Implementação de um modelo de gestão de cuidados nos Serviços de Saúde Mental Portugueses: base conceptual

ABSTRACT - Case management implementation processes are one of the best examples on how an evidence-based practice can influence health services organisation. This practice helped shaping mental health teams, increasing their multidisciplinarity and interdisciplinary work in the last decades. Examples from several countries show how effectiveness research blends into health policy development to meet different needs in each health system, thus influencing case management inception and improvement of care. Portugal followed its own path in case management implementation, determined mostly by mental health services organisation and closely linked with the capacity to implement a national mental health policy in the last years.RESUMO - Os processos de implementação de um Modelo de Gestão de Cuidados são um dos melhores exemplos de como uma prática baseada na evidência pode influenciar a organização dos serviços de saúde. Esta prática ajudou a moldar as equipas de saúde mental nas últimas décadas, aumentando a sua multidisciplinaridade e o trabalho interdisciplinar. Os exemplos de vários países mostram como a investigação sobre a efectividade se harmoniza com o desenvolvimento de políticas de saúde para fazer face às diferentes necessidades de cada sistema de saúde, influenciando a implementação da gestão de cuidados e a melhoria de cuidados. Portugal seguiu o seu próprio caminho na implementação da gestão de cuidados, determinado maioritariamente pela organização de serviços associada à capacidade de implementar uma política nacional de saúde mental, nos últimos anos.info:eu-repo/semantics/publishedVersio

Serious Games Network

[EN] “Serious games” can be defined as (digital) games used for purposes other than mere entertainment. Serious Games can be applied to a broad spectrum of areas, e.g. educational, healthcare, training in hazardous environments or situations. Game-based Learning, one aspect of Serious Games, are also more and more explored for all levels of education in different subjects, such as Ancient History. The SEGAN (SErious GAmes Network) will create a Community of Practice on the Serious Games subject. The main objective is to create a stable (but expanding) consortium to exchange ideas and experiences related to Serious Games. The SEGAN Network invites the people of the community of Archaeology, Cultural Heritage and Ancient History interested in Serious Games to join the net and to participate in their activities.[ES] Los “juegos serios" se podrían definir como aquellos juegos (digitales) utilizados para fines distintos del mero entretenimiento. El concepto de “juegos serios” se puede aplicar a un amplio espectro de áreas, por ejemplo la educación, la sanidad, la formación en entornos o situaciones peligrosas. Los juegos de aprendizaje también son cada vez más utilizados en todos los niveles de la educación y en prácticamente todos los temas, como por ejemplo la Historia Antigua. La red SEGAN (SErious GAmes Network) va a crear una comunidad de trabajo sobre el tema de los “juegos serios". El objetivo principal es crear un consorcio estable -pero en expansión- para intercambiar ideas y experiencias relacionadas con los Juegos Serios. La Red SEGAN invita a las personas de la comunidad de Arqueología, Patrimonio Cultural y la Historia Antigua interesado en juegos serios a unirse a la red y participar en sus actividades.This paper has been partly funded by the project “Serious Games Project – SEGAN”, no. 519332- LLP-1-2011-1-PT-KA3-KA3NW. Lifelong Learning. Education, Audiovisual and Culture Agency of the European Union. This paper has been funded by the project “Replikants: Towards a New Generation of Human‐like Agents”, TIN2011‐24660, S. G. P. I., Ministerio Ciencia e Innovación (Spain)Vaz De Carvalho, C.; Latorre Andrés, PM.; Serón Arbeloa, FJ. (2013). Serious Games Network. Virtual Archaeology Review. 4(9):174-180. https://doi.org/10.4995/var.2013.4271OJS17418049ANDERSON, Eike Falk et al. (2010): "Developing Serious Games for Cultural Heritage: A State-ofthe- Art Review", Virtual Reality 14(4), Springer, pp. 255-275.FRANSSILA, H. & PEHKONNEN, M. (2005): "Why do ICT-Strategy implementation in schools fail and ICT-Practices do no develop?", in Media Skills and Competence Conference Proceedings. Tampere, Finland, pp. 9-16.HOUTHOFF BURUMA - The Game. http://www.ranj.com/content/werk/houthoff-buruma-thegameHUSSAIN, T.S. & FERGUSON, W. (2005): "Efficient development of large-scale military training environments using a multi-player game", in Proceedings of the 2005 Fall Simulation Interoperability Workshop, pp. 421-431. Orlando, FL, September.IBM Service Management Virtual Simulator http://www-01.ibm.com/software/tivoli/features/smsimulator/The Novicraft HRD game http://www.teamingstream.com/The SEGAN project http://seriousgamesnet.euMOLONEY, J. & AMOR, R.: "StringCVE: Advances in a Game Engine-Based Collaborative Virtual Environment for Architectural Design", in Proceedings of the International Conference on Applications of Virtual Reality, Blacksburg, 2003, September 156-168, pp. 24-26.SUSI, Tarja (2007): "Serious Games - An Overview", Technical Report HS- IKI -TR-07-001. School of Humanities and Informatics. University of Skövde, Sweden.The TIMEMESH Game http://timemesh.eu/WALLIN, E. (2005): "The Rise and Fall of Swedish Educational Technology1960-1980", in Scandinavian Journal of Educational Research, 5, pp. 437-460

PillCam COLON 2© in Crohn's disease: A new concept of pan-enteric mucosal healing assessment

AIM To evaluate mucosal healing in patients with small bowel plus colonic Crohn's disease (CD) with a single non-invasive examination, by using PillCam COLON 2 (PCC2). METHODS Patients with non-stricturing nonpenetrating small bowel plus colonic CD in sustained corticosteroid-free remission were included. At diagnosis, patients had undergone ileocolonoscopy to identify active CD lesions, such as ulcers and erosions, and small bowel capsule endoscopy to assess the Lewis Score (LS). After = 1 year of follow-up, patients underwent entire gastrointestinal tract evaluation with PCC2. The primary endpoint was assessment of CD mucosal healing, defined as no active colonic CD lesions and LS < 135. RESULTS Twelve patients were included (7 male; mean age: 32 years), and mean follow-up was 38 mo. The majority of patients (83.3%) received immunosuppressive therapy. Three patients (25%) achieved mucosal healing in both the small bowel and the colon, while disease activity was limited to either the small bowel or the colon in 5 patients (42%). It was possible to observe the entire gastrointestinal tract in 10 of the 12 patients (83%) who underwent PCC2. CONCLUSION Only three patients in sustained corticosteroid-free clinical remission achieved mucosal healing in both the small bowel and the colon, highlighting the limitations of clinical assessment when stratifying disease activity, and the need for pan-enteric endoscopy to guide therapeutic modification

Water erosion in a Yellow-Red Ultisol under different patterns of simulated rain

Visou-se, neste trabalho, determinar as perdas de solo, água e nutrientes em um Argissolo Vermelho-Amarelo submetido a quatro diferentes padrões de chuva simulada. O estudo foi conduzido no Campo Experimental da Embrapa-Agrobiologia, localizado no município de Seropédica, RJ, e consistiu na aplicação de chuvas simuladas com diferentes padrões caracterizados como avançado (AV), intermediário (IN), atrasado (AT) e constante (CT), em uma área amostral de 0,80 m de largura por 1,0 m de comprimento. As chuvas tiveram duração de 60 min com uma lâmina total aplicada de 30 mm e um pico de 110 mm h-1, para os padrões de intensidade variável. Os resultados obtidos possibilitaram concluir que após 60 min de chuva simulada as perdas de solo e água observadas para o padrão atrasado foram, em média, superiores em 61,6, 46,4 e 13,6%, respectivamente, para o CT, AV e IN (solo), e de 42,0, 19,0 e 19,0%, respectivamente, para o AV, IN e CT (água) e as perdas de nutrientes não diferiram entre os padrões de precipitação, sendo mais influenciadas pelas perdas de água escoada superficialmente que pelo material sólido em suspensão.This study was carried out in order to determine the soil, water and nutrient losses in a Yellow-Red Ultisol, under four different patterns of simulated rainfall. The experiment was conducted at the Embrapa Agrobiologia experimental field, located in the municipality of Seropédica, Rio de Janeiro, Brazil. The study consisted in the application of simulated rains using variable rainfall intensity classified in different patterns as: advanced (AD), intermediate (IN), delayed (DE), and constant (CT), in plots 0.8 m wide and 1.0 m long. The rain had a duration of 60 min, with a total applied depth of 30 mm, and a peak of 110 mm h-1, for the variable intensity patterns. With the results obtained it was possible to verify that after 60 min of simulated DE pattern provided losses higher than CT, AD and IN, in 61.6, 46.4 and 13.6%, respectively (soil), and 42.0, 19.0 and 19.0% (run-off), respectively, for the AD, IN and CT patterns; and the nutrients losses did not differ among the rainfall patterns, being more affected by water run-off than solid material in suspension

Desempenho do cultivo da berinjela em plantio direto submetida a diferentes lâminas de irrigação.

Este estudo foi conduzido no município de Seropédica, RJ, com o objetivo de se determinar, em cultivo orgânico e sistema de plantio direto, a produtividade da cultura da berinjela sob diferentes lâminas de irrigação e sistemas de cultivo (consorciada com leguminosa e solteira). O delineamento experimental adotado foi o de blocos ao acaso, no esquema de parcela subdividida com quatro repetições caracterizando, na parcela, os tratamentos equivalentes à lâmina de irrigação (40; 70; 100 e 120% ETc) e, na subparcela, os sistemas de cultivo consorciado com feijão caupi e solteiro. Ambos os sistemas de cultivo não influenciaram a produtividade final da berinjela; no entanto, considerando as diferentes lâminas, a maior produtividade comercial foi de 65,41 Mg ha-1, obtida para uma lâmina total de 690,04 mm (106,8% ETc). A menor lâmina aplicada resultou em qualidade inferior dos frutos em relação às maiores lâminas, sendo a taxa de descarte dos frutos de 3 e 14%, respectivamente, para a maior e a menor lâmina

Assessment of direct radiological risk and indirect associated toxic risks originated by Coal-Fired Power Plants

Over the past few decades there has been some discussion concerning the increase of the natural background radiation originated by coal-fired power plants, due to the uranium and thorium content present in combustion ashes. The radioactive decay products of uranium and thorium, such as radium, radon, polonium, bismuth and lead, are also released in addition to a significant amount of 40K. Since the measurement of radioactive elements released by the gaseous emissions of coal power plants is not compulsory, there is a gap of information concerning this situation. Consequently, the prediction of dispersion and mobility of these elements in the environment, after their release, is based on limited data and the radiological impact from the exposure to these radioactive elements is unknown. This paper describes the methodology that is being developed to assess the radiological impact due to the raise in the natural background radiation level originated by the release and dispersion of the emitted radionuclides. The current investigation is part of a research project that is undergoing in the vicinity of Sines coal-fired power plant (south of Portugal) until 2013. Data from preliminary stages are already available and possible of interpretation