Drawing upon the argument according to which history and memory are investigated by visual artists by means other, but no less relevant, than those of professional historians, this article will argue for the importance of attending to the visual, auditory, textual, object- and research-based ways in which artists from several generations and geographies have been unearthing the repressed histories and memories of the Carnation Revolution in Portugal and of anticolonial struggles, decolonization and post-independence nation-building in Mozambique, Guinea-Bissau and Angola. The discussion focuses on several works by Ângela Ferreira, but attention will also be paid to precursors in imaging the Revolution, such as Ana Hatherly, and to a younger generation of artists such as Filipa César, Kiluanji Kia Henda and Daniel Barroca.

Designing cnc knit for hybrid membrane and bending active structures

Recent advances in computation allow for the integration of design and simulation of highly interrelated systems, such as hybrids of structural membranes and bending active elements. The engaged complexities of forces and logistics can be mediated through the development of materials with project specific properties and detailing. CNC knitting with high tenacity yarn enables this practice and offers an alternative to current woven membranes. The design and fabrication of an 8m high fabric tower through an interdisciplinary team of architects, structural and textile engineers, allowed to investigate means to design, specify, make and test CNC knit as material for hybrid structures in architectural scale. This paper shares the developed process, identifies challenges, potentials and future work.

Arquitecturas imaginárias. Espaço real e ilusório no Barroco português

Tese de Doutoramento em Arquitectura / Cultura Arquitectónica.

Se tu eliminares o conto de fadas da realidade eu sou contra ti: disse Kahn

Dissertação de mestrado integrado em Arquitetura (área de especialização em Cultura Arquitetónica)

Património natural e arquitectónico: plano de intervenção na aldeia de Ermelo

Dissertação de mestrado integrado em Arquitectura (área de especialização em Cidade e Território)

Validation of the Portuguese version of the Evidence-Based Practice Questionnaire

OBJECTIVES: To describe the process of translation and linguistic and cultural validation of the Evidence Based Practice Questionnaire for the Portuguese context: Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). METHOD: A methodological and cross-sectional study was developed. The translation and back translation was performed according to traditional standards. Principal Components Analysis with orthogonal rotation according to the Varimax method was used to verify the QECPBE's psychometric characteristics, followed by confirmatory factor analysis. Internal consistency was determined by Cronbach's alpha. Data were collected between December 2013 and February 2014. RESULTS: 358 nurses delivering care in a hospital facility in North of Portugal participated in the study. QECPBE contains 20 items and three subscales: Practice (α=0.74); Attitudes (α=0.75); Knowledge/Skills and Competencies (α=0.95), presenting an overall internal consistency of α=0.74. The tested model explained 55.86% of the variance and presented good fit: χ2(167)=520.009; p = 0.0001; χ2df=3.114; CFI=0.908; GFI=0.865; PCFI=0.798; PGFI=0.678; RMSEA=0.077 (CI90%=0.07-0.08). CONCLUSION: confirmatory factor analysis revealed the questionnaire is valid and appropriate to be used in the studied context.

Towards an engine for coordination-based architectural reconfigurations

Software reconfigurability became increasingly relevant to the architectural process due to the crescent dependency of modern societies on reliable and adaptable systems. Such systems are supposed to adapt themselves to surrounding environmental changes with minimal service disruption, if any. This paper introduces an engine that statically applies reconfigurations to (formal) models of software architectures. Reconfigurations are specified using a domain specific language— ReCooPLa—which targets the manipulation of software coordinationstructures,typicallyusedinservice-orientedarchitectures(soa).Theengine is responsible for the compilation of ReCooPLa instances and their application to the relevant coordination structures. The resulting configurations are amenable to formal analysis of qualitative and quantitative (probabilistic) properties.

On the verification of architectural reconfigurations

In a reconfigurable system, the response to contextual or internal change may trigger reconfiguration events which, on their turn, activate scripts that change the system׳s architecture at runtime. To be safe, however, such reconfigurations are expected to obey the fundamental principles originally specified by its architect. This paper introduces an approach to ensure that such principles are observed along reconfigurations by verifying them against concrete specifications in a suitable logic. Architectures, reconfiguration scripts, and principles are specified in Archery, an architectural description language with formal semantics. Principles are encoded as constraints, which become formulas of a two-layer graded hybrid logic, where the upper layer restricts reconfigurations, and the lower layer constrains the resulting configurations. Constraints are verified by translating them into logic formulas, which are interpreted over models derived from Archery specifications of architectures and reconfigurations. Suitable notions of bisimulation and refinement, to which the architect may resort to compare configurations, are given, and their relationship with modal validity is discussed.