Caminhos para a avaliação da formação em odontologia: desenvolvimento, validação e aplicação de critérios

The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators’ perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.

Efeitos do treino de marcha em esteira com adição de carga ao membro inferior não parético de indivíduos com acidente vascular cerebral: ensaio clínico controlado e randomizado

Introduction: Gait after stroke is characterized by a significant asymmetry between the lower limbs, with predominant use of the non-paretic lower limb (NPLL) over using the paretic lower limb. Accordingly, it has been suggested that adding load/weight to the NPLL as a form of restricting the movement of this limb may favor the use of the paretic limb, reducing interlimb asymmetry. However, few studies have been conducted up to this moment, which only investigated the immediate effects of this practice. Objectives: 1) Investigating whether there is an influence of adding load to the NPLL during treadmill training on cardiovascular parameters and on gait performance of individuals with stroke, compared to treadmill training without load addition; 2) Analyzing the effects of treadmill training with and without load added to the NPLL on kinematic parameters of each lower limb during gait; 3) Analyzing the effects of treadmill training with and without load added to the NPLL on measurements of functional mobility and postural balance of these patients. Materials and Methods: This is a randomized single blinded clinical trial involving 38 subjects, with a mean age of 56.5 years, at the subacute post-stroke phase (with mean time since stroke of 4.5 months). Participants were randomly assigned into an experimental group (EG) or control group (CG). EG (n= 19) was submitted to gait training on a treadmill with the addition of load to the NPLL by ankle weights equivalent to 5% of body weight. CG (n= 19) was only submitted to gait training on a treadmill. Behavioral strategies which included home exercises were also applied to both groups. The interventions occurred daily for two consecutive weeks (Day 1 to Day 9), being of 30 minutes duration each. Outcome measures: postural balance (Berg Functional Balance Scale – BBS), functional mobility (Timed Up and Go – TUG; kinematic variables of 180° turning) and kinematic gait variables were assessed at baseline (Day 0), after four training sessions (Day 4), after nine training sessions (Day 9), and 40 days after completion of training (Follow-up). Cardiovascular parameters (mean arterial pressure and heart rate) were evaluated at four moments within each training session. Analysis of variance (ANOVA) was used to compare outcomes between EG and CG in the course of the study (Day 0, Day 4, Day 9 and Follow-up). Unpaired t-tests allowed for intergroup comparison at each training session. 5% significance was used for all tests. Results: 1) Cardiovascular parameters (systemic arterial pressure, heart rate and derivated variables) did not change after the interventions and there were no differences between groups within each training session. There was an improvement in gait performance, with increased speed and distance covered, with no statistically significant difference between groups. 2) After the interventions, patients had increased paretic and non-paretic step lengths, in addition to exhibiting greater hip and knee joint excursion on both lower limbs. The gains were observed in the EG and CG, with no statistical difference between the groups and (mostly) maintained at follow-up. 3) After the interventions, patients showed better postural balance (higher scores on BBS) and functional mobility (reduced time spent on the TUG test and better performance on the 180° turning). All gains were observed in the EG and CG, with no statistically significant difference between groups and were maintained at follow-up. Conclusions: The addition of load to the NPLL did not affect cardiovascular parameters in patients with subacute stroke, similar to treadmill training without load, thus seemingly a safe training to be applied to these patients. However, the use of the load did not bring any additional benefits to gait training. The gait training program (nine training sessions on a treadmill + strategies and exercises for paretic limb stimulation) was useful for improving gait performance and kinematics, functional mobility and postural balance, and its use is suggested to promote the optimization of these outcomes in the subacute phase after stroke.

The star formation and extinction coevolution of UV-selected galaxies over 0.05 < z < 1.2

We use a new stacking technique to obtain mean mid-IR and far-IR to far-UV flux ratios over the rest-frame near-UV, near-IR color-magnitude diagram. We employ COMBO-17 redshifts and COMBO-17 optical, GALEX far- and near-UV, and Spitzer IRAC and MIPS mid-IR photometry. This technique permits us to probe the infrared excess (IRX), the ratio of far-IR to far-UV luminosity, and the specific star formation rate (SSFR) and their coevolution over 2 orders of magnitude of stellar mass and over redshift 0.1 < z < 1.2. We find that the SSFR and the characteristic mass (Script M_0) above which the SSFR drops increase with redshift (downsizing). At any given epoch, the IRX is an increasing function of mass up to Script M_0. Above this mass the IRX falls, suggesting gas exhaustion. In a given mass bin below Script M_0, the IRX increases with time in a fashion consistent with enrichment. We interpret these trends using a simple model with a Schmidt-Kennicutt law and extinction that tracks gas density and enrichment. We find that the average IRX and SSFR follow a galaxy age parameter ξ, which is determined mainly by the galaxy mass and time since formation. We conclude that blue-sequence galaxies have properties which show simple, systematic trends with mass and time such as the steady buildup of heavy elements in the interstellar media of evolving galaxies and the exhaustion of gas in galaxies that are evolving off the blue sequence. The IRX represents a tool for selecting galaxies at various stages of evolution.

Power, Arab media Moguldum & gender rights as entertainment in the Middle East

Discourse is a giant field of research and gender related rights are still a disputed area of thinking. Thus, when Arab transnational satellite televisions produce dialogues, images, stories and narratives about the disputed “universal” gender rights in the Middle East, the big questions remain how and why. According to De Beauvoir (1949), one becomes woman and to Butler (1990) one is not born a gender at all but is “done” and “undone” to become one via discourse. Islamic feminism speaks of a cultural/religious specificity in defending women rights and even gender diversity based on new Quranic interpretations. The gender, “Al-Naw’u”, remains synonym to sex “Al Jins” as gender and queer theories never developed in Arabic in tandem with the European institutions or the theories of the19th century– especially those ideas emerging from studies of the mental asylum. This research tries to understand gender related “rights” and “wrongs” as manifest in the discursive institutions owned by media mogul Prince Al Waleed Ben Talal Al Saud. The trouble of such a study is lexical, ideological and institutional at the same time. Since we lack a critique of the discourses and narratives addressed in the pan-Arab satellite channels, in general it is difficult to understand their significance and influence in everyday life practices. What language is used to speak of gender rights or wrongs? Which ideology is favoured in this practice of legitimisation and/or policing? Using case studies, CDA of social and religious talk shows, narrative analysis of Arabic cinemas, this research adapted triangulation to show the complexity of conversing and narrating gender related content at the micro and macro levels within an institution of power. Using semi-structured interviews from fieldwork in Egypt (2009) and Lebanon (2011), archive research and online ethnography, the research exposes the power structure under which gender discourses evolve. It emerges that gender content is abundant on the Pan Arab satellite space, “manufactured” on talk shows and plotted tactfully in the cinematic “creative-act”. The result is a complex discourse of gender content that scratches the surface calling for interpretation. So how and why do gender rights and wrongs find place on Prince Al Waleed’s Media Empire?

Diseño y proyección del espacio dramático en "Los amantes" de Andrés Rey de Artieda

En el presente trabajo se analiza la manera en la que el dramaturgo valenciano Andrés Rey de Artieda diseñó los diferentes espacios dramáticos por los que transcurre la acción de su única pieza teatral conocida: Los amantes. Compuesta poco después de 1577, se trata de una obra deudora de los parámetros dramatúrgicos de su tiempo, pues el componente literario del texto dramático predomina claramente sobre el espectacular. Estamos ante un tipo de teatro fundamentado en la palabra y muy poco en lo visual.Sin embargo, ya se perciben en el texto ciertos rasgos de innegable modernidad, que es el asunto que me ha interesado a la hora de acercarme a él. Mi objetivo será demostrar el dinamismo con el que se producen los cambios de espacio dramático a lo largo de la trama argumental para subrayar que Rey de Artieda tenía ya asumidas algunas de las innovaciones que desembocarán en el teatro nacional español unas décadas más tarde.

Estimating the effect of state-level gun purchasing policy on county-level firearm suicide mortality

Thesis (Master's)--University of Washington, 2016-08

RETINAL ANGIOMATOUS PROLIFERATION: A Quantitative Analysis of the Fundoscopic Features of the Fellow Eye

PURPOSE: To quantitatively analyze and compare the fundoscopic features between fellow eyes of retinal angiomatous proliferation and typical exudative age-related macular degeneration and to identify possible predictors of neovascularization. METHODS: Retrospective case-control study. Seventy-nine fellow eyes of unilateral retinal angiomatous proliferation (n = 40) and typical exudative age-related macular degeneration (n = 39) were included. Fundoscopic features of the fellow eyes were assessed using digital color fundus photographs taken at the time of diagnosis of neovascularization in the first affected eye. Grading was performed by two independent graders using RetmarkerAMD, a computer-assisted grading software based on the International Classification and Grading System for age-related macular degeneration. RESULTS: Baseline total number and area (square micrometers) of drusen in the central 1,000, 3,000, and 6,000 μm were considerably inferior in the fellow eyes of retinal angiomatous proliferation, with statistically significant differences (P < 0.05) observed in virtually every location (1,000, 3,000, and 6,000 μm). A soft drusen (≥125 μm) area >510,196 μm2 in the central 6,000 μm was associated with an increased risk of neovascularization (hazard ratio, 4.35; 95% confidence interval [1.56-12.15]; P = 0.005). CONCLUSION: Baseline fundoscopic features of the fellow eye differ significantly between retinal angiomatous proliferation and typical exudative age-related macular degeneration. A large area (>510,196 μm2) of soft drusen in the central 6,000 μm confers a significantly higher risk of neovascularization and should be considered as a phenotypic risk factor.

Un-Editing Alfred: Rethinking Modern Editions of Pre-modern Texts from a Post-modern Sensibility

Thesis (Ph.D.)--University of Washington, 2016-06

Corporate Social Responsibility no sector bancário

Vivemos num mundo globalizado onde as exigências são diversas e constantemente presentes. É impossível analisar a área social, económica ou ambiental de forma isolada. A visão que relaciona o mundo empresarial com a sociedade e que lhe reconhece obrigações e responsabilidades para com a mesma não é nova e tem vindo a obter uma importância e visibilidade crescentes. O conceito corporate social responsibility (CSR) tem sido objecto de grande enfoque, sobretudo desde os anos cinquenta do século passado. Todavia, este conceito não tem permanecido inalterado com o passar do tempo. Desde a referida década até à actualidade verifica-se um desenvolvimento notório da definição de CSR, das suas vertentes, do binómio mundo empresarial e social e de alguns conceitos conexos como sejam corporate citizenship, business ethics e sustainability. Actualmente a maioria da doutrina que versa sobre o tema aceita, de forma pacífica, que o mundo empresarial não se pode fechar sobre si próprio pretendendo alcançar ganhos e visibilidade demitindo-se da responsabilidade para com a sociedade onde se encontra inserido. Compreende-se que a interligação entre a esfera económica, social e ambiental permite às empresas diversos benefícios, nomeadamente a viabilização de projectos a longo prazo, prestígio, notoriedade e a vantagem competitiva face às suas concorrentes. O objectivo do presente trabalho é demonstrar a evolução do conceito de CSR, nas suas várias vertentes, o impacto e os benefícios decorrentes das actuações empresarias compatíveis com este conceito e verificar, no que ao sector bancário respeita, se os clientes destas instituições conhecem os projectos sociais, pelas mesmas desenvolvidos e se a realização destes projectos possuem impacto na relação cliente/banco.

Biliary duct injuries in the laparoscopic era: our experience

Aim. The main aim of our study is to evaluate the incidence, the type, the causes and the therapy of biliary duct injuries which occurred after the video laparoscopic cholecystectomies performed in our Department during the period from 1990 to 2012. Patients and methods. A retrospective analysis of 1186 VLC has been made in our Department from March 1990 to June 2012. Before the cholecystectomy all patient were evaluated with trans abdominal echography. Beyond the incidence of BDI was evaluated damaging mechanism, etiology, therapy and time of diagnosis. Results. From 1990 to 2012 a total of 9 BDIs occurred, with an incidence of 0,75%. Out of 9 patients 4 had major lesions and 5 had minor lesions; the most common BDI was Strasberg A (45%), the most common etiology was the presence of anatomical variations. In four cases the diagnosis has been intraoperative, in five cases has been postoperative. Conclusions. Our clinical experience shows that the main cause of BDI are the surgeon experience and the bile ducts anatomical variation.

RETINAL ANGIOMATOUS PROLIFERATION: A Quantitative Analysis of the Fundoscopic Features of the Fellow Eye

PURPOSE: To quantitatively analyze and compare the fundoscopic features between fellow eyes of retinal angiomatous proliferation and typical exudative age-related macular degeneration and to identify possible predictors of neovascularization. METHODS: Retrospective case-control study. Seventy-nine fellow eyes of unilateral retinal angiomatous proliferation (n = 40) and typical exudative age-related macular degeneration (n = 39) were included. Fundoscopic features of the fellow eyes were assessed using digital color fundus photographs taken at the time of diagnosis of neovascularization in the first affected eye. Grading was performed by two independent graders using RetmarkerAMD, a computer-assisted grading software based on the International Classification and Grading System for age-related macular degeneration. RESULTS: Baseline total number and area (square micrometers) of drusen in the central 1,000, 3,000, and 6,000 μm were considerably inferior in the fellow eyes of retinal angiomatous proliferation, with statistically significant differences (P < 0.05) observed in virtually every location (1,000, 3,000, and 6,000 μm). A soft drusen (≥125 μm) area >510,196 μm2 in the central 6,000 μm was associated with an increased risk of neovascularization (hazard ratio, 4.35; 95% confidence interval [1.56-12.15]; P = 0.005). CONCLUSION: Baseline fundoscopic features of the fellow eye differ significantly between retinal angiomatous proliferation and typical exudative age-related macular degeneration. A large area (>510,196 μm2) of soft drusen in the central 6,000 μm confers a significantly higher risk of neovascularization and should be considered as a phenotypic risk factor.

A proteção da parentalidade em matéria de organização de tempo de trabalho : análise sobre a perspetiva jurídica-económica

Dissertação de Mestrado, Ciências Económicas e Empresariais, 8 de Julho de 2016, Universidade dos Açores.

O Impacto do Envolvimento Parental numa Pedagogia Participativa

Relatório de Estágio apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de Mestre em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico

Health-related quality of life and determinant factors in celiac disease: a population-based analysis of adult patients in Spain

Background: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. Methods: An observational, cross-sectional study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. Results: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. Conclusions: The HRQL level of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.

Coping religioso, resiliência e qualidade de vida de pessoas com HIV/AIDS

Tese (doutorado)—Universidade de Brasília, Instituto de Psicologia, Programa de Pós-Graduação em Processos de Desenvolvimento Humano e Saúde, 2016.