Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial

Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

Expertise sportive et entraînement perceptivo-cognitif de l’athlète

Pour être performant au plus haut niveau, les athlètes doivent posséder une capacité perceptivo-cognitive supérieure à la moyenne. Cette faculté, reflétée sur le terrain par la vision et l’intelligence de jeu des sportifs, permet d’extraire l’information clé de la scène visuelle. La science du sport a depuis longtemps observé l’expertise perceptivo-cognitive au sein de l’environnement sportif propre aux athlètes. Récemment, des études ont rapporté que l’expertise pouvait également se refléter hors de ce contexte, lors d’activités du quotidien par exemple. De plus, les récentes théories entourant la capacité plastique du cerveau ont amené les chercheurs à développer des outils pour entraîner les capacités perceptivo-cognitives des athlètes afin de les rendre plus performants sur le terrain. Ces méthodes sont la plupart du temps contextuelles à la discipline visée. Cependant, un nouvel outil d’entraînement perceptivo-cognitif, nommé 3-Dimensional Multiple Object Tracking (3D-MOT) et dénué de contexte sportif, a récemment vu le jour et a fait l’objet de nos recherches. Un de nos objectifs visait à mettre en évidence l’expertise perceptivo-cognitive spécifique et non-spécifique chez des athlètes lors d’une même étude. Nous avons évalué la perception du mouvement biologique chez des joueurs de soccer et des non-athlètes dans une salle de réalité virtuelle. Les sportifs étaient systématiquement plus performants en termes d’efficacité et de temps de réaction que les novices pour discriminer la direction du mouvement biologique lors d’un exercice spécifique de soccer (tir) mais également lors d’une action issue du quotidien (marche). Ces résultats signifient que les athlètes possèdent une meilleure capacité à percevoir les mouvements biologiques humains effectués par les autres. La pratique du soccer semble donc conférer un avantage fondamental qui va au-delà des fonctions spécifiques à la pratique d’un sport. Ces découvertes sont à mettre en parallèle avec la performance exceptionnelle des athlètes dans le traitement de scènes visuelles dynamiques et également dénuées de contexte sportif. Des joueurs de soccer ont surpassé des novices dans le test de 3D-MOT qui consiste à suivre des cibles en mouvement et stimule les capacités perceptivo-cognitives. Leur vitesse de suivi visuel ainsi que leur faculté d’apprentissage étaient supérieures. Ces résultats confirmaient des données obtenues précédemment chez des sportifs. Le 3D-MOT est un test de poursuite attentionnelle qui stimule le traitement actif de l’information visuelle dynamique. En particulier, l’attention sélective, dynamique et soutenue ainsi que la mémoire de travail. Cet outil peut être utilisé pour entraîner les fonctions perceptivo-cognitives des athlètes. Des joueurs de soccer entraînés au 3D-MOT durant 30 sessions ont montré une amélioration de la prise de décision dans les passes de 15% sur le terrain comparés à des joueurs de groupes contrôles. Ces données démontrent pour la première fois un transfert perceptivo-cognitif du laboratoire au terrain suivant un entraînement perceptivo-cognitif non-contextuel au sport de l’athlète ciblé. Nos recherches aident à comprendre l’expertise des athlètes par l’approche spécifique et non-spécifique et présentent également les outils d’entraînements perceptivo-cognitifs, en particulier le 3D-MOT, pour améliorer la performance dans le sport de haut-niveau.

Source Provenance of Pre-Historic Granitic Grindstones: The Case Study of the Cogotas I Archaeological Site of Arroyo Mucientes/San Lázaro (Castronuño, Valladolid) and a Proposal on the General Methodological Flow Process

The occurrence of hand grindstones at the Cogotas I archaeological sites is considered to be a common feature. Given that a distant-provenance raw material is frequently involved, determination of its source is a basic factor in the search for a better understanding of resource management and for any Political Economy approach. To progress in these directions an overall study should be planned, using selected grindstones with a view to covering diverse sub-zones of the Cogotas I dispersal area, especially because of its considerable distance from the granite basement source. Such a study may today includes diverse analytical procedures combining successive geographic, petrographic, mineralogical and geochemical criteria. To check the plausibility of the proposed methodology, a preliminary test has been carried out on two granite grindstones, obtained at the archaeological excavation at the Castronuño (Valladolid) Cogotian site, which is fifty km away from an inferred source area that was presumably located at Peñausende (Zamora). The result obtained validates the proposed operational process, yielding a generalizable knowledge to other similar situations.

A process evaluation of a cluster randomised trial to reduce potentially inappropriate prescribing in older people in primary care (OPTI-SCRIPT study)

Background
The OPTI-SCRIPT cluster randomised controlled trial (RCT) found that a three-phase multifaceted intervention including academic detailing with a pharmacist, GP-led medicines reviews, supported by web-based pharmaceutical treatment algorithms, and tailored patient information leaflets, was effective in reducing potentially inappropriate prescribing (PIP) in Irish primary care. We report a process evaluation exploring the implementation of the intervention, the experiences of those participating in the study and lessons for future implementation.

Methods
The OPTI-SCRIPT trial included 21 GP practices and 196 patients. The process evaluation used mixed methods. Quantitative data were collected from all GP practices and semi-structured interviews were conducted with GPs from intervention and control groups, and a purposive sample of patients from the intervention group. All interviews were transcribed verbatim and analysed using a thematic analysis.

Results
Despite receiving a standardised academic detailing session, intervention delivery varied among GP practices. Just over 70 % of practices completed medicines review as recommended with the patient present. Only single-handed practices conducted reviews without patients present, highlighting the influence of practice characteristics and resources on variation. Medications were more likely to be completely stopped or switched to another more appropriate medication when reviews were conducted with patients present. The patient information leaflets were not used by any of the intervention practices. Both GP (32 %) and patient (40 %) recruitment rates were modest. For those who did participate, overall, the experience was positively viewed, with GPs and patients referring to the value of medication reviews to improve prescribing and reduce unnecessary medications. Lack of time in busy GP practices and remuneration were identified as organisational barriers to future implementation.

Conclusions
The OPTI-SCRIPT intervention was positively viewed by both GPs and patients, both of whom valued the study’s objectives. Patient information leaflets were not a successful component of the intervention. Academic detailing and medication reviews are important components in changing PIP, and having patients present during the review process seems to be a more effective approach for decreasing PIP.

Data-Driven Dynamic Modeling of Coupled Thermal and Electric Outputs of Microturbines

Microturbines are among the most successfully commercialized distributed energy resources, especially when they are used for combined heat and power generation. However, the interrelated thermal and electrical system dynamic behaviors have not been fully investigated. This is technically challenging due to the complex thermo-fluid-mechanical energy conversion processes which introduce multiple time-scale dynamics and strong nonlinearity into the analysis. To tackle this problem, this paper proposes a simplified model which can predict the coupled thermal and electric output dynamics of microturbines. Considering the time-scale difference of various dynamic processes occuring within microturbines, the electromechanical subsystem is treated as a fast quasi-linear process while the thermo-mechanical subsystem is treated as a slow process with high nonlinearity. A three-stage subspace identification method is utilized to capture the dominant dynamics and predict the electric power output. For the thermo-mechanical process, a radial basis function model trained by the particle swarm optimization method is employed to handle the strong nonlinear characteristics. Experimental tests on a Capstone C30 microturbine show that the proposed modeling method can well capture the system dynamics and produce a good prediction of the coupled thermal and electric outputs in various operating modes.

Data-Driven Dynamic Prediction of Interrelated Heat and Electric Outputs of Microturbines

Microturbines are among the most successfully commercialized distributed energy resources, especially when they are used for combined heat and power generation. However, the interrelated thermal and electrical system dynamic behaviors have not been fully investigated. This is technically challenging due to the complex thermo-fluid-mechanical energy conversion processes which introduce multiple time-scale dynamics and strong nonlinearity into the analysis. To tackle this problem, this paper proposes a simplified model which can predict the coupled thermal and electric output dynamics of microturbines. Considering the time-scale difference of various dynamic processes occuring within microturbines, the electromechanical subsystem is treated as a fast quasi-linear process while the thermo-mechanical subsystem is treated as a slow process with high nonlinearity. A three-stage subspace identification method is utilized to capture the dominant dynamics and predict the electric power output. For the thermo-mechanical process, a radial basis function model trained by the particle swarm optimization method is employed to handle the strong nonlinear characteristics. Experimental tests on a Capstone C30 microturbine show that the proposed modeling method can well capture the system dynamics and produce a good prediction of the coupled thermal and electric outputs in various operating modes.

Extending Automated Testing To High-level Software Requirements : A study on the feasibility of automated acceptance-testing

Automated acceptance testing is the testing of software done in higher level to test whether the system abides by the requirements desired by the business clients by the use of piece of script other than the software itself. This project is a study of the feasibility of acceptance tests written in Behavior Driven Development principle. The project includes an implementation part where automated accep- tance testing is written for Touch-point web application developed by Dewire (a software consultant company) for Telia (a telecom company) from the require- ments received from the customer (Telia). The automated acceptance testing is in Cucumber-Selenium framework which enforces Behavior Driven Development principles. The purpose of the implementation is to verify the practicability of this style of acceptance testing. From the completion of implementation, it was concluded that all the requirements from customer in real world can be converted into executable specifications and the process was not at all time-consuming or difficult for a low-experienced programmer like the author itself. The project also includes survey to measure the learnability and understandability of Gherkin- the language that Cucumber understands. The survey consist of some Gherkin exam- ples followed with questions that include making changes to the Gherkin exam- ples. Survey had 3 parts: first being easy, second medium and third most difficult. Survey also had a linear scale from 1 to 5 to rate the difficulty level for each part of the survey. 1 stood for very easy and 5 for very difficult. Time when the partic- ipants began the survey was also taken in order to calculate the total time taken by the participants to learn and answer the questions. Survey was taken by 18 of the employers of Dewire who had primary working role as one of the programmer, tester and project manager. In the result, tester and project manager were grouped as non-programmer. The survey concluded that it is very easy and quick to learn Gherkin. While the participants rated Gherkin as very easy.

Model-driven development of sensor network applications with optimization of non-functional constraints

Wireless sensor networks (WSNs) differ from conventional distributed systems in many aspects. The resource limitation of sensor nodes, the ad-hoc communication and topology of the network, coupled with an unpredictable deployment environment are difficult non-functional constraints that must be carefully taken into account when developing software systems for a WSN. Thus, more research needs to be done on designing, implementing and maintaining software for WSNs. This thesis aims to contribute to research being done in this area by presenting an approach to WSN application development that will improve the reusability, flexibility, and maintainability of the software. Firstly, we present a programming model and software architecture aimed at describing WSN applications, independently of the underlying operating system and hardware. The proposed architecture is described and realized using the Model-Driven Architecture (MDA) standard in order to achieve satisfactory levels of encapsulation and abstraction when programming sensor nodes. Besides, we study different non-functional constrains of WSN application and propose two approaches to optimize the application to satisfy these constrains. A real prototype framework was built to demonstrate the developed solutions in the thesis. The framework implemented the programming model and the multi-layered software architecture as components. A graphical interface, code generation components and supporting tools were also included to help developers design, implement, optimize, and test the WSN software. Finally, we evaluate and critically assess the proposed concepts. Two case studies are provided to support the evaluation. The first case study, a framework evaluation, is designed to assess the ease at which novice and intermediate users can develop correct and power efficient WSN applications, the portability level achieved by developing applications at a high-level of abstraction, and the estimated overhead due to usage of the framework in terms of the footprint and executable code size of the application. In the second case study, we discuss the design, implementation and optimization of a real-world application named TempSense, where a sensor network is used to monitor the temperature within an area.

Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

Citizen science and natural resource governance: program design for vernal pool policy innovation

Effective natural resource policy depends on knowing what is needed to sustain a resource and building the capacity to identify, develop, and implement flexible policies. This retrospective case study applies resilience concepts to a 16-year citizen science program and vernal pool regulatory development process in Maine, USA. We describe how citizen science improved adaptive capacities for innovative and effective policies to regulate vernal pools. We identified two core program elements that allowed people to act within narrow windows of opportunity for policy transformation, including (1) the simultaneous generation of useful, credible scientific knowledge and construction of networks among diverse institutions, and (2) the formation of diverse leadership that promoted individual and collective abilities to identify problems and propose policy solutions. If citizen science program leaders want to promote social-ecological systems resilience and natural resource policies as outcomes, we recommend they create a system for internal project evaluation, publish scientific studies using citizen science data, pursue resources for program sustainability, and plan for leadership diversity and informal networks to foster adaptive governance.

European student mobility and intercultural learning at a portuguese university

The purpose of this study is to understand, impact and evaluate the development of intercultural communicative competencies among European credit-seeking exchange students and other sojourners through purposeful intercultural pedagogy. This pedagogy encompasses intentional intercultural- educational approaches which aim to support and enhance sojourners’ intercultural learning throughout the study abroad cycle (pre-departure, in-country and reentry phases). To test and validate these pedagogies a 20-hour intervention was designed and implemented among two cohorts of 31 sojourners during the in-country phase of their sojourn in Portugal. The process to develop and validate the intercultural intervention was driven by a mixed-methods methodology which combined quantitative and qualitative data to triangulate, complement and expand research results from a pragmatic stance. The mixed methods research design adopted is multi-phased and encompasses a multi-case study and an evaluative component. The multi-case component is embodied by sojourner cohorts: (1) the primary case study involves 19 incoming students at the University of Aveiro (Portugal) as participants in the European exchange program Campus Europae; (2) the second case study comprises three incoming Erasmus students and nine highly skilled immigrants at the same university. All 31 sojourners attended two intermediate Portuguese as Foreign Language classrooms where the intervention was employed. Data collection was extensive and involved collecting, analyzing and mixing quantitative and qualitative strands across four research phases. These phases refer to the: (1) development, (2) implementation and (3) evaluation of the intervention, as well as to (4) a stakeholder analysis of the external value of the intervention and of the Campus Europae program. Data collection instruments included pre and posttest questionnaires and semi-structured interviews. Results confirm the intercultural effectiveness of the intervention and the positive impact upon research participants’ intercultural gains. This impact was, however, greater in case study 2. Among explanatory variables, three stand out: (1) participant meaning-making abilities, (2) host language proficiency and related variables, and (3) type of sojourn or exchange programs. Implications for further research highlight the need to systematize purposeful intercultural pedagogy in sojourner populations in general, and in European credit student mobility in particular. In the latter case, these pedagogies should be part of the design and delivery of credit-bearing exchange programs in pre- departure, in-country and re-entry phases. Implications for practice point to the urge to improve intercultural practices in: macro (higher education institutions), mezzo (exchange programs) and micro (sojourner language classrooms) contexts where this research took place, and wider social scenarios they represent.

Page Composition using PPML as a Link-editing Script

The advantages of a COG (Component Object Graphic) approach to the composition of PDF pages have been set out in a previous paper [1]. However, if pages are to be composed in this way then the individual graphic objects must have known bounding boxes and must be correctly placed on the page in a process that resembles the link editing of a multi-module computer program. Ideally the linker should be able to utilize all declared resource information attached to each COG. We have investigated the use of an XML application called Personalized Print Markup Language (PPML) to control the link editing process for PDF COGs. Our experiments, though successful, have shown up the shortcomings of PPML's resource handling capabilities which are currently active at the document and page levels but which cannot be elegantly applied to individual graphic objects at a sub-page level. Proposals are put forward for modifications to PPML that would make easier any COG-based approach to page composition.

FRAMEWORK SYNTHESIS FOR SYMBOLIC EXECUTION OF EVENT-DRIVEN FRAMEWORKS

Symbolic execution is a powerful program analysis technique, but it is very challenging to apply to programs built using event-driven frameworks, such as Android. The main reason is that the framework code itself is too complex to symbolically execute. The standard solution is to manually create a framework model that is simpler and more amenable to symbolic execution. However, developing and maintaining such a model by hand is difficult and error-prone. We claim that we can leverage program synthesis to introduce a high-degree of automation to the process of framework modeling. To support this thesis, we present three pieces of work. First, we introduced SymDroid, a symbolic executor for Android. While Android apps are written in Java, they are compiled to Dalvik bytecode format. Instead of analyzing an app’s Java source, which may not be available, or decompiling from Dalvik back to Java, which requires significant engineering effort and introduces yet another source of potential bugs in an analysis, SymDroid works directly on Dalvik bytecode. Second, we introduced Pasket, a new system that takes a first step toward automatically generating Java framework models to support symbolic execution. Pasket takes as input the framework API and tutorial programs that exercise the framework. From these artifacts and Pasket's internal knowledge of design patterns, Pasket synthesizes an executable framework model by instantiating design patterns, such that the behavior of a synthesized model on the tutorial programs matches that of the original framework. Lastly, in order to scale program synthesis to framework models, we devised adaptive concretization, a novel program synthesis algorithm that combines the best of the two major synthesis strategies: symbolic search, i.e., using SAT or SMT solvers, and explicit search, e.g., stochastic enumeration of possible solutions. Adaptive concretization parallelizes multiple sub-synthesis problems by partially concretizing highly influential unknowns in the original synthesis problem. Thanks to adaptive concretization, Pasket can generate a large-scale model, e.g., thousands lines of code. In addition, we have used an Android model synthesized by Pasket and found that the model is sufficient to allow SymDroid to execute a range of apps.

Biofuels and high value added products from the yeast Rhodosporidium toruloides NCYC 921: Strategies towards a true cost-effective and environmentally sustainable integrated multiproduct driven biorefinery [Poster]

Single-cell oils (SCO) have been considered a promising source of 3rd generation biofuels mainly in the final form of biodiesel. However, its high production costs have been a barrier towards the commercialization of this commodity. The fast growing yeast Rhodosporidium toruloides NCYC 921 has been widely reported as a potential SCO producing yeast. In addition to its well-known high lipid content (that can be converted into biodiesel), is rich in high value added products such as carotenoids with commercial interest. The process design and integration may contribute to reduce the overall cost of biofuels and carotenoid production and is a mandatory step towards their commercialization. The present work addresses the biomass disruption, extraction, fractionation and recovery of products with special emphasis on high added valued carotenoids (beta-carotene, torulene, torularhodin) and fatty acids directed to biodiesel. The chemical structure of torularhodin with a terminal carboxylic group imposes an additional extra challenge in what concern its separation from fatty acids. The proposed feedstock is fresh biomass pellet obtained directly by centrifugation from a 5L fed-batch fermentation culture broth. The use of a wet instead of lyophilised biomass feedstock is a way to decrease processing energy costs and reduce downstream processing time. These results will contribute for a detailed process design. Gathered data will be of crucial importance for a further study on Life-Cycle Assessment (LCA).