Assessment of microbiological air quality in hemato-oncology units and its relationship with the occurrence of invasive fungal infections: an integrative review

Worldwide aging of the human population has promoted an increase in the incidence of neoplasia, including hematological cancers, which render patients particularly vulnerable to invasive fungal infections. For this reason, air filtration in hemato-oncology units has been recommended. However, scarce literature has assessed the impact of microbiological air quality on the occurrence of fungal infections in this population. We performed an integrative review of studies in the MEDLINE database that were published between January 1980 and October 2012, using the following combinations of keywords: air × quality × HEPA, air × quality × hematology, and airborne fungal infections. The search yielded only 13 articles, suggesting that high-efficiency filtering of the ambient air in hemato-oncology units can prevent the incidence of invasive fungal infections. However, no randomized clinical trial was found to confirm this suggestion. Currently, there is no consensus about the maximum allowable count of fungi in the air, which complicates filtration monitoring, including filter maintenance and replacement, and needs to be addressed in future studies.

How to promote and enhance communication between a big retailer's after-sales department and its suppliers

W is the biggest electronic goods retailer in Portugal accounting with almost fifty percent of market share in its area. During the last years, many small W suppliers had to close their doors, and many others are in huge troubles. Among the reason for this situation, the huge bargaining power of W in the relationship seems crucial. The focus of the directed research will be in the after sales department where I did an internship from September 2014 to January 2015.

Sustainable urban planning: parameters to the operational process

In modern society, energy consumption and respect for the environment have become essential aspects of urban planning. The rising demand for alternative sources of energy, coupled with the decline in the construction sector and material usage, gives the idea that the thinking on modern cities, where attention is given to reduced energy consumption, savings, waste recycling and respect for the surrounding environment, is being put into practice. If we examine development of the city over recent centuries, by means of the theories of the most famous and influential urban planners, it is possible to identify the major problems caused by this type of planning. For this reason, in recent urban planning the use of systems of indicators that evaluate and certify land environmentally and energetically guides the master plan toward a more efficient city model. In addition the indicators are targeted on key factors determined by the commissioner or the opportunities the territory itself provides. Due the complexity of the environmental mechanics, the process of design and urban planning has become a challenging issue. The introduction of the indicators system has made it possible to register the life of the process, with a spiral route that allows the design itself to be refined. The aim of this study, built around the creation of a system of urban sustainability indicators that will evaluate highly eco-friendly cities, is to develop a certification system for cities or portions of them. The system will be upgradeable and objective, will employ real data and will be concerned with energy production and consumption.

Eco-epidemiologic study of emerging fungi related to the work of babaçu coconut breakers in the State of Maranhão, Brazil

Introduction: There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected. Methods: The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture. Results: In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women. Conclusions: The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation.

Contraexemplos e raciocínio dedutivo

Tese de Doutoramento apresentada ao ISPA - Instituto Universitário

Optimisation and design of post-tensioning anchorage corner blisters in concrete box girder bidges

The design of anchorage blisters of internal continuity post-tensioning tendons of bridges built by the cantilever method, presents some peculiarities, not only because they are intermediate anchorages but also because these anchorages are located in blisters, so the prestressing force has to be transferred from the blister the bottom slab and web of the girder. The high density of steel reinforcement in anchorage blisters is the most common reason for problems with concrete cast in situ, resulting in zones with low concrete compacity, leading to concrete crushing failures under the anchor plates. A solution may involve improving the concrete compression and tensile strength. To meet these requirements a high-performance fibre reinforced self-compacting mix- ture (HPFRC) was used in anchorage corner blisters of post-tensioning tendons, reducing the concrete cross-section and decreasing the reinforcement needed. To assess the ultimate capacity and the adequate serviceability of the local anchorage zone after reducing the minimum concrete cross-section and the confining reinforcement, specified by the anchorage device supplier for the particular tendon, load transfer tests were performed. To investigate the behaviour of anchorage blisters regarding the transmission of stresses to the web and the bottom slab of the girder, and the feasibility of using high performance concrete only in the blister, two half scale models of the inferior corner of a box girder existing bridge were studied: a reference specimen of ordinary reinforced concrete and a HPFRC blister specimen. The design of the reinforcement was based in the tensile forces obtained on strut-and-tie models. An experimental program was carried out to assess the models used in design and to study the feasibility of using high performance concrete only in the blister, either with casting in situ, or with precast solutions. A non-linear finite element analysis of the tested specimens was also performed and the results compared.

Relatório de estágio no departamento central de investigação e acção penal

The means of obtaining evidence, the amount of evidence obtained, the number of defendants related to each criminal case and the gravity of the crimes for which the magistrates of the Department are holders of penal action, define its real importance to the Rule of Law. I have deeply studied the subject of the institution of hierarchical intervention required by the assistant and the application of an opening statement by the defendant, starting from a hypothetical case, provided when the query of an investigation with the subject of the crime of active corruption, where this institution was called as a reaction to the archiving dispatch delivered by the Public Ministry. I have study about the implementation of the institution of provisional suspension of the process, specifically in the scope of fiscal criminality, analyzing the effective satisfaction of the purposes of the sentences in two slopes: general prevention and special prevention. I went for my first time to a Central Court of Criminal Instruction, where I attended the measures of inquiry and instructive debate of a process that culminated with the prosecution and pronunciation of the defendants. In addition to this criminal experience, I have deepened and consolidated the academic knowledge with the study of various criminal cases from various fields in the scope of criminality investigated by the Department. I could therefore check the basis of procedural delays, regarding to our legal system, especially in this type of crime, raising issues that I analyzed and discussed, always in a critical and academic way. I had the opportunity to attend and witness a seminar in the Lisbon Directorate of Finance as well of entering the Centre for Judicial Studies to attend a conference on the International Anti-Corruption Day. Focus on the investigatory importance of the international judicial cooperation, through the various organs, with special interest to EUROJUST. I comprehended the organization and functioning of these communitarian organs and means of communication of procedural acts, in particular, the rogatory letters and european arrest warrants. This involvement is motivated by the moratorium factor of the investigations where rogatory letters are necessary for the acquisition of evidence or information relevant to the good continuation of the process. For this reason the judicial cooperation through the relevant communitarian organs, translates a streamlined response between the competent judicial authorities of the Member States, through the National Member that integrates EUROJUST. This report aims to highlight some of the difficulties and procedural issues that Public Prosecutors of DCIAP and criminal police bodies that assist them, face in combating violent and organized crime, of national and transnational nature, of particular complexity, according to the specifics of criminal types.

Hormone replacement therapy and the risk of breast cancer: assessment of therapy acceptance in a cohort of previously treated breast cancer patients

INTRODUCTION: In the postmenopausal period, an average of 25% of women will present symptomatic ovarian failure requiring hormonal replacement therapy. Estrogen can relieve vasomotor symptoms. Hormonal replacement therapy is generally not recommended for breast cancer patients due to the potential risk of tumor recurrence. To answer the questions about the safety of hormonal replacement therapy in this subgroup of women, it is necessary to establish the acceptance of treatment. METHODS: Between September 1998 and February 2001, a cohort of 216 breast cancer patients were asked to complete a questionnaire. All patients had completed their treatment and were informed about survival rates after breast cancer and hormonal replacement therapy. RESULTS: Among the 216 patients, 134 (62%) would refuse hormonal replacement therapy. A hundred patients were afraid of relapse (74.6%). Adjuvant tamoxifen therapy was the only statistically significant variable (70.3% versus 29.7% p=0.003). Understanding clinical stage (p= 0.045) and type of medical assistance (private versus public , p=0.033) also seemed to influence the decision. Early stage disease (p= 0.22), type of surgical procedure (radical versus conservative, p=0.67), adjuvant chemotherapy (p=0.082) or marital status (p=0.98 ) were not statistically significant in decision making. Several patients submitted to adjuvant chemotherapy (41.6%) would accept hormonal replacement therapy under medical supervision, as did most of advanced clinical stage patients (58.3%; p=0.022). CONCLUSION: There is a high level of rejection for hormonal replacement therapy among breast cancer patients when current data on tumor cure rates, and potential risks of estrogen use is available. Adverse effects of tamoxifen in the adjuvant setting may be the reason for refusal of hormonal replacement therapy .

BRISA’S takeover offer

This project is composed by a Case Study regarding Tagus’ takeover offer for Brisa. The case study describes each player involved in the operation: the target company – Brisa, the acquirers – José de Mello and Arcus; as well as the circumstances surrounding the takeover, with a description of the takeover itself and the conflict between the acquirers and Abertis. Associated to the case, there is a group of six question and their respective answers, regarding the motive of the takeover, the price per share, what should be the positions of Brisa’s shareholders regarding the takeover and the reason Brisa’s share price declined after the success of the operation.

O regime penal das imunidades dos titulares dos órgãos políticos de soberania

Portugal is one of the countries that has a constitutional regime of immunity. This protects certain individuals in political positions from prosecution under the law. These individuals are said to have a privileged status when compared to ordinary citizens. The purpose of this study is to examine the immunities enjoyed by President, the members of Parliament and the government ministers. The regime of immunities can be found to generate a certain sense of injustice and feelings of mistrust since the individual can not, albeit temporarily, be held criminally responsible for criminal conduct. It is urgent, therefore, to find a consistent justification with the principles and values of the Criminal Law. The Parliament is the place of the exercise of democratic power and, therefore, a member of Parliament assumes a central position in parliamentary activity. For this reason, it will be necessary to determine analysis to determine the meaning the prerogative of criminal irresponsibility. One question that must be asked is to know how the dogmatic plan that the immunities of the political organs of sovereignty must be seen.

In Search of the Origins of Modernism: Venice and the Crisis of Classical Architecture in the mid-eighteenth century

This paper attempts to prove that in the years 1735 to 1755 Venice was the birthplace and cradle of Modern architectural theory, generating a major crisis in classical architecture traditionally based on the Vitruvian assumption that it imitates early wooden structures in stone or in marble. According to its rationalist critics such as the Venetian Observant Franciscan friar and architectural theorist Carlo Lodoli (1690-1761) and his nineteenth-century followers, classical architecture is singularly deceptive and not true to the nature of materials, in other words, dishonest and fallacious. This questioning did not emanate from practising architects, but from Lodoli himself– a philosopher and educator of the Venetian patriciate – who had not been trained as an architect. The roots of this crisis lay in a new approach to architecture stemming from the new rationalist philosophy of the Enlightenment age with its emphasis on reason and universal criticism.

Sistema de segurança interna : a unificação do sistema em Portugal

A aceleração do ritmo de mudança verificado nas sociedades atuais, tem sido impulsionado pela globalização, fenómeno decorrente da evolução das tecnologias da informação, das telecomunicações, das comunicações e transportes e do desaparecimento de fronteiras. Viver na “aldeia global” ou à escala global como o previu Marshall McLuhan (1964) no livro Understanding Media, é hoje uma realidade inquestionável. As consequências desta transformação foram múltiplas quer do ponto de vista dos benefícios, quer do ponto de vista dos problemas gerados. No plano da segurança, face ao multiculturalismo envolvido e ao aumento crescente do crime transfronteiriço, tornou-se essencial a partilha de informação a nível internacional tendo em vista o seu combate não só olhando a situação dos cidadãos como a defesa dos princípios democráticos. Realça-se que os progressos tecnológicos e as facilidades que criam aos seus utilizadores, neste caso os criminosos, fazem com que as ações por estes praticadas sejam cada vez mais meticulosas, imprevisíveis, sofisticadas e complexas o que impõe uma resposta correspondente e adequada. Por essa razão, as políticas de segurança existentes mostraram-se insuficientes e esgotadas requerendo novas respostas capazes de produzir os efeitos desejáveis para uma efetiva prevenção da criminalidade. Pelas dimensões que tem vindo a tomar, a criminalidade tornou-se uma preocupação que ultrapassou o domínio da segurança interna de cada país para ser encarada a nível internacional ou mesmo mundial. Para o efeito urge concertar processos e procedimentos securitários agregando vontades que convirjam e defendam a unificação dos sistemas dos países a nível mundial. A verificar-se tal intento, daí resultariam significativas melhorias da segurança a todos os níveis (nacional, internacional e mundial). Além disso também resultariam ganhos em termos de tempo, redução de custos, impacto na qualidade dos serviços prestados, na gestão das pessoas e na eficiência das organizações. Realça-se que a democracia ao promover a dignidade do homem densificando os seus direitos, liberdades e garantias, criou indiretamente condições para que fosse gerada instabilidade e o desenvolvimento de comportamentos criminosos. Importa, portanto, face à situação existente e à previsível complexidade do crime no futuro, estudar profundamente a nova realidade neste domínio, para tomar as medidas preventivas tendentes a reporem a estabilidade e a promoverem a paz social. Foi neste contexto que a presente investigação, desenvolvida no âmbito académico, mas também suportado na realidade profissional, pretendeu refletir sobre o estado da segurança global e dar o seu contributo nesta matéria.

Aspectos fundamentais da experiência da vida

A tese que de seguida se esboça assenta sobre uma inquietação fundamental: o facto de cada um dar por si atirado na vida, de, quando cada um dá por si, dar por si a ser vida, etc. Acontece que, logo que se tenta focar mais precisamente de que é de que se trata quando se trata da “vida”, nota-se que esse fenómeno tem habitualmente a forma de um acontecimento anónimo: não se sabe bem a que é que corresponde, que conteúdos tem, que estruturas fundamentais a suportam, etc. Isto é: somos levados pela vida (passamos pela vida, atravessamo-la, estamos expostos a ela, etc.) sem saber exactamente a que é que estamos expostos, o que é que nos leva, sobre que pilares assenta a nossa vivência e a nossa compreensão dela, etc. A tese que se segue não tem a pretensão de deixar definitivamente respondidas estas perguntas; tudo o que faz, na verdade, é meramente proceder a um breve levantamento ou a um registo de algumas das estruturas fundamentais da vida a partir do ângulo da experiência da vida. E, como se espera deixar claro, procurar a resposta a partir do ângulo da experiência (do ângulo da experiência da vida) não é algo acidental ou fortuito. O que se procurará apurar é se não haverá tais laços de afinidade entre “vida” e “experiência” que todas as operações próprias da experiência têm lugar numa vinculação e estão subordinadas às estruturas fundamentais da vida (estruturas que ultrapassam o âmbito da “experiência”) e que, assim também, a vida tenha, de raiz, no modo como nela somos levados e conduzidos, a estrutura ou a forma da “experiência”.

Portugal no conselho de segurança das Nações Unidas

The United Nations is an international organization that was created after World War II, whose main objective is to promote cooperation, social and economic development, as well as to ensure international peace and security. The Member States are key actors in the international political system. For that reason they have strategic interests in what regards taking part in the international organizations. They see it as an opportunity to achieve those goals. The United Nations Security Council has a very important role in preserving international peace and security. It is the organ of the United Nations in which fifteen member states are represented: five permanently and ten non-permanently, being that the latter are elected for two years. Participating in the Security Council is a unique opportunity for middle powers like Portugal to promote their national interests and to increase their international visibility. In addition, they can contribute to the world’s destiny during their mandate period. Portugal has exercised his third term as a non-permanent member of the Security Council in 2011-2012 biennium, defeating Canada after a successful campaign carried out by the Portuguese diplomacy. This study analyses the participation of Portugal in the Security Council´s 2011-2012 biennium. It will focus the application process and election and the role of Portugal in the Security Council, especially in its the presidency and its intervention in the presidency of the Sanctions Committee on Libya. Its aim is to show the impact of Portuguese participation in the Security Council for international peace and security, as well as the geopolitical importance for the country of being part of the Security Council.

Characterization of the clients retention in the tlecommunications companies

The ability of a company to be able to do a precisely churn prediction, so it can act on it, is paramount. For this reason, Deloitte addressed me the challenge of characterizing the client’s retention in the telecom companies. To do so, it was created a comprehensive tool that enables Deloitte to evaluate the churn management maturity level of a telecom operator and highlight its strengths and weaknesses. The development of this matrix was based on a depth churn research, a market research based on 40 interviews and 2 focus group and the valuable feedback from Deloitte consultants.