965 resultados para Actively Managed
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Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação
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Dissertação de mestrado em Engenharia e Gestão da Qualidade
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Tese de Doutoramento em Ciências da Educação (Especialidade de Tecnologia Educativa)
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Dissertação de mestrado integrado em Engenharia Civil
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Introduction Electroconvulsive therapy (ECT) is considered the most effective treatment for catatonia regardless its underlying condition. The rigid fixed posture and immobility observed in catatonia may lead to several clinical complications, of which, pulmonary embolism (PE) is one of the most severe. The rapid improvement of the psychiatric condition in catatonia-related PE is essential, since immobility favors the occurrence of new thromboembolic events and further complications. In that scenario, ECT should be considered, based on a risk-benefit analysis, aiming at the faster resolution of the catatonia. Methods Case report and literature review. Results A 66-years-old woman admitted to the psychiatric ward with catatonia due to a depressive episode presented bilateral PE. Clinically stable, but still severely depressed after a trial of antidepressants, she was treated with ECT in the course of full anticoagulation with enoxaparin. After five ECT sessions, her mood was significantly better and she was walking and eating spontaneously. She did not present complications related either to PE or to anticoagulation. After the eighth ECT session, she evolved with hypomania, which was managed with oral medication adjustments. The patient was completely euthymic at discharge. Conclusion The case we presented provides further evidence to the anecdotal case reports on the safety of ECT in the course of concomitant full anticoagulant therapy after PE, and illustrates how, with the proper precautions, the benefits of ECT in such condition might outweigh its risks.
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Tese de Doutoramento em História - Especialidade de Idade Moderna
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Public participation in environmental governance is typically associated with citizen access to power despite many closures and limitations having been identified in participatory processes. This article proposes an analytical framework to analyse discursive practices involved in public consultation processes. Critical Discourse Analysis is used to examine and appraise citizens’ access, standing and influence. We apply that framework to a ‘notice and comment’ process on a hydroelectric power plan in Portugal and show that it was discursively managed to justify the decision of constructing 10 large dams and to reject critical or alternative views. Citizens’ access, standing and influence were constrained through diverse discursive practices which (re)produced very unequal power relationsbetween policy proponents and participating individuals. More generally, the article illustrates the potential of Critical Discourse Analysis to assess voice(s) in policy processes. Focusing on argumentative, interactional and rhetorical levels, and how they are interwoven in public consultation discourses, the proposed framework is conceivably applicable in other studies.
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This is the report of a rare case of endomyocardial fibrosis associated with massive calcification of the left ventricle in a male patient with dyspnea on great exertion, which began 5 years earlier and rapidly evolved. Due to lack of information and the absence of clinical signs that could characterize impairment of other organs, the case was initially managed as a disease with a pulmonary origin. With the evolution of the disease and in the presence of radiological images of heterogeneous opacification in the projection of the left ventricle, the diagnostic hypothesis of endomyocardial disease was established. This hypothesis was later confirmed on chest computed tomography. The patient died on the 16th day of the hospital stay, probably because of lack of myocardial reserve, with clinical findings of refractory heart failure, possibly aggravated by pulmonary infection. This shows that a rare disease such as endomyocardial fibrosis associated with massive calcification of the left ventricle may be suspected on a simple chest X-ray and confirmed by computed tomography.
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OBJECTIVE: To compare the outcome of balloon PTCA with final coronary stenosis diameter (SD) <=30%, with elective coronary stenting. METHODS: We performed a comparative analysis of the 6 month outcomes in patients treated with primary stenting and those who obtained an optimal balloon PTCA result treated during the first 12 hours of AMI onset included in the STENT PAMI randomized trial. RESULTS: The results were analysed into 3 groups: primary stenting (441 patients, SD=22±6%), optimal PTCA (245 patients), and nonoptimal PTCA (182 patients, SD= 37±5%). At the end of the 6 months primary stent group presented with the lowest restenosis(23 vs. 31 vs. 45%, p=0.001, respectively). Ischemia-driven target vessel revascularization rate (TVR) (7 vs. 15.5 vs. 19%, p=0.001, respectively). CONCLUSION: At the 6 month follow-up, primary stenting offered the lowest restenosis and ischemia-driven TVR rates. Compared to optimal balloon PTCA. Nonoptimal primary balloon PTCA pts (SD=31-50%), had the worst late angiographic outcomes and should be treated more actively with coronary stent implantation.
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Relatório de estágio de mestrado em Educação Pré-escolar e Ensino no 1.º Ciclo do Ensino Básico
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Dissertação de mestrado em Educação Especial (área de especialização em Intervenção Precoce)
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A realização deste estudo junta duas áreas distintas: a arbitragem de futsal e o Balanced Scorecard (BSC). Nos últimos anos, devido ao crescimento acentuado da modalidade de Futsal, a mesma tem sido alvo de várias mudanças, nomeadamente no número de competições realizadas ao longo de uma época desportiva. Inerente ao elevado nível de competitividade alcançado, surge a necessidade de melhorar a gestão de uma área fundamental do jogo de futsal, a arbitragem. A arbitragem de futsal a nível nacional é gerida pelo Conselho de Arbitragem da Federação Portuguesa de Futebol (FPF). O Balanced Scorecard é uma metodologia de gestão estratégica, desenvolvida por Robert Kaplan e David Norton em 1992, que pode ser aplicada quer em organizações com fins lucrativos quer em organizações sem fins lucrativos, como é o caso do Conselho de Arbitragem da FPF. Desta forma, para colmatar a necessidade de melhorar a gestão da arbitragem de futsal, o presente estudo propõem-se aplicar a metodologia Balanced Scorecar ao Conselho de Arbitragem da Federação Portuguesa de Futebol na vertente futsal. Assim, irá ser apresentada uma análise do ambiente externo e interno, a definição de posicionamento e planeamento estratégico, o mapa estratégico e os objetivos definidos para cada perspetiva. Por fim, será feita uma reflexão quanto ao problema e aos objetivos do estudo, bem como, uma apresentação de algumas recomendações para futuros estudos.
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This project focuses on the EU Landfill Directive targets for Biodegradable Municipal Waste (BMW) specifically focusing on how the targets will affect Ireland and its waste management infrastructure. Research will consist of reviewing relevant literature, legislation and policies that will provide a comparable between Ireland and other nations. Planning processes which govern both the building structure and running capacities of treatment facilities is also necessary in order to predict amounts of waste diverted from landfill. The efficiency of these treatment plants also requires investigation. Another objective is to research further information on Irelands organic ‘brown’ bin service, this will involve discovering the roll out of bins in the future over a defined time scale as well as the potential amounts of waste that will be collected. Figures received from waste management and waste treatment companies will be combined with figures from the Environmental Protection Agency’s (EPA) annual reports. This will give an indication to past trends and shed light on possible future trends. With this information annul waste volumes consigned to landfill can be calculated and used to determine whether or not Ireland can achieve the EU Landfill Directive targets. Without significant investment in Irelands waste management infrastructure it is unlikely that the targets will be met. Existing waste treatment facilities need to be managed as efficiently as possible. Waste streams must also be managed so waste is shared appropriately between companies and not create a monopolising waste treatment facility. The driving forces behind an efficient waste management infrastructure are government policy and legislation. An overall and efficient waste management strategy must be in place, along with disincentives for landfilling of waste such as the landfill levy. Encouragement and education of the population is the fundamental and first step to achieving the landfill directive targets.
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Almost half of Ireland’s commercial stocks face overexploitation. As traditional species decrease in abundance and become less profitable, the industry is increasingly turning to alternate species. Atlantic saury (Scomberesox saurus saurus (Walbaum)) has been identified as a potential species for exploitation. Very little information is available on its biology or population dynamics, especially for Irish waters. This thesis aims to obtain sound scientific data, which will help to ensure that a future Atlantic saury fishery can be sustainably managed. The research has produced valuable data, some of which contradicts previous studies. Growth of Atlantic saury measured using otolith microstructure is found to be more than twice that previously calculated from annual structures on scales and otoliths. This results in a significant reduction of the expected life span from five to about two years. Investigation of maturity stage at age indicates that Atlantic saury will reproduce for the first time at age one and will survive for one or at most two reproduction seasons. It is concluded that a future Irish fishery will target mostly fish prior to their first reproduction. Finally the thesis gives some insights into the population structure of Atlantic saury, by analysis of otolith morphometric. Significant differences are detected between Northeastern Atlantic and western Mediterranean Sea specimens of the 0+ age class (less than one year old). The implications of these results for the management of an emerging fishery are discussed.
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I - Pneumococcus develops more actively on media containing 1% of glucose. II - When smaller percentages of glucose are used, growth is not so abundant. When percentages above 1% are used, the number of germs per cubic centimeter of medium is in a lower proportion, the higher the concentration of glucose is, up to the limit of 20% in which no growth at all is observed. III - Final pH in 1% glucose broth medium is approximately 4.5 to 5.0.