Desenvolvimento de Competências Musicais no 2.º Ciclo do Ensino Básico: Práticas Pedagógicas

A disciplina de Educação Musical está presente no currículo do ensino básico nacional há quarenta e cinco anos, no entanto a informação sobre as práticas musicais nessas aulas é escassa. A presente tese tem por objecto de estudo as práticas dos professores de Educação Musical no 2.º ciclo do ensino básico e pretende perceber o que efectivamente se ensina nessas aulas. Participaram 411 alunos e 15 professores, ao longo de duas fases do estudo: uma fase exploratória, constituída por entrevistas qualitativas a uma pequena amostra (4 professores e 10 alunos) e uma segunda fase, dividida em duas etapas de recolha e análise de dados – questionário a alunos e professores (construído com base nos resultados do estudo exploratório), seguido de entrevistas focalizadas aos professores (participaram, nesta fase, 401 alunos e 11 professores de 9 escolas do 2º ciclo do ensino básico). Trata-se de um estudo misto (qualitativo e quantitativo). O questionário teve como objectivo averiguar as percepções dos alunos e dos professores relativamente às práticas pedagógicas desenvolvidas na aula de Educação Musical. Seguiram-se as entrevistas focalizadas aos professores, que tiveram o intuito de os confrontar com as suas respostas e com as dos seus alunos e ampliar a compreensão das mesmas. Os resultados mostraram que os professores realizam maioritariamente actividades no âmbito das áreas de interpretação, teoria e audição musical. Por outro lado, concretizam poucas experiências de aprendizagem e, ainda menos, actividades de composição musical. Constata-se que as contingências circundantes influenciam as práticas lectivas na disciplina de Educação Musical. A profissionalidade docente é uma construção indissociável das práticas dos professores. Discutem-se os resultados e suas implicações para intervenções pedagógicas no âmbito da Educação Musical, numa lógica de reflexão/investigação/acção sobre a prática.

The World Health Organization Multi-Professional Patient Safety Curriculum : implementation of key modules and its impact on patient safety knowledge, skills, and attitudes of medical students at the University of Algarve

ABSTRACT - Objectives: We attempted to show how the implementation of the key elements of the World Health Organization Patient Safety Curriculum Guide Multi-professional Edition in an undergraduate curriculum affected the knowledge, skills, and attitudes towards patient safety in a graduate entry Portuguese Medical School. Methods: After receiving formal recognition by the WHO as a Complementary Test Site and approval of the organizational ethics committee , the validated pre-course questionnaires measuring the knowledge, skills, and attitudes to patient safety were administered to the 2nd and3rd year students pursuing a four-year course (N = 46). The key modules of the curriculum were implemented over the academic year by employing a variety of learning strategies including expert lecturers, small group problem-based teaching sessions, and Simulation Laboratory sessions. The identical questionnaires were then administered and the impact was measured. The Curriculum Guide was evaluated as a health education tool in this context. Results: A significant number of the respondents, 47 % (n = 22), reported having received some form of prior patient safety training. The effect on Patient Safety Knowledge was assessed by using the percentage of correct pre- and post-course answers to construct 2 × 2 contingency tables and by applying Fishers’ test (two-tailed). No significant differences were detected (p < 0.05). To assess the effect of the intervention on Patient Safety skills and attitudes, the mean and standard deviation were calculated for the pre and post-course responses, and independent samples were subjected to Mann-Whitney’s test. The attitudinal survey indicated a very high baseline incidence of desirable attitudes and skills toward patient safety. Significant changes were detected (p < 0.05) regarding what should happen if an error is made (p = 0.016), the role of healthcare organizations in error reporting (p = 0.006), and the extent of medical error (p = 0.005). Conclusions: The implementation of selected modules of the WHO Patient Safety Curriculum was associated with a number of positive changes regarding patient safety skills and attitudes, with a baseline incidence of highly desirable patient safety attitudes, but no measureable change on the patient safety knowledge, at the University of Algarve Medical School. The significance of these results is discussed along with implications and suggestions for future research.

Use of tacrolimus in rescue therapy of acute and chronic rejection in liver transplantation

PURPOSE: To study the indications and results of tacrolimus as rescue therapy for acute cellular or chronic rejection in liver transplantation. PATIENTS AND METHODS: Eighteen liver transplant recipients who underwent rescue therapy with tacrolimus between March 1995 and August 1999 were retrospectively studied. The treatment indication, patients, and graft situation were recorded as of October 31st, 1999. The response to tacrolimus was defined as patient survival with a functional graft and histological reversal of acute cellular, or for chronic rejection, bilirubin serum levels decreasing to up to twice the upper normal limit. RESULTS: Fourteen cases (77.8%) presented a good response. The response rate for the different indications was: (1) acute cellular + sepsis - 0/1 case; (2) recurrent acute cellular - 1/1 case; (3) OKT3-resistant acute cellular - 2/2 cases; (4) steroid-resistant acute cellular + active viral infection - 3/3 cases; (5) chronic rejection - 8/11 cases (72.7% response rate). The 4 patients who did not respond died. CONCLUSION: Tacrolimus rescue therapy was successful in most cases of acute cellular and chronic rejection in liver transplantation.

Results of microsurgical anastomosis in men with seminal tract obstruction due to inguinal herniorrhaphy

The incidence of vasal injury during inguinal herniorrhaphy is estimated at 0.5%. We sought to assess the patency rates and long-term fertility outcome after microsurgical repair of vasal obstruction related to prior inguinal herniorrhaphy. METHODS: Twenty procedures were performed on 13 men diagnosed with infertility and vasal injury secondary to previous inguinal herniorrhaphy. Eight of these men had undergone bilateral and 5 unilateral inguinal herniorrhaphy. Twelve procedures were vasovasostomies, 3 were crossover vasovasostomies, 2 were vasoepididymostomies, and 3 were crossover vasoepididymostomies. Eight patients were azoospermic, 2 were severely oligospermic (<1 M/mL), 1 was oligospermic, and 2 were asthenospermic. Patency data was obtained on all 13 patients, and pregnancy data was available for 10 couples (77%), with a mean follow-up of 69.5 months. RESULTS: The overall patency rate was 65%. In the vasovasostomy group, the patency rate was 60% (9/15), and in the vasoepididymostomy group it was 80% (4/5). Among the azoospermic patients, 13 procedures were performed. The patency rate was 42.9% for the vasovasostomy (3/7), and 100% for the vasoepididymostomy procedure (4/4). The overall pregnancy rate was 40%. Of the men who underwent vasoepididymostomy, 80% (4/5) established a pregnancy. CONCLUSIONS: Microsurgical vasovasostomy after inguinal vas injury results in a reasonable patency rate but a lower pregnancy rate than that after vasectomy reversal. When microsurgical vasoepididymostomy was possible, it resulted in high patency and pregnancy rate. Crossover vasoepididymostomy, when appropriate, can be a useful alternative to inguinal vasovasostomy.

Dynamics of serotonergic neurons revealed by fiber photometry

This work was developed in the context of the MIT Portugal Program, area of Bioengineering Systems, in collaboration with the Champalimaud Research Programme, Champalimaud Center for the Unknown, Lisbon, Portugal. The project entitled Dynamics of serotonergic neurons revealed by fiber photometry was carried out at Instituto Gulbenkian de Ciência, Oeiras, Portugal and at the Champalimaud Research Programme, Champalimaud Center for the Unknown, Lisbon, Portugal

Inversão do Contencioso: um contributo para o estudo deste regime no seio das providências cautelares

Dissertação de mestrado em Direito Judiciário: Direitos Processuais e Organização Judiciária

O Sinclinal de ferro de Torre de Moncorvo: um recurso mineral como catalisador de um Tempolntermitente

Dissertação de mestrado integrado em Arquitectura

Catatonia due to systemic lupus erythematosus

Objectives Discuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE) in a pediatric patient. Methods Single case report. Result A 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions) that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. Conclusion Although catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration.

Forensic neuropsychological assessment: clinical case of depression and working incapacity

Issues related to mental health in relation to court matters have increasingly required the participation of the psychologist. We present the use of forensic neuropsychological assessment in a case of retirement reversal. Incapacity was attested due to disability resulting from depression of a 35-year-old attorney, and the case was forwarded from the courts to the Forensic Psychiatry and Psychology Unit at the USP Clinical Hospital. A clinical interview and application of cognitive tests was conducted. Despite the depression, significant cognitive losses that would prevent return to his professional assignments were not detected. The neuropsychological assessment has been shown to be an important tool in the forensic context, as it assists with diagnostic value for clarification of functional aspects in the various psychopathological areas in terms of disabilities or potentialities.

Dos efeitos da Procriação Medicamente Assistida no Direito Sucessório

Dissertação de mestrado em Direito das Crianças, Família e Sucessões

Instability of excitation waves induced by electrical fields

Pyrogallol, uncatalyzed bromate oscillator, electric field, pulse wave, Belousov-Zhabotinsky reaction, reversal

Une approche psychanalytique de la notion de dangerosité. Violence et subjectivation : le risque de la rencontre

Après avoir situé la question de la dangerosité dans les perspectives psychiatriques actuelles, l'auteur propose de penser cette notion complexe dans un renversement du paradigme couramment admis : ainsi la référence à la dangerosité témoignerait-elle, au premier plan, de la part non symbolisée de la rencontre de la violence. Cette proposition prend appui dans un premier temps sur les propositions esquissées par M. Foucault dans sa compréhension du rapport à la violence et à la dangerosité. Puis, le recours au concept psychanalytique d'identification projective permet de proposer une modélisation clinique de la dangerosité, qui sera discutée à partir de deux observatoires dans le champ des violences sexuelles : celui d'une recherche menée auprès d'adolescents engagés dans des agirs sexuels violents et celui d'une pratique d'expertise judiciaire. First the author proposes to situate dangerousness's question in actual psychiatric field. Then, he proposes to think this complex notion into a reversal of dangerousness's paradigm: the reference to dangerousness will be thought as the expression of non-symbolized part through violence's meeting. This proposition relies in a first time on M. Foucault's propositions about a comprehension of the relation with violence and dangerousness. In a second time, the psychoanalytic concept of projective identification allows to propose clinical comprehension of dangerousness's notion. Two clinical situations about sexual violences will be asked in this plan: a research with Young sexual offenders and practice of judiciary evaluation.

A Multicenter Randomized Clinical Trial of Primary Anastomosis or Hartmann's Procedure for Perforated Left Colonic Diverticulitis With Purulent or Fecal Peritonitis.

OBJECTIVES: : To evaluate the outcome after Hartmann's procedure (HP) versus primary anastomosis (PA) with diverting ileostomy for perforated left-sided diverticulitis. BACKGROUND: : The surgical management of left-sided colonic perforation with purulent or fecal peritonitis remains controversial. PA with ileostomy seems to be superior to HP; however, results in the literature are affected by a significant selection bias. No randomized clinical trial has yet compared the 2 procedures. METHODS: : Sixty-two patients with acute left-sided colonic perforation (Hinchey III and IV) from 4 centers were randomized to HP (n = 30) and to PA (with diverting ileostomy, n = 32), with a planned stoma reversal operation after 3 months in both groups. Data were analyzed on an intention-to-treat basis. The primary end point was the overall complication rate. The study was discontinued following an interim analysis that found significant differences of relevant secondary end points as well as a decreasing accrual rate (NCT01233713). RESULTS: : Patient demographics were equally distributed in both groups (Hinchey III: 76% vs 75% and Hinchey IV: 24% vs 25%, for HP vs PA, respectively). The overall complication rate for both resection and stoma reversal operations was comparable (80% vs 84%, P = 0.813). Although the outcome after the initial colon resection did not show any significant differences (mortality 13% vs 9% and morbidity 67% vs 75% in HP vs PA), the stoma reversal rate after PA with diverting ileostomy was higher (90% vs 57%, P = 0.005) and serious complications (Grades IIIb-IV: 0% vs 20%, P = 0.046), operating time (73 minutes vs 183 minutes, P < 0.001), hospital stay (6 days vs 9 days, P = 0.016), and lower in-hospital costs (US $16,717 vs US $24,014) were significantly reduced in the PA group. CONCLUSIONS: : This is the first randomized clinical trial favoring PA with diverting ileostomy over HP in patients with perforated diverticulitis.

Methylation profile of TP53 regulatory pathway and mtDNA alterations in breast cancer patients lacking TP53 mutations.

The present study investigated promoter hypermethylation of TP53 regulatory pathways providing a potential link between epigenetic changes and mitochondrial DNA (mtDNA) alterations in breast cancer patients lacking a TP53 mutation. The possibility of using the cancer-specific alterations in serum samples as a blood-based test was also explored. Triple-matched samples (cancerous tissues, matched adjacent normal tissues and serum samples) from breast cancer patients were screened for TP53 mutations, and the promoter methylation profile of P14(ARF), MDM2, TP53 and PTEN genes was analyzed as well as mtDNA alterations, including D-loop mutations and mtDNA content. In the studied cohort, no mutation was found in TP53 (DNA-binding domain). Comparison of P14(ARF) and PTEN methylation patterns showed significant hypermethylation levels in tumor tissues (P < 0.05 and <0.01, respectively) whereas the TP53 tumor suppressor gene was not hypermethylated (P < 0.511). The proportion of PTEN methylation was significantly higher in serum than in the normal tissues and it has a significant correlation to tumor tissues (P < 0.05). mtDNA analysis revealed 36.36% somatic and 90.91% germline mutations in the D-loop region and also significant mtDNA depletion in tumor tissues (P < 0.01). In addition, the mtDNA content in matched serum was significantly lower than in the normal tissues (P < 0.05). These data can provide an insight into the management of a therapeutic approach based on the reversal of epigenetic silencing of the crucial genes involved in regulatory pathways of the tumor suppressor TP53. Additionally, release of significant aberrant methylated PTEN in matched serum samples might represent a promising biomarker for breast cancer.

Automatización de la gestión del ciclo de vida de entornos Linux y Solaris

Los requisitos del Negocio que requieren un gran crecimiento generan mayor complejidad en los Centros de Cómputo.Son los administradores quienes necesitan gestionar el creciente volumen de datos, aplicaciones, y usuarios, así como la rápida proliferación de los servidores y los diferentes sistemas operativos. En este proyecto se pretende reducir la complejidad en la gestión de los Centros de Cómputo, combinando la automatización de la gestión del ciclo de vida y todas las medidas de contingencia necesarias para mantener la integridad de los mismos.