Mejoras en el procesamiento de imágenes de TC para el tratamiento con radioterapia adaptativa del cáncer de próstata

El cáncer de próstata es el tipo de cáncer con mayor prevalencia entre los hombres del mundo occidental y, pese a tener una alta tasa de supervivencia relativa, es la segunda mayor causa de muerte por cáncer en este sector de la población. El tratamiento de elección frente al cáncer de próstata es, en la mayoría de los casos, la radioterapia externa. Las técnicas más modernas de radioterapia externa, como la radioterapia modulada en intensidad, permiten incrementar la dosis en el tumor mientras se reduce la dosis en el tejido sano. Sin embargo, la localización del volumen objetivo varía con el día de tratamiento, y se requieren movimientos muy pequeños de los órganos para sacar partes del volumen objetivo fuera de la región terapéutica, o para introducir tejidos sanos críticos dentro. Para evitar esto se han desarrollado técnicas más avanzadas, como la radioterapia guiada por imagen, que se define por un manejo más preciso de los movimientos internos mediante una adaptación de la planificación del tratamiento basada en la información anatómica obtenida de imágenes de tomografía computarizada (TC) previas a la sesión terapéutica. Además, la radioterapia adaptativa añade la información dosimétrica de las fracciones previas a la información anatómica. Uno de los fundamentos de la radioterapia adaptativa es el registro deformable de imágenes, de gran utilidad a la hora de modelar los desplazamientos y deformaciones de los órganos internos. Sin embargo, su utilización conlleva nuevos retos científico-tecnológicos en el procesamiento de imágenes, principalmente asociados a la variabilidad de los órganos, tanto en localización como en apariencia. El objetivo de esta tesis doctoral es mejorar los procesos clínicos de delineación automática de contornos y de cálculo de dosis acumulada para la planificación y monitorización de tratamientos con radioterapia adaptativa, a partir de nuevos métodos de procesamiento de imágenes de TC (1) en presencia de contrastes variables, y (2) cambios de apariencia del recto. Además, se pretende (3) proveer de herramientas para la evaluación de la calidad de los contornos obtenidos en el caso del gross tumor volumen (GTV). Las principales contribuciones de esta tesis doctoral son las siguientes: _ 1. La adaptación, implementación y evaluación de un algoritmo de registro basado en el flujo óptico de la fase de la imagen como herramienta para el cálculo de transformaciones no-rígidas en presencia de cambios de intensidad, y su aplicabilidad a tratamientos de radioterapia adaptativa en cáncer de próstata con uso de agentes de contraste radiológico. Los resultados demuestran que el algoritmo seleccionado presenta mejores resultados cualitativos en presencia de contraste radiológico en la vejiga, y no distorsiona la imagen forzando deformaciones poco realistas. 2. La definición, desarrollo y validación de un nuevo método de enmascaramiento de los contenidos del recto (MER), y la evaluación de su influencia en el procedimiento de radioterapia adaptativa en cáncer de próstata. Las segmentaciones obtenidas mediante el MER para la creación de máscaras homogéneas en las imágenes de sesión permiten mejorar sensiblemente los resultados de los algoritmos de registro en la región rectal. Así, el uso de la metodología propuesta incrementa el índice de volumen solapado entre los contornos manuales y automáticos del recto hasta un valor del 89%, cercano a los resultados obtenidos usando máscaras manuales para el registro de las dos imágenes. De esta manera se pueden corregir tanto el cálculo de los nuevos contornos como el cálculo de la dosis acumulada. 3. La definición de una metodología de evaluación de la calidad de los contornos del GTV, que permite la representación de la distribución espacial del error, adaptándola a volúmenes no-convexos como el formado por la próstata y las vesículas seminales. Dicha metodología de evaluación, basada en un nuevo algoritmo de reconstrucción tridimensional y una nueva métrica de cuantificación, presenta resultados precisos con una gran resolución espacial en un tiempo despreciable frente al tiempo de registro. Esta nueva metodología puede ser una herramienta útil para la comparación de distintos algoritmos de registro deformable orientados a la radioterapia adaptativa en cáncer de próstata. En conclusión, el trabajo realizado en esta tesis doctoral corrobora las hipótesis de investigación postuladas, y pretende servir como cimiento de futuros avances en el procesamiento de imagen médica en los tratamientos de radioterapia adaptativa en cáncer de próstata. Asimismo, se siguen abriendo nuevas líneas de aplicación futura de métodos de procesamiento de imágenes médicas con el fin de mejorar los procesos de radioterapia adaptativa en presencia de cambios de apariencia de los órganos, e incrementar la seguridad del paciente. I.2 Inglés Prostate cancer is the most prevalent cancer amongst men in the Western world and, despite having a relatively high survival rate, is the second leading cause of cancer death in this sector of the population. The treatment of choice against prostate cancer is, in most cases, external beam radiation therapy. The most modern techniques of external radiotherapy, as intensity modulated radiotherapy, allow increasing the dose to the tumor whilst reducing the dose to healthy tissue. However, the location of the target volume varies with the day of treatment, and very small movements of the organs are required to pull out parts of the target volume outside the therapeutic region, or to introduce critical healthy tissues inside. Advanced techniques, such as the image-guided radiotherapy (IGRT), have been developed to avoid this. IGRT is defined by more precise handling of internal movements by adapting treatment planning based on the anatomical information obtained from computed tomography (CT) images prior to the therapy session. Moreover, the adaptive radiotherapy adds dosimetric information of previous fractions to the anatomical information. One of the fundamentals of adaptive radiotherapy is deformable image registration, very useful when modeling the displacements and deformations of the internal organs. However, its use brings new scientific and technological challenges in image processing, mainly associated to the variability of the organs, both in location and appearance. The aim of this thesis is to improve clinical processes of automatic contour delineation and cumulative dose calculation for planning and monitoring of adaptive radiotherapy treatments, based on new methods of CT image processing (1) in the presence of varying contrasts, and (2) rectum appearance changes. It also aims (3) to provide tools for assessing the quality of contours obtained in the case of gross tumor volume (GTV). The main contributions of this PhD thesis are as follows: 1. The adaptation, implementation and evaluation of a registration algorithm based on the optical flow of the image phase as a tool for the calculation of non-rigid transformations in the presence of intensity changes, and its applicability to adaptive radiotherapy treatment in prostate cancer with use of radiological contrast agents. The results demonstrate that the selected algorithm shows better qualitative results in the presence of radiological contrast agents in the urinary bladder, and does not distort the image forcing unrealistic deformations. 2. The definition, development and validation of a new method for masking the contents of the rectum (MER, Spanish acronym), and assessing their impact on the process of adaptive radiotherapy in prostate cancer. The segmentations obtained by the MER for the creation of homogenous masks in the session CT images can improve significantly the results of registration algorithms in the rectal region. Thus, the use of the proposed methodology increases the volume overlap index between manual and automatic contours of the rectum to a value of 89%, close to the results obtained using manual masks for both images. In this way, both the calculation of new contours and the calculation of the accumulated dose can be corrected. 3. The definition of a methodology for assessing the quality of the contours of the GTV, which allows the representation of the spatial distribution of the error, adapting it to non-convex volumes such as that formed by the prostate and seminal vesicles. Said evaluation methodology, based on a new three-dimensional reconstruction algorithm and a new quantification metric, presents accurate results with high spatial resolution in a time negligible compared to the registration time. This new approach may be a useful tool to compare different deformable registration algorithms oriented to adaptive radiotherapy in prostate cancer In conclusion, this PhD thesis corroborates the postulated research hypotheses, and is intended to serve as a foundation for future advances in medical image processing in adaptive radiotherapy treatment in prostate cancer. In addition, it opens new future applications for medical image processing methods aimed at improving the adaptive radiotherapy processes in the presence of organ’s appearance changes, and increase the patient safety.

Generación de modelos físicos personalizados y segmentación de la pared arterial y el trombo intraluminal en imágenes de aneurismas aórticos abdominales

Esta tesis doctoral está encuadrada dentro del marco general de la ingeniería biomédica aplicada al tratamiento de las enfermedades cardiovasculares, enfermedades que provocan alrededor de 1.9 millones (40%) de muertes al año en la Unión Europea. En este contexto surge el proyecto europeo SCATh-Smart Catheterization, cuyo objetivo principal es mejorar los procedimientos de cateterismo aórtico introduciendo nuevas tecnologías de planificación y navegación quirúrgica y minimizando el uso de fluoroscopía. En particular, esta tesis aborda el modelado y diagnóstico de aneurismas aórticos abdominales (AAA) y del trombo intraluminal (TIL), allí donde esté presente, así como la segmentación de estas estructuras en imágenes preoperatorias de RM. Los modelos físicos específicos del paciente, construidos a partir de imágenes médicas preoperatorias, tienen múltiples usos, que van desde la evaluación preoperatoria de estructuras anatómicas a la planificación quirúrgica para el guiado de catéteres. En el diagnóstico y tratamiento de AAA, los modelos físicos son útiles a la hora de evaluar diversas variables biomecánicas y fisiológicas de las estructuras vasculares. Existen múltiples técnicas que requieren de la generación de modelos físicos que representen la anatomía vascular. Una de las principales aplicaciones de los modelos físicos es el análisis de elementos finitos (FE). Las simulaciones de FE para AAA pueden ser específicas para el paciente y permiten modelar estados de estrés complejos, incluyendo los efectos provocados por el TIL. La aplicación de métodos numéricos de análisis tiene como requisito previo la generación de una malla computacional que representa la geometría de interés mediante un conjunto de elementos poliédricos, siendo los hexaédricos los que presentan mejores resultados. En las estructuras vasculares, generar mallas hexaédricas es un proceso especialmente exigente debido a la compleja anatomía 3D ramificada. La mayoría de los AAA se encuentran situados en la bifurcación de la arteria aorta en las arterias iliacas y es necesario modelar de manera fiel dicha bifurcación. En el caso de que la sangre se estanque en el aneurisma provocando un TIL, éste forma una estructura adyacente a la pared aórtica. De este modo, el contorno externo del TIL es el mismo que el contorno interno de la pared, por lo que las mallas resultantes deben reflejar esta particularidad, lo que se denomina como "mallas conformadas". El fin último de este trabajo es modelar las estructuras vasculares de modo que proporcionen nuevas herramientas para un mejor diagnóstico clínico, facilitando medidas de riesgo de rotura de la arteria, presión sistólica o diastólica, etc. Por tanto, el primer objetivo de esta tesis es diseñar un método novedoso y robusto para generar mallas hexaédricas tanto de la pared aórtica como del trombo. Para la identificación de estas estructuras se utilizan imágenes de resonancia magnética (RM). Deben mantenerse sus propiedades de adyacencia utilizando elementos de alta calidad, prestando especial atención al modelado de la bifurcación y a que sean adecuadas para el análisis de FE. El método tiene en cuenta la evolución de la línea central del vaso en el espacio tridimensional y genera la malla directamente a partir de las imágenes segmentadas, sin necesidad de reconstruir superficies triangulares. Con el fin de reducir la intervención del usuario en el proceso de generación de las mallas, es también objetivo de esta tesis desarrollar un método de segmentación semiautomática de las distintas estructuras de interés. Las principales contribuciones de esta tesis doctoral son: 1. El diseño, implementación y evaluación de un algoritmo de generación de mallas hexaédricas conformadas de la pared y el TIL a partir de los contornos segmentados en imágenes de RM. Se ha llevado a cabo una evaluación de calidad que determine su aplicabilidad a métodos de FE. Los resultados demuestran que el algoritmo desarrollado genera mallas conformadas de alta calidad incluso en la región de la bifurcación, que son adecuadas para su uso en métodos de análisis de FE. 2. El diseño, implementación y evaluación de un método de segmentación automático de las estructuras de interés. La luz arterial se segmenta de manera semiautomática utilizando un software disponible a partir de imágenes de RM con contraste. Los resultados de este proceso sirven de inicialización para la segmentación automática de las caras interna y externa de la pared aórtica utilizando métodos basado en modelos de textura y forma a partir de imágenes de RM sin contraste. Los resultados demuestran que el algoritmo desarrollado proporciona segmentaciones fieles de las distintas estructuras de interés. En conclusión, el trabajo realizado en esta tesis doctoral corrobora las hipótesis de investigación postuladas, y pretende servir como aportación para futuros avances en la generación de modelos físicos de geometrías biológicas. ABSTRACT The frame of this PhD Thesis is the biomedical engineering applied to the treatment of cardiovascular diseases, which cause around 1.9 million deaths per year in the European Union and suppose about 40% of deaths per year. In this context appears the European project SCATh-Smart Catheterization. The main objective of this project is creating a platform which improves the navigation of catheters in aortic catheterization minimizing the use of fluoroscopy. In the framework of this project, the specific field of this PhD Thesis is the diagnosis and modeling of abdominal aortic aneurysm (AAAs) and the intraluminal thrombus (ILT) whenever it is present. Patient-specific physical models built from preoperative imaging are becoming increasingly important in the area of minimally invasive surgery. These models can be employed for different purposes, such as the preoperatory evaluation of anatomic structures or the surgical planning for catheter guidance. In the specific case of AAA diagnosis and treatment, physical models are especially useful for evaluating pressures over vascular structures. There are multiple techniques that require the generation of physical models which represent the target anatomy. Finite element (FE) analysis is one the principal applications for physical models. FE simulations for AAA may be patient-specific and allow modeling biomechanical and physiological variables including those produced by ILT, and also the segmentation of those anatomical structures in preoperative MR images. Applying numeric methods requires the generation of a proper computational mesh. These meshes represent the patient anatomy using a set of polyhedral elements, with hexahedral elements providing better results. In the specific case of vascular structures, generating hexahedral meshes is a challenging task due to the complex 3D branching anatomy. Each patient’s aneurysm is unique, characterized by its location and shape, and must be accurately represented for subsequent analyses to be meaningful. Most AAAs are located in the region where the aorta bifurcates into the iliac arteries and it is necessary to model this bifurcation precisely and reliably. If blood stagnates in the aneurysm and forms an ILT, it exists as a conforming structure with the aortic wall, i.e. the ILT’s outer contour is the same as the wall’s inner contour. Therefore, resulting meshes must also be conforming. The main objective of this PhD Thesis is designing a novel and robust method for generating conforming hexahedral meshes for the aortic wall and the thrombus. These meshes are built using largely high-quality elements, especially at the bifurcation, that are suitable for FE analysis of tissue stresses. The method accounts for the evolution of the vessel’s centerline which may develop outside a single plane, and generates the mesh directly from segmented images without the requirement to reconstruct triangular surfaces. In order to reduce the user intervention in the mesh generation process is also a goal of this PhD. Thesis to develop a semiautomatic segmentation method for the structures of interest. The segmentation is performed from magnetic resonance image (MRI) sequences that have tuned to provide high contrast for the arterial tissue against the surrounding soft tissue, so that we determine the required information reliably. The main contributions of this PhD Thesis are: 1. The design, implementation and evaluation of an algorithm for generating hexahedral conforming meshes of the arterial wall and the ILT from the segmented contours. A quality inspection has been applied to the meshes in order to determine their suitability for FE methods. Results show that the developed algorithm generates high quality conforming hexahedral meshes even at the bifurcation region. Thus, these meshes are suitable for FE analysis. 2. The design, implementation and evaluation of a semiautomatic segmentation method for the structures of interest. The lumen is segmented in a semiautomatic way from contrast filled MRI using an available software. The results obtained from this process are used to initialize the automatic segmentation of the internal and external faces of the aortic wall. These segmentations are performed by methods based on texture and shape models from MRI with no contrast. The results show that the algorithm provides faithful segmentations of the structures of interest requiring minimal user intervention. In conclusion, the work undertaken in this PhD. Thesis verifies the investigation hypotheses. It intends to serve as basis for future physical model generation of proper biological anatomies used by numerical methods.

Reforma del estado como mecanismo de control en democracia delegativa: caso reforma judicial Ecuador 2007-2014

The object of this doctoral thesis is the analysis of the political and administrative purpose that is given to the reform process of a vital sector of State powers within the framework of delegate democracy, such as the administration of Justice. The object is also to analyze if State reform in a diminished or non-liberal surrounding increase or improve conditions of democracy in a given situation, based on the constitutional “what should be”, or if what occurs is a process of “seizure” of the functions of State, which becomes an institutional risk. Finally, we will examine the real and effective existence of a horizontal accountability process through the use of institutional resources, which would evidence the existence of an incomplete model of democracy. This analysis implies the relationship between two institutions within public administration: State Reform, as an act of change in State structure in order to improve qualitatively the outcomes and outputs of public policies, and in sum, to make the system work better. This, as it will be examined later, is the case of Latin America as a response of the State to three processes in crisis: fiscal, as in government intervention or in the form of bureaucratic administration. In that scheme of things, this thesis examines the present state of the art in public administration science of this process to prove that in delegate democracy, this type of instruments disregard the constitutive elements of democracy and serve, especially in critical areas of the administration, allowing for Power to dismiss Law. This research seeks to contribute towards an area seldom analyzed regarding public administration doctrine under the light of the theory of law, which is the connection between previous conditions or principal inputs of an execution process of a democracy and, on the other hand, regarding the effects of introducing a reform within models of a changing democracy and new concepts of the rule of law. While reviewing writings regarding State reform, it is clear that no approximations have been previously made in reference to prior conditions of the political system in order to begin operating a reform which respects fundamental rights as an object of this procedure. Furthermore, no analysis has been found regarding structural change of strategic areas in State services as to the effect caused on democratic exercise and the outcome in an open society...

Partnerships in mental health: Addressing barriers to social inclusion

Current trends in mental health services emphasize working in partnership with consumers and other government and non-government community organizations for improvement in quality of life for service users. People with a mental illness experience social exclusion, thereby limiting their ability to participate fully in community life. Occupational therapists have a substantial role to play in helping service users to overcome barriers to their community inclusion. Partnerships need to be formed to increase access to community resources and participation in activities that are enjoyed by other members of the community. Such partnerships have a health promotion emphasis and foster the relationship between mental-health services and the wider community, thus shifting the focus from direct occupational therapy service delivery to community-based rehabilitation interventions.This article describes the development, implementation and evaluation of an Australian healthy lifestyle course devised to meet the identified rehabilitation goals of people with mental illness to lose weight, get fit, commence vocational study and get a job. The course was run in partnership between mental health consumers, occupational therapists from the St George Mental Health Rehabilitation Service and staff and students from the Sutherland College of Technical and Further Education.

Mentoring for population health in general practice divisions

This paper describes the implementation and evaluation of a three-way model of service development mentoring. This population health mentoring program was funded by the Commonwealth Department of Health and Ageing to enable staff from eight Divisions of General Practice in South Australia to gain a sound understanding of population health concepts relevant to their workplace. The distinguishing features of service development mentoring were that the learning was grounded within an individual's work setting and experience; there was an identified population health problem or issue confronting the Division of General Practice; and there was an expectation of enhanced organisational performance. A formal evaluation found a consensus among all learners that mentoring was a positive and worthwhile experience, where they had achieved what they had set out to do. Mentors found the model of learning agreeable and effective. Division executive officers recognised enhanced skills among their "learner" colleagues, and commented positively on the benefits to their organisations through the development of well researched and relevant projects, with the potential to improve the efficiency of their population health activities.

Custom Surrogate Host for ActiveX In-Process Servers

This paper describes the design, implementation and evaluation of AX Host, a custom surrogate host for ActiveX in-process servers. AX Host aims to give ActiveX client applications improved stability by using software fault isolation.

Papel do município e relações federativas: atuação de municípios cearenses nas políticas de formação continuada de alfabetizadores

The investigation analyze s the role of the municipalities in the ongoing development of literacy teachers, having as a field of study the municipalities of Jaguaruana and Palhano, both in the State of Ceará. The political - educational space adopted as a sample of the study is the p eriod between the years 2003 and 2006, when the emphasis on cooperative action among the federated entities is observed in the Government’s guidelines and Brazilian educational policies, showing the municipal presence in the implementation and execution of these policies. T he historical - dialectical materialistic perspective, understood as an analysis of the social reality as historical elaboration and product of the human praxis, is expressed as the required theoretical - methodological path. The investigatio n is operationalized through interconnected stages: one that involves bibliographical and documental analysis, in which the theoretical input of the research is added, as well as the Federal, State and M unicipal documents accessed ; and another, regarding t he field work, studying the specific character of the object and its mutual rela tionships in the municipalities . The research brings the notion of intergovernmental relationships and cooperative mechanisms as central theoretical tools and, dialoguing with them, ideas such as decentralization, municipalization and municipal autonomy are inserted into a theoretical/practical body, through which the historical and logical aspects of the object are detailed. The study describes and interprets the policies of on going development of literacy teachers with focus on the national guidelines formulated since the 1990’s and on the govern mental incorporation in the national and subnational spaces. In this sense, the analysis is based on the comprehension of the interrel ationship between the municipal policies and the p olicies created by the S tate or Federal G overnments in order to offer ongoing development of literacy teachers. Considering the investigated sample, it shows how the municipal role and the relationships bet ween the State and municipalities of Ceará have emerged, as well as their characteristics regarding the education management policies, taking into account the practices of municipalization and cooperation between the State and municipalities in their histo rical composition. It shows the practices which aim at the ongoing development of literacy teachers observed in the researched municipalities, pointing out the realities and specific marks left by municipal presence in the area, demonstrating the assigned role and the role played. Based on the points of view of the managers interviewed in the municipalities of Jaguaruana e Palhano, it is possible to note the meaning and effectiveness of the policies carried out. With such elements, it discusses the municipa l asymmetries in their homogeneities and heterogeneities rega rding the execution of their federative role. The analysis shows that th e role of the municipalities vary according to the historical, political and social interventions in each municipality. In the fields of formulation and execution of educational policies, the actions of the municipal governments, situated and with expressive interferences, reveal asymmetries in the sense that some municipalities have bigger autonomy and participate more effect ively in the production and distribution of policies than others. In terms of the researched realities, the study shows that taking care of the policies of ongoing development of literacy teachers is not a task that should be assigned exclusively to the mu nicipalities, nonetheless it is a role that they play with varying degrees of success. This role is in fact a joint competence of the federated entities, in the scope the Brazilian cooperative federalism.

O papel dos quintais urbanos na segurança alimentar, bem estar e conservação da biodiversidade

Residential homegardens have environmental and social roles in the urban environment. These green spaces can potentially minimize the impacts caused by the growth of cities, being an alternative to connect fragmented areas or offer refuge to wildlife and therefore support the conservation of biodiversity. In addition, the homegardens demonstrate a leading role in increasing human well-being by promoting socialization opportunities, contact with nature, local culture as well as improvements in food security for the urban families. Nevertheless, it is still unclear what specific characteristics of homegardens can act effectively in the conservation of the biodiversity, as well as in the construction of food security and well being of the homegardeners and their families. The first chapter of this thesis analyzed the diversity of plant species (native and exotic) and assessed the contribution of different types of urban gardens (ornamental and forest gardens alike) in the presence of wildlife such as birds, monkeys and lizards. In the second chapter we evaluated the contribution of those gardens to the welfare and food security of their owners. In order to do this, 41 gardens were visited in Pium, a southern coastal town in the northeastern Brazil, which also happens to be in a periurban region undergoing rapid urban expansion and pressure from the real estate market. We surveyed the planned biodiversity and fauna associated with homegardens. The data related to food security and welfare were sampled through interviews with the person in charge of taking care of the gardens. These interviews covered issues on the supply of food from the garden and absence of chemical products, as well as aspects of the GNH indicator (Gross National Happiness). The results showed that these homegardens generally contribute little to the maintenance of native plant species (native species = 29/ total = 187). From its main features, the gardens were classified as ornamental, forest gardens and forest farms. These groups had a different effect on the presence of the animals studied and the last two contained most of the sampled native species. The diversity of plants and trees was a good predictor of the presence of birds and monkeys. Thus, the contribution of yards for the conservation of biodiversity depends on the type of garden: some even can have negative effects on conservation. These results can direct new approaches to detailed understanding of gardens and also of public policies applied to urban planning. The results of the second chapter showed that the two types of forest gardens contributed to household food security, for providing food and medicinal herbs, which mostly did not have pesticides and chemical 12 fertilizers. But the three groups of gardens are important components for the well being of their stakeholders. Gardens help promote the transmission of knowledge on agriculture, socialization, contact with nature and bring up feelings related to peace and harmony. Thus, forest gardens can be considered important means to get through public projects and policies designed to encourage biodiversity and promote food security and well-being in urban areas

Aprendizagem criativa na aula de piano em grupo

The central focus of this thesis was to investigate creative learning in music at piano group lessons. Thus, the theoretical framework adopted was guided by two main principles: (1) creativity in the field of music education and (2) Piano teaching and learning. As a methodological procedure we used a research-action with students of the disciplines Prática de Instrumento Harmônico I e II, at the Music Education Undergraduate Course of Federal University of Rio Grande do Norte (UFRN). This research-action was structured in four phases: 1) the identification of the starting points and the theme of creativity matters in piano group lessons, considering the context of a teacher training course in music; 2) the projection of actions, the definition of the objectives and the organization of instruments of data collection and analysis; 3) the realization of the planned actions; and 4) the evaluation of the results, the transcription, organization and analysis of the data collected through observation and interviews. Given the Creative Learning Cycle in Music, represented by the activities of composing, performing and criticizing Music, defended by Beineke (2009, 2013, 2015), we propose in this thesis a creative cycle of formation in music to promote creative learning in piano group lessons, in which teachers and students teach and learn creatively, expanding training opportunities in the field of Music Education. This was possible due to the joint experience of creative practices related to improvisation, elaboration of arrangements and musical compositions - elements that contributed positively to the learning process of the participants. But for this to occur, the planning, implementation and evaluation of the creative and pedagogical musical procedures adopted were decisive, considering the perspectives of students, their conceptions, musical creations, processes and collaborative exchange.

Aprendizagem criativa na aula de piano em grupo

The central focus of this thesis was to investigate creative learning in music at piano group lessons. Thus, the theoretical framework adopted was guided by two main principles: (1) creativity in the field of music education and (2) Piano teaching and learning. As a methodological procedure we used a research-action with students of the disciplines Prática de Instrumento Harmônico I e II, at the Music Education Undergraduate Course of Federal University of Rio Grande do Norte (UFRN). This research-action was structured in four phases: 1) the identification of the starting points and the theme of creativity matters in piano group lessons, considering the context of a teacher training course in music; 2) the projection of actions, the definition of the objectives and the organization of instruments of data collection and analysis; 3) the realization of the planned actions; and 4) the evaluation of the results, the transcription, organization and analysis of the data collected through observation and interviews. Given the Creative Learning Cycle in Music, represented by the activities of composing, performing and criticizing Music, defended by Beineke (2009, 2013, 2015), we propose in this thesis a creative cycle of formation in music to promote creative learning in piano group lessons, in which teachers and students teach and learn creatively, expanding training opportunities in the field of Music Education. This was possible due to the joint experience of creative practices related to improvisation, elaboration of arrangements and musical compositions - elements that contributed positively to the learning process of the participants. But for this to occur, the planning, implementation and evaluation of the creative and pedagogical musical procedures adopted were decisive, considering the perspectives of students, their conceptions, musical creations, processes and collaborative exchange.

Intervenção socioeducativa: investigação-ação participativa com trabalhadoras do sexo de rua e uma equipa de outreach

Nos últimos anos, assistimos ao crescimento do conhecimento sobre o trabalho sexual e os seus atores. No entanto, poucos estudos envolvem os/as trabalhadores/as do sexo (TS) como participantes ativos. Esta tese apresenta uma pesquisa de investigação-ação participativa (IAP) composta por dois estudos que, de forma complementar, pretendem contribuir para o desenvolvimento de uma proposta socioeducativa de intervenção centrada nos direitos e necessidades dos/as TS. O estudo preliminar pretende refletir sobre os discursos institucionais produzidos em torno do trabalho sexual e dar a conhecer as práticas socioeducativas empreendidas pelas instituições que dirigem serviços a TS, em Portugal. O segundo estudo apresenta o processo e os resultados de uma IAP, com TS de rua e uma equipa de outreach. O propósito do segundo estudo consistiu em identificar as necessidades e as vontades das TS e de uma equipa de outreach, com a finalidade de encorajar os/as participantes na construção de um modelo socioeducativo de intervenção. O estudo preliminar foi efetuado junto das 23 instituições que, à data deste estudo (de outubro de 2012 a março de 2013), prestavam apoio a TS. Concluímos que os serviços são bastante similares, focados na redução de riscos decorrentes do trabalho sexual, sobretudo a nível da promoção e educação para a saúde, assumindo uma intervenção tradicional centrada na epidemiologia. De forma menos expressiva, encontrámos instituições que se centram no apoio ao abandono da atividade. Todas assumem um papel fundamental no debate social e político sobre a prostituição enquanto trabalho ou opressão. Estes resultados conduziram-nos à formulação das seguintes questões: 1) Os serviços tradicionais centrados na epidemiologia reforçam inadvertidamente o estigma do/a TS?; 2) Quais são as preocupações, necessidades e vontades reais dos/as TS?; 3) O que pensam sobre serem envolvidos/as no desenho, implementação e avaliação de projetos que lhes dizem respeito? Assim, identificámos uma falta de participação dos/as TS em projetos a si dirigidos, corroborada pela literatura científica. O segundo estudo foi desenvolvido, de setembro de 2012 a junho de 2015, através de três ciclos de planificação-ação-reflexão com TS de rua e uma equipa de outreach, em Coimbra, tendo envolvido 28 participantes formais. Através de entrevistas e da reinterpretação conjunta dos resultados das mesmas, verificámos a existência de preocupações comuns, designadamente no que se refere à saúde e segurança ocupacionais, mas pouca coesão entre as TS. As iniciativas de conscientização, desenvolvidas no âmbito da IAP, providenciaram um sentido de controlo, mas a transformação da subjetividade em ação coletiva continua a ser premente. Por tal, propomos um modelo de intervenção socioeducativa com TS, segundo uma abordagem centrada na relação e na prática reflexiva, através do recurso a métodos e à filosofia da IAP. Propomos, ainda, algumas recomendações em torno da educação/formação dos profissionais de proximidade, das/os TS e, a um nível macro, iniciativas educativas centrada na desconstrução social do género.

Influência das etapas do processo de abate de suínos na prevalência de patógenos e níveis de microrganismos indicadores de qualidade e higiene

The pig slaughter process involve different steps that can influence the microbiological quality of carcasses. At this, the understanding of the slaughter process on the microbiological aspects is necessary for the implementation and evaluation of critical control points. The microbiological control of the slaughter process should involve the evaluation of pathogens prevalence and levels of quality and hygiene indicator microorganisms. This study aimed at investigating the influence of steps slaughter process on the microbiological levels of pig carcasses, and evaluate if there is correlation between pathogens (Salmonella spp. and Listeria monocytogenes) and indicators (aerobic mesophilic counts, total coliforms, Escherichia coli and Enterobacteriaceae) microorganisms. A high Salmonella soroprevalence in pigs were founded before the slaughter (57.49 %). While the Salmonella prevalence in carcasses at the initial stage of the slaughter was 26.67 % and in the final stage 1.11 %, L. monocytogenes was detected only in the final washing and cooling steps, with a prevalence of 21.11 and 8.89 %, respectively. The aerobic mesophilic counts, Enterobacteriaceae, total coliforms and E. coli levels in initial steps of slaughter process were 4.25 ± 0.37; 1.25 ± 0.38; 1.10 ± 0.35 and 0.86 ± 0.36, respectively. At the end of slaughter process the results were lower (ranging from 0.16 at 2.70 log CFU/cm2). The step that most reduced microbiological levels was the scalding. The dehairing was a critical step that led to a significant increase of microorganisms levels in the process (p < 0.05). The evisceration not proved to be a critical step on the increase of microbial levels, differently of the final washing, which showed significant increases (p < 0.05) over the levels of aerobic counts, total coliforms, E. coli and enterobacterias (0.30; 0.36; 0.27 and 0.42 log respectively) and Salmonella spp. and L. monocytogenes. The chilling contributes significantly to the reduction of microbiological levels of carcasses, bringing them to levels below the all process stages, with the exception of scalding. No correlation between the hygiene indicator microorganisms used and presence of Salmonella spp. and L. monocytogenes were obtained (p < 0.05). The results show that steps in the process are critical to the sanitary profile, which implies the need to implement actions in the process to reducing the microbiological levels.

Papel das medidas agro-ambientais na gestão da paisagem rural no concelho de Marvão no PNSSM

As paisagens rurais portuguesas construídas e mantidas ao longo dos tempos por sistemas agrícolas tradicionais, estão hoje ameaçadas por motivos tão diversos como o envelhecimento da população, o abandono rural, a intensificação, a homogeneização dos sistemas de produção e a perda de competitividade. Mas apesar destes problemas, estas paisagens agrícolas, suportam ainda várias funções não produtivas, nomeadamente, constituem, um importante suporte de biodiversidade, pelo que a sua manutenção é importante para a conservação destes habitats e espécies. Eventualmente novas formas de gestão destas paisagens devem ser criadas, nomeadamente com base na combinação de várias funções numa perspectiva de multifuncionalidade, através de uma adaptação e integração de políticas públicas. Estando actualmente em discussão o novo programa de Desenvolvimento Rural e a definição das futuras Medidas Agro-Ambientais, e a gestão e o financiamento da Rede Natura 2000, estamos portanto num momento crítico para decisões futuras, que terão forçosamente que interligar, a agricultura, o ambiente e desenvolvimento das zonas rurais portuguesas. Com o intuito de melhor compreender estas problemáticas, em particular, as transformações em curso na paisagem rural, o papel das Medidas Agro-Ambientais e apresentar possíveis soluções, foi efectuado este estudo de caso no concelho de Marvão, concelho típico das áreas marginais agrícolas do interior sul de Portugal. ABSTRACT; The Portuguese rural landscapes built up and kept throughout the times by traditional agricultural systems, are today threatened by so diverse reasons as the ageing of the population, the agricultural abandonment, the intensification, the homogenization of the production systems and the loss of competitiveness. But despite these problems. These agricultural landscapes still support a multitude of non-commodity functions, and particularly they still constitute an important support of biodiversity and thus their maintenance is important for the conservation of these habitats and species. Probably new management forms must be created based on the combination of various functions and the adaptation and integration of public policies. Being currently in discussion the new program of Rural Development and the definition of the future Agri-Environmental Measures, and the management and the financing of the Natura 2000 Network, we are therefore at a critical moment for future decisions that will forcibly have to establish connections, between the agriculture, the environment and the development of the portuguese agricultural areas. With the intention of better understanding these problems and questions, , the transformations taking place in Portuguese peripheric rural areas, and in particular role of the Agri-Environmental Measures, and also for presenting possible solutions, a case study was analyzed in municipality of Marvão, characteristic of the agricultural marginal areas of the interior Southern Portugal.

As redes sociais e a participação política no âmbito do marketing político do Governo Federal Brasileiro entre 2011 e 2014 : atuação do Ministério da Educação no Facebook

A democracia contemporânea vem, ao longo das últimas décadas, recebendo cada vez mais influência dos meios de comunicação em seus processos. Com o surgimento e propagação da Internet, os governos tem precisado se adaptar e se preocupar com a transparência de suas ações e com as inúmeras vozes de atores sociais cada vez mais conectados, informados e munidos de ferramentas, por meio das quais, podem realizar comunicações de grande alcance de forma rápida e eficaz, sem o intermédio de grandes meios de comunicação. Com o objetivo de observar a relação entre o governos e cidadãos por meio das redess sociais online – um dos principais meios por onde a sociedade, hoje, tem se comunicado e se mobilizado sobre inúmeras, inclusive, políticas – esse estudo analisou como o Ministério da Educação do Brasil (MEC), órgão responsável pelo planejamento e desenvolvimento de políticas públicas para educação no país, trabalha sua comunicação com o cidadão por meio do Facebook e como utiliza essa ferramenta no processo de implementação e avaliação de suas políticas. O trabalho foi realizado por meio do estudo exploratório e da análise qualitativa dos dados colhidos na página MEC no Facebook entre anos de 2011 e 2014, período do primeiro mandato da presidente Dilma Rousseff. Com a análise, observou-se que o MEC modificou bastante a forma como se comunica por esta rede social, recebendo, inclusive, aparente melhor infra-estrutura para esta tarefa. Sua mudança de postura no Facebook deixa claro o interesse e a busca pela participação dos cidadadãos no desevolvimento de suas políticas públicas. Por outro lado, mostra que essa participação é, de certa forma, limitada pela atitude do MEC de não desenvolver diálogo com o cidadão, mantendo-os sempre a certa distância.

Propuesta de entrenamiento deportivo de medio fondo para atletas menores de la escuela de atletismo Patricio Quille

RESUMEN. En este trabajo de titulación se describe el proceso de investigación científica y social del diseño, aplicación y evaluación de una propuesta de entrenamiento deportivo para atletas damas y varones de las categorías prejuveniles de la Escuela de Atletismo “Patricio Quille” de la ciudad de Cuenca. Dicha propuesta de trabajo investigativo en el área de la Cultura Física consistió en el diseño de un macrociclo de entrenamiento estructurado por procesos de desarrollo de las cualidades físicas de los deportistas, pero básicamente se centró en el desarrollo de la técnica de la carrera de medio fondo en función de los principios fisiológicos del rendimiento deportivo y la psicopedagogía de la enseñanza deportiva. Al final del proceso, la propuesta fue totalmente validada con los logros deportivos que los atletas inmersos en la investigación alcanzaron enel entorno competitivo local, nacional e incluso internacional.