969 resultados para Guidance
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OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period. RESULTS The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90), 47.6% (n = 80), and 69.6% (n = 117), respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care. CONCLUSIONS Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process.
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OBJECTIVE To assess the factors associated with the use of dietary supplements by people who exercise at gyms.METHODS A cross-sectional study with a sample defined by convenience, considering the number of gyms registered in the Conselho Regional de Educação Física (Regional Council of Physical Education) of Sao Luis, MA, Northeastern Brazil, from July 2011 to July 2012. The final sample comprised 723 individuals who exercise at gyms. The dependent variable was supplement use, and the explanatory variables were length of time and motivation of the physical exercises, duration, goal and self-perception of training, weekly frequency of gym attendance, sex, age, educational attainment, self-perception of body weight, smoking and self-perception of diet. The association between variables was analysed by hierarchical Poisson regression based on a theoretical model.RESULTS Supplement use was reported by 64.7% of the participants. Most of the sample was male (52.6%). The most frequent age group was 20 to 39 years (74.4%). Most participants (46.1%) had been exercising for over a year. The following variables were associated with supplement use: self-perceiving body weight as below ideal (p < 0.001), smoking (p < 0.001), exercising for 7 to 12 months (p = 0.028) or more than one year (p < 0.001), spending more than two hours at the gym (p = 0.051), and perceiving training as moderate (p = 0.024) or intense (p = 0.001).CONCLUSIONS The use of supplements lacks proper professional guidance, being motivated by individuals unsatisfied with their low body weight and who perceive their workout as intense, which raises the need for monitoring this population.
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Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies
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This review aims to identify strategies to optimise radiography practice using digital technologies, for full spine studies on paediatrics focusing particularly on methods used to diagnose and measure severity of spinal curvatures. The literature search was performed on different databases (PubMed, Google Scholar and ScienceDirect) and relevant websites (e.g., American College of Radiology and International Commission on Radiological Protection) to identify guidelines and recent studies focused on dose optimisation in paediatrics using digital technologies. Plain radiography was identified as the most accurate method. The American College of Radiology (ACR) and European Commission (EC) provided two guidelines that were identified as the most relevant to the subject. The ACR guidelines were updated in 2014; however these guidelines do not provide detailed guidance on technical exposure parameters. The EC guidelines are more complete but are dedicated to screen film systems. Other studies provided reviews on the several exposure parameters that should be included for optimisation, such as tube current, tube voltage and source-to-image distance; however, only explored few of these parameters and not all of them together. One publication explored all parameters together but this was for adults only. Due to lack of literature on exposure parameters for paediatrics, more research is required to guide and harmonise practice.
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This paper reviews the literature for lowering of dose to paediatric patients through use of exposure factors and additional filtration. Dose reference levels set by The International Commission on Radiological Protection (ICRP) will be considered. Guidance was put in place in 1996 requires updating to come into line with modern imaging equipment. There is a wide range of literature that specifies that grids should not be used on paediatric patients. Although much of the literature advocates additional filtration, contrasting views on the relative benefits of using aluminium or copper filtration, and their effects on dose reduction and image quality can vary. Changing kVp and mAs has an effect on the dose to the patient and image quality. Collimation protects adjacent structures whilst reducing scattered radiation.
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ABSTRACT OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care. CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning.
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Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar
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Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º Ciclo do Ensino Básico
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Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º Ciclos do Ensino Básico
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Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção do grau de mestre em Ensino do 1.º e 2.º Ciclo do Ensino Básico
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The intent of this dissertation is to review relevant existing management systems and chemical industry initiatives to identify synergies, overlaps and gaps with Sustainability best practices, to map the barriers to the incorporation of Sustainability and formulate recommendations to facilitate execution of Sustainability practices within existing management systems. A chemical industry Sustainability survey was conducted through APEQ, the Portuguese association of chemical companies, which constitutes the first baseline on the topic for this national industry association. The commonly used international standards and the Responsible Care® (RC) initiative were cross-referenced against the United Nations Global Compact Assessment Tool. Guidance on how to incorporate Sustainability into a company‘s modus operandi was collapsed into Sustainability Playbooks. The survey revealed that 73% of the APEQ member companies that participated in the survey have a Sustainability Plan. Both large and small/medium APEQ member companies see the market not willing to pay extra for ‗greener‘ products as one of the main barriers. APEQ large enterprise see complexity of implementation and low return on investment as the other most significant barriers while small/medium enterprise respond that the difficulty to predict customer sustainability needs is the other most significant barrier. Amongst many other insights from this survey reported to APEQ, Life Cycle Assessment practices were found to have a low level of implementation and were also considered of low importance, thus identifying a very important opportunity in Sustainability practices to be addressed by APEQ. Two hundred and seventy three assessment points from United Nations Global Compact Assessment Tool plus five additional items were cross-referenced with international standard requirements. With the authorization of the intellectual property owners, the United Nations Global Compact Assessment Tool was modified to introduce actionable recommendations for each gap identified by management standard. This tool was automated to output specific recommendations for 63 possible combinations after simply selecting from a list of commonly used management standards and the RC initiative. Finally this modified tool was introduced into Playbooks for Incorporation of Sustainability at two levels: a ―Get Started Playbook‖ for beginners or small/medium size enterprise and an ―Advanced Playbook‖ as a second advancement stage or for large enterprise.
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Manufacturing processes need permanently to innovate and optimize because any can be susceptible to continuous improvement. Innovation and commitment to the development of these new solutions resulting from existing expertise and the continuing need to increase productivity, flexibility and ensuring the necessary quality of the manufactured products. To increase flexibility, it is necessary to significantly reduce set-up times and lead time in order to ensure the delivery of products ever faster. This objective can be achieved through a normalization of the pultrusion line elements. Implicitly, there is an increase of productivity by this way. This work is intended to optimize the pultrusion process of structural profiles. We consider all elements of the system from the storehouse of the fibers (rack) to the pultrusion die. Particular attention was devoted to (a) the guidance system of the fibers and webs, (b) the resin container where the fibers are impregnated, (c) standard plates positioning of the fibers towards the entrance to the spinneret and also (d) reviewed the whole process of assembling and fixing the die as well as its the heating system. With the implementation of these new systems was achieved a significant saving of time set-up and were clearly reduced the unit costs of production. Quality assurance was also increased.
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A forte preocupação ambiental, nomeadamente a emissão de Gases com Efeito de Estufa (GEE), aliada à constante ameaça do esgotamento dos combustíveis de origem fóssil, leva à necessidade de consumir energia de forma mais eficiente. Neste sentido, surge a promoção da eficiência energética nos diversos sectores consumidores de energia em todo o Mundo. Sabendo que passamos mais de 80% do nosso tempo dentro de edifícios, e que cerca de 40% da energia mundial é consumida nos mesmos [ADENE], é importante operar no sentido de promover a utilização racional de energia e incentivar ao consumo eficiente da mesma nos edifícios. Apesar do esforço que tem sido realizado a nível nacional, no sentido de melhorar a eficiência energética em edifícios de serviços, através da implementação de legislação diversa e de vários programas de incentivo, existem ainda várias lacunas a serem colmatadas e muito trabalho a fazer nesse sentido. Por tudo isto, e principalmente por ter constantemente em mente premissas como “a energia mais barata é aquela que não se consome” ou “não podemos gerir aquilo que não medimos”, surgiu a ideia de realizar esta dissertação, onde inicialmente através de dados provenientes de telecontagem se desenvolve uma tentativa de padronização/tipificação do consumo eléctrico em seis edifícios de escritórios, identificando-se assim algumas situações anómalas em diversos diagramas de carga construídos. Relaciona-se também o consumo eléctrico dos seis edifícios com algumas variáveis exógenas, de modo a perceber a influência das mesmas no consumo eléctrico de cada edifício. Numa vertente mais prática, foram identificadas e quantificadas potenciais medidas de melhoria, comportamentais e técnicas, num dos edifícios em estudo, de modo a poder contribuir para a redução do consumo energético do mesmo. Espera-se que este trabalho, possa eventualmente constituir uma ajuda na caracterização de consumos e detecção de medidas de melhoria em edifícios de escritórios, alcançando a eficiência energética neste tipo de instalações e facilitando assim o trabalho de vários profissionais do sector. Pretende-se igualmente demonstrar a importância da eficiência energética na gestão do uso da energia eléctrica em edifícios, e efectuar um paralelo entre a energia economizada por meio da implementação de medidas/acções de uso racional e eficiente, com a redução da queima de combustíveis fosseis na geração de energia eléctrica e a sua consequente redução nas emissões de dióxido de carbono (CO2), com o objectivo final de melhorar a qualidade de vida no nosso planeta.
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Descobrir o meio significa ter oportunidade de o observar, de o sentir, de o viver, de o experienciar, em suma, de interagir com ele. As crianças pequenas, quando estimuladas a descobrir o meio que as rodeia, desenvolvem um conjunto de competências que lhes permite a construção de imagens sobre o mundo nas suas múltiplas dimensões. O projeto que apresentamos surgiu de um percurso rotineiro pela área envolvente ao Jardim de Infância. Tem a particularidade de se desenvolver em meio rural, num contexto facilitador de experiências vivas e plenas de significado para as crianças. Percorrendo de forma integrada diferentes áreas de conteúdo, mas privilegiando o Conhecimento do Mundo, a Expressão Dramática e o Desenvolvimento Pessoal e Social, este projeto, centrado na descoberta do trator agrícola, procura no meio e na comunidade envolvente os recursos que o fazem crescer e que o tornam tão significativo para as crianças que nele se envolvem: os espaços, onde se constrói e partilha o conhecimento; os profissionais, a quem se colocam todas as questões e onde se procura ajuda para a realização das tarefas mais difíceis; as famílias, com quem se vive diariamente todo o processo.
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Resumo I (Prática Pedagógica) - No mundo actual, repleto de desafios, em que a sociedade exige cada vez mais do cidadão, é importante que os professores, como elementos fundamentais na formação para a cidadania, desenvolvam profissionalmente capacidades e competências que os façam pensar e reflectir sobre esta realidade. Uma orientação pedagógica construtiva, por parte do professor, não só em termos de aprendizagem dos alunos, mas também na construção do seu saber e prática pedagógica, torna-se fundamental. A Prática Pedagógica a que reporta este relatório foi desenvolvida no ano lectivo de 2012/2013 na Escola de Artes do Norte Alentejano (EANA). O mestrando desenvolveu a orientação pedagógica do ensino do violoncelo a três alunos que, conforme o regulamento em vigor do estágio do Mestrado em Ensino da Música, deve ser ministrada a discentes a frequentar níveis diferentes do ensino especializado da música, neste caso, Iniciação, 3º Grau e 5º Grau. Nesta primeira secção do relatório de estágio elabora-se a caracterização da escola e dos alunos, bem como a explanação das práticas educativas desenvolvidas, fornecendo uma descrição e levantamento das actividades adoptadas e das problemáticas que surgiram no decurso do estágio, identificando as opções tomadas para a resolução das mesmas. A partir dos resultados obtidos no estágio e de uma auto-avaliação da prática educativa, elaborou-se uma análise crítica da actividade docente que permitiu identificar aspectos positivos e menos positivos, que possam ser futuramente melhorados.