Ventilação não invasiva durante o exercício em pacientes com DPOC: revisão sistemática com meta-análise

Mestrado em Fisioterapia

Metacognitive and social cognition training (MSCT) in schizophrenia: a preliminary efficacy study

Psychosocial interventions have proven to be effective in treating social cognition in people with psychotic disorders. The current study aimed to determine the effects of a metacognitive and social cognition training (MSCT) program, designed to both remediate deficits and correct biases in social cognition. Thirty-five clinically stable outpatients were recruited and assigned to the MSCT program (n = 19) for 10 weeks (18 sessions) or to the TAU group (n = 16), and they all completed pre- and post-treatment assessments of social cognition, cognitive biases, functioning and symptoms. The MSCT group demonstrated a significant improvement in theory of mind, social perception, emotion recognition and social functioning. Additionally, the tendency to jump to conclusions was significantly reduced among the MSCT group after training. There were no differential benefits regarding clinical symptoms except for one trend group effect for general psychopathology. The results support the efficacy of the MSCT format, but further development of the training program is required to increase the benefits related to attributional style.

Severe stress urinary incontinence: pelvic floor muscle training program

International guidelines recommend a first line therapy in the treatment of female stress urinary incontinence (SUI), the pelvic floor muscle (PFM) training. This case report assesses the effects of the PFM training program in treating women with severe SUI. The urodynamic parameters allow diagnosed intrinsic sphincter deficiency and urethral hypermobility. The subjective and objective parameters were assessed at the beginning and after six-month of PFM training program. This case report confirms the efficiency of the intensive training program in severe SUI. The medical implications of the PFM training as first treatment option reflect favourable individual results and additionally contribute to the selection of the non-invasive treatment, the reduction of the incidence collateral effects, low costs and that does not prevent future treatment options.

Training needs in TQM: the Portuguese perspective

A survey to assess training needs in TQM was developed in several European countries, within the framework of a Leonardo’s project named IMVOCED. Beyond a comparison of the results in each country, a global analysis was performed to design a TQM programme to be delivered by WBL (Work Based Learning). Differences were found between countries, and the Portuguese results also revealed that different approaches to TQM training should be adopted according to the organisation’s dimension. Based on this evidence, two different strategies for TQM training by WBL are proposed and discussed.

Impact of a training course on the quality of malaria diagnosis by microscopy in Angola

Background: In Angola, malaria is an endemic disease having a major impact on the economy. The WHO recommends testing for all suspected malaria cases, to avoid the presumptive treatment of this disease. In malaria endemic regions laboratory technicians must be very comfortable with microscopy, the golden standard for malaria diagnosis, to avoid the incorrect diagnosis. The improper use of medication promotes drug resistance and undesirable side effects. The present study aims to assess the impact of a three-day refresher course on the knowledge of technicians, quality of blood smears preparation and accuracy of microscopy malaria diagnosis, using qPCR as reference method. Methods: This study was implemented in laboratories from three hospitals in different provinces of Angola: Bengo, Benguela and Luanda. In each laboratory samples were collected before and after the training course (slide with thin and thick blood smears, a dried blood spot and a form). The impact of the intervention was evaluated through a written test, the quality of slide preparation and the performance of microscopy. Results: It was found a significant increase on the written test median score, from 52.5% to 65.0%. A total of 973 slides were analysed to evaluate the quality of thick and thin blood smears. Considering all laboratories there was a significant increase in quality of thick and thin blood smears. To determine the performance of microscopy using qPCR as the reference method we used 1,028 samples. Benguela presented the highest values for specificity, 92.9% and 98.8% pre and post-course, respectively and for sensitivity the best pre-course was Benguela (75.9%) and post-course Luanda (75.0%). However, no significant increase in sensitivity and specificity after the training course was registered in any laboratory analysed. Discussion: The findings of this study support the need of continuous refresher training for microscopists and other laboratory staff. The laboratories should have a quality control programme to supervise the diagnosis and also to assess the periodicity of new training. However, other variables needed to be considered to have a correct malaria diagnosis, such as adequate equipment and reagents for staining and visualization, good working conditions, motivated and qualified personnel.

Nuclear medicine technologist education and training in Europe: literature and web-based findings

Purpose - The education and training of a nuclear medicine technologist (NMT) is not homogeneous among European countries, which leads to different scope of practices and, therefore, different technical skills are assigned. The goal of this research was to characterize the education and training of NMT in Europe. Materials and methods - This study was based on a literature research to characterize the education and training of NMT and support the historical evolution of this profession. It was divided into two different phases: the first phase included analysis of scientific articles and the second phase included research of curricula that allow health professionals to work as NMT in Europe. Results - The majority of the countries [N=31 (89%)] offer the NMT curriculum integrated into the high education system and only in four (11%) countries the education is provided by professional schools. The duration in each education system is not equal, varying in professional schools (2-3 years) and high education level system (2-4 years), which means that different European Credit Transfer and Accumulation System, such as 240, 230, 222, 210 or 180 European Credit Transfer and Accumulation System, are attributed to the graduates. The professional title and scope of the practice of NMT are different in different countries in Europe. In most countries of Europe, nuclear medicine training is not specific and curriculum does not demonstrate the Nuclear Medicine competencies performed in clinical practice. Conclusion - The heterogeneity in education and training for NMT is an issue prevalent among European countries. For NMT professional development, there is a huge need to formalize and unify educational and training programmes in Europe.

Effect of plug-filling, Testing velocity and temperature on the tensile strength of strap repairs on aluminium structures

In this work, an experimental study was performed on the influence of plug-filling, loading rate and temperature on the tensile strength of single-strap (SS) and double-strap (DS) repairs on aluminium structures. Whilst the main purpose of this work was to evaluate the feasibility of plug-filling for the strength improvement of these repairs, a parallel study was carried out to assess the sensitivity of the adhesive to external features that can affect the repairs performance, such as the rate of loading and environmental temperature. The experimental programme included repairs with different values of overlap length (L O = 10, 20 and 30 mm), and with and without plug-filling, whose results were interpreted in light of experimental evidence of the fracture modes and typical stress distributions for bonded repairs. The influence of the testing speed on the repairs strength was also addressed (considering 0.5, 5 and 25 mm/min). Accounting for the temperature effects, tests were carried out at room temperature (≈23°C), 50 and 80°C. This permitted a comparative evaluation of the adhesive tested below and above the glass transition temperature (T g), established by the manufacturer as 67°C. The combined influence of these two parameters on the repairs strength was also analysed. According to the results obtained from this work, design guidelines for repairing aluminium structures were

Influence of the cohesive law parameters on the strength prediction of adhesively-bonded joints

Adhesive joints are largely employed nowadays as a fast and effective joining process. The respective techniques for strength prediction have also improved over the years. Cohesive Zone Models (CZM’s) coupled to Finite Element Method (FEM) analyses surpass the limitations of stress and fracture criteria and allow modelling damage. CZM’s require the energy release rates in tension (Gn) and shear (Gs) and respective fracture energies in tension (Gnc) and shear (Gsc). Additionally, the cohesive strengths (tn0 for tension and ts0 for shear) must also be defined. In this work, the influence of the CZM parameters of a triangular CZM used to model a thin adhesive layer is studied, to estimate their effect on the predictions. Some conclusions were drawn for the accuracy of the simulation results by variations of each one of these parameters.

Numerical and experimental study of tensile strength of single and double-strap repairs

Adhesive bonding as a joining or repair method has a wide application in many industries. Repairs with bonded patches are often carried out to re-establish the stiffness at critical regions or spots of corrosion and/or fatigue cracks. Single and double-strap repairs (SS and DS, respectively) are a viable option for repairing. For the SS repairs, a patch is adhesively-bonded on one of the structure faces. SS repairs are easy to execute, but the load eccentricity leads to peel peak stresses at the overlap edges. DS repairs involve the use of two patches, one on each face of the structure. These are more efficient than SS repairs, due to the doubling of the bonding area and suppression of the transverse deflection of the adherends. Shear stresses also become more uniform as a result of smaller differential straining. The experimental and Finite Element (FE) study presented here for strength prediction and design optimization of bonded repairs includes SS and DS solutions with different values of overlap length (LO). The examined values of LO include 10, 20 and 30 mm. The failure strengths of the SS and DS repairs were compared with FE results by using the Abaqus® FE software. A Cohesive Zone Model (CZM) with a triangular shape in pure tensile and shear modes, including the mixed-mode possibility for crack growth, was used to simulate fracture of the adhesive layer. A good agreement was found between the experiments and the FE simulations on the failure modes, elastic stiffness and strength of the repairs, showing the effectiveness and applicability of the proposed FE technique in predicting strength of bonded repairs. Furthermore, some optimization principles were proposed to repair structures with adhesively-bonded patches that will allow repair designers to effectively design bonded repairs.

Lean learning academy: an innovative framework for lean manufacturing training

Worldwide competitiveness poses enormous challenges on managers, demanding a continuous quest to increase rationality in the use of resources. As a management philosophy, Lean Manufacturing focuses on the elimination of activities that do not create any type of value and therefore are considered waste. For companies to successfully implement the Lean Manufacturing philosophy it is crucial that the human resources of the organization have the necessary training, for which proper tools are required. At the same time, higher education institutions need innovative tools to increase the attractiveness of engineering curricula and develop a higher level of knowledge among students, improving their employability. This paper describes how Lean Learning Academy, an international collaboration project between five EU universities and five companies, from SME to Multinational/Global companies, developed and applied an innovative training programme for Engineers on Lean Manufacturing, a successful alternative to the traditional teaching methods in engineering courses.

Digital serious games and simulation games - comparison of two approaches to lean training

In an increasingly competitive and globalized world, companies need effective training methodologies and tools for their employees. However, selecting the most suitable ones is not an easy task. It depends on the requirements of the target group (namely time restrictions), on the specificities of the contents, etc. This is typically the case for training in Lean, the waste elimination manufacturing philosophy. This paper presents and compares two different approaches to lean training methodologies and tools: a simulation game based on a single realistic manufacturing platform, involving production and assembly operations that allows learning by playing; and a digital game that helps understand lean tools. This paper shows that both tools have advantages in terms of trainee motivation and knowledge acquisition. Furthermore, they can be used in a complementary way, reinforcing the acquired knowledge.

Shear strength of adhesively bonded polyolefins with minimal surface preparation

Interest in polyethylene and polypropylene bonding has increased in the last years. However, adhesive joints with adherends which are of low surface energy and which are chemically inert present several difficulties. Generally, their high degree of chemical resistance to solvents and dissimilar solubility parameters limit the usefulness of solvent bonding as a viable assembly technique. One successful approach to adhesive bonding of these materials involves proper selection of surface pre-treatment prior to bonding. With the correct pre-treatment it is possible to glue these materials with one or more of several adhesives required by the applications involved. A second approach is the use of adhesives without surface pre-treatment, such as hot melts, high tack pressure-sensitive adhesives, solvent-based specialty adhesives and, more recently, structural acrylic adhesives as such 3M DP-8005® and Loctite 3030®. In this paper, the shear strengths of two acrylic adhesives were evaluated using the lap shear test method ASTM D3163 and the block shear test method ASTM D4501. Two different industrial polyolefins (polyethylene and polypropylene) were used for adherends. However, the focus of this study was to measure the shear strength of polyethylene joints with acrylic adhesives. The effect of abrasion was also studied. Some test specimens were manually abraded using 180 and 320 grade abrasive paper. An additional goal of this work was to examine the effect of temperature and moisture on mechanical strength of adhesive joints.

Strength prediction of adhesively-bonded scarf repairs in composite structures under bending

This work reports on the experimental and numerical study of the bending behaviour of two-dimensional adhesively-bonded scarf repairs of carbon-epoxy laminates, bonded with the ductile adhesive Araldite 2015®. Scarf angles varying from 2 to 45º were tested. The experimental work performed was used to validate a numerical Finite Element analysis using ABAQUS® and a methodology developed by the authors to predict the strength of bonded assemblies. This methodology consists on replacing the adhesive layer by cohesive elements, including mixed-mode criteria to deal with the mixed-mode behaviour usually observed in structures. Trapezoidal laws in pure modes I and II were used to account for the ductility of the adhesive used. The cohesive laws in pure modes I and II were determined with Double Cantilever Beam and End-Notched Flexure tests, respectively, using an inverse method. Since in the experiments interlaminar and transverse intralaminar failures of the carbon-epoxy components also occurred in some regions, cohesive laws to simulate these failure modes were also obtained experimentally with a similar procedure. A good correlation with the experiments was found on the elastic stiffness, maximum load and failure mode of the repairs, showing that this methodology simulates accurately the mechanical behaviour of bonded assemblies.

Buckling strength of adhesively-bonded single and double-strap repairs on carbon-epoxy structures

This work reports on an experimental and finite element method (FEM) parametric study of adhesively-bonded single and double-strap repairs on carbon-epoxy structures under buckling unrestrained compression. The influence of the overlap length and patch thickness was evaluated. This loading gains a particular significance from the additional characteristic mechanisms of structures under compression, such as fibres microbuckling, for buckling restrained structures, or global buckling of the assembly, if no transverse restriction exists. The FEM analysis is based on the use of cohesive elements including mixed-mode criteria to simulate a cohesive fracture of the adhesive layer. Trapezoidal laws in pure modes I and II were used to account for the ductility of most structural adhesives. These laws were estimated for the adhesive used from double cantilever beam (DCB) and end-notched flexure (ENF) tests, respectively, using an inverse technique. The pure mode III cohesive law was equalled to the pure mode II one. Compression failure in the laminates was predicted using a stress-based criterion. The accurate FEM predictions open a good prospect for the reduction of the extensive experimentation in the design of carbon-epoxy repairs. Design principles were also established for these repairs under buckling.

Strength prediction and experimental validation of adhesive joints including polyethylene, carbon-epoxy and aluminium adherends

Polyolefins are especially difficult to bond due to their non-polar, non-porous and chemically inert surfaces. Acrylic adhesives used in industry are particularly suited to bond these materials, including many grades of polypropylene (PP) and polyethylene (PE), without special surface preparation. In this work, the tensile strength of single-lap PE and mixed joints bonded with an acrylic adhesive was investigated. The mixed joints included PE with aluminium (AL) or carbon fibre reinforced plastic (CFRP) substrates. The PE substrates were only cleaned with isopropanol, which assured cohesive failures. For the PE CFRP joints, three different surfaces preparations were employed for the CFRP substrates: cleaning with acetone, abrasion with 100 grit sand paper and peel-ply finishing. In the PE AL joints, the AL bonding surfaces were prepared by the following methods: cleaning with acetone, abrasion with 180 and 320 grit sand papers, grit blasting and chemical etching with chromic acid. After abrasion of the CFRP and AL substrates, the surfaces were always cleaned with acetone. The tensile strengths were compared with numerical results from ABAQUS® and a mixed mode (I+II) cohesive damage model. A good agreement was found between the experimental and numerical results, except for the PE AL joints, since the AL surface treatments were not found to be effective.