"Things I did not know”: Retrospectives on a Canadian rural male youth suicide using an instrumental photo voice case study

In Canada, it is young rural based men who are at the greatest risk for suicide. While there is no consensus on the reasons for this, evidence points to contextual social factors including isolation, lack of confidential services and pressure to uphold restrictive norms of rural masculinity. In this article we share findings drawn from an instrumental photo voice case study to distil factors contributing to the suicide of a young Canadian rural based man. Integrating photo voice methods and in-depth qualitative we conducted interviews with 7 family members and close friends of the deceased. The interviews and image data were analyzed using constant comparative methods to discern themes related to participants’ reflections on and perceptions about rural male suicide. Three inductively derived themes, “Missing the signs”, “Living up to his public image” and “Down in Rural Canada ” reflect the challenges that survivors and young rural men can experience in attempting to be comply with restrictive dominant ideals of masculinity. We conclude that community based suicide prevention efforts would benefit from gender-sensitive and place specific approaches to advancing men’s mental health by making tangibly available and affirming an array of masculinities to foster the well-being of young rural based men.

Victims, Violence and Voice: Transitional Justice, Oral History and Dealing with the Past

Transitional justice is concerned with the legal and social processes established to deal with the legacy of violence in post-conflict and post-authoritarian contexts. These processes are essentially “creatures of law” – they are established by statute, their work is molded and shaped by lawyers, and their outcomes are benchmarked against what is or is not acceptable in domestic and international law. Concerns have mounted in recent years about the dominance of legalism within the field and the instrumentalization of those most directly affected by past violence. A commonly prescribed – but as yet largely empirically untested – corrective is that transitional justice theory and practice must become more open to interdisciplinary insights and perspectives. The interview – in different guises, contexts and settings – is at the heart of most transitional justice processes. As a historian now working in a School of Law I reflect in this article on the theoretical and practical intersections between law, history, and the interview. Drawing on more than 200 interviews concerning the Northern Ireland conflict and six other international case studies I concentrate in particular on interview-based initiatives that purport to be “victim-centered”. Having identified three interrelated risks - the manipulation of victim voice by vested interests, the affording of authority to particular voices, and the reification or “freezing” of identity - and having related these to the constraints of legal mechanisms and a wider failure to manage victims’ expectations, I argue that a greater familiarity with oral history theory and praxis can usefully illuminate the tensions between legal and historical approaches to engaging voice, and ultimately offer guidance to the shared challenge of victim-centered transitional justice.

The African Pediatric Fellowship Program: Training in Africa for Africans

Africa has a significant burden of childhood disease, with relatively few skilled health care professionals. The African Paediatric Fellowship Programme was developed by the Department of Pediatrics and Child Health at the University of Cape Town to provide relevant training for African child health professionals, by Africans, within Africa. Trainees identified by partner academic institutions spend 6 months to 2 years training in the Department of Pediatrics and allied disciplines. They then return to their home institution to build practice, training, research, and advocacy. From 2008 to 2015, 73 physicians have completed or are completing training in general pediatrics or a pediatric subspecialty. At 1 year posttraining, 98% to 100% are practicing back in their home institution. The impact of the returning fellows is evident from their practice interventions, research collaborations, and positions as stakeholders who can change health care policies. Thirty-three centers in 13 African countries are partners with the program, and the program template is now followed by other partner sites in Africa. Increasing and retaining the skills pool of African child health specialists is building a network of motivated, highly skilled clinicians who are equipped to advance child health in Africa.

A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

BACKGROUND: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall.

STUDY DESIGN: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments.

RESULTS: Balance game training had a significant effect on levels of functional balance and balance confidence (P < 0.05). This was further demonstrated in participants who were deemed at high risk of falls. The overall pattern of results suggests the training program is effective and suitable for individuals at all levels of ability and may therefore play a role in reducing the risk of falls.

CONCLUSIONS: Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population.

THE TEACHING ABOUT THE CARE OF THE ELDERLY IN NURSING TRAINING: THE SITUATION IN PORTUGAL

This paper aims to look at the teaching situation of the nursing undergraduate degree’s courses about eldercare in Portugal. A documentary research on the teaching programs in 39 nursing schools, 26 schools presented syllabus units related to the topic ‘eldercare’ and in eight of these schools the contents of the units were identified. Using textual analysis and from the categories we concluded that the teaching regarding eldercare for the nurse training in Portugal is focused on hospital care; it is directed to the adult/elderly/family; it explores the definitions related to the aging process; it explores community issues, legislation and research. People responsible for the design/monitoring of teaching programs should include teaching regarding eldercare in the nurse training, considering that the elder population is increasing in Portugal.

Nursing training in Brazil and in Portugal: similarities and specificities

Objective: To identify similarities/specificities in the nursing training in Brazil and in Portugal. This is a documentary research conducted in two higher education institutions, in January 2013. Method: It was focused on the National Curriculum Guidelines and on the Bologna Process. Results: Common points: objectives and profile of the newly-trained nurses grounded on competencies; teaching of education in/for health. Brazilian specificity: universal admission; three disciplines focused on research; mandatory discipline related to elderly care; two optional disciplines: Alternative therapies and Brazilian Language of Signs; insertion of complementary activities, actions in teaching/research/extension; basis of teaching: compliance with the Brazilian Unified Health System. Portuguese Specificity: admission with regionalized medical certificate; grounded on the European Credit Transfer and Accumulation System; compulsory disciplines: Clinical Reasoning in Nursing; Family Nursing; Development throughout life; Rehabilitative Nursing and Prospects of development of the Nursing; two optional disciplines: entrepreneurship and arts; basis of teaching: clinical teaching. Conclusions: There are similarities and specificities between the surveyed courses.

Nursing training in Brazil and in Portugal: similarities and specificities

Objective: To identify similarities/specificities in the nursing training in Brazil and in Portugal. This is a documentary research conducted in two higher education institutions, in January 2013. Method: It was focused on the National Curriculum Guidelines and on the Bologna Process. Results: Common points: objectives and profile of the newly-trained nurses grounded on competencies; teaching of education in/for health. Brazilian specificity: universal admission; three disciplines focused on research; mandatory discipline related to elderly care; two optional disciplines: Alternative therapies and Brazilian Language of Signs; insertion of complementary activities, actions in teaching/research/extension; basis of teaching: compliance with the Brazilian Unified Health System. Portuguese Specificity: admission with regionalized medical certificate; grounded on the European Credit Transfer and Accumulation System; compulsory disciplines: Clinical Reasoning in Nursing; Family Nursing; Development throughout life; Rehabilitative Nursing and Prospects of development of the Nursing; two optional disciplines: entrepreneurship and arts; basis of teaching: clinical teaching. Conclusions: There are similarities and specificities between the surveyed courses.

A morte e o luto em contexto escolar: das vivências na primeira pessoa à (re) significação do conceito de escola acolhedora

A morte é, porventura, o grande tabu da sociedade ocidental contemporânea, fenómeno com clara ressonância na forma como os sobreviventes vivenciam o luto por perda de figura significativa. Numa sociedade que se mantém à margem da morte, as emoções decorrentes do luto são escamoteadas e reprimidas, com sérios riscos para a saúde mental dos enlutados. Essa conspiração do silêncio desagua também nos contextos educativos, onde os valores da juventude, do bem-estar, do prazer e da felicidade, quase não deixam espaço para o sofrimento e a morte. Deste modo, este estudo pretende ser uma contribuição para a compreensão dos efeitos do processo de luto em alunos adolescentes, nomeadamente ao nível do seu desempenho escolar, e, concomitantemente, para a análise do tipo de apoio que a comunidade educativa proporciona a esses alunos, com enfoque no papel dos professores (em geral) e dos diretores de turma (em particular). Pretende ainda apresentar estratégias interventivas, a implementar nas escolas, potenciadoras de uma educação para a vida, mesmo em circunstâncias de morte, e para a gestão do luto, que se revelem promotoras de um lidar pedagógico inclusivo. Sendo o luto um processo que afeta o indivíduo em todas as dimensões que o definem, um paradigma educacional que encontre na complexidade a sua matriz identitária, foi assumido neste estudo como o único capaz de resgatar a importância da gestão equilibrada dos afetos no processo de ensinoaprendizagem. À luz deste paradigma que assume um princípio de totalidade, partindo da totalidade, ou seja, que promove o desenvolvimento do ser humano na sua multidimensionalidade, assumimos também que a missão suprema e última da educação é a construção do sujeito ético. E é nos marcos de uma educação integral, humanista e ética, de responsabilidade pelo Outro, que ganha contornos a figura do professor cuidador, como sendo alguém atento às necessidades emocionais dos seus alunos. Do ponto de vista metodológico, esta investigação desenvolveu-se de acordo com uma abordagem de natureza predominantemente qualitativa, interpretativa e complexa e o estudo realizado centrou-se em três fases, tendo a recolha de dados decorrido entre setembro de 2009 e setembro de 2012: (i) Estudo exploratório, dirigido aos Diretores das 61 escolas secundárias do Distrito do Porto, com base num questionário adaptado, com o objetivo de sustentar a importância e pertinência do estudo principal e recolher indicadores para o orientar; (ii) Estudo de Caso Coletivo, envolvendo três alunas adolescentes em luto por perda de pai. Na primeira parte, e com vista à caracterização do contexto, a escola frequentada pelas três alunas, procedeuse à análise documental, concretamente do Projeto Educativo, mas também ao inquérito por entrevista a vários agentes da comunidade educativa: o Diretor, a Psicóloga, a Coordenadora dos Diretores de Turma do ensino secundário e seis Diretores de Turma. Na segunda parte, procedeu-se a uma abordagem holística e aprofundada da complexidade inerente a cada caso, procurando dar “voz” à forma única como cada uma das alunas vivenciou, significou e enfrentou a sua experiência de luto, tendo-se recorrido ao inquérito por entrevista. De forma a cruzar perspetivas de vários informantes, e identificar significados transversais, complementares ou alternativos, foram também entrevistadas as Encarregadas de Educação e os Diretores de Turma das alunas; (iii) Caraterização das conceções de professores sobre a temática em análise e validação de propostas de intervenção a implementar nas escolas, mobilizando-se, assim, dimensões emergentes das Fases I e II da investigação, mas também do quadro teórico que sustentou o estudo. Para a recolha de dados, foi construído um questionário que se aplicou aos professores do 2º e 3º ciclos do ensino básico e ensino secundário do Agrupamento onde se centrou o estudo de caso desenvolvido na Fase II. Procurando uma leitura global dos resultados obtidos e corroborando o que é amplamente defendido na literatura da especialidade, o estudo demonstra o impacto negativo que o luto tem no desempenho escolar e revela que o padrão afetivo da ambiência escolar não é favorável à expressão emocional de alunos enlutados, prevalecendo uma atitude de evitação por parte dos colegas e professores, o que sugere a necessidade de serem trilhados novos caminhos, por um lado, ao nível da formação de professores e, por outro lado, através da implementação em contexto escolar de uma intervenção pedagógica que eduque para a vida, mas sem descurar os fenómenos de perda afetiva significativa e respetivas vivências de luto. Deste estudo sai também reforçada a responsabilidade acrescida dos Diretores de Turma na constituição de um ethos de suporte envolvendo alunos em luto, cabendo-lhes um importante papel na articulação entre os vários agentes da comunidade educativa. Em suma: para além da necessidade de repensar o perfil de competências dos professores, mais consentâneo com o paradigma de escola acolhedora, deste estudo ressalta também a premência de validar na prática propostas de intervenção articuladas, consistentes e, sobretudo, éticas.

Curricular training report: pharmaceutical industry & spin-off company

O presente relatório expõe as atividades desenvolvidas durante o estágio curricular, frequentado na Bluepharma - Indústria Farmacêutica S.A. e na TREAT U, Lda. uma Spin-off da Universidade de Coimbra, no âmbito do Mestrado em Biomedicina Farmacêutica da Universidade de Aveiro. Esta foi uma experiência de 6 meses que teve duas componentes, uma multidisciplinar e outra monodisciplinar, as quais me permitiram desenvolver os conhecimentos e aptidões adquiridas ao longo do curso de mestrado e de as aplicar ao mundo real. Para além do desenvolvimento de competências profissionais, esta experiência possibilitou também a aquisição e desenvolvimento de várias aptidões, quer a nível pessoal como social. Nos primeiros dois meses desta minha experiência adquiri um conhecimento essencialmente teórico em várias áreas da indústria farmacêutica (financeira, desenvolvimento de negócio, assuntos regulamentares, investigação e desenvolvimento de medicamentos, garantia da qualidade, etc.) através da minha passagem pela Bluepharma. De seguida, na minha experiência de quatro meses na TREAT U, foi-me dada a oportunidade de realizar de forma mais independente, as funções inerentes ao cargo de assistente da gerência, com especial enfoque para atividades de gestão de projeto (incluindo assuntos regulamentares), tais como, apoio na preparação do plano de desenvolvimento não clínico e na preparação do pedido de aconselhamento científico. Este relatório começa assim por descrever os objectivos do estágio e uma breve descrição das instituições que me acolheram para a sua realização. De seguida, os conhecimentos adquiridos na vertente multidisciplinar do estágio e depois as atividades desenvolvidas no âmbito monodisciplinar. Por fim, apresenta uma análise das dificuldades e desafios encontrados bem como os esforços realizados para os ultrapassar.

Impact of exercise training on cancer-induced cardiac dysfunction

Cachexia is a complex syndrome characterized by severe weight loss frequently observed in cancer patients and associated with poor prognosis. Cancer cachexia is also related to modifications in cardiac muscle structure and metabolism leading to cardiac dysfunction. In order to better understand the cardiac remodeling induced by bladder cancer and the impact of exercise training after diagnosis on its regulation, we used an animal model of bladder cancer induced by exposition to N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) in the drinking water. Healthy animals and previously BBN exposed animals were submitted to a training program in a treadmill at a speed of 20m/min, 60 min/day, 5 days/week during 13 weeks. At the end of the protocol, animals exposed to BBN presented a significant decrease of body weight, in comparison with control groups, supporting the presence of cancer cachexia. Morphological analysis of the cardiac muscle sections revealed the presence of fibrosis and a significant decrease of cardiomyocyte’s cross-sectional area, suggesting the occurrence of cardiac dysfunction associated with bladder cancer. These modifications were accompanied by heart metabolic remodeling characterized by a decreased fatty acid oxidation given by diminished levels of ETFDH and of complex II subunit  from the respiratory chain. Exercise training promoted an increment of connexin 43, a protein involved in cardioprotection, and of c-kit, a protein present in cardiac stem cells. These results suggest an improved heart regenerative capacity induced by exercise training. In conclusion, endurance training seems an attractive non-pharmacological therapeutic option for the management of cardiac dysfunction in cancer cachexia.

A hybrid training method for B-spline neural networks

Current and past research has brought up new views related to the optimization of neural networks. For a fixed structure, second order methods are seen as the most promising. From previous works we have shown how second order methods are of easy applicability to a neural network. Namely, we have proved how the Levenberg-Marquard possesses not only better convergence but how it can assure the convergence to a local minima. However, as any gradient-based method, the results obtained depend on the startup point. In this work, a reformulated Evolutionary algorithm - the Bacterial Programming for Levenberg-Marquardt is proposed, as an heuristic which can be used to determine the most suitable starting points, therefore achieving, in most cases, the global optimum.

Completely supervised training algorithms for B-spline neural networks and neuro-fuzzy systems

Complete supervised training algorithms for B-spline neural networks and fuzzy rule-based systems are discussed. By interducing the relationship between B-spline neural networks and certain types of fuzzy models, training algorithms developed initially for neural networks can be adapted by fuzzy systems.

Training multilayer perceptrons - an optimization perspective

Multilayer perceptrons (MLPs) (1) are the most common artificial neural networks employed in a large field of applications. In control and signal processing applications, MLPs are mainly used as nonlinear mapping approximators. The most common training algorithm used with MLPs is the error back-propagation (BP) alg. (1).