Relación entre la farmacocinética y los cambios hemodinámicos durante la inducción y posicionamiento en pacientes quirúgicos anestesiados con propofol

Tesis por compendio de publicaciones[EN]For long years, it was thought that anaesthetic management did not influence patient’s outcome. Surgical morbidity and long-term mortality were attributed to patient’s comorbidity, malignance of the disease, risk infection and type of surgery. Nowadays, there is an increasing evidence that intraoperative anaesthetic management can influence long-term patient outcomes. In the last two decades, surgical mortality rates have been falling and, in part, this is due to a huge improvement in anaesthesia related factors and safety. For an anaesthesiologist, perioperative care is no longer the simple fact of administrating the anaesthetic drug and maintaining the patient “asleep”. Direct-guided fluid therapy, maintaining intraoperative normothermia, minimizing blood transfusion and avoiding low mean arterial pressure and deep hypnotic level are additional procedures the anaesthesiologist is responsible for and that will probably improve patient’s outcome and decrease surgical mortality. Hypotension after induction of anaesthesia is quite common and more prevalent during the late post-induction period and before skin incision (5-10 minutes after), generally thought to be clinically irrelevant. Nowadays, there is some evidence that small haemodynamic changes, such as hypotension, even for small periods, are associated with poor patient outcomes, because they have the potential to cause an ischemia–reperfusion injury which may be manifested as dysfunction of any vital organ, like acute kidney and myocardial injury. Intra-operative management of hypotension is usually guided by conventional monitoring (systolic blood pressure and MAP) but these parameters could mask low levels of blood flow and oxygen delivery, even for short periods, leading to major surgical complications and longer hospital stays

Contact precautions in Intensive Care Units: facilitating and inhibiting factors for professionals' adherence

Objetivou-se identificar os fatores que facilitam ou dificultam a adesão às precauções de contato, por parte de profissionais de um Centro de Terapia Intensiva de hospital geral. Tratou-se de um estudo transversal, realizado de maio a outubro de 2007, utilizando-se um questionário semi-estruturado para coleta de dados. Participaram do estudo 102 profissionais: técnico de enfermagem (54,9%), enfermeiro (12,7%), médico preceptor (10,8%), fisioterapeuta aprimorando (8,8%), fisioterapeuta preceptor (7,8%) e médico residente (4,9%). Os fatores dificultadores para a adesão à higienização das mãos foram o esquecimento, falta de conhecimento, distância da pia, irritação da pele e falta de materiais. O uso do capote apresentou maior dificuldade (45%) pela sua ausência no box, acondicionamento inadequado, calor, e ao seu uso coletivo. O uso de luvas foi a conduta de maior facilidade na prática cotidiana. Os resultados deste estudo apontam a necessidade de implementar medidas de precaução a fim de minimizar a disseminação de microrganismos resistentes.Este estudio tuvo por objetivo identificar los factores facilitadores y limitantes de la adhesión a las precauciones de contacto por parte de los profesionales de la Unidad de Terapia Intensiva de un hospital general. Se trató de un estudio transversal realizado entre mayo y octubre de 2007, utilizándose un cuestionario semiestructurado para la recopilación de datos. Participaron del estudio 102 profesionales de las siguientes áreas: técnicos de enfermería (54,9%), enfermeros (12,7%), médicos de planta (10,8%), fisioterapeutas residentes (8,8%), fisioterapeutas de planta (7,8%) y médicos residentes (4,9%). Los factores limitantes para la adhesión a la higienización de manos fueron: el olvido, la falta de conocimiento, la distancia hasta los lavatorios, irritación de la piel y falta de materiales. El uso de guardapolvos y similares presentó mayor dificultad (45%) por su ausencia en el box, acondicionamiento inadecuado, calor y uso colectivo. La utilización de guantes fue la conducta de mayor aceptación en la práctica cotidiana. Los resultados de este estudio indican la necesidad de implementar medidas de precaución para minimizar la propagación de microorganismos resistentes.The objective of this study was to identify facilitating and limiting factors for professionals' compliance with contact precautions in an intensive care unit of a general hospital. This cross-sectional study was performed from May to October 2007, using a semi-structured questionnaire for data collection. Participants were 102 professionals, as follows: nursing technician (54.9%), nurse (12.7%), preceptor physician (10.8%), apprentice physiotherapist (8.8%), preceptor physiotherapist (7.8%) and resident physician (4.9%). The limiting factors for compliance with hand cleansing were forgetting, lack of knowledge, distance from sink, skin irritation, and lack of materials. The use of scrubs presented the most difficulty (45%) because they were not available at the shower box, were inappropriately stored, and due to the heat and collective use. Glove use was the practice most easily conducted in everyday practice. Results show the need to implement precaution measures to minimize the dissemination of resistant microorganisms

Primary english practice programme for ages 6/7 : the need for a transformative and sustainable primary english teaching and learning processes

In the ever-evolving landscape of primary education, the significance of English instruction in shaping cognitive and linguistic development is irrefutable. As we navigate the complexities of the 21st century, a paradigm shift towards transformative and sustainable educational practices becomes imperative. This communication delves into the trajectory of a primary English teaching and learning process that aligns with transformative principles while embedding sustainability, by focusing on the main results of the implementation of the Primary English Practice Programme for Ages 6/7 (PEPPA) in the school year 2022-2023. The PEPPA project, a pilot project, aims to promote the implementation of the English disciplinary area in the curriculum of the 1st and 2nd years of schooling, in a Portuguese municipality. Its main objectives include raising awareness among pupils about the importance of learning foreign languages and providing teacher training for effective instruction in the 1st and 2nd years of schooling. Grounded in 21st-century educational paradigms, the theoretical foundation of this study underscores the importance of transformative learning experiences for primary English learners. Departing from traditional rote methods, the emphasis is on pedagogies that stimulate critical thinking, creativity, and cultural understanding. Project-Based Learning (PBL) emerges as a transformative approach, providing an immersive language acquisition experience by connecting English instruction with real-world projects. Sustainability in English education is conceptualized through the integration of eco-friendly materials, environmental themes, and responsible language use, fostering a sense of global interconnectedness among pupils. To unravel the efficacy of the proposed transformative and sustainable primary English teaching and learning process, a mixed-methods research design was employed. Qualitative data were gathered through classroom observations, questionnaires, and content analysis of educational materials. The research tools included observation grids to analyse teacher’s and pupils’ practices during lessons, rubrics for assessing project-based outcomes, and questionnaires applied to teachers. The analysis of gathered data reveals a substantial shift in primary English education towards transformative and sustainable practices. Project-Based Learning, when implemented, demonstrates enhanced language acquisition experiences, promoting critical thinking and problem-solving skills. Sustainability integration correlates with heightened environmental awareness and responsible language use among pupils. Multimodal resources, including digital platforms and interactive content, are shown to cater effectively to diverse learning styles. Continuous professional development initiatives empower educators to implement transformative practices successfully. In conclusion, the results underscore the effectiveness of embracing transformative and sustainable approaches in primary English education. The shift towards project-based, eco-conscious pedagogies positively impacts language acquisition, critical thinking, and global awareness among students. These findings advocate for a collective commitment from educators, administrators, and policymakers to foster a future generation that is not only proficient in English communication but also equipped to navigate the complexities of the 21st century. Keywords: primary English, sustainable development, soft skills, foreign language learning

Conocimiento y comportamiento de los profesionales de un centro de terapia intensiva en relación a la adopción de las precauciones de contacto

This study aimed to assess the knowledge and behavior of professionals working in Intensive Care Units (ICU) related to the adoption of contact precautions for the control of hospital infections (HI). This cross-sectional study used a semi-structured questionnaire to collect data. Descriptive and multivariate analyses were carried out, including logistic regression and decision tree using CHAID algorithm. A total of 102 professionals participated in the study, of whom 36.3% presented appropriate knowledge and 51% appropriate behavior in relation to HI control measures. Nursing professionals had almost four times more chance (OR = 3.58, CI 1.48-8.68) of presenting appropriate behavior than the remaining professionals. The multivariate analysis did not reveal variables associated with knowledge. No statistically significant association was found between knowledge and behavior (p = 0.196). These results suggest the need to implement educational activities so as to permit a balance between theory and professionals' practice concerning HI preventive measures, aiming to improve knowledge and behavior.El objetivo fue evaluar el conocimiento y comportamiento de los profesionales de un CTI en relación a la adopción de precauciones de contacto para el control de las infecciones hospitalarias (IH). Se realizó estudio transversal, utilizando un cuestionario semiestructurado para recolección de datos. Fue realizado análisis descriptivo y multivariado (regresión logística y algoritmo CHAID). Participaron del estudio 102 profesionales, 36,3% presentaron conocimiento adecuado y 51% comportamiento adecuado para las medidas de control de IH. Los profesionales de enfermería presentaron casi cuatro veces más probabilidad (OR=3,58; IC; 1,48-8,68) de tener comportamiento adecuado que los demás profesionales. Ninguna variable fue asociada al conocimiento. No hubo asociación estadísticamente significativa entre conocimiento y comportamiento (p=0,196). Se evidenció la necesidad de implementar actividades de orientación capaces de permitir el equilibrio entre la teoría y la práctica de los profesionales en lo que se refiere a medidas de prevención de IH, con el objetivo de perfeccionar el conocimiento y el comportamiento.Objetivou-se avaliar o conhecimento e comportamento dos profissionais de um CTI em relação à adoção das precauções de contato para o controle das infecções hospitalares (IH). Realizou-se estudo transversal, utilizando-se questionário semiestruturado para coleta de dados. Foi realizada análise descritiva e multivariada (regressão logística e algoritmo CHAID). Participaram do estudo 102 profissionais, 36,3% apresentaram conhecimento adequado e 51% comportamento adequado para as medidas de controle de IH. Profissionais de enfermagem apresentaram quase quatro vezes mais chance (OR=3,58; IC 1,48-8,68) de ter comportamento adequado que os demais profissionais. Nenhuma variável foi associada ao conhecimento. Não houve associação estatisticamente significativa entre conhecimento e comportamento (p=0,196). Evidencia-se a necessidade de implementar atividades de orientação capazes de permitir equilíbrio entre teoria e prática dos profissionais no tocante às medidas de prevenção de IH, visando aprimorar o conhecimento e o comportamento

THE LANDSCAPE STRUCTURE ANALYSIS OF NATIONAL PARK OF SUPERAG cI, PARAN\uc1 STATE AND THE BUFFER'S ZONE

O Parque Nacional do Superag\ufci est\ue1 localizado no litoral norte do Estado do Paran\ue1, maior \ue1rea cont\uednua remanescente de Floresta Atl\ue2ntica do pa\ueds, bioma este entre os mais amea\ue7ados do mundo. Esta \ue1rea abrange o litoral norte do Estado e compreende uma s\ue9rie de unidades de conserva\ue7\ue3o de diferentes categorias, sendo a \uc1rea de Prote\ue7\ue3o Ambiental de Guaraque\ue7aba a de maior extens\ue3o, sobrepondo-se \ue0s demais. O presente trabalho teve como objetivo analisar a estrutura da paisagem (matriz e fragmentos) do PN do Superag\ufci e sua zona de amortecimento. A partir da classifica\ue7\ue3o supervisionada da imagem digital Landsat 5 TM, foi feita a classifica\ue7\ue3o da cobertura do solo da \ue1rea e definidos os atributos de \ue1rea e per\uedmetro dos pol\uedgonos obtidos. Feita a an\ue1lise da estrutura da paisagem, constatou-se que a matriz do Parque \ue9 formada por vegeta\ue7\ue3o nativa interrompida pela presen\ue7a de fragmentos. Cerca de 7% da \ue1rea de estudo \ue9 formado por fragmentos, os quais pertencem \ue0s classes de vegeta\ue7\ue3o alterada, solo descoberto, \ue1reas urbanizadas, areia e \ue1gua; em grande parte possuem menos de um hectare e t\ueam forma regular. A zona de amortecimento do Parque n\ue3o est\ue1 totalmente inserida dentro dos limites da APA Federal de Guaraque\ue7aba, sendo que grande parte da zona de amortecimento \ue9 formada por \ue1reas marinhas. Conclui-se que a an\ue1lise da estrutura da paisagem, atrav\ue9s de seus componentes estruturais matriz e fragmentos, \ue9 um subs\ueddio eficaz para verificar a funcionalidade da cobertura do solo da UC e sua zona de amortecimento.The National Park of Superag\ufci is located on the north coast of Paran\ue1 state. It is the largest continuous area of the Atlantic Forest remaining in the country and this biome is among the most threatened ones in the world. This area covers the north coast of the state and includes several conservation units of different categories, and the Environmental Protection Area of Guaraque\ue7aba, is the largest one. The objective of this study was to analyze the landscape structure (matrix and patches) of the National Park of Superag\ufci, and its buffer zone. The classification of land cover and the definition of the attributes of the area and perimeter were made using a digital image Landsat 5 TM. According to the landscape structure analysis, it was observed that the Park matrix is formed by native vegetation interrupted by the presence of patches. Approximately 7% of the studied area is composed by fragments, which belong to class of changed vegetation, exposed soil, urban areas, sand and water; mostly have less than one hectare and have a regular shape. The Park buffer zone is not fully incorporated within the limits of Environmental Protection Area of Guaraque\ue7aba, where marine areas form a great portion. It follows that landscape structure analysis, through its structural components matrix and patches, is an efficient subsidy to verify the park land cover functionality and its buffer zone

Filhote - ferramenta de suporte à análise e interpretação de dados biológicos

This work presents a proposal to structure the data of fishes collected in the region of hydroelectric plant Luís Eduardo Magalhães (or hydroelectric plant of Lajeado), during the 1999-2012 period and also a tool development, called Filhote, for the administration of these data. The main purpose is to provide an efficient way to manipulate and store the obtained data, enabling the construction of time series aggregating results from future collections. To this intent, it was developed a data model for the structured storage of this set, aiming to provide the basis for studies on the monitoring of fish fauna in environments with and without reservoir. Taking this model as the basis, the Filhote tool has been integrated into the application of Data Mining WEKA in order to provide the researcher a means of data analysis through the generation of association rules. The data model and the developed tool are viable to treatment of existing data and they are presented as a good alternative for projects that collect data in this same direction, enabling the expansion of the storage modules, as well as the inclusion of new data mining algorithms.Este trabalho apresenta uma proposta para a estruturação dos dados de peixes coletados na região da Usina Hidrelétrica Luís Eduardo Magalhães (ou Usina de Lajeado), no período de 1999 a 2012, e o desenvolvimento de uma ferramenta, chamada Filhote, para a administração destes dados. O principal objetivo é oferecer um meio de manipulação e armazenamento eficiente aos dados obtidos possibilitando a construção de séries históricas com a agregação de resultados de futuras coletas. Para isto, foi desenvolvido um modelo de dados para o armazenamento estruturado desta série, visando servir de alicerce aos estudos de monitoramento da fauna de peixes em ambientes com e sem reservatório. Tomando este modelo como base, a ferramenta Filhote foi integrada à aplicação de Mineração de Dados WEKA com o intuito de prover ao pesquisador um meio de análise de dados através da geração de regras de associação. O modelo de dados e a ferramenta desenvolvida são viáveis para o tratamento dos dados existentes e se apresentam como uma boa alternativa para projetos que coletam dados neste mesmo sentido, possibilitando a expansão dos módulos de armazenamento, bem como com a inclusão de novos algoritmos de mineração de dados

And now what? Changing fields and methodologies during the Covid-19 pandemic: from international mobilities to education

The Covid-19 pandemic and the worldwide lockdown have brought about profound changes to the way in which fieldwork is done. During a time particularly marked by social distancing, how do social scientists cope with the need to alter their methodologies with fields in transition? This essay reflects upon the changes caused by the pandemic, both in the field and in the methodologies adopted by the authors – all in different phases of their PhD research. Drawing from their research areas, it focuses on two main thematic axes, both deeply affected by the current situation: international mobilities (of commodities and people) and education (in Portugal and abroad).info:eu-repo/semantics/publishedVersio

InterNetWorking Conference - Intercultural Week 2019: livro de resumos/ book of abstracts

Esta monografia pretende dar conta do conjunto de palestras, comunicações, oficinas e cursos livres de língua e cultura que tiveram lugar durante a InterNetWorking Conference – Intercultural Week 2019.info:eu-repo/semantics/publishedVersio

PISA 2015 and collaborative problem solving: the results of Portuguese students

Neste artigo apresentamos uma análise sobre um dos domínios de literacia do Programme for International Student Assessment (PISA): Resolução Colaborativa de Problemas (RCP). Comparativamente a outras literacias avaliadas pelo PISA (Leitura, Ciências, Matemática, Financeira), a RCP tem sido pouco estudada em Portugal. Recorremos a uma metodologia interpretativa com base nos relatórios e bases de dados produzidos(as) por diferentes organizações. Os resultados revelam que Portugal está no topo da escala relativamente à valorização de relações e valorização do trabalho em equipa, apontando que os estudantes portugueses de15 anos se sentem integrados socialmente, que os rapazes obtêm avaliações globais inferiores às raparigas, seguindo as tendências internacionais e que existe uma diferenciação entre regiões da NUTS III. Na análise correlacional feita entre as pontuações de RCP e de outras International Large Scale Assessments (ILSA), verificou-se que há uma correlação estatisticamente significativa, positiva, somente com os três domínios do PISA-2015 – Leitura, Matemática e Ciências.In this article we present an analysis of one of the literacy domains of the Program for International Student Assessment (PISA): Collaborative Problem Solving (CPR). Compared to other literacies assessed by PISA (Reading, Science, Mathematics, Finance), CPR has been little studied in Portugal. We use an interpretative methodology based on reports and databases produced by different organizations. The results show that Portugal is at the top of the scale in relation to valuing relationships and valuing teamwork, pointing out that 15-year-old Portuguese students feel socially integrated, that boys obtain lower overall assessments than girls, following international trends, and that there is a differentiation between NUTS III regions. In the correlational analysis made between the scores of CPR and other International Large Scale Assessments (ILSA), it was found that there is a statistically significant correlation, positive, only with the three domains of PISA-2015 – Lecture. Mathematics and Science.info:eu-repo/semantics/publishedVersio