Sistemas de saúde e participação cidadã: algumas reflexões críticas na perspetiva da sociologia da saúde

Nos últimos dez a quinze anos temos assistido a um aumento do número de iniciativas com a participação da sociedade civil, no sentido de exercer pressão para a reformulação dos direitos sociais. Estes já não são tão vistos como direitos para aceder aos serviços estruturados e administrados pelo Estado (de acordo com o conceito de cidadania de Marshall), mas como uma reivindicação dos cidadãos para terem um papel ativo na definição das políticas públicas e dos serviços. Este debate tem sido muito intenso entre os cientistas sociais desde a década de 1980 e está bastante presente no sistema de cuidados de saúde. Vários estudos têm salientado a forte tensão entre o tecnicismo da medicina e a organização burocrática do sistema de saúde, por um lado, e o modelo de comunicação quotidiana, por outro lado. De facto, um dos temas centrais das reformas dos cuidados de saúde nos últimos 20 anos centrou-se na valorização da experiência e da perspetiva dos cidadãos. O artigo começa com um breve esboço das novas abordagens sociológicas em torno da relação entre os sistemas sociais e o mundo real – nas dimensões micro e macro; estrutura e ação. Assim, apresenta-se o estado da arte atual sobre a participação nos sistemas de saúde ocidentais, resultante da revisão da literatura, destacando as novas estratégias de envolvimento dos doentes bem como as questões relativas às críticas e às limitações. Para terminar, procede-se a uma reflexão acerca da complexidade da relação entre o sistema de cuidados de saúde e as associações de doentes e utentes.

Optimal design for active damping in sandwich structures using the Direct MultiSearch method

This paper addresses the problem of optimal positioning of surface bonded piezoelectric patches in sandwich plates with viscoelastic core and laminated face layers. The objective is to maximize a set of modal loss factors for a given frequency range using multiobjective topology optimization. Active damping is introduced through co-located negative velocity feedback control. The multiobjective topology optimization problem is solved using the Direct MultiSearch Method. An application to a simply supported sandwich plate is presented with results for the maximization of the first six modal loss factors. The influence of the finite element mesh is analyzed and the results are, to some extent, compared with those obtained using alternative single objective optimization. (C) 2013 Elsevier Ltd. All rights reserved.

Demand response in future power systems management – a conceptual framework and simulation tool

Mestrado em Engenharia Electrotécnica – Sistemas Eléctricos de Energia

A 5GHz/1.8V CMOS Active Balun Integrated with LNA

The development of high performance monolithic RF front-ends requires innovative RF circuit design to make the best of a good technology. A fully differential approach is usually preferred, due to its well-known properties. Although the differential approach must be preserved inside the chip, there are cases where the input signal is single-ended such as RF image filters and IF filters in a RF receiver. In these situations, a stage able to convert single-ended into differential signals (balun) is needed. The most cited topology, which is capable of providing high gain, consists on a differential stage with one of the two inputs grounded. Unfortunately, this solution has some drawbacks when implemented monolithically. This work presents the design and simulated results of an innovative high-performance monolithic single to differential converter, which overcomes the limitations of the circuits.The integration of the monolithic active balun circuit with an LNA on a 0.18μm CMOS process is also reported. The circuits presented here are aimed at 802.11a. Section 2 describes the balun circuit and section 3 presents its performance when it is connected to a conventional single-ended LNA. Section 4 shows the simulated performance results focused at phase/amplitude balance and noise figure. Finally, the last section draws conclusions and future work.

Clinical and functional aspects of work-related musculoskeletal disorders among active workers

OBJECTIVE: To evaluate musculoskeletal disorders among active industrial workers. METHODS: The study was carried out in São Carlos, Southeastern Brazil, in 2005. One hundred and thirty-four female workers were physically evaluated and answered questions about their physical symptoms, filled out a pain scale and gave responses in the Oswestry Disability Questionnaire, and the Work Ability Index questionnaire. The data were analyzed descriptively, and in correlation tests and through applying logistic regression. The outcome was evaluated in relation to the perceptions of pain, symptoms, physical assessment, ability to work and disability. RESULTS: Clinical evaluations and sick leave presented positive correlations with the subjective variables. The Work Ability Index presented a negative correlation with the physical disability index (r=-0.69). Symptoms reported at the time of the assessment presented a good correlation with the results from the pain scale and the clinical findings. Previous sick leave showed an association with disability (OR=1.13; 95% CI:1.08;1.18). CONCLUSION: Symptom reports and pain scales may be useful for assessing current conditions at the time of evaluating individuals with work-related musculoskeletal disorders, as they are easier to apply. In more severe cases of such injuries, clinical and functional evaluations and questionnaires such as those relating to ability to work and disability are preferable. Precise and specific evaluations of these disorders may contribute towards fairer legal and administrative decisions.

Relação entre a unidade de biofeedback de pressão, deslocamento do centro de pressão e atividade eletromiográfica durante o active straight leg raising em indivíduos com e sem dor lombo-pélvica.

Introdução: A unidade de biofeedback de pressão, em indivíduos com dor lombo-pélvica, é utilizada durante exercícios de estabilização segmentar, no entanto ainda carece de evidência científica. Objetivo: Determinar a relação entre a unidade de biofeedback de pressão (UBFP), o deslocamento do centro de pressão no sentido médio-lateral (COPml) e a atividade eletromiográfica abdominal durante o active straight leg raising (ASLR) em indivíduos com e sem dor lombo-pélvica, bem como identificar diferenças entre os grupos. Metodologia: Estudo transversal analítico em 18 estudantes universitários voluntários com dor lombo-pélvica crónica inespecífica (GCD) e em 20 sem dor (GSD). Durante o ASLR (desafio postural dinâmico) foram avaliadas as variações máxima e média da pressão (recorrendo à UBFP) e do deslocamento do COPml (através da plataforma de forças), bem como a atividade muscular abdominal, bilateralmente, com recurso à eletromiografia de superfície. Estatisticamente recorreu-se à correlação de Spearman e ao teste Mann-Whitney U, ambos com um nível de significância de 0,05. Resultados: No GCD, ao contrário do GSD, não foi verificada uma relação entre a UBFP e a atividade do transverso abdominal/obliquo interno (TrA/OI) contra-lateral. Correlações moderadas, mas com sentidos opostos, foram evidenciadas em ambos os grupos, entre o deslocamento do COPml e a atividade do TrA/OI contra-lateral. Em ambos os grupos, a UBFP demonstrou estar fortemente correlacionada com o COPml. Não foram observadas diferenças significativas entre os grupos nas variáveis avaliadas. Conclusão: A UBFP, no GCD, não se apresentou relacionada com a atividade do TrA/OI. Contudo, demonstrou uma relação com o deslocamento do COPml, em ambos os grupos, sendo portanto um indicador de estabilidade do tronco e assim, uma ferramenta útil em ambiente clínico. No GCD observou-se que uma maior atividade muscular TrA/OI pressupõe maior deslocamento do COPml, sendo uma relação contrária à verificada no GSD, podendo ser um indicador da perda da sua ação tónica.

A participação das crianças em lares de infância e juventude: representações e práticas. um estudo de caso.

Dissertação de 2º Ciclo conducente ao grau de Mestre em Ciências da Educação - especialização em Educação Social e Intervenção Comunitária

Factors associated to quality of life in active elderly

OBJECTIVE: To analyze whether quality of life in active, healthy elderly individuals is influenced by functional status and sociodemographic characteristics, as well as psychological parameters. METHODS: Study conducted in a sample of 120 active elderly subjects recruited from two open universities of the third age in the cities of São Paulo and São José dos Campos (Southeastern Brazil) between May 2005 and April 2006. Quality of life was measured using the abbreviated Brazilian version of the World Health Organization Quality of Live (WHOQOL-bref) questionnaire. Sociodemographic, clinical and functional variables were measured through crossculturally validated assessments by the Mini Mental State Examination, Geriatric Depression Scale, Functional Reach, One-Leg Balance Test, Timed Up and Go Test, Six-Minute Walk Test, Human Activity Profile and a complementary questionnaire. Simple descriptive analyses, Pearson's correlation coefficient, Student's t-test for non-related samples, analyses of variance, linear regression analyses and variance inflation factor were performed. The significance level for all statistical tests was set at 0.05. RESULTS: Linear regression analysis showed an independent correlation without colinearity between depressive symptoms measured by the Geriatric Depression Scale and four domains of the WHOQOL-bref. Not having a conjugal life implied greater perception in the social domain; developing leisure activities and having an income over five minimum wages implied greater perception in the environment domain. CONCLUSIONS: Functional status had no influence on the Quality of Life variable in the analysis models in active elderly. In contrast, psychological factors, as assessed by the Geriatric Depression Scale, and sociodemographic characteristics, such as marital status, income and leisure activities, had an impact on quality of life.

Participação e acção pedagógica: a valorização da(s) competência(s) e acção social das crianças

Este texto parte do pressuposto de que a forma como se organizam as dinâmicas sociais entre adultos e crianças, nomeadamente nos contextos educativos, não é isenta de marcas de invisibilidade e exclusão, no que diz respeito ao protagonismo das últimas nos processos educativos. Pretendemos discutir de que forma as crianças se apresentam, em muitos contextos, como um grupo geracional discriminado no que diz respeito ao seu direito a assumir uma efectiva participação no processo educativo, tentando demonstrar que este estatuto é, ainda, alimentado por um conjunto de pressupostos associados à ideia da incapacidade e incompetência, associada tacitamente ao sujeito criança, influenciando as relações e dinâmicas com as crianças. Apresentamos neste texto a defesa de uma acção pedagógica participativa e baseada nos direitos da criança, sobretudo a partir dos seus direitos de participação, para questionar tais pressupostos e práticas excludentes face ao grupo social da infância. São estes os caminhos para a construção de dinâmicas sociais ativas, mais críticas e emancipatórias e promotoras de práticas sociais fundamentais numa sociedade livre, pacífica, equitativa e democrática

Characterization of airborne particles generated from metal active gas welding process

This study is focused on the characterization of particles emitted in the metal active gas welding of carbon steel using mixture of Ar + CO2, and intends to analyze which are the main process parameters that influence the emission itself. It was found that the amount of emitted particles (measured by particle number and alveolar deposited surface area) are clearly dependent on the distance to the welding front and also on the main welding parameters, namely the current intensity and heat input in the welding process. The emission of airborne fine particles seems to increase with the current intensity as fume-formation rate does. When comparing the tested gas mixtures, higher emissions are observed for more oxidant mixtures, that is, mixtures with higher CO2 content, which result in higher arc stability. These mixtures originate higher concentrations of fine particles (as measured by number of particles by cm 3 of air) and higher values of alveolar deposited surface area of particles, thus resulting in a more severe worker's exposure.

Por uma família participativa: estratégias e propostas de atividade para o envolvimento parental

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

Quanto tempo o tempo tem? as crianças como construtoras da noção de tempo

Relatório da Prática Profissional Supervisionada Mestrado em educação pré-escolar

A participação das crianças na planificação e gestão da rotina diária

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

Weaving encounters: towards an art of participation

In the early 21st Century, with the phenomenon of digital convergence, the consecration of Web 2.0, the decrease of the cost of cameras and video recorders, the proliferation of mobile phones, laptops and wireless technologies, we witness the arising of a new wave of media, of an informal, personal and at times “minority” nature, facilitating social networks, a culture of fans, of sharing and remix. As digital networks become fully and deeply intricate in our experience, the idea of “participation” arises as one of the most complex and controversial themes of the contemporary critical discourse, namely in what concerns contemporary art and new media art. However, the idea of “participation” as a practice or postulate traverses the 20th century art playing an essential role in its auto-critic, in questioning the concept of author, and in the dilution of the frontiers between art, “life” and society, emphasizing the process, the everyday and a community sense. As such, questioning the new media art in light of a “participatory art” (Frieling, 2008) invokes a double gaze simultaneously attentive to the emerging figures of a “participatory aesthetics” in digital arts and of the genealogy in which it is included. In fact, relating the new media art with the complex and paradoxical phenomenon of “participation” allows us to, on the one hand, avoid “digital formalism” (Lovink, 2008) and analyse the relations between digital art and contemporary social movements; on the other hand, this angle of analysis contributes to reinforce the dialogue and the links between digital art and contemporary art, questioning the alleged frontiers that separate them.

Short- and medium-term effects of manual therapy on cervical active range of motion and pressure pain sensitivity in latent myofascial pain of the upper trapezius muscle: a randomized controlled trial

Objective: The purpose of this study was to investigate effects of different manual techniques on cervical ranges of 17 motion and pressure pain sensitivity in subjects with latent trigger point of the upper trapezius muscle. 18 Methods: One hundred seventeen volunteers, with a unilateral latent trigger point on upper trapezius due to computer 19 work, were randomly divided into 5 groups: ischemic compression (IC) group (n = 24); passive stretching group (n = 20 23); muscle energy technique group (n = 23); and 2 control groups, wait-and-see group (n = 25) and placebo group 21 (n = 22). Cervical spine range of movement was measured using a cervical range of motion instrument as well as 22 pressure pain sensitivity by means of an algometer and a visual analog scale. Outcomes were assessed pretreatment, 23 immediately, and 24 hours after the intervention and 1 week later by a blind researcher. A 4 × 5 mixed repeated- 24 measures analysis of variance was used to examine the effects of the intervention and Cohen d coefficient was used. 25 Results: A group-by-time interaction was detected in all variables (P b .01), except contralateral rotation. The 26 immediate effect sizes of the contralateral flexion, ipsilateral rotation, and pressure pain threshold were large for 3 27 experimental groups. Nevertheless, after 24 hours and 1 week, only IC group maintained the effect size. 28 Conclusions: Manual techniques on upper trapezius with latent trigger point seemed to improve the cervical range of 29 motion and the pressure pain sensitivity. These effects persist after 1 week in the IC group. (J Manipulative Physiol 301 Ther 2013;xx:1-10)