992 resultados para domiciliary visit


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Dissertação de Mestrado apresentada ao Instituto Superior de Contabilidade e Administração do Porto, para obtenção do grau de Mestre em Marketing Digital, sob orientação da Prof. Sandrina Teixeira

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Informação é o conceito genérico de tudo que possa representar, conhecimento ou comunicação. Trata-se de conhecimento registado de forma impressa ou digital, oral ou audiovisual, mas ainda pode ser registada em suporte físico. Desde o início da civilização que o Ser Humano tenta criar novas formas de transmitir informação, antes da invenção da forma escrita era utilizado o método do desenho para descrever a realidade, este método ao longo do tempo foi evoluindo, ganhando mais qualidade, pormenor e suportes mais evoluídos. Mas sempre com a mesma intenção, a de conseguir transmitir de forma mais direta e percetível informação a qualquer individuo. Dado isto, o Ser Humano sempre produziu arte e a foi preservando para mostrar aos vindouros. Neste processo, os museus em conjunto com espaços culturais e artísticos, foram assumindo um papel de relevo na sociedade. Mas inicialmente o objetivo principal dos museus era o de preservar e expor artefactos históricos e culturais. A grande evolução tecnológica dos últimos anos veio dotar o Ser Humano com formas de aceder à informação tão simples e diversificadas, que no passado eram completamente impensáveis e certamente que no futuro irão ser descobertas ainda mais formas de registar e propagar a informação. Assim o presente trabalho descreve a investigação realizada, através de uma recolha de bibliografia, levantamento do estado-da-arte, que pretende descobrir se a construção de visitas virtuais imersivas é uma boa forma para mostrar um espaço cultural ao público, que está cada vez mais exigente e disperso geograficamente. Além do levantamento são estudados alguns exemplos de visitas virtuais existentes, de modo a detetar boas praticas e formas mais usuais para a criação de uma visita. Finalmente foi descrito todo o processo desde a recolha de informação até à própria implementação, construção de um protótipo para apresentar ao utilizador o espaço de uma fundação, a do escultor José Rodrigues. Este protótipo tem por objetivo mostrar ao utilizador a fundação o mais aproximado do real possível.

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Este texto parte de la caracterización del concepto de multiculturalismo en general y específicamente en el contexto de la UE. A continuación, intentamos demostrar el carácter multicultural de una red de información, la red de los CDE, presente en todo el território de la EU, a partir de los resultados de encuestas distribuídas a los responsables, a sus utilizadores y en base a los datos recogidos durante visitas a algunos de ellos. Efectivamente, se verifica la existência de diferencias substanciales Finlandia, Irlanda, Hungría y Portugal en lo que respecta a la localización de los CDE, las tipologías de utilizadores, al uso de lenguages sistemáticos y alfabéticos para la organización de la información. Estas diferencias son menos marcadas pero también existen en lo que respecta a las áreas temáticas mas buscadas y los aspectos que los utilizadores de los CDE consideran que facilitan su acceso a la información. Por lo que se refiere a las formas de búsqueda en el catálogo y a los aspectos que se apuntan como obstáculos en el acceso a la información parece haber más coincidencia entre los diferentes países.

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The clinical and epidemiologic aspects of infection with Ascaris lumbricoides were studied in a random stratified sample of the population of the subdistrict of Cavacos, municipality of Alterosa (Minas Gerais, Brazil). The effect of mass treatment with a single dose of albendazole on the prevalence and intensity of infection was also studied six months later in the same population. During the first phase of the study, a questionnaire was applied to 248 individuals to obtain information about the socioeconomic, sanitary and clinical conditions of the population surveyed. A total of 230 fecal samples were also examined by the Kato-Katz technique in order to determine the intensity of A. lumbricoides infection. Two hundred and two individuals were simultaneously submitted to blood counts and 70 children aged 12 years or less were evaluated for nutritional status. The presence of A. lumbricoides and other helminth eggs was also determined in 22 soil samples collected in the urban zone of Cavacos. Infection with enteroparasitic helminths was detected in 29.1% of the sample, with a predominance of A. lumbricoides (23.9%). Parasitism and/or intensity of A. lumbricoides infection were significantly correlated with age range (15 years or less), social class, sanitary and living conditions (water, sewage and domiciliary area per person), and presence of abdominal pain. However, these parameters were not correlated with nutritional status or hematocrit levels. During the second phase of the study, a slight but not statistically significant decrease in the prevalence of A. lumbricoides infection was detected after treatment with albendazole. However, an important and significant reduction in the amount of A. lumbricoides eggs eliminated through the feces was detected, indicating that the intensity of A. lumbricoides infection was lower in all the age ranges of the Cavacos population, especially among younger individuals, even six months after administration of the anthelminthic agent.

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Since the beginning of the seventies the natural transmission of Chagas’ infection has been considered to be under control in the State of São Paulo and not even a case of American Trypanosomiasis, transmitted by triatomine bugs, has been detected by the epidemiological surveillance system. This situation justifies the report of a case of acute Chagas’ disease that occurred in a forest area considered free of domiciliary triatomines along the Southern seacoast of São Paulo State. In May, 1995 the presence of trypomastigote forms of Trypanosoma cruzi had been diagnosed in a retired 57 year-old male patient, born and living in Santos (São Paulo State), complaining of fever, fatigue and malaise. The patient reported that 40 days before he had participated with 17 friends in a 7-day excursion in a forest area of the municipalities of Itanhaém and Peruíbe. During this period the group had been lodged in three houses located within the forest. Eight days after the end of the excursion the patient began to have fever, malaise and fatigue. During the next 31 days he had received medical care both as an inpatient and an outpatient, without any significant improvement. After the detection of T. cruzi trypomastigotes in his blood stream the patient began to be treated with benzonidazole in a hospital but died 8 days after the beginning of treatment. The epidemiological investigation carried out showed no signs of the presence of triatomine bugs in the three houses where the group had been lodged, or any indication of Chagas' infection in other excursionists

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Early in 1995 the first case of Hantavirus Pulmonary Syndrome was serologically confirmed in El Bolsón (Province of Río Negro, Argentina), corresponding to the third outbreak reported in Argentina. A total of 26 cases of HPS related to the Andean region of Rio Negro Province, were reported from 1993 to 1996, 17 in El Bolsón, 4 in San Carlos de Bariloche, and 5 in Buenos Aires. The incidence rate was 5.03 x 100000 with a mortality rate of 51.85 x 100. The occurrence of cases was mainly seasonal, with a significantly greater number in the spring, and the persons affected mainly lived in urban or periurban areas. In four cases, the affected individuals were members of a couple, spouses or live-in contacts. Seven cases were Health workers (physicians, nurses or administrative staff). Twelve cases were related among them, due to an outbreak of 80 days. Two of them did not visit the Andean region. A total of 139 rodents were captured and seven of them, Olygoryzomys longicaudatus, were found to be serologically positive. The possibility of infection by contact with rodents or fecal matter is being analyzed and also hypothesis related with interhuman transmission

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O trabalho foi desenvolvido na empresa Masterprojetos – soluções integradas, através da elaboração e desenvolvimento do projeto de estabilidade de um edifício de cinco pisos, em que um deles se encontra enterrado. Este edifício incorpora um bloco de habitação multifamiliar e um bloco de habitação unifamiliar e comércio. Tanto o edifício como a empresa estão localizados no Peso da Régua. O trabalho pode-se dividir em duas partes: Numa primeira parte estão descritas as funções desempenhadas e contextualizada a metodologia de trabalho. Nesta parte está ainda descrita a ferramenta de trabalho Cypecad, a qual não houve oportunidade de aprender a usar durante o meu percurso académico e desenvolveu-se capacidades de maneira autodidata. São ainda referidos alguns softwares disponíveis no mercado, para o mesmo ramo de atividade. Numa segunda parte encontram-se descritos os pressupostos considerados no pré-dimensionamento do edifício assim como os elementos utilizados para a formulação do modelo de cálculo. Estão ainda feitas algumas verificações analíticas para a validação do modelo tido em conta para o dimensionamento. Estabeleceu-se também uma comparação entre as soluções obtidas através do software Cypecad e através do cálculo analítico para uma laje maciça. No final estão descritas as conclusões que foram obtidas, das quais se salientam a atenção que é necessário ter, quando se utiliza softwares de cálculo automático, quanto à introdução de dados e soluções que se obtêm , assim como a poupança de tempo que este tipo de ferramenta proporciona. É de referir também neste ponto as oportunidades que o estágio me proporcionou, como a visita de alguns locais de obras, as atividades de medição e orçamento de obra e acompanhamento de projetos de outras especialidades como redes prediais, térmica, acústica e ITED (infra-estruturas de Telecomunicações em Edifícios).

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The clinical and public health importance of indeterminate results in HIV-1/2 testing is still difficult to evaluate in volunteer blood donors. At Fundação Hemominas, HIV-1/2 ELISA is used as the screening test and, if reactive, is followed by Western blot (WB). We have evaluated 84 blood donors who had repeatedly reactive ELISA tests for HIV-1/2, but indeterminate WB results. Sixteen of the 84 donors (19.0%) had history of sexually transmitted diseases; 18/84 (21.4%) informed receiving or paying for sex; 3/84 (3.6%) had homosexual contact; 2/26 women (7.6%) had past history of multiple illegal abortions and 3/84 (3.6%) had been previously transfused. Four out of 62 donors (6.5%) had positive anti-nuclear factor (Hep2), with titles up to 1:640. Parasitological examination of the stool revealed eggs of S. mansoni in 4/62 (6.4%) donors and other parasites in 8/62 (12.9%). Five (5.9%) of the subjects presented overt seroconversion for HIV-1/2, 43/84 (51.2%) had negative results on the last visit, while 36/84 (42.9%) remained WB indeterminate. Although some conditions could be found associated with the HIV-1/2 indeterminate WB results and many donors had past of risky behavior, the significance of the majority of the results remains to be determined.

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RESUMO:A determinação da fracção exalada de óxido nítrico (FENO) é amplamente utilizada como um biomarcador da inflamação eosinofílica das vias aéreas. Alguns estudos sugerem que a produção de óxido nítrico (NO) é influenciada pelas variações cíclicas hormonais na mulher,porém os dados não são consensuais. Deste modo, o objectivo do nosso estudo foi avaliar como varia a FENO ao longo do ciclo menstrual. Com esta finalidade, avaliamos um grupo de 20 voluntárias, em idade fértil, com ciclo menstrual regular, não fumadoras, que não utilizavam contraceptivos hormonais, nem suplementos alimentares e/ou medicamentosos e que não se encontravam grávidas, nem a amamentar. Todas referiram não ter conhecimento de qualquer patologia que afecte a FENO. A existência de atopia foi controlada através de testes cutâneos por prick, tendo-se excluído as participantes que apresentaram testes positivos. Realizamos quatro visitas de estudo, com base na periodicidade do ciclo de cada participante, nas quais, efectuamos a determinação da FENO, a quantificação dos níveis plasmáticos de óxido nítrico e nitratos (NO/NO3 -) e o doseamento hormonal de 17 -estradiol e progesterona. As avaliações realizaram-se no período da manhã, em jejum absoluto, tendo respeitado uma dieta pobre em nitratos no dia anterior e abstido da prática de exercício vigoroso uma hora antes da avaliação. Com este trabalho, verificamos um aumento significativo da FENO na fase secretora (17.97 ppb ± 5.8) comparativamente com a fase menstrual e proliferativa (16.48 ppb ± 3.6 e 15.95 ppb ±2.8, respectivamente). Não observamos variações significativas dos níveis plasmáticos de NO/NO3 - ao longo do ciclo. Constatamos uma correlação positiva entre a FENO e os níveis plasmáticos de NO/NO3 - durante a ovulação e verificamos que, para a nossa amostra, os níveis hormonais de estradiol e progesterona não são preditores do valor da FENO, nem dos níveis plasmáticos de NO/NO3-. Os resultados deste trabalho mostram uma variação da FENO ao longo do ciclo, ainda assim, mantendo-se os seus valores dentro do intervalo de referência, reforçando a fiabilidade deste biomarcador.--ABSTRACT:The determination of fractional exhaled nitric oxide (FENO) is widely used as a biomarker of eosinophilic airway inflammation. Some studies suggest that nitric oxide (NO) is influenced by cyclical hormonal changes in women, but those are not consensual. The aim of our study was to assess how FENO varies throughout the menstrual cycle. With this purpose, we studied a group of 20 volunteers within childbearing age, with regular menstrual cycle, non-smokers, who were not taking any medications including hormonal contraception and food supplements and who were not pregnant or breast-feeding. All participants reported not being aware of any condition that could affect the FENO. The presence of atopy was controlled by a skin prick test, having been excluded participants with positive test. We conducted four study visits, based on the periodicity of the cycle of each participant. In each visit, we made the determination of the FENO, the quantification of plasmatic levels of nitric oxide and nitrates (NO/NO3 -) and the blood levels of hormone estradiol-17 and progesterone. The evaluations occurred at morning, after overnight fasting. The participants were request to follow a low-nitrate diet in the previous day and refrained from vigorous exercise, for at least one hour before the visit We found a significant increase of FENO on secretory phase (17.97 ppb ± 5.8) compared with the menstrual and proliferative phase (16.48 ppb ± 3.6 and 15.95 ppb ± 2.8, espectively). No significant variations were found throughout the menstrual cycle in plasmatic levels of NO/NO3 -. We found a positive correlation between FENO and plasmatic levels of NO/NO3 - during ovulation. Finally, in our sample, the levels of oestradiol and progesterone are not predictors of FENO value nor of plasmatic levels of NO/NO3-. This study shows a variation of FENO over the menstrual cycle, nevertheless, the values remain within the reference range, reinforcing the reliability of this biomarker.

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To date few studies have been undertaken in Portugal dealing with the attitudes, motivations, and profile of tourists who visit World Heritage Sites. Also, few studies have dealt with destination image (e.g., Agapito, Mendes & Valle, 2010; Lopes, 2011). As far as it is known, none have approached the issue of gender differences in the choice of a Portuguese heritage destination. Since cultural tourism destinations need to differentiate themselves from each other, appropriate market segmentation must be based on a deep understanding of the customers’ motivations and preferences. Keeping in mind results from empirical literature (e.g., Silberberg, 1995; Beerli & Martin, 2004; Richards, 2004; Pérez, 2009; Sheng, Shen, & Chen, 2008), gender seems to be a possible approach to market segmentation, whether for Guimarães or for other cultural tourism destinations around the world. Located in the north-western region of Portugal, Guimarães is a city of strong symbolic and cultural significance, and the nomination of its historical centre as a World Heritage Site in 2001 enhanced its tourism potential. This study analyses the possible relation between gender and attitudes and motivations towards a World Heritage Site, such as Guimarães. Additionally, the empirical approach used in the study tries to capture differences in the perceived attributes of the city. Commonalities and distinctions within and between groups of tourists, by focusing on the specific characteristic of gender, were analysed. The study addressed two main questions: first, whether males and females have similar or different preferences in choosing the city as their destination; and, second, whether there are gender differences in the perception of the attributes of Guimarães. A better understanding of the gendered nature of the destination is a valuable cue for shaping products and services according to visitors’ preferences.

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Esta dissertação descreve o levantamento da gestão de uma unidade fabril no âmbito do engarrafamento de águas, para a implementação de um Sistema de Gestão Ambiental (SGA) recorrendo á Norma NP EN ISO 14001:2012 tendo como objetivo proporcionar a melhoria contínua dos processos implementados na empresa bem como todos os benefícios que este referencial pressupõe. Foi realizada, numa primeira fase, uma auditoria diagnóstico com uma visita á fabrica no âmbito da implementação da ISO 14001, e posteriormente realizado todo o trabalho de aplicação ao referencial. Este trabalho consistiu a abordagem a todos os requisitos da norma ISO 14001 com principal foco na fase de Planeamento de um SGA, procurando-se responder essencialmente ao requisito 4.3 da referida norma. Procedeu-se á identificação das atividades da empresa (entradas e saídas), dos aspetos ambientais associados (respetiva significância) e levantamento dos requisitos legais aplicáveis (obrigações). Os restantes requisitos foram abordados e fez-se uma sugestão para o seu cumprimento, para além de que muitos já se encontram em cumprimento por compatibilidade com a norma ISO 9001 da qual a empresa já se encontra certificada. Esta dissertação pretende discutir e apresentar propostas para a implementação do SGA, possíveis vantagens daí decorrentes e as barreiras a ultrapassar (aspetos ambientais significativos) de maneiras a por em prática os requisitos do referencial normativo que venha a ser adotado. Foi realizada uma revisão bibliográfica destas temáticas e, ainda que estas medidas propostas não tenham sido implementadas, assim que implementadas esperam-se ganhos na economia de recursos como também outros benefícios descritos ao longo da dissertação que permita, com implementação do SGA não só enquanto estratégia, ser inovadora e competitiva.

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The aim of this study was to undertake a comparative analysis of the practices and information behaviour of European information users who visit information units specialising in European information in Portugal and Spain. The study used a quantitative methodology based on a questionnaire containing closed questions and one open question. The questions covered the general sociological profile of the respondents and their use of European Document Centres, in addition to analysing aspects associated with information behaviour relating to European themes. The study therefore examined data on the preferred means and sources for accessing European information, types of documents and the subjects investigated most. The use of European databases and the Internet to access material on Europe was also studied, together with the reasons which users considered made it easy or difficult to access European information, and the aspects they valued most in accessing this information. The questionnaire was administered in European Document Centres in 2008 and 2010.

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A total of 320 horses were studied in this paper, both male and female, between two and 17 years of age, which were used for traction of wagons in the urban area of the municipality of Londrina (PR). These animals were kept, after their daily work, in abandoned areas or plots, in the outskirts of the urban area of the city. When these animals were attended by the veterinarians, between 1996 and 2005, none of them presented symptoms suggesting leptospirosis. The most frequent reasons for the visit were loss of weight, unwillingness for work, parasitism, laminess, and wounds. Microscopic Seroagglutination Test (SAM), with 22 Leptospira serovars, was performed in sera sample from all these animals. The aim of this study was to investigate the occurrence of antibodies against Leptospira spp. in horses from the urban area of Londrina (PR). From the samples tested, 214 (66.88%) were considered positive, with titers between 100 and 3200, being that 49 (22.90%) presented antibodies against a single serovar of Leptospira, and 165 (77.10%) samples presented antibodies against two or more serovars simultaneously, where in 88 (53.33%) it was possible to characterize the most likely probable serovar. Antibodies against the serovar Icterohaemorrhagiae were detected in 32 (23.36%) animals.

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The purpose of this report is to record the first case of a hematophagous bat (Desmodus rotundus) infected with rabies virus in an urban area in Brazil. To the authors' knowledge, this is the first such case in Latin America. After discovering a bat in his garden at 10 o'clock in the morning, a resident of Ubatuba municipality asked the Zoonosis Control Center team to visit his home. The animal was caught alive on the same day and sent to the Pasteur Institute laboratory, where it was identified as a Desmodus rotundus specimen. Standard tests for rabies diagnosis were carried out (direct immunofluorescence and viral isolation), and the results were positive. The presence of different species of (primarily insectivorous) bats in urban areas represents a serious public health problem. This case, however, is indicative of a much greater risk because the species in question has hematophagous habits, what means this animals has a low energy reserves and, therefore, its need to feed daily.

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Introduction: Rhinoscleroma is a rare, chronic, granulomatous disease that most frequently affects the upper respiratory tract, especially the nasal cavity and sometimes extends through the lower respiratory tract. Is associated with Klebsiella rhinoscleromatis, which is endemic in certain geographic regions namely Central America. The pathogenesis and risk factors remain unclear. Clinical case: We report a five years Old Portuguese boy, previously healthy, brought to the Emergency Department with epistaxis, without other accompanying signs or symptoms. The Otorhinolaryngologist (ORL) performed rhinoscopy and identified an intranasal bleeding mass. The MRI revealed an intranasal mass with extension to the ethmoid bone sinus, and performed biopsy. The histopathology was vital, making the diagnosis of Rhinoscleroma. The child had traveled abroad for the first time on vacations a year before to Dominican Republic. The bacteriologic exam identified a Klebsiella spp. sensible to the association of amoxicillin and clavulanic acid. Blood test performed excluded association of immunodeficiency. Since it’s a rare disease genetic study are under course. Monthly evaluation by ORL and pediatrician was performed which documented progressive reduction until total disappearing of the macro and microscopic lesion, and negative bacteriologic exam. Six months of antibiotic therapy were completed without any known secondary effects. The child remained asymptomatic up to the last visit, 3 months following treatment and has shown no evidence of recurrence. Conclusion: Globalization and free transit of people to areas far from origin countries here some rare diseases are endemic brings a new challenge to modern medicine. Sometimes vacations bring more than memories.