Evaluation of the improvements on pharmacy technicians' work practices after implementation of operational procedures

Several antineoplasic drugs have been demonstrated to be carcinogenic or to have mutagenic and teratogenic effects. The greatest protection is achieved with the implementation of administrative and engineering controls and safety procedures. Objective: to evaluate the improvements on pharmacy technicians' work practices, after the implementation of operational procedures related to individual protection, biologic safety cabinet disinfection and cytotoxic drug preparation. Method: case-study in a hospital pharmacy undergoing a certification process. Six pharmacy technicians were observed during their daily activities. Characterization of the work practices was made using a checklist based on ISOPP and PIC guidelines. The variables studied concerning cleaning/disinfection procedures, personal protective equipment and procedures for preparing cytotoxic drugs. The same work practices were evaluated after four months of operational procedures implementation. Concordance between work practices and guidelines was considered to be a quality indicator (guidelines concordance practices number/total number of practices x 100). Results: improvements were observed after operational procedures implementation. An improvement of 6,25% in personal protective equipment practice was achieved by changing second pair of gloves every thirty minutes. The major progress, 10%, was obtained in disinfection procedure, where 80% of tasks are now realized according to guidelines.By now, we hot an improvement of only 1% at drug preparation procedure by placing one cytotoxic drug at a time inside the biological safety cabinet. Then, 85% of practices are according to guidelines. Conclusion: before operational procedures implementation 80,3% of practices were according to the guidelines, while now is 84,4%. This indicates that is necessary to review the procedures frequently in the benefit to reduce the risks associated with handling cytotoxic drugs and maintenance of drug specifications.

Re-evaluation of a reported increased micronucleus frequency in lymphocytes of workers occupationally exposed to formaldehyde

A replicate evaluation of increased micronucleus (MN) frequencies in peripheral lymphocytes of workers occupationally exposed to formaldehyde (FA) was undertaken to verify the observed effect and to determine scoring variability. May–Grünwald–Giemsa-stained slides were obtained from a previously performed cytokinesis-block micronucleus test (CBMNT) with 56 workers in anatomy and pathology laboratories and 85 controls. The first evaluation by one scorer (scorer 1) had led to a highly significant difference between workers and controls (3.96 vs 0.81 MN per 1000 cells). The slides were coded before re-evaluation and the code was broken after the complete re-evaluation of the study. A total of 1000 binucleated cells (BNC) were analysed per subject and the frequency of MN (in ‰) was determined. Slides were distributed equally and randomly between two scorers, so that the scorers had no knowledge of the exposure status. Scorer 2 (32 exposed, 36 controls) measured increased MN frequencies in exposed workers (9.88 vs 6.81). Statistical analysis with the two-sample Wilcoxon test indicated that this difference was not significant (p = 0.17). Scorer 3 (20 exposed, 46 controls) obtained a similar result, but slightly higher values for the comparison of exposed and controls (19.0 vs 12.89; p = 0.089). Combining the results of the two scorers (13.38 vs 10.22), a significant difference between exposed and controls (p = 0.028) was obtained when the stratified Wilcoxon test with the scorers as strata was applied. Interestingly, the re-evaluation of the slides led to clearly higher MN frequencies for exposed and controls compared with the first evaluation. Bland–Altman plots indicated that the agreement between the measurements of the different scorers was very poor, as shown by mean differences of 5.9 between scorer 1 and scorer 2 and 13.0 between scorer 1 and scorer 3. Calculation of the intra-class correlation coefficient (ICC) revealed that all scorer comparisons in this study were far from acceptable for the reliability of this assay. Possible implications for the use of the CBMNT in human biomonitoring studies are discussed.

Risk factors for metabolic bone disease in Crohn's disease patients

Background: The aim was to evaluate the presence of metabolic bone disease (MBD) in patients with Crohn’s disease (CD) and to identify potential etiologic factors. Methods: The case–control study included 99 patients with CD and 56 controls with a similar age and gender distribution. Both groups had dual-energy x-ray absorptionmetry and a nutritional evaluation. Single nucleotide polymorphisms at the IL1, TNF-a, LTa, and IL-6 genes were analyzed in patients only. Statistical analysis was performed using SPSS software. Results: The prevalence of MBD was significantly higher in patients (P ¼ 0.006). CD patients with osteoporosis were older (P < 0.005), small bowel involvement and surgical resections were more frequent (P < 0.005), they more often exhibited a penetrating or stricturing phenotype (P < 0.05), duration of disease over 15 years (P < 0.005), and body mass index (BMI) under 18.5 kg/m2 (P < 0.01) were more often found. No association was found with steroid use. Patients with a Z-score < 2.0 more frequently had chronic active disease (P < 0.05). With regard to diet, low vitamin K intake was more frequent (P ¼ 0.03) and intake of total, monounsaturated, and polyunsaturated fat was higher in patients with Z-score < 2.0 (P < 0.05). With respect to genetics, carriage of the polymorphic allele for LTa252 A/G was associated with a higher risk of osteoporosis (P ¼ 0.02). Regression analysis showed that age over 40 years, chronic active disease, and previous colonic resections were independently associated with the risk of developing MBD. Conclusions: The prevalence of MBD was significantly higher in CD patients. Besides the usual risk factors, we observed that factors related to chronic active and long-lasting disease increased the risk of MBD.

Risk of colorectal cancer associated with the C677T polymorphism in 5,10-methylenetetrahydrofolate reductase in Portuguese patients depends on the intake of methyl-donor nutrients

Background: Polymorphisms located in genes involved in the metabolism of folate and some methyl-related nutrients are implicated in colorectal cancer (CRC). Objective: We evaluated the association of 3 genetic polymorphisms [C677T MTHFR (methylene tetrahydrofolate reductase), A2756G MTR (methionine synthase), and C1420T SHMT (serine hydroxymethyltransferase)] with the intake of methyl-donor nutrients in CRC risk. Design: Patients withCRC(n 196) and healthy controls (n 200) matched for age and sex were evaluated for intake of methyl-donor nutrients and the 3 polymorphisms. Results: Except for folate intake, which was significantly lower in patients (P 0.02), no differences were observed in the dietary intake of other methyl-donor nutrients between groups. High intake of folate ( 406.7 g/d) was associated with a significantly lower risk of CRC (odds ratio: 0.67; 95% CI: 0.45, 0.99). The A2756G MTR polymorphism was not associated with the risk of developing CRC. In contrast, homozygosity for the C677TMTHFRvariant (TT) presented a 3.0-fold increased risk of CRC (95% CI: 1.3, 6.7). Similarly, homozygosity for the C1420T SHMT polymorphism also had a 2.6-fold increased risk (95% CI: 1.1, 5.9) of developing CRC. When interactions between variables were studied, low intake of all methyl-donor nutrients was associated with an increased risk ofCRC in homozygous participants for the C677T MTHFR polymorphism, but a statistically significant interaction was only observed for folate (odds ratio: 14.0; 95% CI: 1.8, 108.5). No significant associations were seen for MTR or SHMT polymorphisms. Conclusion: These results show an association between the C677T MTHFR variant and different folate intakes on risk of CRC.

O Balanced Scorecard como instrumento de gestão estratégica: sua implementação numa empresa de engenharia e construção

Mestrado em Contabilidade e Gestão das Instituições Financeiras

Methodology for in-game certification in serious games

Serious games are starting to attain a higher role as tools for learning in various contexts, but in particular in areas such as education and training. Due to its characteristics, such as rules, behavior simulation and feedback to the player's actions, serious games provide a favorable learning environment where errors can occur without real life penalty and students get instant feedback from challenges. These challenges are in accordance with the intended objectives and will self-adapt and repeat according to the student’s difficulty level. Through motivating and engaging environments, which serve as base for problem solving and simulation of different situations and contexts, serious games have a great potential to aid players developing professional skills. But, how do we certify the acquired knowledge and skills? With this work we intend to propose a methodology to establish a relationship between the game mechanics of serious games and an array of competences for certification, evaluating the applicability of various aspects in the design and development of games such as the user interfaces and the gameplay, obtaining learning outcomes within the game itself. Through the definition of game mechanics combined with the necessary pedagogical elements, the game will ensure the certification. This paper will present a matrix of generic skills, based on the European Framework of Qualifications, and the definition of the game mechanics necessary for certification on tour guide training context. The certification matrix has as reference axes: skills, knowledge and competencies, which describe what the students should learn, understand and be able to do after they complete the learning process. The guides-interpreters welcome and accompany tourists on trips and visits to places of tourist interest and cultural heritage such as museums, palaces and national monuments, where they provide various information. Tour guide certification requirements include skills and specific knowledge about foreign languages and in the areas of History, Ethnology, Politics, Religion, Geography and Art of the territory where it is inserted. These skills are communication, interpersonal relationships, motivation, organization and management. This certification process aims to validate the skills to plan and conduct guided tours on the territory, demonstrate knowledge appropriate to the context and finally match a good group leader. After defining which competences are to be certified, the next step is to delineate the expected learning outcomes, as well as identify the game mechanics associated with it. The game mechanics, as methods invoked by agents for interaction with the game world, in combination with game elements/objects allows multiple paths through which to explore the game environment and its educational process. Mechanics as achievements, appointments, progression, reward schedules or status, describe how game can be designed to affect players in unprecedented ways. In order for the game to be able to certify tour guides, the design of the training game will incorporate a set of theoretical and practical tasks to acquire skills and knowledge of various transversal themes. For this end, patterns of skills and abilities in acquiring different knowledge will be identified.

Interlimb coordination during the stance phase of gait in subjects with stroke

Objective: To analyze the relation between contralesional and ipsilesional limbs in subjects with stroke during step-to-step transition of walking. Design: Observational, transversal, analytical study with a convenience sample. Setting: Physical medicine and rehabilitation clinic. Participants: Subjects (nZ16) with poststroke hemiparesis with the ability to walk independently and healthy controls (nZ22). Interventions: Not applicable. Main Outcome Measures: Bilateral lower limbs electromyographic activity of the soleus (SOL), gastrocnemius medialis, tibialis anterior, biceps femoris, rectus femoris, and vastus medialis (VM) muscles and the ground reaction force were analyzed during double-support and terminal stance phases of gait. Results: The propulsive impulse of the contralesional trailing limb was negatively correlated with the braking impulse of the leading limb during double support (rZ .639, PZ.01). A moderate functional relation was observed between thigh muscles (rZ .529, PZ.035), and a strong and moderate dysfunctional relation was found between the plantar flexors of the ipsilesional limb and the vastus medialis of the contralesional limb, respectively (SOL-VM, rZ .80, P<.001; gastrocnemius medialis-VM, rZ .655, PZ.002). Also, a functional moderate negative correlation was found between the SOL and rectus femoris muscles of the ipsilesional limb during terminal stance and between the SOL (rZ .506, PZ.046) and VM (rZ .518, PZ.04) muscles of the contralesional limb during loading response, respectively. The trailing limb relative impulse contribution of the contralesional limb was lower than the ipsilesional limb of subjects with stroke (PZ.02) and lower than the relative impulse contribution of the healthy limb (PZ.008) during double support. Conclusions: The findings obtained suggest that the lower performance of the contralesional limb in forward propulsion during gait is related not only to contralateral supraspinal damage but also to a dysfunctional influence of the ipsilesional limb.

Potential dementia biomarkers based on the time-varying microstructure of sleep EEG spindles

Proceedings of the 29th Annual International Conference of the IEEE EMBS Cité Internationale, Lyon, France August 23-26, 2007

Origem, transporte e deposição do ouro em Manica (Moçambique)

The different types of Archean gold deposits in the Manica greenstone belt of western Mozambique are briefely describcd in the context of their geological setting. Particular attention is devoted to the mineralogy, petrology, geological controls, refractoriness to treatment and prospection of these gold deposits. The genesis of gold was stratigraphically controled, but structural and metamorphic events related to the intrusion of late granites have concentrated and relocated the gold in different geological environments. The possibility of additional gold occurences in different rocks sequences is discussed as well as possible guidelines for future research and development.

Paleoalterações e cimentações nos depósitos continentais terciários de Portugal central: importância na interpretação de processos antigos

This paper describes the palaeoweathering, cementation, clay minerals association and other closely related characteristics of central Portugal allostratigraphic Tertiary units (SLD's), that can be used for palaeoclimatic interpretation and palaeoenvironmental reconstruction. Lateral and vertical changes in palaeosols are of value for improving our understanding of the autocyclic and allocyclic controls on sediment acumulation in an alluvial basin, but they can also have stratigraphic importance. In some cases it is concluded that the geomorphological setting may have been more decisive than climatic conditions to the production of the palaeoweathering. During late Palaeogene (SLD7-8), surface and near-surface silicification were developed on tectonically stable land surfaces of minimal local relief under a semi-arid climate; groundwater flow was responsible for some eodiagenesis calcareous accumulations, with the neoformation of palygorskite. Conditions during the Miocene (SLD9-11) were favourable for the smectization of the metamorphic basement and arenization of granites. Intense rubefaction associated with basement conversion into clay (illite and kaolinite), is ascribed to internal drainage during late Messinian-Zanclean (SLD12). During Piacenzian (SLD13) intense kaolinization and hydromorphism are typical, reflecting a more humid and hot temperate climate and important Atlantic fluvial drainage. Later on (Gelasian-early Pleistocene ?; SLD14). more cold and dry conditicns are interpreted, at the beginning of the fluvial incision sage. Silica cementation is identified in the upper Eocence-Oligocene ? (SLD18; the major period of silicification), middle to upper Miocene (SLD10)and upper Tortonian-Messinian (SLD11); these occurrences are compatible with either arid or semi-arid conditions and the establishment of a flat landscape upon which a silcrete was developed.

Kinematic parameters of throwing performance in patients with schizophrenia using a markerless motion capture system

Motor dysfunction is consistently reported but understudied in schizophrenia. It has been hypothesized that this abnormality may reflect a neuro-developmental disorder underlying this illness. The main goal of this study was to analyze movement patterns used by participants with schizophrenia and healthy controls during overarm throwing performance, using a markerless motion capture system. Thirteen schizophrenia patients and 16 healthy control patients performed the overarm throwing task in a markerless motion capture system. Participants were also examined for the presence of motor neurological soft signs (mNSS) using the Brief Motor Scale. Schizophrenia patients demonstrated a less developed movement pattern with low individualization of components compared to healthy controls. The schizophrenia group also displayed a higher incidence of mNSS. The presence of a less mature movement pattern can be an indicator of neuro-immaturity and a marker for atypical neurological development in schizophrenia. Our findings support the understanding of motor dysfunction as an intrinsic part of the disorder of schizophrenia.

Implicações imunobiológicas da infecção a herpesvirus em tumores malignos : pesquisa e análise quantitativa de herpesvirus humanos no astrocitoma pilocítico

RESUMO: As infecções virais podem contribuir para o desenvolvimento do cancro, estando vários tumores malignos associados aos Herpesvirus (HHV). O vírus de Epstein-Barr (EBV) e o Herpesvirus 8, dois Herpesvirus, foram reconhecidos como agentes etiológicos de várias neoplasias. O astrocitoma pilocítico do cerebelo é um dos tumores cerebrais mais frequentes na criança, adolescentes e jovens adultos e a proliferação astrocitária ocorre geralmente após vários tipos de agressão, nomeadamente a infecção viral. Para investigar esta eventual interligação, estudámos 35 astrocitomas pilocíticos, pesquisando a presença dos 8 Herpesvirus. Neste estudo, foram utilizadas 10 amostras de biópsias do cerebelo de doentes que faleceram por doenças não relacionadas com infecção ou patologia tumoral. A maioria dos astrocitomas (33) eram tumores de baixa malignidade. As amostras foram analisadas por PCR (Polymerase Chain Reaction) quantitativa em tempo real (qPCR), com amplificação do gene da DNA polimerase viral. Treze astrocitomas e 7 controles revelaram pequenas quantidades de DNA viral (1-100 cópias/100ng DNA) de todos os Herpesvirus, com excepção do HHV6 A e B que estava ausente nas amostras. O EBV foi identificado em 9 dos 35 astrocitomas (26%) e em 7 dos 10 controles (70%) estando muito mais presente nos controles. As amostras positivas para o EBV foram também analisadas por imunohistoquímica, não tendo sido imunoreactivas para os anticorpos utilizados. A PCR com CODEHOP (consensus-degenerated hybrid oligonucleotide primers) foi utilizada para investigar a presença de um eventual Herpesvirus novo nestas amostras. Não foi identificada nenhuma sequência indicativa de um novo HHV por este método. 24. Em conclusão, os dados apontam para a presença de Herpesvirus, com particular relevância para o EBV, em tecido de cerebelo normal e em tumores cerebrais, embora em níveis demasiado baixos para poderem ser responsabilizados pela indução tumoral. A presença de sequências de DNA de Herpesvirus, nomeadamente do EBV, no Sistema Nervoso Central vem enriquecer a discussão sobre o significado da infecção viral na oncogénese humana, particularmente na neuro-oncogénese. ABSTRACT: Viral infections can contribute to the development of human cancer. Several human malignancies are linked with Human Herpesviruses (HHVs). Epstein-Barr virus and HHV8, two hHerpesvirus, have been recognized as etiologic agents of several neoplasms. Pilocytic astrocytoma of the cerebellum is one of the most common brain tumour in children, adolescents and young adults and astrocytary proliferation generally occurs after several types of injury, namely viral infection. To further explore this association, we have searched the tissue from 35 pilocytic astrocytoma, for all the 8 HHV. In this study, ten brain biopsies (cerebellum) from patients who died of unrelated diseases were used as controls. Most of the astrocytomas (33) were of low grade malignity. Samples were assessed by Real-time quantitative Polymerase Chain Reaction (q PCR) amplification of viral DNA polymerase gene. Thirteen astrocytoma and 7 controls showed low viral DNA levels (1-100 copies/100ng DNA) for all HHVs, with the exception of HHV6 that was absent. EBV was identified in 9 of the 35 astrocytoma (26 %) and in 7 of the 10 controls (70%) being more present in controls. EBV positive samples were also assessed by Immunohistochemistry (IHC) but none showed immunoreactivity for the antibodies used. PCR with consensus-degenerated hybrid oligonucleotide primers (CODEHOP) were also used to look for novel HHVs in these samples and no sequence indicative of a new HHV was detected. 26 Altogether the data indicate the presence of HHVs, with relevance for EBV in normal cerebellum tissue and also in brain tumours but at too low levels to be considered responsible for tumour induction. The presence of HHV DNA sequences, particularly EBV, in the studied brain tumours and control samples, further enriches the discussion about the relevance of viral infection in human oncogenesis, particularly neuro-oncogenesis.RÉSUMÉ: Les infections virales peuvent contribuer au développement du cancer. Les vírus de type Herpès sont associés à plusieurs néoplasies. Il est par exemple établi que les vírus Epstein-Barr et « human Herpesvirus 8 » (HHV-8) sont responsables de plusieurs tumeurs malignes. L´astrocytome pilocitique du cervelet est l’une des tumeurs les plus fréquentes chez les enfants, adolescents et adultes jeunes. En général la prolifération des astrocytes se produit en réponse à une agression. Posant l’hypothèse d’une agression d’origine virale, nous avons recherché la présence des 8 vírus Herpès dans les tissus de 35 astrocytomes. Dans cette étude, 10 échantillons de biopsie de cervelet de patients décédés suite à d’autres pathologies, ont été utilisés comme contrôles. La majorité des astrocytomes étaient de très basse malignité. Les échantillons ont été étudiés par PCR quantitative en temps réel, en amplifiant le gène de l’ADN-polymérase virale. Treize astrocytomes sur 35 (37%) et 7 contrôles sur 10 (70%) ont été trouvés positifs pour tous les HHV sauf l´HHV6, toujours avec un nombre de copies de polymérase virale bas (< 100 copies/100 ng d’ADN). Notamment l’EBV a été identifié 7 fois dans les contrôles (70%) et 9 fois dans les astrocytomes (26%). Les échantillons positifs pour l`EBV ont aussi été étudiés par immuno-histochimie. Aucun signal n’a été observé avec les anticorps utilisés. Enfin, une technique de PCR avec oligonucléotides dégénérés (CODEHOP ou consensus degenerated hybrid oligonucleotide primers) a été utilisée pour rechercher la présence d´un éventuel nouveau vírus Herpès dans les échantillons d’astrocytome. Aucun nouveau vírus n’a été identifié. 28 En résumé, nous avons établi la présence de vírus Herpès, en particulier l´EBV, dans le cervelet normal et dans les tumeurs du cerveau. Les quantités d’ADN viral retrouvées sont faibles et ne permettent pas d’attribuer à ces vírus la responsabilité de l’induction des tumeurs. Cependant, la présence d’ADN de vírus Herpès dans le cerveau sain ou pathologique vient enrichir la discussion sur le signification de l´infection virale dans les processus d´oncogenèse en général, et dans la neuroonco-genèse en particulier.

Cardiac sympathetic-parasympathetic balance in rats with experimentally-induced acute chagasic myocarditis

To clarify the mechanism responsible for the transient sinus tachycardia in rats with acute chagasic myocarditis, we have examined the cardiac sympathetic-parasympathetic balance of 29 rats inoculated with 200,000 parasites (Trypanosoma cruzi). Sixteen infected animals and 8 controls were studied between days 18 and 21 after inoculation (acute stage). The remaining 13 infected animals and 9 controls were studied between days 60 and 70 after inoculation (sub-acute stage). Under anesthesia (urethane 1.25 g/kg), all animals received intravenous atenolol (5 mg/kg) and atropine (10 mg/kg). Acute stage: The baseline heart rate of the infected animals was significantly higher than that of the controls (P < 0.0001). The magnitude of the negative chronotropic response to atenolol was 4 times that of the controls (P < 0.00001). This response correlated with the baseline heart rate (r= - 0.72, P < 0.001). The heart rate responses to the beta-blocker and to atropine, of the infected animals studied during the sub-acute stage, were not different from controls. These findings suggest that cardiac sympathetic activity is transiently enhanced and cardiac parasympathetic activity is not impaired, in rats with acute chagasic myocarditis. The transient predominance of cardiac sympathetic activity could explain, in part, the sinus tachycardia observed in the acute stage of experimentally-induced chagasic myocarditis.

Video-­‐monitorization system for a realistic driving simulator

Nos últimos anos, o ISEP em colaboração com a FEUP e outras Universidades, criou um simulador realista de condução chamado DRIS, que tem como objectivo ajudar em trabalhos de investigação de diferentes áreas, como engenharia civil, computação gráfica, psicologia, educação, etc. O resultado deste trabalho pretende ajudar os profissionais a analisarem os dados recolhidos em cada experiência de condução, a fim de permitir o estudo das reações do motorista em diferentes obstáculos durante um percurso. O simulador DRIS é constituído por uma tela branca, onde os ambientes de simulação são projetados; um carro real, onde é feita a experiência de condução e quatro câmaras colocadas no carro. Destas quatro câmaras, três estão dentro do carro e uma fora do carro. Cada câmara está focada estrategicamente, em partes críticas da condução: a estrada, o motorista, os pedais e os controles (mudança de marcha, volante, os comandos do limpador, etc). Cada uma das câmaras grava um vídeo, que é guardado em um computador colocado em uma das salas de controlo, dentro do Laboratório de Análise de Tráfego na FEUP. Além disso, um arquivo de texto é guardado no mesmo computador. Este arquivo de texto contém algumas informações sobre a experiência do motorista, como as coordenadas do carro, a velocidade do carro, o tempo, etc O trabalho desta Tese surge com a finalidade de melhorar a forma de os profissionais analisar e interpretar os dados recolhidos a partir de uma experiência de condução no DRIS. Para o efeito, foi criado um sistema de vídeo-­‐monitorização, que consiste em uma aplicação de vídeo, que permite a visualização de quatro vídeos simultaneamente, e ler um arquivo de texto, que contém todos os dados recolhidos na experiência. Ambos (vídeo e texto) têm de estar sincronizados com o mesmo tempo de forma a permitir ao utilizador, navegar backward e forward com a ajuda de um cursor. Além disso, como qualquer reprodutor de vídeo básico, contém alguns botões para controlar o status do vídeo (Play, Stop, Pause) e permiti que os profissionais analisem com detalhe os dados dos quatro vídeos. Aproveitando os avanços no desenvolvimento de software, a aplicação foi feita em C++ usando a biblioteca Qt, em ambiente de desenvolvimento integrado do Qt Creator, o que tornou mais fácil a implementação. No fim deste relatório (capítulo 4) é anexado um manual do usuário, a fim de explicar e ajudar os profissionais a usar a aplicação.

Instrumentos de Ajuda à Mediação do Professor Para Promover a Apredizagem dos Alunos e o Desenvolvimento Profissional dos Professores

Melhorar as práticas de ensino é um desígnio que carece da reflexão dos professores sobre a sua experiência e da investigação didática. Apresenta-se um quadro teórico das práticas de ensino que concebe o professor como mediador em contexto de aprendizagem formal, construído no âmbito de um projeto de investigação sobre as práticas de ensino. Neste âmbito foram concebidos e validados cinco instrumentos de ajuda à mediação do professor. Estes instrumentos de ajuda à mediação podem servir de referência para a melhoria progressiva das práticas de ensino em cinco dimensões importantes para o ensino de ciências e tecnologia: envolvimento produtivo dos alunos, avaliação e feedback, uso de contextos científicos e tecnológicos, trabalho realmente solicitado aos alunos e práticas epistémicas. Finalmente, apresentam-se os cinco instrumentos de ajuda, largamente ilustrados com excertos de práticas de ensino reais.