863 resultados para Life course perspective
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Hybridisation is a systematic process along which the characteristic features of hybrid logic, both at the syntactic and the semantic levels, are developed on top of an arbitrary logic framed as an institution. It also captures the construction of first-order encodings of such hybridised institutions into theories in first-order logic. The method was originally developed to build suitable logics for the specification of reconfigurable software systems on top of whatever logic is used to describe local requirements of each system’s configuration. Hybridisation has, however, a broader scope, providing a fresh example of yet another development in combining and reusing logics driven by a problem from Computer Science. This paper offers an overview of this method, proposes some new extensions, namely the introduction of full quantification leading to the specification of dynamic modalities, and exemplifies its potential through a didactical application. It is discussed how hybridisation can be successfully used in a formal specification course in which students progress from equational to hybrid specifications in a uniform setting, integrating paradigms, combining data and behaviour, and dealing appropriately with systems evolution and reconfiguration.
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Relatório EPE - Relatório de estágio em Educação Pré-Escolar: O presente Relatório de Estágio de Qualificação Profissional situa-se no contexto de Educação Pré-Escolar, tendo como propósito revelar o que foi sendo realizado no Centro Social da Paróquia Nossa Senhora da Ajuda ao longo de quatro meses em contexto de creche. A prática educativa sustentou-se num quadro teórico-concetual de referência, com vista à construção de saberes para a Educação de Infância, pelo compromisso e responsabilização progressiva da ação docente, tendo sido encarado como um momento de singular importância. O contexto de formação assumiu-se, portanto, como um lugar privilegiado de articulação entre teoria e prática, onde o processo de ensino e aprendizagem ficou pautado por intencionalidades educativas com vista ao desenvolvimento integral de cada criança, bem como para a construção de saberes e competências profissionais. No âmbito da investigação-ação e associada à observação, à planificação, à avaliação e à ação propriamente dita, esteve sempre presente a comunicação e a articulação, pois são estas etapas interligadas que revelam a intencionalidade do processo educativo que carateriza a intervenção profissional do educador. A reflexão evidenciou-se também fulcral, pois só mediante uma reflexão na ação e sobre a ação é possível uma introspeção pessoal, despoletando uma compreensão mais sustentada da ação, facilitando a tomada de decisões conscientes. Salienta-se, ainda, a importância de uma formação profissional ao longo da vida, de modo a potenciar o desenvolvimento de uma atitude perante a Educação cada vez mais crítica, indagadora e reflexiva, em prol do desenvolvimento de cada criança.
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The debate on the relation between career counseling and psychotherapy revealed the close relation between psychosocial and career issues. The connection between these two approaches paves the way for the integration of career counseling into psychotherapy. One of the key challenges of integrating career counseling into psychotherapy is to avoid discontinuities and inconsistencies in the psychotherapeutic intervention. The aim of this article is, therefore, to present the Systematic Treatment Selection perspective as a framework for an effective integration of psychotherapy and career counseling. Then, Life Design Counseling is described, highlighting its possibilities to fit the psychotherapeutic approach. Finally, an illustrative case is presented and discussed.
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Noonan syndrome is a relatively common and heterogeneous genetic disorder, associated with congenital heart defect in about 50% of the cases. If the defect is not severe, life expectancy is normal. We report a case of Noonan syndrome in a preterm infant with hypertrophic cardiomyopathy and lethal outcome associated to acute respiratory distress syndrome caused by Adenovirus pneumonia. A novel mutation in the RAF1 gene was identified: c.782C>G (p.Pro261Arg) in heterozygosity, not described previously in the literature. Consequently, the common clinical course in this mutation and its respective contribution to the early fatal outcome is unknown. No conclusion can be established regarding genotype/phenotype correlation.
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George Keith, fourth Earl Marischal is a case study of long-term, quietly successful and stable lordship through the reign of James VI. Marischal’s life provides a wholly underrepresented perspective on this era, where the study of rebellious and notorious characters has dominated. He is also a counter-example to the notion of a general crisis among the European nobility, at least in the Scottish context, as well as to the notion of a ‘conservative’ or ‘Catholic’ north east. In 1580 George inherited the richest earldom in Scotland, with a geographical extent stretching along the east coast from Caithness to East Lothian. His family came to be this wealthy as a long term consequence of the Battle of Flodden (1513) where a branch of the family, the Inverugie Keiths had been killed. The heiress of this branch was married to the third earl and this had concentrated a large number of lands, and consequently wealth, in the hands of the earls. This had, however, also significantly decreased the number of members and hence power of the Keith kindred. The third earl’s conversion to Protestantism in 1544 and later his adherence to the King’s Party during the Marian Civil War forced the Keiths into direct confrontation with their neighbours in the north east, the Gordons (led by the Earls of Huntly), a Catholic family and supporters of the Queen’s Party. Although this feud was settled for a time at the end of the war, the political turmoil caused by a succession of short-lived factional regimes in the early part of the personal reign of James VI (c.1578-1585) led the new (fourth) Earl Marischal into direct confrontation with the new (sixth) Earl of Huntly. Marischal was outclassed, outmanoeuvred and outgunned at both court and in the locality in this feud, suffering considerably. However, Huntly’s over-ambition in wider court politics meant that Marischal was able to join various coalitions against his rival, until Huntly was exiled in 1595. Marischal also came into conflict briefly with Chancellor John Maitland of Thirlestane as a consequence of Marischal’s diplomatic mission to Denmark in 1589-1590, but was again outmatched politically and briefly imprisoned. Both of these feuds reveal Marischal to be relatively cautious and reactionary, and both reveal the limitations of his power. Elsewhere, the study of Marischal’s activities in the centre of Scottish politics reveal him to be unambitious. He was ready to serve King James, the two men having a healthy working relationship, but Marischal showed no ambition as a courtier, to woo the king’s favour or patronage, instead delegating interaction with the monarch to his kinsmen. Likewise, in government, Marischal rarely attended any of the committees he was entitled to attend, such as the Privy Council, although he did keep a keen eye on the land market and the business conducted under the Great Seal. Although personally devout and a committed Protestant, the study of Marischal’s interaction with the national Kirk and the parishes of which he was patron reveal that he was at times a negligent patron and exercised his right of ministerial presentation as lordly, not godly patronage. The notion of a ‘conservative North East’ is, however, rejected. Where Marischal was politically weak at court and weak in terms of force in the locality, we see him pursuing sideways approaches to dealing with this. Thus he was keen to build up his general influence in the north and in particular with the burgh of Aberdeen (one result of this being the creation of Marischal College in 1593), pursued disputes through increasing use of legal methods rather than bloodfeud (thus exploiting his wealth and compensating for his relative lack of force) and developed a sophisticated system of maritime infrastructure, ultimately expressed through the creating of the burghs of Peterhead and Stonehaven. Although his close family caused him a number of problems over his lifetime, he was able to pass on a stable and enlarged lordship to his son in 1623.
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Life Cycle Climate Performance (LCCP) is an evaluation method by which heating, ventilation, air conditioning and refrigeration systems can be evaluated for their global warming impact over the course of their complete life cycle. LCCP is more inclusive than previous metrics such as Total Equivalent Warming Impact. It is calculated as the sum of direct and indirect emissions generated over the lifetime of the system “from cradle to grave”. Direct emissions include all effects from the release of refrigerants into the atmosphere during the lifetime of the system. This includes annual leakage and losses during the disposal of the unit. The indirect emissions include emissions from the energy consumption during manufacturing process, lifetime operation, and disposal of the system. This thesis proposes a standardized approach to the use of LCCP and traceable data sources for all aspects of the calculation. An equation is proposed that unifies the efforts of previous researchers. Data sources are recommended for average values for all LCCP inputs. A residential heat pump sample problem is presented illustrating the methodology. The heat pump is evaluated at five U.S. locations in different climate zones. An excel tool was developed for residential heat pumps using the proposed method. The primary factor in the LCCP calculation is the energy consumption of the system. The effects of advanced vapor compression cycles are then investigated for heat pump applications. Advanced cycle options attempt to reduce the energy consumption in various ways. There are three categories of advanced cycle options: subcooling cycles, expansion loss recovery cycles and multi-stage cycles. The cycles selected for research are the suction line heat exchanger cycle, the expander cycle, the ejector cycle, and the vapor injection cycle. The cycles are modeled using Engineering Equation Solver and the results are applied to the LCCP methodology. The expander cycle, ejector cycle and vapor injection cycle are effective in reducing LCCP of a residential heat pump by 5.6%, 8.2% and 10.5%, respectively in Phoenix, AZ. The advanced cycles are evaluated with the use of low GWP refrigerants and are capable of reducing the LCCP of a residential heat by 13.7%, 16.3% and 18.6% using a refrigerant with a GWP of 10. To meet the U.S. Department of Energy’s goal of reducing residential energy use by 40% by 2025 with a proportional reduction in all other categories of residential energy consumption, a reduction in the energy consumption of a residential heat pump of 34.8% with a refrigerant GWP of 10 for Phoenix, AZ is necessary. A combination of advanced cycle, control options and low GWP refrigerants are necessary to meet this goal.
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During the process of accessing services provided within urban interior and outer spaces the elderly and disabled individuals encounter with a myriad of problems due to the limitations posed by structured environments. This limitation hinders elderly and disabled individuals from mobility without assistance, which in turn negatively affects their full participation to urban and social life. Rearrangement of urban spaces to meet the needs of elderly and disabled individuals would correspondingly bolster life quality of the entire range of users. Within the scope of present research, as mandated by universal design principles to stick to plans and designs approaches inclusive for all users, it is aimed to conduct evaluations on the use of urban outer spaces situated within Konya City Center. In the hypothetical and theoretical part of this paper, the perception of disability throughout historical process has been examined from a sociological perspective. In addition, concept of universal design, its principles and gravity have also been elaborated. In the part dealing with the case study, outer spaces within Konya City Center have been analyzed with respect to universal design principles and a range of suggestions have been developed.
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We take for granted that we exist in dimensions of time and space. We accept that time passes and that space extends as a matter of course. Just as our personal space is important to us, so is time of our own. The individual is capable of developing a variety of time perspectives or orientations, each applicable to a different aspect of life, for instance, home, leisure, economic, political and organisational. Our temporal perspective influences a wide range of psychological processes, from motivation, emotions and spontaneity to risk-taking creativity and problem-solving. Our temporal landscapes are made up of recognisable domains, with permeable borders – private time and public time, home time and work time, past, present and future time, cyclical time. Just as a geography of space contains recognisable natural features – rivers, deserts, mountains – and features created by human beings – canals, roads, skyscrapers – so our temporal landscape contains natural features – day and night, the seasons – and features created by us – the ordering of social, economic, legal, and organisational time into, among others, the practices of family life, financial periods, prison sentences and workloads. This paper views the temporal landscapes of night nurses, and is based on longitudinal ethnographic research. It highlights areas such as shift work, workload, and the temporal aspects of caring. The result is the production of a map, albeit a rough one, of the temporal landscape inhabited by night nurses as they go about their working lives.
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Background: Acute burns of the hands are complex and may impact on various aspects of a person’s life. Physiotherapy rehabilitation and restoration of hand function is critical for the patient’s independence and re-integration into society. Purpose: This study aimed to explore the perceptions and experiences of physiotherapists in the management of patients with their hand burn injuries. Method: Five focus groups consisting of physiotherapists and physiotherapy assistants working with burn injured patients from each of the five selected public hospitals in KwaZulu-Natal were recruited. An explorative qualitative approach was adopted. Results: Physiotherapists emphasised that the acute management of the hand was trivialised due to a primary focus on the survival of the burn sufferer. Therapists identified several factors that determined the patients’ level of participation and motivation in therapy one of which was the procedural pain experienced. The role of the therapists’ within the rehabilitation framework was found to be critical to their recovery however there appeared to be a breakdown in the collaboration and communication among health care professionals to the detriment of effective intervention. Conclusion: A multidisciplinary team approach is the foundation in the management of acute burn injuries and during the trajectory of the trauma care continuum.
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Between 2009 and 2011, a joint academia-industry effort took place to integrate Second Life and OpenSimulator platforms into a corporate elearning provider’s learning management platform. The process involved managers and lead developers at the provider and an academic engineering research team. We performed content analysis on the documents produced in this process, seeking data on the corporate perspective of requirements for virtual world platforms to be usable in everyday practice. In this paper, we present the requirements found in the documents, and detail how they emerged and evolved throughout the process.
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L’objectif de la présente thèse est de générer des connaissances sur les contributions possibles d’une formation continue à l’évolution des perspectives et pratiques des professionnels de la santé buccodentaire. Prônant une approche centrée sur le patient, la formation vise à sensibiliser les professionnels à la pauvreté et à encourager des pratiques qui se veulent inclusives et qui tiennent compte du contexte social des patients. L’évaluation de la formation s’inscrit dans le contexte d’une recherche-action participative de développement d’outils éducatifs et de transfert des connaissances sur la pauvreté. Cette recherche-action aspire à contribuer à la lutte contre les iniquités sociales de santé et d’accès aux soins au Québec; elle reflète une préoccupation pour une plus grande justice sociale ainsi qu’une prise de position pour une santé publique critique fondée sur une « science des solutions » (Potvin, 2013). Quatre articles scientifiques, ancrés dans une philosophie constructiviste et dans les concepts et principes de l’apprentissage transformationnel (Mezirow, 1991), constituent le cœur de cette thèse. Le premier article présente une revue critique de la littérature portant sur l’enseignement de l’approche de soins centrés sur le patient. Prenant appui sur le concept d’une « épistémologie partagée », des principes éducatifs porteurs d’une transformation de perspective à l’égard de la relation professionnel-patient ont été identifiés et analysés. Le deuxième article de thèse s’inscrit dans le cadre du développement participatif d’outils de formation sur la pauvreté et illustre le processus de co-construction d’un scénario de court-métrage social réaliste portant sur la pauvreté et l’accès aux soins. L’article décrit et apporte une réflexion, notamment sur la dimension de co-formation entre les différents acteurs des milieux académique, professionnel et citoyen qui ont constitué le collectif À l’écoute les uns des autres. Nous y découvrons la force du croisement des savoirs pour générer des prises de conscience sur soi et sur ses préjugés. Les outils développés par le collectif ont été intégrés à une formation continue axée sur la réflexion critique et l’apprentissage transformationnel, et conçue pour être livrée en cabinet dentaire privé. Les deux derniers articles de thèse présentent les résultats d’une étude de cas instrumentale évaluative centrée sur cette formation continue et visant donc à répondre à l’objectif premier de cette thèse. Le premier consiste en une analyse des transformations de perspectives et d’action au sein d’une équipe de 15 professionnels dentaires ayant participé à la formation continue sur une période de trois mois. L’article décrit, entre autres, une plus grande ouverture, chez certains participants, sur les causes structurelles de la pauvreté et une plus grande sensibilité au vécu au quotidien des personnes prestataires de l’aide sociale. L’article comprend également une exploration des effets paradoxaux dans l’apprentissage, notamment le renforcement, chez certains, de perceptions négatives à l’égard des personnes prestataires de l’aide sociale. Le quatrième article fait état de barrières idéologiques contraignant la transformation des pratiques professionnelles : 1) l’identification à l’idéologie du marché privé comme véhicule d’organisation des soins; 2) l’attachement au concept d’égalité dans les pratiques, au détriment de l’équité; 3) la prédominance du modèle biomédical, contraignant l’adoption de pratiques centrées sur la personne et 4) la catégorisation sociale des personnes prestataires de l’aide sociale. L’analyse des perceptions, mais aussi de l’expérience vécue de ces barrières démontre comment des facteurs systémiques et sociaux influent sur le rapport entre professionnel dentaire et personne prestataire de l’aide sociale. Les conséquences pour la recherche, l’éducation dentaire, le transfert des connaissances, ainsi que pour la régulation professionnelle et les politiques de santé buccodentaire, sont examinées à partir de cette perspective.
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Objective: Cost-effectiveness analysis of a 6-month treatment of apixaban (10 mg/12h, first 7 days; 5 mg/12h afterwards) for the treatment of the first event of venous thromboembolism (VTE) and prevention of recurrences, versus low-molecular-weight heparins/vitamin K antagonists treatment (LMWH/VKA). Material and methods: A lifetime Markov model with 13 health states was used for describing the course of the disease. Efficacy and safety data were obtained from AMPLIFY and AMPLIFY-EXT clinical trials; health outcomes were measured as life years gained (LYG) and quality-adjusted life years (QALY). The chosen perspective of this analysis has been the Spanish National Health System (NHS). Drugs, management of VTE and complications costs were obtained from several Spanish data sources (, 2014). A 3% discount rate was applied to health outcomes and costs. Univariate and probabilistic sensitivity analyses (SA) were performed in order to assess the robustness of the results. Results: Apixaban was the most effective therapy with 7.182 LYG and 5.865 QALY, versus 7.160 LYG and 5.838 QALYs with LMWH/VKA. Furthermore, apixaban had a lower total cost (13,374.70 vs 13,738.30). Probabilistic SA confirmed dominance of apixaban (led to better health outcomes with less associated costs) in 89% of the simulations. Conclusions: Apixaban 5 mg/12h versus LMWH/VKA was an efficient therapeutic strategy for the treatment and prevention of recurrences of VTE from the NHS perspective.
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Tese (doutorado)—Universidade de Brasília, Instituto de Ciências Sociais, Centro de Pesquisa e Pós-Graduação sobre as Américas, Programa de Pós-Graduação em Estudos Comparados sobre as Américas, 2016.
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Heart valve disease occurs in adults as well as in pediatric population due to age-related changes, rheumatic fever, infection or congenital condition. Current treatment options are limited to mechanical heart valve (MHV) or bio-prosthetic heart valve (BHV) replacements. Lifelong anti-coagulant medication in case of MHV and calcification, durability in case of BHV are major setbacks for both treatments. Lack of somatic growth of these implants require multiple surgical interventions in case of pediatric patients. Advent of stem cell research and regenerative therapy propose an alternative and potential tissue engineered heart valves (TEHV) treatment approach to treat this life threatening condition. TEHV has the potential to promote tissue growth by replacing and regenerating a functional native valve. Hemodynamics play a crucial role in heart valve tissue formation and sustained performance. The focus of this study was to understand the role of physiological shear stress and flexure effects on de novo HV tissue formation as well as resulting gene and protein expression. A bioreactor system was used to generate physiological shear stress and cyclic flexure. Human bone marrow mesenchymal stem cell derived tissue constructs were exposed to native valve-like physiological condition. Responses of these tissue constructs to the valve-relevant stress states along with gene and protein expression were investigated after 22 days of tissue culture. We conclude that the combination of steady flow and cyclic flexure helps support engineered tissue formation by the co-existence of both OSS and appreciable shear stress magnitudes, and potentially augment valvular gene and protein expression when both parameters are in the physiological range. ^
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Dissertação apresentada para obtenção do grau de Mestre em Educação Social e Intervenção Comunitária