Implementação de cursos em regime de e-learning em ambiente hospitalar. A MEDUCA como suporte

A sociedade moderna encontra-se numa evolução progressiva e constante no que respeita às novas tecnologias. Independentemente da área de conhecimento, é de senso comum, que cada vez mais é necessária formação sólida, sendo fundamental a preparação e a consolidação das futuras gerações na utilização das novas tecnologias. As plataformas de e-learning são hoje em dia uma realidade mais que afirmada, e com aplicação em todos os sectores de actividade. A área da saúde não foge à regra, verificando-se que os seus profissionais evidenciam falta de disponibilidade para participação nas formações presenciais, fundamentais para o seu processo de formação contínua (LLL – Long Liffe Learning). Estes profissionais necessitam de estar continuamente actualizados, de forma a melhor poderem contribuir para o desempenho das suas funções, como o aconselhamento dos utentes, acompanhamento de doentes crónicos, uso correcto dos medicamentos, entre outros. O presente trabalho pretende implementar em ambiente hospitalar o modelo de formação à distância em regime de e-learning ou b-learning, identificando potenciais vantagens e constrangimentos inerentes ao processo. Para o efeito, será utilizada a plataforma MEDUCA criada pelo GILT-ISEP e baseada em Moodle, como uma plataforma destinada á formação para profissionais da área da Saúde. Esta dissertação apresenta uma investigação sobre a implementação da dita plataforma em ambiente hospitalar. Esta dissertação apresenta todo o estudo/trabalho desenvolvido para a implementação da plataforma MEDUCA nalgumas entidades contactadas da área da saúde. Espera-se que esta ferramenta ofereça uma alternativa interactiva de educação e aprendizagem, visando melhorar constantemente o nível formativo de cada profissional de saúde.

Avaliação geriátrica global integrada: perspetiva de atuação na prática clínica

O envelhecimento progressivo da população idosa, com aumento de prevalência de doenças crónicas, está associado a um aumento da prevalência de deterioração funcional, dependência, admissões hospitalares, e maior morbilidade e mortalidade. É nosso objetivo sinalizar a estrutura da avaliação geriátrica global integrada e a demonstração da sua eficiência na prática clinica. A avaliação geriátrica global integrada (AGGI) constitui desejavelmente uma prática multidimensional, sistemática, de caracterização do estado clínico, nutricional, funcional, qualidade de vida e aspectos sociais em pessoas idosas. A equipa de profissionais que a elaboram deverá ser multiprofissional de acordo com a diversidade de competências necessárias para uma avaliação que, a nível hospitalar, será efetuada na admissão e na alta do doente. Recomenda-se que seja protocolada em todas as instituições, que haja um registo único, onde todos os profissionais possam colocar as suas observações, constituindo uma forma eficiente de informação entre os intervenientes profissionais, os seus pares e os doentes e suas redes de apoio. A utilização de questionários de risco validados constitui uma mais valia na deteção de risco ou de situações já alteradas mas subnotificadas e no planeamento da sua intervenção. Após a realização da AGGI, deverá ser delineada e registada uma estratégia de intervenção, com o estabelecimento de objetivos a curto e a longo prazo, a serem monitorizados e ajustados, de acordo com a necessidade. A evidência científica tem demonstrado que a prática da AGGI constitui um método eficaz na redução da morbilidade e mortalidade em indivíduos idosos.

James W. Carey as critical theorist of the information age

This paper suggests that the thought of the North-American critical theorist James W. Carey provides a relevant perspective on communication and technology. Having as background American social pragmatism and progressive thinkers of the beginning of the 20th century (as Dewey, Mead, Cooley, and Park), Carey built a perspective that brought together the political economy of Harold A. Innis, the social criticism of David Riesman and Charles W. Mills and incorporated Marxist topics such as commodification and sociocultural domination. The main goal of this paper is to explore the connection established by Carey between modern technological communication and what he called the “transmissive model”, a model which not only reduces the symbolic process of communication to instrumentalization and to information delivery, but also politically converges with capitalism as well as power, control and expansionist goals. Conceiving communication as a process that creates symbolic and cultural systems, in which and through which social life takes place, Carey gives equal emphasis to the incorporation processes of communication.If symbolic forms and culture are ways of conditioning action, they are also influenced by technological and economic materializations of symbolic systems, and by other conditioning structures. In Carey’s view, communication is never a disembodied force; rather, it is a set of practices in which co-exist conceptions, techniques and social relations. These practices configure reality or, alternatively, can refute, transform and celebrate it. Exhibiting sensitiveness favourable to the historical understanding of communication, media and information technologies, one of the issues Carey explored most was the history of the telegraph as an harbinger of the Internet, of its problems and contradictions. For Carey, Internet was seen as the contemporary heir of the communications revolution triggered by the prototype of transmission technologies, namely the telegraph in the 19th century. In the telegraph Carey saw the prototype of many subsequent commercial empires based on science and technology, a pioneer model for complex business management; an example of conflict of interest for the control over patents; an inducer of changes both in language and in structures of knowledge; and a promoter of a futurist and utopian thought of information technologies. After a brief approach to Carey’s communication theory, this paper focuses on his seminal essay "Technology and ideology. The case of the telegraph", bearing in mind the prospect of the communication revolution introduced by Internet. We maintain that this essay has seminal relevance for critically studying the information society. Our reading of it highlights the reach, as well as the problems, of an approach which conceives the innovation of the telegraph as a metaphor for all innovations, announcing the modern stage of history and determining to this day the major lines of development in modern communication systems.

Aurícula direita: mecânica e sobrecarga de volume

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Ultrassonografia Cardiovascular

HFCs e soluções alternativas viáveis

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

A ingerência do conhecimento explícito no conhecimento tácito: a técnica Alexander e a prática e ensino da flauta

Doutoramento em Música

Estudo Estratigráfico e Paleontológico do Jurássico do Algarve Ocidental

Algarve Province, Southern Portugal, corresponds in part to a meso-cenozoic basin running along the coast from Cabo S. Vicente to beyond Spanish border. Structurally it is a big monocline plunging southwards much deformed mainly by two East-West longitudinal flexures. Lithostratigraphical and chronostratigraphical studies dealt specially with Jurassic formations. This and the geological mapping of the post-Hercynian sedimentary formations allow us to define the following units: Triassic-Lower Liassic Arenitos de Silves (Silves sandstones sensu P. Choffat, pro parte) - At their base the Silves sandstones (0-150m) are represented mainly by cross-bedded red sandstones. This unit is Upper Triassic (Keuper) in age, on the evidence of some Brachiopoda. Complexo margo-carbonatado de Silves (Silves marl-limestone complex=Silves sandstones sensu P. Choffat, pro parte) (80-200m) overlies the preceding, it may be reported to the Upper Triassic-Hettangian. It consists of a thick pelite-marl-dolomite-limestone series with many intercalations of greenstones. Since no fossils were found it is not possible to conclude whether it is still Hettangian or if it does correspond, in the whole or in part, already to the Sinemurian. Liassic Dolomitos e calcários dolomíticos de Espiche (Espiche dolomite-rocks and dolomitic-limestones) - The usually massive and finely crystalline or saccharoidal dolomites and dolomitic-limestones are the toughest strata of the Algarve margin giving rise to several hills. Its thickness attains in certain points 60 metres at least. Based on geometry and on lithological similarities with the carbonated complex of the northern basin of Tagus river (Peniche, São Pedro de Muel, Quiaios), this formation can be accepted as Sinemurian in age. As it happens with the carbonated complex, here also the first dolomite beds are non-isochronal throughout the region; upper time-limit of the dolomitic facies is either Lower Carixian, Lower Toarcian or even Lower Dogger. The dolomitization is secondary but not much later than sedimentation. However, between Cabo S. Vicente-Vila do Bispo there is evidence of an even later secondary dolomitization related to the regional fault complex. Calcário dolomítico com nódulos de silex da praia de Belixe (Belixe beach dolomitic-limestone with silex nodules) (50-55m) - Ascribed to Lower or Middle Carixian on the basis of Platypleuroceras sp., Metaderoceras sp. nov. and M. gr. Venarense. Calcário cristalino compacto com Protogrammoceras, Fuciniceras e ? Argutarpites de Belixe (Belixe compact crystalline limestone with Protogrammoceras, Fuciniceras and ? Argutarpites) (30m) - Ascribed to Lower Domerian. Middle and Upper Domerian are indicated but by a single specimen of ? Argutarpites. Calcários margosos e margas com Dactylioceras semicelatum e Harpoceratídeos de Armação Nova (Armação Nova marly limestones and marls with D. semicelatum and Harpoceratidae) (25m) -Ascribed to Lower Toarcian. Middle and Upper Toarcian formations are not known in the Algarve. Dogger Calcários oolíticos, c. corálicos, c. pisolíticos, c. calciclásticos, c. dolomíticos e dolomitos de Almadena (Almadena oolitic-limestones, coral-reef-limestones, pisolite-limestones, limeclastic-limestones, dolomitic-limestones and dolomite-rocks) (more than 50 metres), with lagoonal facies. Ascribed to Aalenian-Bathonian-? Callovian. Margas acinzentadas e calcários detríticos com Zoophycos da praia de Mareta (Mareta beach greyish marls and detritical limestones with Zoophycos) (40m) - Pelagic transreef facies with Upper Bajocian and Bathonian ammonites. Calcários margosos e margas da praia de Mareta (Mareta beach pelagic marly-limestones and marls) (110m) - Ascribed to the Callovian on its ammonites. Malm Near Cabo S. Vicente and Sagres the first Upper Jurassic level consists of a yellowish-brown nodular, compact, locally phosphated and ferruginous, sometimes conglomeratic, marly limestone (0,35-1,50m) containing a rich macrofauna, which includes: 1) Callovian forms unknown at Lower Oxfordian; 2) Upper Callovian forms that still survived in Lower and Middle Oxfordian; 3) Lower Oxfordian forms (Mariae and Cordatum Zones); 4) Lower and Middle Oxfordian forms (Mariae to Plicatilis Zone); 5) Middle Oxfordian forms (plicatilis Zone), and some ones appearing in Middle Oxfordian. This condensed deposit is therefore dated from Middle Oxfordian (Plicatilis Zone). The other Upper Jurassic lithostratigraphical units were also mapped but their detailed study is not presented in this work. Correlations between lithostratigraphical and chronostratigraphical scales from P. Choffat, J. Pratsch, C. Palain and from the author are stated. Further correlations are attempted between zonc scales of Carixian-Lower Toarcian and Upper Bajocian-Middle Oxfordian of France, Spain (Asturias, Iberian and Betic Chains), Argel (Orania) and Portugal (northern Tagus basin and Algarve). The study of pyritous fossil assemblages common in Upper Bathonian-Lower Callovian marly levels of the praia da Mareta seems to suggest that these sediments were deposited in a bay or in an almost closed coastal re-entrance virtually without deep water circulation. Although such conditions may occur at any depth one may suppose that these ones actually correspond to an infralittoral neritic environment. The thaphocoenosis collected there are almost entirely composed of nektonic (ammonites, Belemnites) and planktonic (Bositra) faunas. The sedentary (crinoids, brachiopods) or free (sea-urchins, gastropods) epibenthonic forms are very scarce; endobenthonic forms are not known. The palaeontological study of all Nautiloids and Ammonoids of the Liassic and Dogger is presented (except Kosmoceratidae and Perisphinctaceae). Among the thirty one taxa dealt with, one is new (Metaderoceras sp. nov.) and the great majority of the others has been identified for the first time in Algarve. Some others have never been reported before in Portuguese formations. The evolution, during Jurassic times, of the sedimentary basins of the Portuguese plate margin is described. The absence of Cephalopods in the very extensive marly and dolomitic limestones, partly marine, suggests that, during Lower Liassic, palaeogeography underwent no great changes. Dolomitic-limestone with silex nodules from Cabo S. Vicente contain the first ammonites recorded at the base of the Middle Liassic. This facies, although very common in Tethys, is unknown north of the Tagus. The faunal assemblage has a mediterranean to submediterranean character. Comparisons between faunal assemblage" from Algarve with the ones known north of the Tagus show that communications between Boreal Europe and Tethys, virtually non-existent during Lower and Middle Carixian, became very easy during Lower Domerian. In earlier Pliensbachian times two distinct seas were adjacent to the Iberian plate. One, an epicontinental sea with a tethyan fauna, extended southwards from the Meseta margin. Another, was a boreal sea; during its transgressive episodes boreal faunas attained into the basin north of the Tagus. During Middle Carixian and Lower Domerian, owing to simultaneous transgressions, these two seas joined together allowing faunal exchanges along the epicontinental areas which limited the emerging hercynian chains belts. During Liassic, the Algarve belonged undoubtedly to the tethyan submediterranean province. The area north of the Tagus, on the contrary, was a complex realm where subboreal and tethyan affinities alternatively prevailed. In the Algarve the first Middle Jurassic deposits do frequently show lateral thickness reductions as well as unconformities contemporaneous with other generalized disturbances on the sedimentation processes in other parts of Europe. By this time, near Sagres, a barrier reef developed separating lagoonal or ante-reef facies from the transreef pelagic zone. The presence of tethyan fauna, the abundance of Phylloceratidae and the absence of boreal forms allow us to consider the Algarve basin as a submediterranean province. The presence of Callovian pelagic fossiliferous formations in the Loulé area shows that during Middle Jurassic the marl-limestone transreef sedimentation was not confined to the western Algarve. They would extend eastwards where they only can be seen in the core of some anticlines. This is due to the progressive sinking of the meso-cenozoic formations as we proceed towards the South of the Sagres-Algoz-Querença flexure. In the whole of the Peninsule, and as for the Middle Callovian, an important regression can be clearly recognized on the evidence of an erosion surface which strikes obliquely the Middle and Upper Callovian strata. The geographic boundaries of the different faunal provinces are not changed by the presence of many Kosmoceratidae in the phosphate nodules since they are but a minority in comparison with the tethyan forms. An abstract model can be constructed showing that in Western Europe the Kosmoceratidae may have migrated South and westwards through a channel of the sea that linked Paris basin to Poitou and Aquitaine. By migrating between the Iberian meseta and the Armorican massif this fauna reached northern Tagus basin at the beginning of Upper Callovian (Athleta Zone); this south and southwest bound migration would have proceeded, allowing such forms to reach Algarve basin only in latest Callovian times (Lamberti Zone). This migration means that during Middle Jurassic a widely spread North Atlantic sea would exist, flooding the western part of Portugal up to the Poitou.

Faciès, biostratigraphie et paléogéographie du Jurassique portugais

The facies distribution along the Jurassic stages in an already well established stratigraphic frame is defined for the three portuguese basins: North of Tagus, Santiago de Cacém and Algarve. The deposits are organized in two sedimentary cycles. The first one from the Liassic to Calovian shows, in the Tagus Basin, a transgression from NW which did not surpass the Meseta present limits. The iniatilly brackish deposits only changed to marine by the end of Lotharingian. The sedimentation, mainly marly during the Liassic became more calcareous since the Aalenian. During the Dogger the basin differentiated into platform deposits towards East and South and open sea zone towards West. This zone underwent a progressive reduction and, during the Callovian, two small basins were individualized: Cabo Mondego basin in the North and Serra de El-Rei-Montejunto in the South. It is from the latter that the second sedimentary cycle (Middle Oxfordian-Portlandian) developed with open sea deposits along the Sintra–Torres Vedras axis surrounded by platform and litoral brackish formations. During the first sedimentary cycle only litoral platform deposits are known in Santiago de Cacém and Algarve basins. During the second sedimentary cycle temporary sea open deposits are known in Santiago de Cacém and Central Algarve.

Análise estática não linear de um edifício em betão armado

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil

Assessment of the quality of brain regions and neuroimaging metrics as biomarkers of Alzheimer’s disease

Alzheimer Disease (AD) is characterized by progressive cognitive decline and dementia. Earlier diagnosis and classification of different stages of the disease are currently the main challenges and can be assessed by neuroimaging. With this work we aim to evaluate the quality of brain regions and neuroimaging metrics as biomarkers of AD. Multimodal Imaging Brain Connectivity Analysis (MIBCA) toolbox functionalities were used to study AD by T1weighted, Diffusion Tensor Imaging and 18FAV45 PET, with data obtained from the AD Neuroimaging Initiative database, specifically 12 healthy controls (CTRL) and 33 patients with early mild cognitive impairment (EMCI), late MCI (LMCI) and AD (11 patients/group). The metrics evaluated were gray-matter volume (GMV), cortical thickness (CThk), mean diffusivity (MD), fractional anisotropy (FA), fiber count (FiberConn), node degree (Deg), cluster coefficient (ClusC) and relative standard-uptake-values (rSUV). Receiver Operating Characteristic (ROC) curves were used to evaluate and compare the diagnostic accuracy of the most significant metrics and brain regions and expressed as area under the curve (AUC). Comparisons were performed between groups. The RH-Accumbens/Deg demonstrated the highest AUC when differentiating between CTRLEMCI (82%), whether rSUV presented it in several brain regions when distinguishing CTRL-LMCI (99%). Regarding CTRL-AD, highest AUC were found with LH-STG/FiberConn and RH-FP/FiberConn (~100%). A larger number of neuroimaging metrics related with cortical atrophy with AUC>70% was found in CTRL-AD in both hemispheres, while in earlier stages, cortical metrics showed in more confined areas of the temporal region and mainly in LH, indicating an increasing of the spread of cortical atrophy that is characteristic of disease progression. In CTRL-EMCI several brain regions and neuroimaging metrics presented AUC>70% with a worst result in later stages suggesting these indicators as biomarkers for an earlier stage of MCI, although further research is necessary.

Evidence based for exercise program in physical therapy in patients with multiple sclerosis

Background: Multiple sclerosis is a disease of the central nervous system that affects more frequently young women. It is a progressive and unpredictable disease, resulting in some cases of disabilities and limitations to physical, psychological and social level. Purpose: To review the literature for evidence based of the effectiveness of physiotherapy intervention in multiple sclerosis.

Penalty fuzzy function for derivative-free optimization

Penalty and Barrier methods are normally used to solve Nonlinear Optimization Problems constrained problems. The problems appear in areas such as engineering and are often characterised by the fact that involved functions (objective and constraints) are non-smooth and/or their derivatives are not know. This means that optimization methods based on derivatives cannot net used. A Java based API was implemented, including only derivative-free optimizationmethods, to solve both constrained and unconstrained problems, which includes Penalty and Barriers methods. In this work a new penalty function, based on Fuzzy Logic, is presented. This function imposes a progressive penalization to solutions that violate the constraints. This means that the function imposes a low penalization when the violation of the constraints is low and a heavy penalisation when the violation is high. The value of the penalization is not known in beforehand, it is the outcome of a fuzzy inference engine. Numerical results comparing the proposed function with two of the classic penalty/barrier functions are presented. Regarding the presented results one can conclude that the prosed penalty function besides being very robust also exhibits a very good performance.

Intervenção da fisioterapia na esclerose múltipla: uma revisão da literatura

Mestrado em Fisioterapia

Physiotherapy and Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is a severe, progressive disease first described by Meryon in 1852 and later by Guillaume Duchene. It is the most common and severe form of childhood muscular dystrophy, affecting 1 in 3500 live male births. Is caused by an X—linked recessive genetic disorder resulting in a deficiency of the dystrophin protein, responsible for linking contractile proteins to the sarcolemma. Diagnosis is not always easy and the first symptoms are often related to weakness and difficulty or delay in acquiring the ability to perform simple activities. Progressive weakness leads to the use of compensatory strategies in order to maintain the ability to walk and perform other activities. Respiratory muscles are also affected and the complications resulting from its impairments are frequently the cause of early death of these patients. The advances in DMD management has increased life expectancy of these children with the need for adequate care in adulthood. DMD manifestations include muscle weakness, contractures, respiratory and cardiac complications. Some authors also refer that one-third of patients have difficulties with learning and delayed global development because the gene that encodes dystrophyn expresses various dystrophin isoforms that are found in Schwann and Purkinje celis in the brain. Body functions and structure impairments like muscle weakness, contractures and reduced range of motion lead to limitations in activities, i.e., impairments affect the performance of tasks by the individual. In a physiotherapist’s point of view analysing these limitations is mandatory because physiotherapy’s final purpose is to restore or preserve the ability to perform ADL and to improve quality of life.

Estudo da influência da carga específica na fragmentação de rocha granítica no desmonte em bancada

Mestrado em Engenharia Geotécnica e Geoambiente