Do número natural ao número racional : um projeto de colaboração com uma professora do 3º ano de escolaridade

Tese de mestrado, Educação (Didáctica da Matemática), Universidade de Lisboa, Instituto de Educação, 2012Este estudo tem como objetivo compreender o trabalho de uma professora do 3.º ano de escolaridade orientado para a construção, pelos alunos, do conceito de número racional, representado na forma de fração, numa perspetiva de desenvolvimento de sentido de número. Concretamente pretende-se descrever e analisar as suas práticas, na preparação e concretização de uma trajetória de aprendizagem dos números racionais, perspetivando os desafios e dificuldades com que se vai confrontando. O quadro teórico problematiza o ensino dos números racionais através de problemas, evidenciando perspetivas, contornos e desafios do ensino em geral, e do ensino do número racional, em particular. Do ponto de vista metodológico, o estudo inscreve-se numa abordagem qualitativa de investigação e, em particular, situa-se na interface entre o paradigma interpretativo e o colaborativo. Neste âmbito, foi realizado um estudo de caso sobre as práticas de uma professora do 3.º ano relativas à preparação e concretização de uma trajetória de aprendizagem dos números racionais, negociada no decurso do desenvolvimento de um projeto de colaboração. A recolha de dados foi realizada através de (i) duas entrevistas semiestruturadas à professora, (ii) da observação de aulas registadas em áudio e vídeo, (iii) da recolha documental e (iv) da conversação informal. As conclusões evidenciam a necessidade de uma abordagem holística na construção do conceito de número racional, a partir da compreensão da fração, uma noção complexa e multifacetada. Essa abordagem requer proporcionar aos alunos uma experiência diversificada, apoiada em tarefas criteriosamente selecionadas e encadeadas que possam fazer emergir as grandes ideias matemáticas relacionadas com o conceito de número racional, e um trabalho em torno das estratégias usadas pelos alunos, apoiado em modelos para suportar o seu pensamento. A escolha de tarefas matematicamente poderosas, uma compreensão profunda da estrutura matemática subjacente a estas tarefas e a orquestração das discussões na aula de modo a fazer emergir e instituir como objeto de reflexão essas grandes ideias, revelaram-se aspetos importantes das práticas da professora.This study aims to understand a third grade teacher’s work oriented towards the construction, by the students, of the concept of rational number, represented as a fraction, in a perspective of number sense development. Specifically it intends to describe and analyze the teacher’s practices concerning the preparation and implementation of a learning trajectory of rational numbers as well as the challenges and difficulties faced by her. The theoretical framework is focused on teaching rational numbers through problem solving, illustrating perspectives and challenges related to teaching, in general, and to teaching rational numbers, in particular. From a methodological point of view, the study is based on a qualitative research approach and, in particular, lies at the interface between the interpretive and the collaborative paradigms. In this context, a case study on a third grade teacher’s practices was carried out, that is related to the preparation and achievement of a learning trajectory of rational numbers, which was negotiated during the development of a collaboration project. The data was collected through (i) two semi-structured interviews with the teacher, (ii) classroom observation in which audio and video records were made, (iii) documentary collection and (iv) informal conversation. The findings show the need of an holistic approach in the construction of the rational number concept, starting by the understanding of fraction as a complex and wide-ranging concept. This approach requires to provide students with a diversified experience, supported by carefully selected and sequenced tasks that can bring out the big mathematical ideas related to the concept of rational number, and a work based on the strategies used by students, supported by models to foster their thinking. The choice of powerful mathematical tasks, a deep understanding of the mathematical structure underlying these tasks and the orchestration of collective discussions, in order to bring out and to establish as an object of reflection these big ideas, turned out to be significant aspects of the teacher’s practices

Colistin heteroresistance in Klebsiella pneumonia and its association with slow-growing subpopulations within biofilms

The emergence of multidrug-resistant strains of Klebsiella pneumoniae is a growing clinical concern that is leading to the re-introduction of the old and toxic colistin as a salvage therapy. However, several cases of heteroresistance to this antimicrobial have been recently reported in planktonic studies. Therefore, the understanding of the conditions that trigger heteroresistance is attracting considerable research interest. In this scope, this work aimed to more comprehensively study the response of K. pneumoniae biofilms to colistin and to inspect the occurrence of heteroresistance in biofilm-cells.K. pneumoniae presented susceptibility to colistin in its planktonic form, though biofilms presented an enhanced resistance. The population analysis profiles pointed out the existence of a slow-growing sub-population resistant to colistin within a K. pneumoniae strain that seemed to be exclusively associated with biofilms. This resistant sub-population is characterized by a small colony morphology (diameter around 5 mm), which remains unchangeable, and a completely different response to colistin compared to the observed in the wild-type morphotype. Colistin was ineffective in this small colony variant since it was never achieved any reduction in biofilm-cells viability. These findings suggest that heteroresistance is linked to biofilm formation and to a morphological distinct sub-population. Moreover, this is the first evidence that biofilm formation can trigger the emergence of heteroresistance from an apparently susceptible strain

Toque terapêutico no cuidado da enfermagem: uma análise conceitual

Objective: To analyze the concept of therapeutic touch in nursing care, specifying its attributes, antecedents, and consequents. Methods: This is a conceptual analysis of the evolutive view of Rodgers (2000), about the concept of therapeutic touch in nursing care, together with an integrative literature review based on the research question: What is the concept of therapeutic touch in nursing care? What are the attributes, antecedents, and consequents of therapeutic touch in nursing care? The search was conducted in the electronic databases CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, in the b-on Online Knowledge Library, by combining the descriptors DeCS/MESH “therapeutic touch”, “nursing” e “nursing care” and the Boolean operator AND over the period from 2000 to 2020. Results: The sample was composed of eight studies that identified three thematic pillars: (i) attributes: complementary and effective method, technique, tool, nursing intervention, use of hands, intention to help or heal, complementary treatment, intentional touch, and energy transfer; (ii) antecedents: pain, anxiety, fatigue, dementia, Alzheimer’s disease, tension headache, fibromyalgia syndrome, and cardiovascular problems; (iii) consequents: promotes a calming effect; increases empathy, satisfaction, interaction, respect, sense of worth and life; promotes well-being, comfort, tranquility and peace, hope, security, motivation, mood and sleep quality; reduces stress and disruptive behaviors; promotes better functional status and quality of life. Conclusion: Therapeutic touch is implicit in the professional practice of nurses, requiring concrete and unique adjustment to the real circumstances and needs of the person, towards a practice that promotes comfort.Objetivo: Analisar o conceito de toque terapêutico no cuidado de enfermagem, especificando seus atributos, antecedentes e consequentes. Métodos: Trata-se de uma análise conceitual na visão evolutiva de Rodgers (2000), sobre o conceito de toque terapêutico na assistência de enfermagem, juntamente com a revisão integrativa da bibliografia baseada na questão da pesquisa: Qual é o conceito de toque terapêutico no cuidado de enfermagem? Quais são os atributos, antecedentes e consequentes do toque terapêutico no cuidado com a enfermagem? A pesquisa foi realizada nas bases de dados eletrônicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, na Biblioteca do Conhecimento Online b-on, através da conjugação dos descritores DeCS/MESH “therapeutic touch”, “nursing” e “nursing care” e do operador booleano AND no período temporal de 2000 a 2020. Resultados: A amostra foi formada por oito estudos que identificaram três pilares temáticos: (i) atributos: método complementar e eficaz, técnica, ferramenta, intervenção de enfermagem, uso de mãos, intenção de ajudar ou curar, tratamento complementar, toque intencional e transferência de energia; (ii) antecedentes: dor, ansiedade, fadiga, demência, doença de Alzheimer, cefaleia de tensão, síndrome de fibromialgia e problemas cardiovasculares; (iii) consequentes: promove um efeito calmante; aumenta a empatia, satisfação, interação, respeito, senso de valor e vida; promove bem-estar, conforto, tranquilidade e paz, esperança, segurança, motivação, humor e qualidade do sono; reduz o estresse e comportamentos perturbadores; promove melhor estado funcional e qualidade de vida. Conclusão: O toque terapêutico está implícito na prática profissional dos enfermeiros, exigindo um ajuste concreto e singular às circunstâncias e necessidades reais da pessoa, em favor de uma prática que promova o conforto.info:eu-repo/semantics/publishedVersio

Estudio de caso de un adolescente según el Modelo Teórico de Ajuste al Cáncer Parental

Objective: To describe and analyze the experience of an adolescent experiencing parental cancer, based on A Model of Children’s Adjustment to Parental Cancer, and to prescribe nursing interventions in classified language. Method: This is a single case study, qualitative, of a 16-year-old adolescent experiencing maternal cancer. We analyzed a semi-structured interview, based on a script conceptualized by the selected theoretical model. Data processing took place through content analysis. Authorization was obtained from the Research Ethics Committee TI 25/2020. Results: The analysis of the adolescent’s interview allowed identifying categories in agreement with the model variables. Psychosocial adjustment dimensions and stress response symptoms, such as academic performance and somatic symptoms, were recognized in the adolescent’s adjustment process. Nursing interventions will focus on education and support. Conclusion: The theoretical model contributed to assess the needs of adolescents experiencing parental cancer, allowing nursing interventions to be prescribed in classified language that consider moderating and mediating variables, promoting adjustment. The model proved to be suitable for future interventions for adolescents experiencing similar situations.info:eu-repo/semantics/publishedVersio

Observación participante de la consulta de enfermería para la salud infantil

Diagnóstico de situação utilizando metodologia científica de natureza exploratória e descritiva (observação participada com tratamento estatístico descritivo) com objectivo de identificar as práticas de enfermagem na área da promoção de saúde durante uma consulta de enfermagem de saúde infantil. Das 31 consultas observadas (n=31) a maioria das observações ocorreu em crianças com idade inferior a 2 anos sendo os temas mais abordados a alimentação com utilização predominante de metodologia expositiva. Verificou-se ainda pouca utilização de suporte informacional e quando são utilizados reportam-se aos temas segurança e alimentação. A maioria dos prestadores de cuidados colocou questões e houve um reduzido registo da interacção prestador/criança existindo um dispêndio médio de 23 minutos por consulta. Face aos resultados e reflexão sobre os mesmos destaca-se como intervenção a elaboração de um manual de promoção de saúde com integração de aspectos teóricos e evidência científica de boas práticas nesta área.Diagnóstico de situación con una metodología científica de carácter exploratorio y descriptivo (observación participante con tratamiento estadístico descriptivo) con el fin de identificar las prácticas de enfermería en el ámbito de la promoción de la salud durante la consulta de enfermería para la salud infantil. De las 31 consultas observadas (n = 31) se mostró que la mayoría de las observaciones se produjeron en niños menores de 2 años siendo que el tema más discutido és alimentación con el uso predominante de la metodología expositiva. Se verificó poca utilización de apoyo informativo y cuando se utilizan se refieren a temas de seguridad y nutrición. La mayoría de los proveedores ha hecho preguntas y se verifico reducido registro de la interacción proveedores/niños con un expendio promedio de 23 minutos por consulta. Teniendo en cuenta los resultados y reflectando en ellos se destaca como intervención la elaboración de un manual para la promoción de la salud con la integración de la teoría y la evidencia de las buenas prácticas en este ámbito.Situation diagnosis using exploratory and descriptive scientific methodology (participant observation with descriptive statistical treatment) in order to identify nursing' practices in the area of health promotion during a nursing child health consultation. The 31 consultations observed (n = 31) showed that the majority of observations occurred in children younger than 2 years being the most discussed topic feed with predominant use of expository methodology. There was also little use of informational support and when used relate to the themes of security and nutrition. Most providers raised questions and there was limited registration of the interaction between provider and child with an expenditure averaging of 23 minutes per consultation. Given the results and reflecting about them stands out as intervention the construction of a health promotion manual with the integration of theory and evidence of good practice in this area

Estudios realizados en Portugal en el campo de cateterización venosa periférica: protocolo de scoping review

Background: Despite its ubiquitous nature, the practice of peripheral venous catheterization is not homogeneous among international clinical contexts. In Portugal, the information regarding the practice of peripheral venous catheterization is scattered in the literature, hindering efforts of a comprehensive analysis of its nature and implications. Objective: To map the studies developed in Portugal in the field of peripheral venous catheterization. Review method: Scoping review methodology proposed by the Joanna Briggs Institute. An adequate protocol was established for each base/repository to identify studies that meet the criteria outlined. The analysis of data relevance, extraction, and synthesis will be performed by independent reviewers. Presentation and interpretation of results: The mapping of the studies carried out in Portugal in this area will contribute to the identification of the main structure, process, and outcome indicators described in national studies. Conclusion: It is expected that this review will support the development of future interventions and systematic reviews that enhance the efficacy/safety of the care provided to patients with a peripheral catheter.Contexto: Apesar da sua natureza ubíqua, a prática de cateterização venosa periférica não é homogénea entre contextos clínicos internacionais. Em Portugal, a informação referente à prática de cateterismo venoso periférico encontra-se dispersa na literatura, impossibilitando uma análise suficientemente compreensiva e abrangente da sua natureza e implicações. Objetivos: Mapear os estudos realizados em Portugal no âmbito do cateterismo venoso periférico. Método de revisão: Metodologia de scoping review proposta pelo Joanna Briggs Institute. Foi definido um protocolo adequado a cada base/repositório, que visa a identificação de estudos que respondam aos critérios delineados. O processo de análise da relevância, extração e síntese dos dados será desenvolvido por revisores independentes. Apresentação e interpretação dos resultados: O mapeamento dos estudos realizados em Portugal neste âmbito contribuirá para a identificação dos principais indicadores de estrutura, processo e resultado descritos em estudos nacionais. Conclusão: Espera-se que esta revisão sustente o desenvolvimento de intervenções e revisões sistemáticas futuras que potenciem a eficácia/segurança dos cuidados prestados ao doente com cateter periférico.Contexto: Apesar de su naturaleza ubicua, la práctica del cateterismo venoso periférico no es homogénea en contextos clínicos internacionales. En Portugal, la información sobre la práctica del cateterismo venoso periférico está dispersa en la literatura, haciéndolo imposible un análisis lo suficientemente completo de su naturaleza e implicaciones. Objetivos: Mapear los estudios realizados en Portugal en el ámbito del cateterismo venoso periférico. Método de revisión: Metodología de scoping review propuesta por Joanna Briggs Institute. Se definió un protocolo adecuado a cada base/repositorio para identificar estudios que respondan a los criterios delineados. El proceso de análisis da relevancia, extracción y síntesis de los datos será desarrollado por revisores independientes. Presentación e interpretación de los resultados: El mapeo de los estudios realizados en Portugal en esta área contribuirá a la identificación de los principales indicadores de estructura, proceso y resultado descritos en estudios nacionales. Conclusión: Se espera que esta revisión contribuya al desarrollo de futuras intervenciones y revisiones sistemáticas que mejoren la eficacia/seguridad de la atención del paciente con catéter periférico.info:eu-repo/semantics/publishedVersio

The Palace of Knossos Case Study and Material Characterization

The funding from the European Union Horizon 2020 research and innovation programme H2020-DRS-2015 GA nr. 700395 (HERACLES project).The study and characterization of mortars is generally related to the knowledge of the properties of the material, which guarantee or improve its performance and durability. When we consider the study of historical mortars, the main objective is to understand the characteristics of the material and how it has reached the present day, considering that, often, the time of its preparation and application is separated from the present by a long period of time, perhaps centuries, and is thus difficult to specify. This type of study may give indications on historical issues relevant to the understanding of a particular site or monument and, in addition, can assist in actions related to its preservation. Mortars can be used with different functions, ranging from structural function, protection, or finish, which requires distinct properties that are suitable for this functionality. It is necessary to consider that the desired characteristics, after drying the mortar, will depend on a set of factors, including the selection and quality of the raw material, the proportion between the main components, the way they are prepared and applied, and the environmental conditions they will be subjected to over time. Furthermore, the larger the monument is, the greater the chances of changes, reconstructions or interventions, including materials prepared in different periods with different raw materials and techniques. This is precisely the case of the Palace of Knossos, located near the Heraklion in Crete. It is estimated that the first palace was built in 2000 B.C.; however, it was destroyed and rebuilt more majestically in 1700 B.C. The definitive abandonment of the palace would have occurred around 1450 B.C., but the site where it was built maintained its importance for many centuries. Excavated at the beginning of the 20th century, the Palace of Knossos is one of the most important archaeological sites in Europe, both for its size and the complexity of its plant, with architectural solutions worthy of a well-developed civilization, as well as for the many reclaimed materials and frescos found. In addition to all of the material wealth found in its excavation, the palace has undergone peculiar historical conservation including the reconstruction of many of its structures, even as late as the early 20th century, all considered of great importance for the history of the monument. For this study, samples of mortars were collected at different points of the Palace of Knossos, both from areas of archaeological remains as well as from reconstructed areas. For the characterization, we opted for a multi-analyses approach which involved optical microscopy observation, X-ray fluorescence, X-ray diffraction, FTIR, -Raman, simultaneous thermogravimetry and differential thermal analysis. The results obtained indicated that the samples were mostly lime mortars with different hydraulicity indexes produced from local raw materials. The results also indicated that the samples presented considerable differences depending on the area in which they were collected, showing the variety and complexity of the materials produced in different periods, even when used for the same function.publishersversionpublishe

Referenciais teóricos utilizados pelos enfermeiros em Enfermagem de Saúde Familiar: protocolo scoping de review

Poster apresentado no XV Encontro do Dia Internacional da Família: Famílias e mudanças demográficas, promovido pela Unidade Científico-Pedagógica de Saúde Pública, Familiar e Comunitária da Escola Superior de Enfermagem de Coimbra e a Sociedade Portuguesa de Enfermagem de Saúde Familiar. Online, 15 de Maio de 2023N/

Current costs of heart failure in Portugal and expected increases due to population aging

Introdução e objetivos: A insuficiência cardíaca (IC) é um problema crescente de saúde pública. Este estudo estima os custos atuais e futuros da IC em Portugal Continental. Métodos: A estimativa dos custos foi realizada na ótica da prevalência e na perspetiva da sociedade. Os custos anuais da IC incluíram os custos diretos (consumos de recursos) e indiretos (impacto na produtividade da população). Utilizaram‐se maioritariamente dados da Base de Dados de Morbilidade Hospitalar, dados da prática clínica real relativamente aos consumos nos cuidados primários e opiniões de peritos. Estimaram‐se os custos para 2014 e, tendo em conta o envelhecimento da população, a evolução dos mesmos até 2036. Resultados: Os custos diretos em 2014 totalizaram €299 milhões (39% por internamentos, 24% por medicamentos, 17% por meios complementares de diagnóstico e terapêutica, 16% por consultas e o restante por outras rubricas como urgências e cuidados continuados). Os custos indiretos totalizaram €106 milhões (16% por absenteísmo e 84% por redução de emprego). Entre 2014 e 2036, por efeitos demográficos, os custos totais passarão de €405 para €503 milhões. O aumento nos custos por habitante será de 34%, um aumento superior ao dos custos totais (+ 24%) dada a redução prevista da população residente. Conclusões: A IC tem um importante impacto económico atual (2,6% do total das despesas públicas em saúde) e previsivelmente maior no futuro, o qual deve ser tido em consideração pelos responsáveis pelas políticas de saúde por forma a adequar a gestão de recursos atual e futura e minimizar o impacto desta doença.Introduction and Objectives: Heart failure (HF) is a growing public health problem. This study estimates the current and future costs of HF in mainland Portugal. Methods: Costs were estimated based on prevalence and from a societal perspective. The annual costs of HF included direct costs (resource consumption) and indirect costs (productivity losses). Estimates were mostly based on data from the Diagnosis‐Related Groups database, real‐world data from primary care, and the opinions of an expert panel. Costs were estimated for 2014 and, taking population aging into account, changes were forecast up to 2036. Results: Direct costs in 2014 were €299 million (39% for hospitalizations, 24% for medicines, 17% for exams and tests, 16% for consultations, and the rest for other needs, including emergencies and long‐term care). Indirect costs were €106 million (16% for absenteeism and 84% for reduced employment). Between 2014 and 2036, due to demographic dynamics, total costs will increase from €405 to €503 million. Per capita costs are estimated to rise by 34%, which is higher than the increase in total costs (+24%), due to the expected reduction in the resident population. Conclusions: HF currently has a significant economic impact, representing around 2.6% of total public health expenditure, and this is expected to increase in the future. This should be taken into account by health policy makers, alerting them to the need for resource management in order to mitigate the impact of this disease.info:eu-repo/semantics/publishedVersio