Evolução do Campus da Caparica: Historial dos Estudos de implantação e caracterização do terreno do Campus e suas implicações para o SGA

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para a obtenção do grau de Mestre em Engenharia do Ambiente, perfil de Gestão e Sistemas Ambientais

[Archives de la Parole]. , Sīkā me tānge : a song in Chhattīsgaṛhī Hindī from Raipur (C.P.) [i.e. Central Provinces] / [Sir George Grierson], éd. ; Linguistic survey of India ; [Brijlal Raut], voix

[Traditions. Asie. Inde. Chhattisgarh. Raipur]

[Archives de la Parole]. , Parable of the prodigal son in Chhattīsgaṛhī Hindī / [Sir George Grierson], éd. ; Linguistic survey of India ; [Mr. Ramanand, B.A., LL.B], voix

[Traditions. Asie. Inde. Madhya Pradesh. Chhattisgarh]

Vad köparena säga om "Ares" båtmotorer

29 x 37 cm

Complementarity of Subjective Global Assessment (SGA) and Nutritional Risk Screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients

Background & aims: We evaluated the ability of Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) to predict malnutrition related to poor clinical outcomes. Methods: We assessed 705 patients at a public university hospital within 48 h of admission. Logistic regression and number needed to screen (NNS) were calculated to test the complementarity between the tools and their ability to predict very long length of hospital stay (VLLOS), complications, and death. Results: Of the patients screened, 27.9% were at nutritional risk (NRS+) and 38.9% were malnourished (SGA B or C). Compared to those patients not at nutritional risk, NRS+, SGA B or C patients were at increased risk for complications (p = 0.03, 0.02, and 0.003, respectively). NRS+ patients had an increased risk of death (p = 0.03), and SGA B and C patients had an increased likelihood of VLLOS (p = 0.008 and p < 0.0001, respectively). Patients who were both NRS+ and SGA C had lower estimates of NNS than patients who were NRS+ or SGA C only, though their confidence intervals did overlap. Conclusions: The concurrent application of SGA in NRS+ patients might enhance the ability to predict poor clinical outcomes in hospitalized patients in Brazil. (C) 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Vad kommunikation vill säga : En iscensättande studie om specialpedagogers yrkesroll och kunskapande samtal

This thesis is about the role of special educators in (pre)school and about developing democratic communication. It is based on the theory of argumentation developed by Jürgen Habermas. The aim of the study was to describe the conditions that create possibilities for deliberative communication between special educators, parents, students and colleagues in (pre)school. My overarching aim was to contribute to a more distinct description of special educators´ field of knowledge. I have used a social constructionist approach. The project has been based in the field of action research. A precondition for deliberative dialogues in (pre)schools is to start out from a communicative perspective. That means that (1) some theoretical conditions have been made apparent, (2) knowledge about these conditions have been shown to be crucial for using an aware communicative perspective in a speech act, (3) an aware communicative perspective is revealed through procedures of knowledge. These procedures were understood by and made evident to me as a result of network meeting discussions. A communicative perspective, a special educator as facilitator and procedures of knowledge are found to be crucial for collaboration using a deliberative attitude in (pre)schools. Today there is often a lack of pedagogical professionals in (pre)schools who can act as a link between authorities, organisations, professionals and parents, and who have the authority to pose challenging pedagogical questions. This can be changed if the role of special educators is, instead of teacher, defined as communicative special educators working with dialogues on different levels.

Avaliação da implantação de um sistema de gestão ambiental (SGA) em empresa do setor metal-mecânico

Com objetivo de contribuir para a defesa do meio ambiente, este trabalho trata do estudo de caso de uma empresa metal-mecânica, situada em Caxias do Sul, que implementou um Sistema de Gestão Ambiental (SGA). Tal sistema visa a melhoria contínua do desempenho ambiental da empresa na prevenção da poluição, em cumprimento à legislação ambiental aplicável à atividade desenvolvida. O SGA é um processo cíclico, pois o sistema é revisto e avaliado periodicamente; desta maneira é possível identificar as oportunidades de melhoria. O trabalho que mostra os passos, os métodos e as estratégias adotadas pela empresa com fim de certificação na norma ISO 14000, evidencia também os benefícios conquistados através da redução do consumo de matérias-primas, energia e água, alcançados através da melhoria da eficiência dos processos.

The SAKK cancer-specific geriatric assessment (C-SGA): a pilot study of a brief tool for clinical decision-making in older cancer patients

BACKGROUND Recommendations from international task forces on geriatric assessment emphasize the need for research including validation of cancer-specific geriatric assessment (C-SGA) tools in oncological settings. The objective of this study was to evaluate the feasibility of the SAKK Cancer-Specific Geriatric Assessment (C-SGA) in clinical practice. METHODS A cross sectional study of cancer patients >=65 years old (N = 51) with pathologically confirmed cancer presenting for initiation of chemotherapy treatment (07/01/2009-03/31/2011) at two oncology departments in Swiss canton hospitals: Kantonsspital Graubunden (KSGR N = 25), Kantonsspital St. Gallen (KSSG N = 26). Data was collected using three instruments, the SAKK C-SGA plus physician and patient evaluation forms. The SAKK C-SGA includes six measures covering five geriatric assessment domains (comorbidity, function, psychosocial, nutrition, cognition) using a mix of medical record abstraction (MRA) and patient interview. Five individual domains and one overall SAKK C-SGA score were calculated and dichotomized as below/above literature-based cut-offs. The SAKK C-SGA was evaluated by: patient and physician estimated time to complete, ease of completing, and difficult or unanswered questions. RESULTS Time to complete the patient questionnaire was considered acceptable by almost all (>=96%) patients and physicians. Patients reported slightly shorter times to complete the questionnaire than physicians (17.33 +/- 7.34 vs. 20.59 +/- 6.53 minutes, p = 0.02). Both groups rated the patient questionnaire as easy/fairly easy to complete (91% vs. 84% respectively, p = 0.14) with few difficult or unanswered questions. The MRA took on average 8.32 +/- 4.72 minutes to complete. Physicians (100%) considered time to complete MRA acceptable, 96% rated it as easy/fairly easy to complete. Individual study site populations differed on health-related characteristics (excellent/good physician-rated general health KSGR 71% vs. KSSG 32%, p = 0.007). The overall mean C-SGA score was 2.4 +/- 1.12. Patients at KSGR had lower C-SGA scores (2.00 +/- 1.19 vs. 2.81 +/- 0.90, p = 0.009) and a smaller proportion (28% vs.65%, p = 0.008) was above the C-SGA cut-off score compared to KSSG. CONCLUSIONS These results suggest the SAKK C-SGA is a feasible practical tool for use in clinical practice. It demonstrated discriminative ability based on objective geriatric assessment measures, but additional investigations on use for clinical decision-making are warranted. The SAKK C-SGA also provides important usable domain information for intervention to optimize outcomes in older cancer patients.

SSA disability : SGA levels appear to affect the work behavior of relatively few beneficiaries, but more data needed : report to the Committee on Finance, U.S. Senate and the Committee on Ways and Means, House of Representatives /

"GAO-02-224."

Efficacy and safety of second-generation antipsychotic long-acting injections (SGA LAIs) in maintenance treatment of bipolar disorder:protocol for a systematic review and meta-analysis

INTRODUCTION: Bipolar disorder requires long-term treatment but non-adherence is a common problem. Antipsychotic long-acting injections (LAIs) have been suggested to improve adherence but none are licensed in the UK for bipolar. However, the use of second-generation antipsychotics (SGA) LAIs in bipolar is not uncommon albeit there is a lack of systematic review in this area. This study aims to systematically review safety and efficacy of SGA LAIs in the maintenance treatment of bipolar disorder. METHODS AND ANALYSIS: The protocol is based on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and will include only randomised controlled trials comparing SGA LAIs in bipolar. PubMed, EMBASE, CINAHL, Cochrane Library (CENTRAL), PsychINFO, LiLACS, http://www.clinicaltrials.gov will be searched, with no language restriction, from 2000 to January 2016 as first SGA LAIs came to the market after 2000. Manufacturers of SGA LAIs will also be contacted. Primary efficacy outcome is relapse rate or delayed time to relapse or reduction in hospitalisation and primary safety outcomes are drop-out rates, all-cause discontinuation and discontinuation due to adverse events. Qualitative reporting of evidence will be based on 21 items listed on standards for reporting qualitative research (SRQR) focusing on study quality (assessed using the Jadad score, allocation concealment and data analysis), risk of bias and effect size. Publication bias will be assessed using funnel plots. If sufficient data are available meta-analysis will be performed with primary effect size as relative risk presented with 95% CI. Sensitivity analysis, conditional on number of studies and sample size, will be carried out on manic versus depressive symptoms and monotherapy versus adjunctive therapy.

Auditoria e identificação de propostas de melhoria no SGA da Funfrap

O compromisso das organizações com as obrigações decretadas ao nível do ambiente, segurança e qualidade emancipa a implementação de Sistemas de Gestão e o processo de auditar. Neste trabalho, decorrente do estágio curricular no âmbito do Mestrado em Engenharia do Ambiente, está evidenciada a importância dos Sistemas de Gestão Ambiental e as razões preponderantes para que sejam auditados. O trabalho pretendeu auditar e avaliar a conformidade do sistema de gestão ambiental, de acordo com a NP EN ISO 14001:2004, de uma indústria de fundição de metais, Funfrap -. Fundição Portuguesa SA, a fim de identificar oportunidades de melhoria no desempenho ambiental da organização. No âmbito do estágio foram ainda realizadas outras atividades, incluindo campanhas de sensibilização, inventário de resíduos sólidos, ferramentas da metodologia World Class Manufacturing, formação sobre a separação de resíduos nos postos de trabalho, acompanhamento de um ensaio na estação de tratamento de águas residuais industriais e apoio para o desenvolvimento do relatório ambiental anual. Da auditoria interna identificaram-se e corrigiram-se nove não conformidades menores e cinco observações. Da auditoria externa foram identificadas apenas duas não conformidades, nenhuma delas relacionadas com as detetadas anteriormente. Além deste resultado foram sugeridas algumas medidas para alcançar um melhor desempenho ambiental da organização.

Neurodevelopment Of Small-for-gestational Age Infants: Behavioral Aspects In First Year.

The purpose of this study was to compare the behavior of full-term small-for-gestational age (SGA) with full-term appropriate-for gestational age (AGA) infants in the first year of life. We prospectively evaluated 68 infants in the 2nd month, 67 in the 6th month and 69 in the 12th month. The Bayley Scales of Infant Development-II were used, with emphasis on the Behavior Rating Scale (BRS). The groups were similar concerning the item interest in test materials and stimuli; there was a trend toward differences in the items negative affect, hypersensitivity to test materials and adaptation to change in test materials. The mean of Raw Score was significantly lower for the SGA group in the items predominant state, liability of state of arousal, positive affect, soothability when upset, energy, exploration of objects and surroundings, orientation toward examiner. A lower BRS score was associated with the SGA group in the 2nd month.