Global trends in myopia management attitudes and strategies in clinical practice

PURPOSE: Myopia is a global public health issue; however, no information exists as to how potential myopia retardation strategies are being adopted globally. METHODS: A self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. RESULTS: Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5 (±37.8)% prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%). CONCLUSIONS: Regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.

Az „iránymutató vízió” szerepe a regionális fejlesztésekben, egy hazai agráripari vállalkozás tapasztalatai (The role of „guiding vision“ on regional developments and experiences of a domestic agro-industrial enterprise)

A szerző tanulmányában külföldi és hazai példák alapján a fenntartható gazdaság kialakítására hoz példákat. Bemutat egy osztrák energiarégiót és egy magyar biodízelgyártó vállalkozást. Mindegyik esetre jellemző, hogy olyan társadalmi-gazdasági környezetet kell teremteni, hogy minden stakeholder a win-win megoldásban legyen érdekelt. _____ Agricultural land ownership and the desirable scale of operation have been the subjects of a plethora of studies. Mainstream research, however, has a tendency not to take the human factor into consideration. The unpredictability of economic policies, uncertainties about EU subsidies, the optimal scale of operation and industry- specific characteristics all constitute a far more exciting and reasonable research topic for the majority. According to literature, social support for the efforts and the existence of a clear “guiding vision” have a crucial role in the success of rural development strategies. Concerning the development of a region or village, it is important to determine whether there exists a leading personality, an example-setting entrepreneur or entrepreneurial group that can act as a fundamental driving force or an initiator in reforming the rural way of life; one that could help preserve positive rural values while nurturing economically successful enterprises. Experience has shown that success can only be built upon partnership and mutual cooperation.

Regional aspects of Miami crime fiction

This thesis argues that forces of literary regionalism and postmodern culture are behind the explosion of crime fiction being written in and about South Florida by a growing number of resident authors. Research included four methods of investigation: 1. A critical reading of many of the novels that make up the sub-genre. 2. A study of the theories of regionalism, postmodernism and the genre of the crime fiction. 3. Interviews with a number of the authors and a prominent Miami book seller. 4. Sociological studies of Miami in terms of historical events and their cultural significance. Today's South Florida crime fiction authors cast their narratives in the old genre of the detective novel where characters are delineated according to traditional definitions of good and evil. Evil characters threaten established order. What makes South Florida crime fiction different from traditional detective fiction is its interest in the exotic, postmodern culture and setting of South Florida. Like the region, the villains are exotic and the order that they threaten is postmodern. There is less of an interest in attributing a larger social meaning to the heroes. Rather, there is an ontological interest in the playing out of good against evil in an almost mythical setting that magnifies economic, environmental and racial issues. There is a unique cultural diversity of the city due to the geographical location of Miami in relationship to Latin America and the Caribbean, and the political forces at work in the region. South Florida's subtropical climate, fragile ecosystem, and elements of frontier life in a cosmopolitan city work to support Miami crime fiction. The setting personifies the unpredictability and pastiche of a postmodern world and may call for a new definition for literature that relies on non-traditional regional characteristics.

Expectativas reprodutivas de pais e filhos: uma avaliação do conflito pais-prole

Reproduction is an essential part of humans species’ existence and survival. We are interested in securing it, and having a direct interest in the reproduction of those with whom we have strong genetic relationship. Trivers (1974) featured the parent-offspring conflict, as a divergence about the parents’ investment, which has been mainly studied in the early stages of children’s development. However, the divergence in investment can also be expressed at the time of the reproductive decisions of the offspring. Thus, we investigated whether parents and children have conflicting interests regarding reproductive expectations of the children, understanding reproductive expectations as desired age to marry, have children, have sexual intercourse and desired amount of children. We found that parents and children disagree on some of these points, we also find a more conservative expectation when it comes to daughters, reiterating the daughter-guarding hypothesis. When we consider how much help would be given towards the up bringing of a grandson, we found a clear variation according to the age of the baby's parents: the younger the baby’s parents are, the larger the amount of assistance would be provided by grandparents. Considering the amount and quality of offspring and conditions of reproduction, parental investment is an element that presents itself closely linked to the history of the subject's life. Parents are the first to communicate to children how the environment in which they are inserted is presenting itself. As the life history is closely linked with reproduction, and, therefore, with parental investment, we intend to investigate whether there is a correlation between aspects of the individuals’ history of life (unpredictability and parental care) and their reproductive expectations, seeking further assess on whether there is relationship between parents' life history and their reproductive expectations for their children. We find evidence that partially confirm our expectations; we find relationships of some elements of reproductive expectations with indicators of unpredictability and parental care. The experiences of parents also reflected in their expectations for their children, with a more present correlation to their expectations for daughters. From our results, we find evidence that parent-offspring conflict appears in the reproductive expectations of children and relates to aspects of individuals’ life history.

A descoberta do elétron como tema gerador de um ensino de física mediado por experimentação remota

In this work, we have proposed and applied a methodology for teaching electromagnetism, based on an experimental activity and designed in an investigative teaching model, and containing a high degree of dialogism among teachers and students. We have used the discovery of the electron as a generator theme and a remote experiment to determine the charge-to-mass ratio of the electron as an educational resource. Our analyses indicate favorably towards the promotion of ways of appropriation of knowledge by the student, very different from those perceived in traditional expositive classes. Similarly, we find that the presence of a technological resource and an experimental activity create new posture of the teacher in the classroom, probably caused by the unpredictability of the results from the use of such resources. A challenge that we still need to solve is how to engage students in extra classroom tasks, since learning is not only effective in time for classes. We also present the weaknesses detected in our methodological proposal as well as implementations necessary in order to continue the validation process of this methodology.

Investigation of factors driving the costs of operating the 2020 Irish power system with large-scale wind generation

The main goal of this work is to determine the true cost incurred by the Republic of Ireland and Northern Ireland in order to meet their EU renewable electricity targets. The primary all-island of Ireland policy goal is that 40% of electricity will come from renewable sources in 2020. From this it is expected that wind generation on the Irish electricity system will be in the region of 32-37% of total generation. This leads to issues resulting from wind energy being a non-synchronous, unpredictable and variable source of energy use on a scale never seen before for a single synchronous system. If changes are not made to traditional operational practices, the efficient running of the electricity system will be directly affected by these issues in the coming years. Using models of the electricity system for the all-island grid of Ireland, the effects of high wind energy penetration expected to be present in 2020 are examined. These models were developed using a unit commitment, economic dispatch tool called PLEXOS which allows for a detailed representation of the electricity system to be achieved down to individual generator level. These models replicate the true running of the electricity system through use of day-ahead scheduling and semi-relaxed use of these schedules that reflects the Transmission System Operator's of real time decision making on dispatch. In addition, it carefully considers other non-wind priority dispatch generation technologies that have an effect on the overall system. In the models developed, three main issues associated with wind energy integration were selected to be examined in detail to determine the sensitivity of assumptions presented in other studies. These three issues include wind energy's non-synchronous nature, its variability and spatial correlation, and its unpredictability. This leads to an examination of the effects in three areas: the need for system operation constraints required for system security; different onshore to offshore ratios of installed wind energy; and the degrees of accuracy in wind energy forecasting. Each of these areas directly impact the way in which the electricity system is run as they address each of the three issues associated with wind energy stated above, respectively. It is shown that assumptions in these three areas have a large effect on the results in terms of total generation costs, wind curtailment and generator technology type dispatch. In particular accounting for these issues has resulted in wind curtailment being predicted in much larger quantities than had been previously reported. This would have a large effect on wind energy companies because it is already a very low profit margin industry. Results from this work have shown that the relaxation of system operation constraints is crucial to the economic running of the electricity system with large improvements shown in the reduction of wind curtailment and system generation costs. There are clear benefits in having a proportion of the wind installed offshore in Ireland which would help to reduce variability of wind energy generation on the system and therefore reduce wind curtailment. With envisaged future improvements in day-ahead wind forecasting from 8% to 4% mean absolute error, there are potential reductions in wind curtailment system costs and open cycle gas turbine usage. This work illustrates the consequences of assumptions in the areas of system operation constraints, onshore/offshore installed wind capacities and accuracy in wind forecasting to better inform the true costs associated with running Ireland's changing electricity system as it continues to decarbonise into the near future. This work also proposes to illustrate, through the use of Ireland as a case study, the effects that will become ever more prevalent in other synchronous systems as they pursue a path of increasing renewable energy generation.

Community owned solutions: identifying local best practices for social-ecological sustainability

Policies and actions that come from higher scale structures, such as international bodies and national governments, are not always compatible with the realities and perspectives of smaller scale units including indigenous communities. Yet, it is at this local social-ecological scale that mechanisms and solutions for dealing with unpredictability and change can be increasingly seen emerging from across the world. Although there is a large body of knowledge specifying the conditions necessary to promote local governance of natural resources, there is a parallel need to develop practical methods for operationalizing the evaluation of local social-ecological systems. In this paper, we report on a systemic, participatory, and visual approach for engaging local communities in an exploration of their own social-ecological system. Working with indigenous communities of the North Rupununi, Guyana, this involved using participatory video and photography within a system viability framework to enable local participants to analyze their own situation by defining indicators of successful strategies that were meaningful to them. Participatory multicriteria analysis was then used to arrive at a short list of best practice strategies. We present six best practices and show how they are intimately linked through the themes of indigenous knowledge, local governance and values, and partnerships and networks. We highlight how developing shared narratives of community owned solutions can help communities to plan governance and management of land and resource systems, while reinforcing sustainable practices by discussing and showcasing them within communities, and by engendering a sense of pride in local solutions.

Modelagem de emoções utilizando redes bayesianas

As emoções são consideradas a regra central de nossas vidas, tendo grande impacto na tomada de decisões, ações, memória, atenção, etc. Sendo assim, existe grande interesse em simulá-las em ambientes computacionais, possibilitando que situações do cotidiano humano possam ser estudadas em ambientes controlados. Embora existam modelos teóricos para o funcionamento de emoções, estes por si só são insuficientes para uma simulação precisa em meios computacionais. Tendo como base um destes modelos, o modelo OCC, essa dissertação propõe a simulação de emoções em ambientes mutiagentes através da criação de uma rede Bayesiana capaz de traduzir estímulos gerados neste ambiente em emoções. A utilização de redes Bayesianas combinadas à estrutura do modelo OCC busca a adição de imprevisibilidade ao modelo, além de fornecê-lo uma estrutura computacional. A aplicação do modelo proposto a um sistema multiagentes proporciona o estudo da influência das emoções sobre as ações e comportamento dos agentes, possibilitando um estudo de comparação entre os resultados obtidos ao se realizar uma simulação multiagentes clássica e uma simulação multiagentes contendo emoções. De forma a validar e avaliar seu funcionamento, é apresentado o estudo da aplicação da rede Bayesiana de emoções sobre um modelo multiagentes exemplo, observando as variações que as emoções provocam sobre o comportamento dos agentes.

Relação supervisiva e desenvolvimento da identidade profissional: acompanhamento das práticas clínicas dos estudantes de enfermagem

Este estudo centrou-se num Curso de Licenciatura em Enfermagem e teve como objetivo compreender a influência da relação supervisiva no desenvolvimento da identidade profissional dos estudantes. Os eixos estruturantes que suportam esta investigação e que concorrem para a definição do seu objeto de estudo articulam-se em torno da relação supervisiva, do desenvolvimento de competências profissionais e do desenvolvimento da identidade pessoal e profissional em contexto clínico. A formação desenvolvida através da prática clínica destina-se a preparar indivíduos de acordo com a atual realidade socioprofissional, onde os sujeitos, independentemente da singularidade de cada um, desenvolvem saberes adquiridos em sala de aula. Quando comparada com o espaço escolar, a aprendizagem em contexto clínico é condicionada por fatores que se caraterizam por maior imprevisibilidade e obriga frequentemente o estudante a confrontar-se com situações únicas e impares. A identidade dos estudantes torna-se assim construída e vivida a partir de um conjunto de dimensões que ocorrem no decurso das vivências clínicas. Metodologicamente optou-se por um estudo etnográfico no âmbito do paradigma qualitativo, numa abordagem longitudinal segundo a lógica do estudo de caso. A natureza dos dados a recolher englobou ainda o recurso a procedimentos de natureza quantitativa. Como técnica de recolha de dados recorremos à observação participante, entrevistas semiestruturadas e questionários. O estudo desenvolveu-se numa Escola Superior de Enfermagem da Zona Norte do país e fizeram parte da população 69 estudantes de uma turma de segundo ano, quatro tutores e um professor. O plano de estudo da referida escola está organizado de forma a que a aprendizagem dos estudantes seja progressivamente integradora de saberes interligando a componente teórica com a componente prática. Assim, os ensinos clínicos estão distribuídos entre o 2º e o 4º ano. Da análise e discussão dos dados e subsequentes conclusões ressalta que, quer a relação supervisiva, quer os contextos clínicos, foram influenciadores do desenvolvimento de competências profissionais, bem como da identidade pessoal e profissional dos estudantes. Verificamos que os dois contextos clínicos estudados – medicina e cirurgia – favoreceram o desenvolvimento de competências distintas, no entanto complementares. Tornou-se visível que, os supervisores do contexto de medicina, possuidores de uma visão holística da profissão de enfermagem, promoveram nos estudantes uma visão integradora do doente, resultante de uma contínua atitude reflexiva sobre a Pessoa Humana. Por sua vez, no contexto de cirurgia, caraterizada por intervenções mais invasivas e mais centradas no tratar, as competências mais valorizadas pelos tutores, embora que de uma forma não verbalmente assumida, foram do domínio técnicocientífico, com especial relevo pelas competências instrumentais.

Adaptability, Transformation and Complex Changes in Namibia and Tanzania: Resilience and Innovation System Development in Local Communities

This thesis is a research about the recent complex spatial changes in Namibia and Tanzania and local communities’ capacity to cope with, adapt to and transform the unpredictability engaged to these processes. I scrutinise the concept of resilience and its potential application to explaining the development of local communities in Southern Africa when facing various social, economic and environmental changes. My research is based on three distinct but overlapping research questions: what are the main spatial changes and their impact on the study areas in Namibia and Tanzania? What are the adaptation, transformation and resilience processes of the studied local communities in Namibia and Tanzania? How are innovation systems developed, and what is their impact on the resilience of the studied local communities in Namibia and Tanzania? I use four ethnographic case studies concerning environmental change, global tourism and innovation system development in Namibia and Tanzania, as well as mixed-methodological approaches, to study these issues. The results of my empirical investigation demonstrate that the spatial changes in the localities within Namibia and Tanzania are unique, loose assemblages, a result of the complex, multisided, relational and evolutional development of human and non-human elements that do not necessarily have linear causalities. Several changes co-exist and are interconnected though uncertain and unstructured and, together with the multiple stressors related to poverty, have made communities more vulnerable to different changes. The communities’ adaptation and transformation measures have been mostly reactive, based on contingency and post hoc learning. Despite various anticipation techniques, coping measures, adaptive learning and self-organisation processes occurring in the localities, the local communities are constrained by their uneven power relationships within the larger assemblages. Thus, communities’ own opportunities to increase their resilience are limited without changing the relations in these multiform entities. Therefore, larger cooperation models are needed, like an innovation system, based on the interactions of different actors to foster cooperation, which require collaboration among and input from a diverse set of stakeholders to combine different sources of knowledge, innovation and learning. Accordingly, both Namibia and Tanzania are developing an innovation system as their key policy to foster transformation towards knowledge-based societies. Finally, the development of an innovation system needs novel bottom-up approaches to increase the resilience of local communities and embed it into local communities. Therefore, innovation policies in Namibia have emphasised the role of indigenous knowledge, and Tanzania has established the Living Lab network.

O efeito das substituições no comportamento tático e no rendimento físico dos jogadores profissionais de futebol de alto rendimento

O objetivo deste estudo foi analisar o impacto das substituições no comportamento tático e no rendimento físico de jogadores profissionais de futebol da primeira liga inglesa. Foram analisadas 40 substituições diretas de jogadores das posições de médios centro, extremos e avançados, ocorridas durante a segunda parte dos jogos. Para captar o comportamento tático individual dos jogadores foram utilizadas duas variáveis compostas: a variação da distância de cada jogador ao seu locus de referência espacial e a distribuição espacial dos deslocamentos de cada jogador (heat map). A partir destas variáveis foram calculadas a média, desvio padrão e coeficiente de variação, assim como duas medidas de entropia - que permitem mensurar a regularidade e a variabilidade/imprevisibilidade do comportamento tático individual de cada jogador. Para captar o rendimento físico dos jogadores foi utilizada a distância total percorrida e a distância percorrida em cinco categorias de intensidade. Os médios centro e os avançados substituídos apresentaram uma diminuição da imprevisibilidade no período inicial do jogo comparativamente com o período anterior à substituição. Foi também evidente a tendência para ocorrer uma diminuição do rendimento físico nos jogadores substituídos entre o período inicial de jogo e o período imediatamente anterior à substituição. Da mesma forma, para os médios e os extremos, os jogadores quando entraram na qualidade de substitutos apresentam também um maior rendimento físico que os jogadores substituídos. O jogador da posição do substituto/substituído, que permaneceu em campo apresentou também menor rendimento físico que os substitutos. Estes resultados sugerem que as motivações táticas justificam as substituições de médios centro e avançados e as motivações físicas justificam as substituições de médios centro e extremos.

A flexibilidade no interior doméstico

Dissertação para obtenção do grau de Mestre em Arquitetura, apresentada na Universidade de Lisboa - Faculdade de Arquitetura.

Plano de Gestão do Risco dos Projetos da Marinha Portuguesa

A gestão de projetos tem vindo a ser considerada uma arma competitiva para as organizações, a qual possibilita níveis de eficiência, qualidade e respetivo valor acrescentado sobre o produto ou serviço disponibilizado. A aplicação de conhecimentos e práticas nesta área permite um rigoroso controlo das principais componentes de um projeto, mesmo que essas componentes sejam consideradas variáveis incertas, devido a serem caracterizadas pela sua imprevisibilidade de ocorrência e pela sua influência sobre os objetivos do projeto. Deste modo, a gestão do risco viabiliza um tratamento destas variáveis que condicionam o sucesso do projeto, classificadas como riscos, daí a importância desta gestão ser efetuada de uma forma adequada e o mais completa possível. A Marinha Portuguesa adaptou a doutrina de gestão de projetos às suas atividades, edificando a Capacidade de Gestão de Projetos. Esta capacidade permitiu compilar a informação e as técnicas reconhecidas pela doutrina que, se julgaram indispensáveis para o cumprimento das atividades. Todavia, a doutrina tem vindo a ser atualizada permitindo, cada vez mais, condições de sucesso garantido através da aplicação de conhecimentos e procedimentos válidos em todas as áreas de conhecimento da gestão de projetos. Neste sentido, a presente investigação tem como objetivo principal, o estudo de uma das áreas mais delicadas da gestão de projetos, a gestão do risco, possibilitando a atualização e otimização desta área do conhecimento, adaptada à Marinha Portuguesa, através da conceção de um modelo do Plano de Gestão do Risco. Este documento trata e revela o modo como será executada a gestão do risco por meio de estratégias e técnicas devidamente selecionadas, garantindo o sucesso dos projetos e respetivo valor acrescentado para a organização.

Análise não linear de séries temporais e aplicações à Psicologia

Nesta dissertação estudámos as séries temporais que representam a complexa dinâmica do comportamento. Demos especial atenção às técnicas de dinâmica não linear. As técnicas fornecem-nos uma quantidade de índices quantitativos que servem para descrever as propriedades dinâmicas do sistema. Estes índices têm sido intensivamente usados nos últimos anos em aplicações práticas em Psicologia. Estudámos alguns conceitos básicos de dinâmica não linear, as características dos sistemas caóticos e algumas grandezas que caracterizam os sistemas dinâmicos, que incluem a dimensão fractal, que indica a complexidade de informação contida na série temporal, os expoentes de Lyapunov, que indicam a taxa com que pontos arbitrariamente próximos no espaço de fases da representação do espaço dinâmico, divergem ao longo do tempo, ou a entropia aproximada, que mede o grau de imprevisibilidade de uma série temporal. Esta informação pode então ser usada para compreender, e possivelmente prever, o comportamento. ABSTRACT: ln this thesis we studied the time series that represent the complex dynamic behavior. We focused on techniques of nonlinear dynamics. The techniques provide us a number of quantitative indices used to describe the dynamic properties of the system. These indices have been extensively used in recent years in practical applications in psychology. We studied some basic concepts of nonlinear dynamics, the characteristics of chaotic systems and some quantities that characterize the dynamic systems, including fractal dimension, indicating the complexity of information in the series, the Lyapunov exponents, which indicate the rate at that arbitrarily dose points in phase space representation of a dynamic, vary over time, or the approximate entropy, which measures the degree of unpredictability of a series. This information can then be used to understand and possibly predict the behavior.