VirtualECare: group decision supported by idea generation and argumentation

In the last years there has been a considerable increase in the number of people in need of intensive care, especially among the elderly, a phenomenon that is related to population ageing (Brown 2003). However, this is not exclusive of the elderly, as diseases as obesity, diabetes, and blood pressure have been increasing among young adults (Ford and Capewell 2007). As a new fact, it has to be dealt with by the healthcare sector, and particularly by the public one. Thus, the importance of finding new and cost effective ways for healthcare delivery are of particular importance, especially when the patients are not to be detached from their environments (WHO 2004). Following this line of thinking, a VirtualECare Multiagent System is presented in section 2, being our efforts centered on its Group Decision modules (Costa, Neves et al. 2007) (Camarinha-Matos and Afsarmanesh 2001).On the other hand, there has been a growing interest in combining the technological advances in the information society - computing, telecommunications and knowledge – in order to create new methodologies for problem solving, namely those that convey on Group Decision Support Systems (GDSS), based on agent perception. Indeed, the new economy, along with increased competition in today’s complex business environments, takes the companies to seek complementarities, in order to increase competitiveness and reduce risks. Under these scenarios, planning takes a major role in a company life cycle. However, effective planning depends on the generation and analysis of ideas (innovative or not) and, as a result, the idea generation and management processes are crucial. Our objective is to apply the GDSS referred to above to a new area. We believe that the use of GDSS in the healthcare arena will allow professionals to achieve better results in the analysis of one’s Electronically Clinical Profile (ECP). This attainment is vital, regarding the incoming to the market of new drugs and medical practices, which compete in the use of limited resources.

Avaliação e controlo da dor em pediatria: uma década

Introdução – A negligência no controlo da dor é um problema amplamente reconhecido em Portugal. Desde 2001 têm sido realizadas inúmeras iniciativas para melhorar a prática de cuidados nesta área. Desenvolveram-se ações de sensibilização e formação dos profissionais de saúde, publicaram-se orientações técnicas e guias de boas práticas e realizaram-se os primeiros estudos para se fazer um diagnóstico da situação. Objetivos – O objetivo deste trabalho foi o de caracterizar os cuidados prestados na avaliação e no controlo da dor nas crianças até aos 18 anos internadas em serviços hospitalares em Portugal e analisar a evolução feita nos cuidados entre os anos de 2002 e 2012. Metodologia – Estudo descritivo, transversal, de consulta retrospetiva seriada de registos intermitentes efetuados no processo clínico em relação a um período de 24 horas. O recrutamento da amostra foi aleatório e incluiu todos os processos clínicos de crianças até aos 18 anos internados em serviços de quatro hospitais Portugueses entre agosto e dezembro de 2011. Resultados – A prevalência de dor reduziu de forma significativa entre 2002 e 2012. As crianças livres de dor subiram de 37% para 75%. O registo da avaliação da intensidade da dor e a colheita de informação sobre a história de dor passou a ser uma prática comum na maioria dos casos (53% e 64%, respetivamente), embora ainda direcionada para o modelo de cuidados biomédico. A prevalência das intervenções farmacológicas não se alterou (43% versus 42%), mas a implementação de estratégias não-farmacológicas baixou significativamente (72% versus 15%). Conclusões – As ações de sensibilização/formação realizadas no âmbito das políticas implementadas nestes últimos dez anos na área da avaliação e controlo da dor pediátrica geraram evidentes ganhos na qualidade de cuidados prestados, pelo que o investimento na formação deve continuar. No entanto, deve ser dada prioridade à formação para a aplicação de estratégias de intervenção não-farmacológicas e ao desenvolvimento de mais investigação que suporte as práticas.

Notice on a methodology for characterizing emissions of ultrafine particles/nanoparticles in microenvironments

Bearing in mind the potential adverse health effects of ultrafine particles, it is of paramount importance to perform effective monitoring of nanosized particles in several microenvironments, which may include ambient air, indoor air, and also occupational environments. In fact, effective and accurate monitoring is the first step to obtaining a set of data that could be used further on to perform subsequent evaluations such as risk assessment and epidemiologic studies, thus proposing good working practices such as containment measures in order to reduce occupational exposure. This paper presents a useful methodology for monitoring ultrafine particles/nanoparticles in several microenvironments, using online analyzers and also sampling systems that allow further characterization on collected nanoparticles. This methodology was validated in three case studies presented in the paper, which assess monitoring of nanosized particles in the outdoor atmosphere, during cooking operations, and in a welding workshop.

Comparing the content of instruments assessing environmental factors using the International Classification of Functioning, Disability and Health

Purpose: To describe and compare the content of instruments that assess environmental factors using the International Classification of Functioning, Disability and Health (ICF). Methods: A systematic search of PubMed, CINAHL and PEDro databases was conducted using a pre-determined search strategy. The identified instruments were screened independently by two investigators, and meaningful concepts were linked to the most precise ICF category according to published linking rules. Results: Six instruments were included, containing 526 meaningful concepts. Instruments had between 20% and 98% of items linked to categories in Chapter 1. The highest percentage of items from one instrument linked to categories in Chapters 2–5 varied between 9% and 50%. The presence or absence of environmental factors in a specific context is assessed in 3 instruments, while the other 3 assess the intensity of the impact of environmental factors. Discussion: Instruments differ in their content, type of assessment, and have several items linked to the same ICF category. Most instruments primarily assess products and technology (Chapter 1), highlighting the need to deepen the discussion on the theory that supports the measurement of environmental factors. This discussion should be thorough and lead to the development of methodologies and new tools that capture the underlying concepts of the ICF.

Avaliação e garantia da qualidade da auditoria interna

Mestrado em Auditoria

A gestão e avaliação do risco: perspectiva das organizações e da auditoria no sector público

Mestrado em Auditoria

Avaliação da intervenção socioeducativa sobre a violência na escola

A investigação desenvolvida no âmbito do projeto Estratégias de Intervenção socioeducativa em contextos sociais complexos enquadra-se na avaliação das políticas sociais e educativas, em particular no que diz respeito à segurança escolar em contextos marcados pela diversidade e complexidade social e cultural. O processo de avaliação centrou-se na análise das estratégias de intervenção socioeducativa relativas ao problema da violência na escola, desenvolvidas em três escolas de um concelho da Área Metropolitana de Lisboa. Partindo do pressuposto que a violência na escola é um fenómeno multideterminado e multifacetado, a pesquisa centrou-se numa abordagem que enquadra as esferas de intervenção/ação das instituições formais e dos agentes sociais enquanto mecanismos que estruturam e regulam as concepções e práticas de violência na escola. A recolha e sistematização de informação centrou-se, por um lado, nas estratégias de intervenção que têm vindo a ser desenvolvidas localmente pelas escolas, e, por outro, nas perspetivas dos diferentes intervenientes, considerando-se os alunos, osprofessores, as direções escolares e representantes das entidades e instituições locais. Metodologicamente, privilegiou-se o cruzamento de métodos de carácter extensivo e intensivo, combinando técnicas como a Observação Direta, a realização de Entrevistas, de Grupos Focais, de Questionários, e ainda, a Análise de Redes e a Análise Documental. Numa fase posterior, os diversos intervenientes participaram na discussão e análise dos resultados previamente recolhidos, e na validação conjunta de uma metodologia de intervenção que define um conjunto de estratégias gerais de combate às situações de violência na escola e nos territórios educativos. Esta metodologia é o principal produto do projeto e resulta de um processo de avaliação dinâmico e participado. A contribuição que se apresenta no VI Encontro do CIED ocupa-se dos procedimentos de avaliação desenvolvidos no âmbito deste projeto.

Análise descritiva das práticas e contextos em fisioterapia respiratória nos hospitais centrais públicos de Luanda

Mestrado em Fisioterapia

Relatório de estágio: aulas de grupo de oboé

I (Prática Pedagógica) - Neste relatório de estágio apresenta-se uma caracterização do Conservatório de Música de Santarém (CMS). Dá-se a conhecer um pouco da sua história, o seu funcionamento e os seus objetivos pedagógicos. Caracterizam-se também os alunos que participam no estágio e faz-se uma pequena descrição dos seus percursos académicos; suas influências, motivações e expectativas. Nas práticas desenvolvidas apresentam-se os princípios pedagógicos – A Motivação, como condição fundamental para o sucesso escolar dos alunos; e ainda a importância da aquisição de competências metacognitivas, ao permitirem a reflexão sobre os processos de aprendizagem. É feita uma descrição sobre as estratégias que o professor deve adotar com o objetivo de obter a motivação dos alunos; e apresentam-se os objetivos pedagógicos propostos para este estágio. Por último é feita uma análise do trabalho desenvolvido com os alunos e uma análise crítica da atividade docente, onde a criatividade, a autoavaliação e a reflexão devem estar sempre presentes no íntimo do professor. Ainda no encerramento da secção pedagógica dá-se conta do novo paradigma do ensino vocacional de música, após a Portaria nº 691/2009 de 25 de junho, e a necessidade do professor se adaptar a esta nova realidade.

Práticas de avaliação formativa na aula de matemática: um estudo no 2º ciclo

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Educação Matemática na Educação Pré- Escolar e nos 1º e 2º Ciclo do Ensino Básico

Elaboração e aplicação de um Programa de Treino aos alunos do 2º ano de Dança, da Academia de Dança do Vale do Sousa, com vista à realização do exame de Grau 5 da Royal Academy of Dance

Relatório Final de Estágio apresentado à Escola Superior de Dança, com vista à obtenção do grau de Mestre em Ensino de Dança.

Evaluation of maternal and neonatal hospital care: quality index of completeness

OBJECTIVE Develop an index to evaluate the maternal and neonatal hospital care of the Brazilian Unified Health System.METHODS This descriptive cross-sectional study of national scope was based on the structure-process-outcome framework proposed by Donabedian and on comprehensive health care. Data from the Hospital Information System and the National Registry of Health Establishments were used. The maternal and neonatal network of Brazilian Unified Health System consisted of 3,400 hospitals that performed at least 12 deliveries in 2009 or whose number of deliveries represented 10.0% or more of the total admissions in 2009. Relevance and reliability were defined as criteria for the selection of variables. Simple and composite indicators and the index of completeness were constructed and evaluated, and the distribution of maternal and neonatal hospital care was assessed in different regions of the country.RESULTS A total of 40 variables were selected, from which 27 single indicators, five composite indicators, and the index of completeness of care were built. Composite indicators were constructed by grouping simple indicators and included the following variables: hospital size, level of complexity, delivery care practice, recommended hospital practice, and epidemiological practice. The index of completeness of care grouped the five variables and classified them in ascending order, thereby yielding five levels of completeness of maternal and neonatal hospital care: very low, low, intermediate, high, and very high. The hospital network was predominantly of small size and low complexity, with inadequate child delivery care and poor development of recommended and epidemiological practices. The index showed that more than 80.0% hospitals had a low index of completeness of care and that most qualified heath care services were concentrated in the more developed regions of the country.CONCLUSIONS The index of completeness proved to be of great value for monitoring the maternal and neonatal hospital care of Brazilian Unified Health System and indicated that the quality of health care was unsatisfactory. However, its application does not replace specific evaluations.

Genotoxic assessment in different exposure groups working with antineoplastic agents

Antioneoplastic drugs are widely used in treatment of cancer, and several studies suggest acute and long-term effects associated to antineoplastic drug exposures, namely associating workplace exposure with health effects. Cytokinesis blocked micronucleus (CBMN) assay is one promising short-term genotoxicity assays for human risk assessment and their combination is recommended to monitor populations chronically exposed to genotoxic agents. The aim of this investigation is the genotoxicity assessment in different professionals that handle cytostatics drugs. This research is case-control blinded study constituted by 46 non-exposed subjects and 44 workers that handle antineoplastic drugs, such as pharmacists, pharmacy technicians, and nurses. It was found statistically significant increases in the genotoxicity biomarkers in exposed comparising with controls (p<0.05). The findings address the need for regular biomonitoring of personnel occupationally exposed to these drugs, confirming to an enhanced health risk assessment.

Vocal warm-up and breathing training for teachers: randomized clinical trial

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality.METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists.RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group.CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up.TRIAL RECORD NCT02102399, “Vocal Warm-up and Respiratory Muscle Training in Teachers”.

Children, space, and the urban street: an ethnomathematics posture

Dissertation presented for the PhD Degree in Education Science – Curricular Theory and Science Teaching, by Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia