Intervenções de construção, renovação e manutenção na via-férrea

Tese de mestrado integrado. Engenharia Civil (Especialização em Vias de comunicação). Faculdade de Engenharia. Universidade do Porto. 201

Papel do enfermeiro e envolvimento do cliente no processo de tomada de decisão clínica

This paper is a literature review based on articles in the nursing field about shared clinical decision. The objectives are to examine the role of nurses and patients in the decision-making process in the context of clinical practice. To support these themes, a review of recent literature was conducted with the following results: patients prefer shared decision-making with professionals who should support and provide information to patients in order to overcome the barriers hampering patients' involvement in decision-making. There is a clear need for more research studies that address the problems in the clinical decision-making process so as to contribute to healthcare improvement.El presente trabajo es de revisión de literatura, está basado en artículos de investigación del área de enfermería, abordando el tema: decisión clínica compartida. Los objetivos fueron dirigidos a analizar el papel del enfermero y del paciente en el proceso de la toma de decisiones en contextos de la práctica clínica. Para fundamentar esas temáticas, se hizo una revisión de la literatura reciente, la que reveló los siguientes resultados: los pacientes prefieren compartir la toma de decisiones con los profesionales y los profesionales deben apoyar y dar información a los clientes de forma a diluir las barreras que dificultan su participación en el proceso de decisión. Quedó clara la necesidad de realizar más estudios que presenten evidencias problemáticas en el proceso de decisión en el contexto clínico, con la finalidad de contribuir para la evolución de los cuidados.O presente trabalho é de revisão de literatura, baseada em artigos de investigação da área da enfermagem, abordando o tema: decisão clínica partilhada. Os objetivos estão direcionados para o analisar do papel do enfermeiro e do paciente no processo de tomada de decisão em contextos da prática clínica. Para fundamentar essas temáticas, fez-se revisão de literatura recente que revelou os seguintes resultados: os pacientes preferem partilhar a tomada de decisão com os profissionais e os profissionais devem apoiar e dar informação aos clientes de forma a diluir as barreiras que dificultam o seu envolvimento no processo de decisão. Ficou clara a necessidade de mais estudos que evidenciem problemáticas no processo de decisão em contexto clínico, no sentido de contribuir para a evolução dos cuidados

Factor XI deficiency

We describe a patient with a prolonged aPTT who was diagnosedas having factor XI deficiency after a rather large hematoma wasformed after angiography. Factor XI deficiency affects 1 in 1 millionpeople, but it is more common in Ashkenazim with a gene frequencyof 5% to 11%, being 0.3% homozygotes. These individuals usuallydo not present hemorrhagic events, except in cases of trauma orsurgery. These patients should be identified by routine coagulationscreening; bleeding could be prevented by use of fresh humanplasma or plasma concentrates

Effects of Physical Exercise Program in Adults with Intellectual and Developmental Disabilities—A Study Protocol

We developed a physical exercise (PE) program for people with Intellectual and Developmental Disabilities (IDD), aiming to determine the effects on physical fitness, health, cognitive ability, and quality of life (QoL). Using experimental methodology, this intervention study recruited 21 adults (18 to 65 years old), institutionalized and with no other associated pathology, who will be allocated to one of the different groups: (i) gym/indoor intervention group (using weight machines), (ii) outdoor intervention group (using low-cost materials), or (iii) control group (without specific intervention, who continue with their normal daily activities). Both intervention groups will engage in 45 min of training per session, twice a week, for 24 weeks. Assessments will be conducted at baseline (initial assessment), 3 months (mid-term assessment), and 6 months (final assessment). Variables assessed include anthropometrics, body composition, functional capacity, muscle strength, general health, cognitive ability, and QoL. The results of this study will assist in the development of more effective strategies, recommendations, and interventions to ensure better and greater adherence to PE by institutionalized individuals with IDD, namely, recommendations for assessment, prescription, and implementation of PE for this population. Additionally, we intend to make available two PE programs, if they are adapted and promote positive effects.info:eu-repo/semantics/publishedVersio

Grupo de Pesquisa Formação de Professores, políticas públicas e espaço escolar: compromisso com uma escola pública de qualidade

Our objective in this article is to present the Research Group "Teacher Training, Public Policies and School Space", linked to the Postgraduate Program in Education (Master and Doctorate) of the Faculty of Sciences and Technology of the Paulista State University "Júlio de Mesquita Filho" Campus Presidente Prudente (SP). This Group, during almost two decades of existence in the educational context of the west of São Paulo State, has based his work on the commitment to a quality public school and for everyone, both in teaching and in research and extension.. The text is structured in 9 sections that cover the presentation and history of the GPFOPE, the conceptual framework in which his members research be fited , as well as the prevailing thematic and methodologies are inscribed. It explains the dynamics of work, the relations with other research groups and the academic and technical production of its members. In the final considerations, it brings the aspects considered as outstanding in its trajectory and future perspectives of action.Nosso objetivo neste artigo é apresentar o Grupo de Pesquisa “Formação de Professores, Políticas Públicas e Espaço Escolar”, ligado ao Programa de Pós-Graduação em Educação (Mestrado e Doutorado) da Faculdade de Ciências e Tecnologia da Universidade Estadual Paulista “Júlio de Mesquita Filho”, Campus Presidente Prudente (SP). Este Grupo, ao longo destas duas décadas de existência no contexto educacional do oeste paulista, tem pautado sua atuação no compromisso com uma escola pública de qualidade para todos, tanto na docência quanto na pesquisa e extensão. O texto está estruturado em nove secções que abrangem a apresentação e histórico do GPFOPE, a perspectiva conceitual no qual se inscrevem as pesquisas de seus integrantes, bem como as temáticas e metodologias predominantes. Explicita a dinâmica de trabalho, as relações com outros grupos de pesquisa e a produção acadêmica e técnica de seus integrantes. Nas considerações finais traz os aspectos considerados como marcantes na sua trajetória e as perspectivas futuras de atuação

Longitudinal study of patients with chronic Chagas cardiomyopathy in Brazil (SaMi-Trop project): a cohort profile.

PurposeWe have established a prospective cohort of 1959 patients with chronic Chagas cardiomyopathy to evaluate if a clinical prediction rule based on ECG, brain natriuretic peptide (BNP) levels, and other biomarkers can be useful in clinical practice. This paper outlines the study and baseline characteristics of the participants.ParticipantsThe study is being conducted in 21 municipalities of the northern part of Minas Gerais State in Brazil, and includes a follow-up of 2 years. The baseline evaluation included collection of sociodemographic information, social determinants of health, health-related behaviours, comorbidities, medicines in use, history of previous treatment for Chagas disease, functional class, quality of life, blood sample collection, and ECG. Patients were mostly female, aged 50-74 years, with low family income and educational level, with known Chagas disease for >10 years; 46% presented with functional class >II. Previous use of benznidazole was reported by 25.2% and permanent use of pacemaker by 6.2%. Almost half of the patients presented with high blood cholesterol and hypertension, and one-third of them had diabetes mellitus. N-terminal of the prohormone BNP (NT-ProBNP) level was >300 pg/mL in 30% of the sample.Findings to dateClinical and laboratory markers predictive of severe and progressive Chagas disease were identified as high NT-ProBNP levels, as well as symptoms of advanced heart failure. These results confirm the important residual morbidity of Chagas disease in the remote areas, thus supporting political decisions that should prioritise in addition to epidemiological surveillance the medical treatment of chronic Chagas cardiomyopathy in the coming years. The São Paulo-Minas Gerais Tropical Medicine Research Center (SaMi-Trop) represents a major challenge for focused research in neglected diseases, with knowledge that can be applied in primary healthcare.Future plansWe will continue following this patients' cohort to provide relevant information about the development and progression of Chagas disease in remotes areas, with social and economic inequalities.Trial registration numberNCT02646943; Pre-results

Implementation of energy value stream mapping (EVSM) as an alternative tool for the management and reduction of energy in processes in the industrial sector: a literature review

The increase in the price of energy due to the scarcity of energy resources has imposed enormous pressure on the industries to reduce the consumption of these resources and is forcing them to invest in techniques that contribute to the improvement of their energy efficiency. The application of methods such as Energy Value Stream Mapping (EVSM) has been promising in reducing energy consumption and is being one of the methods widely used by industry professionals to eliminate inefficiencies in processes. Based on this information, the objective of this work is to present an analysis of the literature on EVSM addressing the modes of implementation, advantages and disadvantages, the applied industrial context and the complementary methods. By means of the results it was verified that its use allows the reduction of energy consumption, but is limited to a static representation and allows the analysis of only one product. In addition, the implementation of EVSM is performed through procedures, methodologies and simulation tools, and the most used method is the Sankey diagram and the electronics sector was the one in which EVSM is most implemented. Finally, suggestions are made for methods to complement its use and to assist future research in this area