Reverse remodeling: Much room for research

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Literacia musical e literacia científica: uma díade na promoção de aprendizagem no 1º CEB

Mestrado em Educação Préescolar e Ensino do 1.º Ciclo do Ensino BásicoO presente relatório final de estágio descreve o trajeto de um projeto de intervenção-investigação, no âmbito das unidades curriculares Prática Pedagógica Supervisionada e Seminário de Investigação Educacional, que consistiu no planeamento, conceção, implementação e avaliação de uma sequência didática, que teve como principal propósito articular a Educação e Expressão Musical e a Educação em Ciências, como uma díade promotora de aprendizagens no 1.º Ciclo do Ensino Básico. Esta sequência teve o intuito de elucidar para a importância da Educação e Expressão Musical, bem como da Educação em Ciências como partes integrantes da cultura do Ser Humano. Assenta ainda na importância da Educação para o Desenvolvimento Sustentável, na medida em que a temática explorada possibilita a compreensão de todas as culturas do mundo, devendo ser cada uma respeitada e entendida à luz do seu contexto. A sequência didática desenvolvida foi suportada por orientações teóricas como a Educação para o Desenvolvimento Sustentável, a Literacia científica, a importância da Educação em Ciências desde os primeiros anos, a orientação CTS e a perspetiva de ensino por pesquisa. A sequência didática incluiu estratégias e atividades diversificadas que foram implementadas ao longo de várias sessões. O projeto de intervenção-investigação teve como principais objetivos averiguar o impacte da sequência didática nas aprendizagens das crianças ao nível dos conhecimentos, capacidades e atitudes e valores, bem como no desenvolvimento profissional da professora-investigadora que a desenvolveu. Este projeto assumiu caraterísticas de uma metodologia de investigação-ação. Sendo assim, como técnicas de recolha de dados adotou-se o inquérito por questionário, a observação participante e compilação documental. Para a análise dos dados, recorreu-se à análise de conteúdo, através de um sistema categorial misto e com auxílio do software WebQDA. Através dos resultados obtidos na análise dos dados recolhidos, pôde-se concluir que a implementação da sequência didática teve efeitos positivos nas crianças, bem como no desenvolvimento profissional da professora-investigadora. Em relação às crianças, estas desenvolveram aprendizagens ao nível conhecimentos, capacidades e atitudes e valores, relacionadas com a díade música e ciência. No que diz respeito à professora-investigadora, esta demonstrou ter desenvolvido competências, enquanto profissional de educação e investigação.This final stage report describes the path of an action-research project in the context of curricular units “Supervised Pedagogical Practice” and Educational Research Seminar, which consisted in the planning, design, implementation and evaluation of a didactic sequence, which had as its main purpose to articulate Education and Musical Expression and Science Education, as a promoter of learning dyad in the primary education. This sequence aimed to elucidate the importance of Education and Musical Expression, and the Science Education as an integral part of the Human culture. It is based on the importance of education for sustainability, because the explored theme enables the understanding of all cultures of the world that should be respected and understood in the light of its context. The developed didactic sequence was supported by theoretical orientations such as education for sustainable development, scientific literacy, the importance of science education from the early years, the didactic guidance CTS and educational perspective for research. The didactic sequence includes diverse strategies and activities that have been implemented over several sessions. The action- research project had as main objective to ascertain/ find out the impact of the didactic sequence in the learning of children at the level of knowledge, skills and attitudes and values as well as in the professional development of the teacher-researcher who developed it. This project took on characteristics of a research-action methodology. Thus, as data collection techniques, it was adopted the questionnaire survey, participant observation and document compilation. For data analysis, it was used the analysis of content through a mixed categorical system and with the help of WebQDA software. With the results obtained in the analysis of the collected data, it might be concluded that the implementation of the teaching sequence had a significant impact on the level of children's learning as well as had an impact on the professional development teacher-researcher. In relation to children, they developed learning at the level of knowledges, skills and attitudes and values related with the dyad music and science. In what concerns to the teacher-researcher, she shown to have developed skills, while professional education and research

Putting Portuguese and European data into perspective

Publisher Copyright: © 2016 Sociedade Portuguesa de Cardiologia.Introduction and Objectives Acute heart failure (AHF) is a heterogeneous clinical syndrome requiring urgent therapy. The prognosis is poor after the index hospitalization, with a high risk for rehospitalization and early death. The costs of managing AHF are thus increasing rapidly. A literature review was performed to gather and compare data on prevalence and treatment and to identify gaps in AHF management, based on European and Portuguese studies. Methods A literature search from 1995 to 2014 was conducted in selected databases (BIOSIS Previews, EMBASE and Ovid MEDLINE). Results and Discussion Seven Portuguese and nine European studies were analyzed. The mean age of AHF patients was ≥65 years and 30-50% were women. Coronary artery disease (42.3% vs. 61.9%) and hypertension (53.3% vs. 76.7%) were identified as primary etiologies in Europe and in Portugal. Similar proportions of heart failure with preserved ejection fraction were found in the Portuguese (19.9-44.7%) and European (32.8-39.1%) studies. Overall, all-cause mortality rates were comparable (six months: 9.3-25.5% vs. 13.5-27.4%; one year: 15.9-31% vs. 17.4-46.5%), as was in-hospital mortality (5.5-14% vs. 3.8-12%) in Portuguese and European studies, respectively. Length of stay was comparable. The studies were performed in very different hospital settings and data on treatment were scarce. Conclusions Gaps were identified in treatment and clinical pathways of patients with AHF. Based on the results of this review, collection and investigation of data on the disease and treatment solutions, training in disease management, and improved organization of healthcare should be the subject of further investment.publishersversionpublishe

Sacubitril/valsartan : um guia prático

© 2019 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. Todos os direitos reservados.Renin-angiotensin-aldosterone system (RAAS) inhibitors are a cornerstone in the treatment of heart failure with reduced ejection fraction (HFrEF). Sacubitril/valsartan modulates the neurohormonal axis by inhibiting both angiotensin receptors and neprilysin, and improves neurohormonal balance more than blocking the RAAS alone. The PARADIGM-HF trial validated this new treatment option for patients with HFrEF. Sacubitril/valsartan was also more effective than enalapril in slowing disease progression by decreasing the risk of worsening heart failure requiring hospitalization or emergency admission and the need for intensified therapy, heart failure devices or cardiac transplantation. More than 70% of patients included in PARADIGM-HF were in NYHA class II, and overall, the results indicate that sacubitril/valsartan should be started in the earliest symptomatic stages of the disease. As PARADIGM-HF has excellent robustness for a cardiovascular trial, sacubitril/valsartan has been included as a new treatment option with a strong level of recommendation in the main international guidelines. This expert task force proposes a practical guide to the use of this new drug that has been endorsed by the Working Group on Heart Failure of the Portuguese Society of Cardiology.Os inibidores do sistema renina-angiotensina-aldosterona são uma das pedras basilares no tratamento da insuficiência cardíaca com fracção de ejecção reduzida. O sacubitril/valsartan promove a modulação neuro-hormonal, bloqueando os recetores da angiotensina e inibindo a neprilisina, e produz um maior equilíbrio neuro-hormonal, mais do que o bloqueio do sistema renina-angiotensina-aldosterona isoladamente. O estudo PARADIGM-HF validou essa nova opção para o tratamento de doentes com insuficiência cardíaca e fração de ejecção reduzida, em alternativa ao IECA/ARA. O sacubitril/valsartan demonstrou ser mais eficaz do que o enalapril em retardar a progressão da doenca, diminuindo o risco de agravamento da insuficiência cardíaca através da diminuição da necessidade de hospitalizacão e da menor necessidade de intensificação terapêutica, dispositivos ou transplante cardíaco. Mais de 70% dos doentes incluídos no estudo PARADIGM-HF estavam em classe II da NYHA, suportando a utilização do Sacubitril/Valsartan precocemente após o início dos sintomas. Como o estudo PARADIGM-HF apresentou uma robustez sem precedentes para um estudo cardiovascular, o Sacubitril/Valsartan foi incluído como uma nova opção de tratamento nas Recomendações internacionais mais relevantes, com um elevado nível de evidência (I-B). Este grupo de peritos em Insuficiência Cardíaca vem propor uma orientação prática para a utilização deste novo fármaco, subscrita pelo Grupo de Estudos de Insuficiência Cardíaca da Sociedade Portuguesa de Cardiologia.info:eu-repo/semantics/publishedVersio

Special Issue on Stingless bees: Integrating basic biology and conservation

It is easy to see why stingless bees (Meliponini) were chosen for this special issue, entitled Stingless bees: Integrating basic biology and conservation. Interest in these bees is increasing each day, with their role as ecosystemservices providers in the pollination of wild and cultivated plants, and their fascinating biology and social behavior. Yet, despite having been kept by the Native Americans for hundreds of years for their honey, they remain much understudied compared to their better known relatives, the bumblebees and honeybees. This is in part due to their massive biodiversity, with known species now numbering over 500 – all with a tropical distribution. The diversity and rich social behavior of the stingless bees has often been compared to the knowledge of the other group of eusocial bees, including the bumblebees (Bombini) and honeybees (Apini). Yet, the development of new scientific techniques and research methods, and progress in deciphering their phylogeny, now allows for an updated interpretation of the evolution, biology and conservation of Meliponini bees

A practical guide revisited

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Sacubitril/valsartan: A practical guide

Funding : Financial support for medical editorial assistance was provided by Novartis Farma --- Produtos Farmacêuticos S.A. The authors had full control of the content and made the final decision on all aspects of this article.© 2019 Sociedade Portuguesa de Cardiologia Renin-angiotensin-aldosterone system (RAAS) inhibitors are a cornerstone in the treatment of heart failure with reduced ejection fraction (HFrEF). Sacubitril/valsartan modulates the neurohormonal axis by inhibiting both angiotensin receptors and neprilysin, and improves neurohormonal balance more than blocking the RAAS alone. The PARADIGM-HF trial validated this new treatment option for patients with HFrEF. Sacubitril/valsartan was also more effective than enalapril in slowing disease progression by decreasing the risk of worsening heart failure requiring hospitalization or emergency admission and the need for intensified therapy, heart failure devices or cardiac transplantation. More than 70% of patients included in PARADIGM-HF were in NYHA class II, and overall, the results indicate that sacubitril/valsartan should be started in the earliest symptomatic stages of the disease. As PARADIGM-HF has excellent robustness for a cardiovascular trial, sacubitril/valsartan has been included as a new treatment option with a strong level of recommendation in the main international guidelines. This expert task force proposes a practical guide to the use of this new drug that has been endorsed by the Working Group on Heart Failure of the Portuguese Society of Cardiology.publishersversionpublishe

o estado da arte depois do estudo SERVE‐HF

Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.Heart failure (HF) is one of the most prevalent conditions worldwide and despite therapeutic advances, its prognosis remains poor. Among the multiple comorbidities in HF, sleep-disordered breathing (SDB) is frequent and worsens the prognosis. Preliminary observational studies suggested that treatment of SDB could modify the prognosis of HF, and the issue has gained importance in recent years. The diagnosis of SDB is expensive, slow and suboptimal, and there is thus a need for screening devices that are easier to use and validated in this population. The first-line treatment involves optimization of medical therapy for heart failure. Continuous positive airway pressure (CPAP) is used in patients who mainly suffer from obstructive sleep apnea. In patients with predominantly central sleep apnea, CPAP is not sufficient and adaptive servo-ventilation (ASV), despite promising results in observational studies, showed no benefit in patients with symptomatic HF and reduced ejection fraction in the SERVE-HF randomized trial; on the contrary, there was unexpectedly increased mortality in the ASV group compared to controls, and so ASV is contraindicated in these patients, calling into question the definition and pathogenesis of SDB and risk stratification in these patients. There are many gaps in the evidence, and so further research is needed to better understand this issue: definitions, simple screening methods, and whether and how to treat SDB in patients with HF.publishersversionpublishe

estimativas para o século XXI em Portugal

Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.INTRODUCTION AND OBJECTIVE: Heart failure is a major public health problem that affects a large number of individuals and is associated with high mortality and morbidity. This study aims to estimate the probable scenario for HF prevalence and its consequences in the short-, medium- and long-term in Portugal. METHODS: This assessment is based on the EPICA (Epidemiology of Heart Failure and Learning) project, which was designed to estimate the prevalence of chronic heart failure in mainland Portugal in 1998. Estimates of heart failure prevalence were performed for individuals aged over 25 years, distributed by age group and gender, based on data from the 2011 Census by Statistics Portugal. RESULTS: The expected demographic changes, particularly the marked aging of the population, mean that a large number of Portuguese will likely be affected by this syndrome. Assuming that current clinical practices are maintained, the prevalence of heart failure in mainland Portugal will increase by 30% by 2035 and by 33% by 2060, compared to 2011, resulting in 479 921 and 494 191 affected individuals, respectively. CONCLUSIONS: In addition to the large number of heart failure patients expected, it is estimated that the hospitalizations and mortality associated with this syndrome will significantly increase its economic impact. Therefore, it is extremely important to raise awareness of this syndrome, as this will favor diagnosis and early referral of patients, facilitating better management of heart failure and helping to decrease the burden it imposes on Portugal.publishersversionpublishe