Psicomotricidade e intervenção precoce no Centro de Desenvolvimento da Criança Torrado da Silva do Hospital Garcia da Orta

Nota: Os anexos referidos no índice do trabalho não foram fornecidos.

Creación de un test neuropsicológico de denominación confrontacional

La evaluación de la capacidad de denominar (encontrar las palabras adecuadas para nombrar objetos) tiene una importancia decisiva en el diagnóstico temprano de la enfermedad de Alzheimer ya que la anomia (pérdida de esta capacidad) es uno de los signos más tempranos de la enfermedad. Dicha evaluación también adquiere importancia en el diagnóstico de otras patologías tales como la demencia semántica o la afasia. Por lo tanto es importante contar con un test de denominación que sea adecuadamente diseñado para nuestro contexto cultural. Debido a que las pruebas de denominación creadas en otros contextos culturales no funcionan adecuadamente al aplicarse transculturalmente es que se comenzó, hace algunos años, a construir el Test de Denominación Córdoba. Éste es un test neuropsicológico para evaluar la capacidad de denominación confrontacional (implica la producción de los nombres correctos de figuras que se le presentan al individuo). Se diseñaron las láminas, y se realizó un estudio piloto para determinar el orden correcto de las mismas y eliminar láminas técnicamente inadecuadas. Luego se comenzaron los estudios de validez y la estandarización del test. En este proyecto se propone finalizar con los estudios de validez, confiabilidad y los baremos. Para ello se propone administrar alrededor de 200 tests a personas cognitivamente sanas para completar el baremo y alrededor de 20 a 25 personas con Enfermedad de Alzheimer para el estudio de validez

Desarrollo de un test de detección temprana de trastornos de aprendizaje- test de velocidad de denominación.

La evaluación de la velocidad de denominación permite la identificación temprana de niños en riesgo de desarrollar dislexia. Por lo tanto es importante contar con un test de velocidad de denominación que sea adecuadamente diseñado para nuestro contexto cultural. Debido a que las pruebas de denominación creadas en otros contextos culturales no funcionan adecuadamente al aplicarse transculturalmente, es que se propone construir el Test de Velocidad de Denominación. Éste es un test neuropsicológico para evaluar la velocidad de denominación (implica cronometrar el tiempo necesario para la producción de los nombres correctos de figuras que se le presentan al individuo). Se diseñarán las láminas y se realizará un estudio piloto para determinar las figuras más adecuadas a incluir. Luego se realizará un estudio de validez del test. Para completar ambos estudios se propone administrar alrededor de cincuenta tests a niños en edad pre-escolar (cuatro y cinco años) para el estudio de diseño de las láminas; y a alrededor de cien niños de primer a tercer grado se les administrará el Test de Velocidad de Denominación y dos subtests de la batería de lectura LEE, para el estudio de validez.

Construcción de un Test de Conocimiento General. Development of a General Knowledge Test

Entre los factores que contribuyen a predecir el rendimiento académico se pueden destacar aquellos que reflejan capacidades cognitivas (inteligencia, por ejemplo), y aquellas diferencias individuales consideradas como no-cognitivas (rasgos de personalidad, por ejemplo). En los últimos años, también se considera al Conocimiento General (CG) como un criterio para el éxito académico (ver Ackerman, 1997), ya que se ha evidenciado que el conocimiento previo ayuda en la adquisición de nuevo conocimiento (Hambrick & Engle, 2001). Uno de los objetivos de la psicología educacional consiste en identificar las principales variables que explican el rendimiento académico, como también proponer modelos teóricos que expliquen las relaciones existentes entre estas variables. El modelo teórico PPIK (Inteligencia-como-Proceso, Personalidad, Intereses e Inteligencia-como-Conocimiento) propuesto por Ackerman (1996) propone que el conocimiento y las destrezas adquiridas en un dominio en particular son el resultado de la dedicación de recursos cognitivos que una persona realiza durante un prolongado período de tiempo. Este modelo propone que los rasgos de personalidad, intereses individuales/vocacionales y aspectos motivacionales están integrados como rasgos complejos que determinan la dirección y la intensidad de la dedicación de recursos cognitivos sobre el aprendizaje que realiza una persona (Ackerman, 2003). En nuestro medio (Córdoba, Argentina), un grupo de investigadores ha desarrollado una serie de recursos técnicos necesarios para la evaluación de algunos de los constructos propuesto por este modelo. Sin embargo, por el momento no contamos con una medida de Conocimiento General. Por lo tanto, en el presente proyecto se propone la construcción de un instrumento para medir Conocimiento General (CG), indispensable para poder contar con una herramienta que permita establecer parámetros sobre el nivel de conocimiento de la población universitaria y para en próximos trabajos poner a prueba los postulados de la teoría PPIK (Ackerman, 1996). Between the factors that contribute to predict the academic achievement, may be featured those who reflect cognitive capacities (i.g. intelligence) and those who reflect individual differences that are considered like non-cognitive (i.g. personality traits). In the last years, also the General Knowledge has been considered like a criterion for the academic successfully (see Ackerman, 1997), since it has been shown that the previous knowledge helps in the acquisition of the new knowledge (Hambrick & Engle, 2001). An interesting theoretical model that has proposed an explanation for the academic achievement, is the PPIK (intelligence like a process, interests and inteligence like knowledge) proposed by Ackerman (1996), who argues that knowledge and the acquired skills in a particular domain are the result of the dedication of cognitive resources that a person perform during a long period of time. This model proposes that personality traits, individuals interests and motivational aspects are integrated as complex traits that determine the direction and the intensity of the dedication of cognitive resources on the learning that a person make (Ackerman, 2003). In our context, (Córdoba, Argentina), a group of researcher has developed a series of necessary technical resoures for the assesment of some of the theoretical constructs proposed by this model. However, by the moment, we do not have an instrument for evaluate the General Knowledge. Therefore, this project aims the construction of an instrument to asess General Knowledge, essential to set parameters on the knowledge level of the university population and for in next works test the PPIK theory postulates.

Sujeto y Política. La constitución de las identidades desde una perspectiva postfundacionalista: hacia la construcción de un marco teórico-metodológico para el análisis histórico-político. Subject and politics. The constitution of political identities from a posfoundational perspective: towards a construction of a theorethico-methodolocal framework for histórico-political analysis.

El proyecto de investigación se dirige a sistematizar un abordaje postfundacionalista de las identidades políticas en vistas a la construcción de un marco teórico-metodológico para el análisis histórico-político. Se parte de la creciente relevancia en las ciencias sociales de la cuestión de la “identidad” para indagar la singularidad del marco teórico adoptado en su estudio. Así, el postfundacionalismo da cuenta de una teoría de las subjetividades políticas que parte de procesos de identificación que suponen una articulación singular entre relativa estructuralidad y agencia. El sujeto emerge en un contexto nunca plenamente suturado ni plenamente abierto, sino a través de un anudamiento de diversas dimensiones reales, simbólicas e imaginarias. Esta visión es altamente productiva para generar conclusiones relevantes en el campo de la ciencia política y del análisis histórico político comparado. This research project seeks to systematise from a postfundationalist view of political identities a theoretico-methodological framework for historico political analysis. The project starts from the increasing relevance of the quistion of 'identity' for contremporary social sciences. Poststructuralism provides an insight of processes of identification that supposes a singular articulation between relative structurality and agency. The subject emerges in a neither fully structured nor fully opened context but through a knotting process of different registers: real, symblic and imaginary. This vision, we believe, is highly productive to generate meaningful conclusions in the field of political science and comparative political analysis.

Estandarización y confiabilidad del test de velocidad de denominación para la detección temprana de dislexia.

La evaluación de la velocidad de denominación permite la identificación temprana de niños en riesgo de desarrollar dislexia. Por lo tanto es importante contar con un test de velocidad de denominación que sea adecuadamente diseñado para nuestro contexto cultural. Debido a que las pruebas de denominación creadas en otros contextos culturales no funcionan adecuadamente al aplicarse transculturalmente es que se construyó el Test de Velocidad de Denominación. Éste es un test neuropsicológico para evaluar la velocidad de denominación (implica cronometrar el tiempo necesario para la producción de los nombres correctos de figuras que se le presentan al individuo). El test consta con satisfactorios estudios de validez. Para la presente etapa se propone administrar el test a doscientos niños de 4 a 8 años para la construcción del baremo. A una submuestra de sesenta niños del grupo de baremación se les readministrará el test a los fines de evaluar la confiabilidad (estabilidad) de la prueba.

Automating the testing process of image processing algorithms

As digital imaging processing techniques become increasingly used in a broad range of consumer applications, the critical need to evaluate algorithm performance has become recognised by developers as an area of vital importance. With digital image processing algorithms now playing a greater role in security and protection applications, it is of crucial importance that we are able to empirically study their performance. Apart from the field of biometrics little emphasis has been put on algorithm performance evaluation until now and where evaluation has taken place, it has been carried out in a somewhat cumbersome and unsystematic fashion, without any standardised approach. This paper presents a comprehensive testing methodology and framework aimed towards automating the evaluation of image processing algorithms. Ultimately, the test framework aims to shorten the algorithm development life cycle by helping to identify algorithm performance problems quickly and more efficiently.

Investigating the long term planning framework for the Galway Bay community from climate change.

This research looked at the scientific evidence available on climate change and in particular, projections on sea level rise which ranged from 0.5m to 2m by the end of the century. These projections were then considered in an Irish context. A review of current policy in Ireland revealed that there was no dedicated Government policy on climate change or coastal zone management. In terms of spatial planning policy, it became apparent that there was little or no guidance on climate change either at a national, regional or local level. Therefore, to determine the likely impacts of sea level rise in Ireland based on current spatial planning practice and policy, a scenario-building exercise was carried out for two case study areas in Galway Bay. The two case study areas were: Oranmore, a densely populated town located to the east of Inner Galway Bay; and Tawin Island, a rural dispersed community, located to the south east of Inner Galway Bay. A ‘best’ and ‘worse’ case scenario was envisaged for both areas in terms of sea level rise. In the absence of specific climate change policies it was projected that in the ‘best’ case scenario of 0.5m sea level rise, Tawin Island would suffer serious and adverse impacts while Oranmore was likely to experience slight to moderate impacts. However, in the ‘worse’ case scenario of a 2m sea level rise, it was likely that Tawin Island would be abandoned while many houses, businesses and infrastructure built within the floodplain of Oranmore Bay would be inundated and permanently flooded. In this regard, it was the author’s opinion that a strategic and integrated climate change policy and adaptation plan is vital for the island of Ireland that recognises the importance of integrated land use and spatial planning in terms of mitigation and adaptation to climate change.

Teste de inclinação (Tilt-test): do necessário ao imprescindível

O teste de inclinação (TI) é muito utilizado para a investigação de síncopes e pré-síncopes, pois possibilita o diagnóstico de diferentes tipos de disautonomias. A principal causa de síncope é a Síndrome Vasovagal, cujo diagnóstico é o mais frequente entre as indicações de TI. O exame é utilizado há cerca de 20 anos, mas muitos médicos desconhecem a metodologia. São importantes a indicação apropriada, após exclusão de causas cardíacas de síncope, e a orientação do paciente para garantir a tranquilidade e a segurança do teste. Existem controvérsias na literatura sobre a capacidade diagnóstica e a confiabilidade dos resultados. Os estudos com protocolos diversos podem explicar a variabilidade dos resultados. Nesta revisão, são colocadas as indicações e a metodologia recomendadas pelas diretrizes, complicações, limitações e perspectivas desse exame.

Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.

4-Second Exercise Test: Reference Values for Ages 18–81 Years

Background: Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. Objective: To present reference data for 4sET in healthy adults. Methods: After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults (61% men) aged between 18 and 81 years subjected to 4sET were evaluated between 1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by calculating the ratio between the duration of two RR intervals in the electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling exercise. Results: CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and slopes of the linear regressions between CVI and age were similar for men and women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the distribution of the CVI values according to age, we chose to express the reference values in percentiles for eight age groups (years): 18–30, 31–40, 41–45, 46–50, 51–55, 56–60, 61–65, and 66+, obtaining progressively lower median CVI values ranging from 1.63 to 1.24. Conclusion: The availability of CVI percentiles for different age groups should promote the clinical use of 4sET, which is a simple and safe procedure for the evaluation of vagal modulation of cardiac chronotropism.

New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

AbstractBackground:Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity.Objectives:In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols.Methods:In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection.Results:Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001).Conclusions:The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP.

Framework for a service-oriented measurement infrastructure

Magdeburg, Univ., Fak. für Informatik, Diss., 2009

Cardiac Autonomic Adjustments During Baroreflex Test in Obese and Non-Obese Preadolescents

Abstract Background: Recent studies have shown changes in cardiac autonomic control of obese preadolescents. Objective: To assess the heart rate responses and cardiac autonomic modulation of obese preadolescents during constant expiratory effort. Methods: This study assessed 10 obese and 10 non-obese preadolescents aged 9 to 12 years. The body mass index of the obese group was between the 95th and 97th percentiles of the CDC National Center for Health Statistics growth charts, while that of the non-obese group, between the 5th and 85th percentiles. Initially, they underwent anthropometric and clinical assessment, and their maximum expiratory pressures were obtained. Then, the preadolescents underwent a constant expiratory effort of 70% of their maximum expiratory pressure for 20 seconds, with heart rate measurement 5 minutes before, during and 5 minutes after it. Heart rate variability (HRV) and heart rate values were analyzed by use of a software. Results: The HRV did not differ when compared before and after the constant expiratory effort intra- and intergroup. The heart rate values differed (p < 0.05) during the effort, being the total variation in non-obese preadolescents of 18.5 ± 1.5 bpm, and in obese, of 12.2 ± 1.3 bpm. Conclusion: The cardiac autonomic modulation did not differ between the groups when comparing before and after the constant expiratory effort. However, the obese group showed lower cardiovascular response to baroreceptor stimuli during the effort, suggesting lower autonomic baroreflex sensitivity.