Health through the global functionality stimulation of the elderly in a continuing care unit

Work performed under the Stage Specialization in Medical-Surgical Nursing in Integrated Continuing Care Unit (ICCU), in order to describe the health gains achieved with a program to stimulate the overall functionality, adapted to the degree of physical dependence patients and the psychological profile

Aprendizagem dos modelos de grafos, por alunos de MACS do 11.º ano, através da resolução de problemas

Uma das finalidades do ensino de matemática é desenvolver a capacidade do aluno de resolver problemas. Esta atividade, para além de dotar de significado o que se aprende, prepara o aluno para fazer face a problemas do quotidiano. Os modelos de grafos, situações de sistemas de distribuição e explorar soluções para problemas. Em detrimento de uma pedagogia expositiva, os conceitos e notações de grafos foram introduzidos e desenvolvidos, numa turma do 11.º ano, através da resolução de problemas. Pretendemos assim averiguar como os alunos interpretam problemas, que estratégias estabelecem na sua resolução e como formulam problemas. Nessa resolução, qualquer processo era valorizado e não existiam indicações para a utilização de conhecimentos destes modelos. Adotando uma metodologia qualitativa e interpretativa, os dados foram recolhidos através da resolução de três problemas pelos alunos, de gravações de aulas e de uma entrevista no final da experiência. As conclusões do estudo evidenciam que os alunos apresentam dificuldades de interpretação e formulação de enunciados de problemas, utilizam diferentes estratégias na resolução de problemas em grupo e aprenderam os conhecimentos dos modelos grafos, reconhecendo a sua utilidade na resolução de problemas do quotidiano

Impact of a heart failure multidisciplinary clinic on the reduction of healthcare-related events and costs: the GEstIC study

IntroductionHeart failure (HF) is the leading cause of hospitalization in the elderly in developed countries and significantly impacts public health expenditures. Patients with HF usually have associated comorbidities that require multidisciplinary management. This study aims to demonstrate the benefits of a multidisciplinary clinic in reducing all-cause hospitalizations and HF events (HF hospitalizations and urgent HF visits) in a real-world setting. Finally, the study evaluates the associated costs of HF events.MethodsThis observational study included patients admitted to GEstIC, a multidisciplinary Portuguese HF clinic, from January 2013 to February 2019, who had one-year follow-up. Hospitalizations and HF events, total days spent in the hospital during HF hospitalizations, and HF events-related costs, in the year before and the year after GEstIC admission, were compared.ResultsOf the 487 patients admitted to the GEstIC, 287 were eligible for the study sample. After one year of HF patients' multidisciplinary management at GEstIC, there was a 53.7% reduction in all-cause hospitalizations (462 vs. 214), a 71.7% reduction in HF hospitalizations (392 vs. 111), and a 39.1% reduction in urgent HF visits (87 vs. 53). As a result, there was a significant decrease of 12.6 days in the length of hospital stay due to HF per patient (15.6 vs. 3.0, p < 0.001). This translated into the release of 9.9 hospital beds in the year following admission to GEstIC. The average total savings associated with the reduction of HF events was €5,439.77 per patient (6,774.15 vs. 1,334.38, p < 0.001), representing a total cost reduction of €1,561,213. Furthermore, the significant reduction in the number of all events was independent of the patient's left ventricular ejection fraction (LVEF).DiscussionSignificant reductions in all-cause and HF hospitalizations and urgent HF visits were observed with the implementation of this multidisciplinary clinic for HF patients' management. This was particularly important for patients with LVEF >40%. Before GEstIC, there was no medical intervention to improve the prognosis of these patients. The reduction of over one million euros in health-related costs after only one year of person-centered multidisciplinary management highlights the need to replicate this approach in other national healthcare institutions

Looking for ‘God’ in Non-Identity: Reading the Transcendental in Agualusa’s The Book of Chameleons

. I demonstrate how The Book of Chameleons is replete with metaphors of what I call the “non-self,” or “supra-self,” or even “God,” which are commonly found in Zen Buddhist thought, classical African epistemological and ontological paradigms, and more specifically, the idea of African Personality as put forward by Léopold S. Senghor or even in some of Emmanuel Lévinas’s philosophical principles related to the dialectic between self and other or otherness (the non-human) and the divine. This use of multiple cross-cultural frameworks serves to reveal how different paradigms (from West to East, North to South) display parallel ontological visions, thus pointing to the idea that humans (wherever they are) yearn to exit their “small self” and expand their selfhood

Suspending the ‘Lack’ Through Art: African and Western Epistemological and Artistic Intersections (Mia Couto, Wole Soyinka, Léopold Senghor, Gaston Bachelard and Mark Epstein)

As a continuation of my previous transcultural comparative project, the current study aims to unearth some other similarities that exist between African classical knowledge systems, as put forward in the writing of Mia Couto and the work of other Africanists such as Wole Soyinka, Jacob Olupona and Léopold Senghor— in respect to their links to poetic speech and relational, holistic and mystical epistemologies—and the ideas defended by some western critics such as Mark Epstein, Gaston Bachelard, John Fox, and Mark Greene, in relation to the powers of poetic language (or art in general) and the search for knowledge, holism, and existential realization. The central argument here is that poetry and creative writing have the function of powerful therapies, serving as tools that allow a holistic apprehension of life, a figurative entrance into and recreation of the “cosmic envelope” and in that sense, are very much associated with relational and holistic African traditional ways of understanding self and universe. Thus, it is argued that both of these processes have a sublimating function serving to disrupt human fragmentation and temporarily (and symbolically) suspend the “lack” (incompletion and loneliness) that most (if not all) humans are bound to feel

Aprendizagem dos modelos de grafos, por alunos de MACS do 11º ano, através do trabalho de projeto

Dissertação de mestrado em Ciências da Educação (área de especialização em Supervisão Pedagógica na Educação Matemática)Este estudo visa analisar o contributo do trabalho de projeto na aprendizagem dos modelos de grafos de alunos de uma turma do 11.º ano de MACS. Trata-se de um estudo interpretativo com um design de estudo de caso com grupos de alunos de desempenhos escolares diferentes — médio, bom e fraco — e que procura responder às seguintes questões: (1) Que atividades realizam os alunos na aprendizagem de modelos de grafos através de um trabalho de projeto? Que dificuldades manifestam os alunos na realização dessas atividades? (2) Em que contribuiu o trabalho de projeto na aprendizagem de modelos de grafos? (3) Que perspectivas têm os alunos sobre o trabalho de projeto na aprendizagem de modelos de grafos? Os estudos de caso reportam-se a três fases distintas que decorreram Antes, Durante e Após a experiência de ensino que teve por base a resolução de um problema que traduzia, a partir de um mapa, o percurso de um camião na recolha do lixo de diferentes freguesias. Os dados foram recolhidos através de um questionário, registos escritos dos alunos, transcrições das aulas áudio gravadas, notas de campo e uma entrevista. A revisão de literatura deste estudo estrutura-se em três partes: (1) as teorias de aprendizagem que evidenciam a atividade do professor e/ou aluno na construção do conhecimento matemático; (2) o trabalho de projeto no campo da educação, evidenciando-se vantagens e desvantagens da sua realização na sala de aula, os resultados de algumas investigações sobre esta temática e as particularidades deste método de trabalho, nomeadamente os elementos didáticos que lhe estão associados; (3) referência à evolução do currículo de Matemática, ao aparecimento dos modelos de grafos no currículo português e algumas vantagens que decorrem dessa introdução, apresentando-se exemplos de estudos que abordaram esta temática. Os três grupos de alunos evidenciaram dificuldades na elaboração do problema promotor do trabalho de projeto, mas mostraram compreender os conteúdos de grafos trabalhados, nomeadamente a construção de um grafo a partir do mapa, a determinação de circuitos e caminhos, a aplicação dos algoritmos da cidade mais próxima, do peso das arestas, e de Kruskal. Durante a realização deste trabalho, os alunos evidenciaram ser autónomos na realização das tarefas, capacidade de pesquisa, de argumentação e de comunicação matemática. No trabalho de grupo que desenvolveram, tornaram-se tolerantes e aprenderam a respeitar os diferentes ritmos de aprendizagem dos seus colegas.This study aims to analyze the contribution of the project work in learning graph models of students in the 11th grade of MACS. It is an interpretative study with a study case design with groups of students from different school performances – average, good and weak – which wants to answer questions like: (1) Which activities did students carry out in learning graph models through project work? Which difficulties do they point out? (2) How did the project work help in learning graph models? (3) Which perspectives do students have about project work in learning graph models? The study cases relate to three distinct phases that took place - before, during and after the teaching experience – That had its basics on the resolution of a problem, which showed, trough a map, the route of a waste truck from different parishes. The data were collected through a questionnaire, students' written records, transcripts of recorded audio lessons, field notes and an interview. The literature of this study is structured in three parts: (1) the learning theories that highlight the work of the teacher and / or student in the construction of mathematical knowledge, (2) the project work in the field of education, pointing out the advantages and disadvantages of its achievement in the classroom, the results of some investigations on this subject and the particularities of this method of work, namely the educational elements associated with, (3) reference to the evolution of the national curriculum, the emergence of graph models in the Portuguese curriculum and the advantages of its introduction, presenting examples of studies that have addressed this subject matter. The three groups of students showed difficulties in the elaboration of the initial problem of the project work, but have shown they learned the content of graphs worked out, namely the graph construction from the streets map where the rubbish was collected, the determination of a circuit and a path, the application of algorithms from the nearest town and the weight of the edges, and even Kruskal. During this work, the students showed to be independent in performing the tasks, their ability to research, to communicate and their mathematical reasoning. In the group work they have developed, they have become tolerant and learned to respect the different learning paces of their colleagues

Face-to-face versus remote: effects of an intervention in reading fluency during COVID-19 pandemic

Fluency is a central skill for successful reading. Research has provided evidence that systematic reading fluency interventions can be effective. However, research is scarce on the effects of interventions delivered remotely versus face-to-face. This study investigated the efficacy of a systematic and standardized intervention for promoting reading fluency in third-grade students (N = 207) during the COVID-19 pandemic. The study had a pretest, posttest, and follow-up design, with two intervention groups (remote vs face-to-face) and a control group. The intervention groups experienced 20 intervention sessions (2 sessions per week), each lasting approximately 50 min. Word reading accuracy, text reading accuracy, and fluency were measured in the three rounds of assessment. In both intervention groups, all measures of reading showed gains from pretest to posttest. The results also suggested that the efficacy of the intervention was similar in the remote and face-to-face modalities. These findings highlight the relevance of systematic interventions in increasing reading fluency and support the use of remote interventions as an adequate alternative to face-to-face interventions.This work was financially supported by the Portuguese Foundation for Science (FCT) and Technology and the Portuguese Ministry of Science, Technology, and Higher Education through national funds within the framework of the Psychology for Positive Development Research Center-CIPD (grant number UIDB/04375/2020) and the Psychology Research Centre (UIDB/PSI/01662/2020)

The Effects Of Frenotomy On Breastfeeding

Although the interference of tongue-tie with breastfeeding is a controversial subject, The use of lingual frenotomy has been widely indicated by health professionals. Objective: To observe changes in breastfeeding patterns after lingual frenotomy concerning the number of sucks, pause length between groups of sucking and mother's complaints. Material and Methods: Oral yes/no questions about breastfeeding symptoms and sucking/swallowing/breathing coordination were answered by the mothers of 109, 30 day old infants. On the same day the infants had their lingual frenulum assessed by administering a lingual frenulum protocol. After the assessment, all tongue-tied infants were referred for frenotomy; nevertheless, only 14 underwent the surgery. Of the 109 infants, 14 infants who did not have frenulum alterations were included as controls. Birth order and gender were the criteria for recruiting the control group. The tongue-tied infants underwent lingual frenotomy at 45 days of age. At the conclusion of the frenotomy, the infants were breastfed. At 75 days old, both groups - control and post-frenotomy - were reassessed. Before the reassessment the same oral yes/no questions were answered by the mothers of the 14 infants who underwent frenotomy. The mothers of the control group answered the questionnaire only at the time of the first assessment. Data were subjected to statistical analysis. Results: After frenotomy, the number of sucks increased and the pause length between sucking decreased during breastfeeding. The controls maintained the same patterns observed in the first assessment. From the questionnaire answered by the mothers of the 14 tongue-tied infants, at 30 days and 75 days, we observed that the symptoms concerning breastfeeding and sucking/swallowing/breathing coordination were improved after lingual frenotomy Conclusions: after lingual frenotomy, changes were observed in the breastfeeding patterns of the the tongue-tied infants while the control group maintained the same patterns. Moreover, all symptoms reported by the mothers of the tongue-tied infants had improved after frenotomy.23215315