Medidas de bioseguridad en la curación del catéter venoso central por enfermeros de emergencia del Hospital Nacional Daniel Alcides Carrión Callao - 2017

Publicación a texto completo no autorizada por el autorDetermina las medidas de bioseguridad que aplican los profesionales de enfermería en la curación del catéter venoso central. Es un estudio de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población está conformada por 20 enfermeros mediante la técnica de observación y la aplicación de la lista de cotejo, previo consentimiento informado. Del 100 % (20), solo 75% aplica las medidas de bioseguridad en la curación del catéter venoso central. Antes del procedimiento 60% aplica y 40% no aplica; durante el procedimiento 20% aplica y 80% no aplica y después del procedimiento 10% aplica y 90% no aplica. Los aspectos que aplican 90% realizan la higiene de manos, 90% la antisepsia de la piel, iniciándose sobre el sitio de inserción del catéter, la zona de unión catéter – piel y la piel adyacente utilizando una gasa estéril impregnada con el antiséptico de elección, y 75% realiza lavado de manos según guía técnica (RM 225-2016); mientras que los aspectos que no aplican 10% no cuentan con el material necesario para la eliminación de desechos biocontaminados, 10% omite realizar la antisepsia de la piel que se inicia sobre la inserción del catéter, así como realizar el lavado de manos según guía técnica (RM 225-2016).Trabajo académic

A new approach to study gait impairments in Parkinson’s disease based on mixed reality

Dissertação de mestrado integrado em Engenharia Biomédica (especialização em Eletrónica Médica)Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease. PD onset is at 55 years-old on average, and its incidence increases with age. This disease results from dopamine-producing neurons degeneration in the basal ganglia and is characterized by various motor symptoms such as freezing of gait, bradykinesia, hypokinesia, akinesia, and rigidity, which negatively impact patients’ quality of life. To monitor and improve these PD-related gait disabilities, several technology-based methods have emerged in the last decades. However, these solutions still require more customization to patients’ daily living tasks in order to provide more objective, reliable, and long-term data about patients’ motor conditions in home-related contexts. Providing this quantitative data to physicians will ensure more personalized and better treatments. Also, motor rehabilitation sessions fostered by assistance devices require the inclusion of quotidian tasks to train patients for their daily motor challenges. One of the most promising technology-based methods is virtual, augmented, and mixed reality (VR/AR/MR), which immerse patients in virtual environments and provide sensory stimuli (cues) to assist with these disabilities. However, further research is needed to improve and conceptualize efficient and patient-centred VR/AR/MR approaches and increase their clinical evidence. Bearing this in mind, the main goal of this dissertation was to design, develop, test, and validate virtual environments to assess and train PD-related gait impairments using mixed reality smart glasses, integrated with another high-technological motion tracking device. Using specific virtual environments that trigger PD-related gait impairments (turning, doorways, and narrow spaces), it is hypothesized that patients can be assessed and trained in their daily challenges related to walking. Also, this tool integrates on-demand visual cues to provide visual biofeedback and foster motor training. This solution was validated with end-users to test the identified hypothesis. The results showed that, in fact, mixed reality has the potential to recreate real-life environments that often provoke PD-related gait disabilities, by placing virtual objects on top of the real world. On the contrary, biofeedback strategies did not significantly improve the patients’ motor performance. The user experience evaluation showed that participants enjoyed participating in the activity and felt that this tool can help their motor performance.A doença de Parkinson (DP) é a segunda doença neurodegenerativa mais comum depois da doença de Alzheimer. O início da DP ocorre, em média, aos 55 anos de idade, e a sua incidência aumenta com a idade. Esta doença resulta da degeneração dos neurónios produtores de dopamina nos gânglios basais e é caracterizada por vários sintomas motores como o congelamento da marcha, bradicinesia, hipocinesia, acinesia, e rigidez, que afetam negativamente a qualidade de vida dos pacientes. Nas últimas décadas surgiram métodos tecnológicos para monitorizar e treinar estas desabilidades da marcha. No entanto, estas soluções ainda requerem uma maior personalização relativamente às tarefas diárias dos pacientes, a fim de fornecer dados mais objetivos, fiáveis e de longo prazo sobre o seu desempenho motor em contextos do dia-a-dia. Através do fornecimento destes dados quantitativos aos médicos, serão assegurados tratamentos mais personalizados. Além disso, as sessões de reabilitação motora, promovidas por dispositivos de assistência, requerem a inclusão de tarefas quotidianas para treinar os pacientes para os seus desafios diários. Um dos métodos tecnológicos mais promissores é a realidade virtual, aumentada e mista (RV/RA/RM), que imergem os pacientes em ambientes virtuais e fornecem estímulos sensoriais para ajudar nestas desabilidades. Contudo, é necessária mais investigação para melhorar e conceptualizar abordagens RV/RA/RM eficientes e centradas no paciente e ainda aumentar as suas evidências clínicas. Tendo isto em mente, o principal objetivo desta dissertação foi conceber, desenvolver, testar e validar ambientes virtuais para avaliar e treinar as incapacidades de marcha relacionadas com a DP usando óculos inteligentes de realidade mista, integrados com outro dispositivo de rastreio de movimento. Utilizando ambientes virtuais específicos que desencadeiam desabilidades da marcha (rodar, portas e espaços estreitos), é possível testar hipóteses de que os pacientes possam ser avaliados e treinados nos seus desafios diários. Além disso, esta ferramenta integra pistas visuais para fornecer biofeedback visual e fomentar a reabilitação motora. Esta solução foi validada com utilizadores finais de forma a testar as hipóteses identificadas. Os resultados mostraram que, de facto, a realidade mista tem o potencial de recriar ambientes da vida real que muitas vezes provocam deficiências de marcha relacionadas à DP. Pelo contrário, as estratégias de biofeedback não provocaram melhorias significativas no desempenho motor dos pacientes. A avaliação feita pelos pacientes mostrou que estes gostaram de participar nos testes e sentiram que esta ferramenta pode auxiliar no seu desempenho motor

Barclaycard: A Go-To Brand for Payments and Lending in the Iberian Peninsula: Strategies of Portfolio Optimization in the Portuguese Market and New Customer Engagement in Spain

CEMSThe CEMS-MIM Business Project carried in partnership with Barclaycard implied the creation of strategies to increase the customer database value, which highly depends on consumer loyalty levels and new customer acquisition rate. In a first stage, the current competition was assessed. Secondly, by studying consumers’ preferences through the creation of two distinct surveys, it was possible to derive the main priorities for Barclaycard’s product portfolio development. Generally, customers highly value immediate benefits and financial benefits. Therefore, Barclaycard is advised to implement cashback, Email/ SMS alerts, and keep flexible repayment conditions, in order to achieve its goals

Conceptions of primary school students and trainee teachers about seed germination

Research into seed germination classroom activities has been common in the last few decades. Didactic proposals have generally focused on the implementation of guided activities in a specific educational stage and context, and an evaluation of the results. However, it is not evident that students approach seed and germination concepts with a reasoned argument. In light of this, comparative research using an inquiry approach was undertaken with 59 primary school students and 82 trainee teachers at an education faculty in Spain, over two academic years. The results showed that it is necessary to give greater relevance to experimental activities to produce reasoned argumentation of seed and germination concepts. Activities should focus on variables that differ from those typical of common or historical agricultural knowledge. Variables derived from genetic information (size of the seed, latency period) are significant and helpful. It is also considered essential to work on the meaning and proper use of scientific terms, such as living and inert matter, sun-light-heat, or plant germination and growth processes. The search for explanations and the development of justifications, for example relating the excess of water to a lack of oxygen for the seeds, is also essential

Molecular study of Familial Dyslipidaemias by Next Generation Sequencing

Tese de mestrado, Bioquímica (Bioquímica Médica) Universidade de Lisboa, Faculdade de Ciências, 2022Dyslipidemia, a clinical condition defined by an abnormal concentration of lipids in the blood, can have a genetic etiology. Familial dyslipidemias constitute a group of genetically determined conditions, the majority being rare. In addition, these are often associated to serious conditions that can be prevented by the early identification of patients. Hypercholesterolemia promotes atherosclerosis, increasing patients' cardiovascular risk. Neurological manifestations and poor weight progression are frequent complications of hypocholesterolemia, and an increased risk of pancreatitis is often verified in cases of hypertriglyceridemia. This project aimed to identify the genetic cause of dyslipidemia in 96 Portuguese individuals, referred to the Cardiovascular Research Group at the National Health Institute, with a clinical diagnosis of several genetic dyslipidemias associated to different traits: hypercholesterolaemia, hypocholesterolaemia, and hypertriglyceridaemia. The lipid profile of the 96 index cases was determined for biochemical characterization. The molecular study of individuals was performed by Next Generation Sequencing with a customised target panel of 57 genes involved in lipid metabolism. Molecular diagnosis was provided after analysis of 18 genes strongly associated with several familial dyslipidemias. Rare variants detected were confirmed by PCR and Sanger Sequencing. A definite cause of monogenic dyslipidemia was established in 35 cases: 22 individuals were diagnosed with familial hypercholesterolaemia, 3 with familial hypobetalipoproteinemia, 2 with familial chylomicronemia syndrome, 7 with multifactorial chylomicronemia, and one with autosomal recessive hypertriglyceridemia. Moreover, several variants with uncertain significance were found by NGS during this project, the majority lacking functional data. As these variants can constitute the cause of disease in some cases, functional studies will be essential to assess variant’s pathogenicity. This work allowed an early and correct identification of Portuguese patients with different familial dyslipidemias, thus providing guidance for pharmacological treatment and lifestyle adaptations to reduce the chance of suffering disease complications, improving this way patients’ prognosis

The potential of the second-hand personal luxury market in Portugal

The Portuguese luxury market is quite undeveloped, due to social and financial factors. Such financial factors could be mitigated through second-hand, which has had a recent global rise, yet to reach Portugal, however. In order to understand the second-hand luxury market potential in Portugal, this Work Project analyzes the behavior of Portuguese towards the market. Thereby, a qualitative and quantitative analysis were conducted to consumers. The results show untapped market potential, which differs from the global one, in terms of consumer profile, motivations, channels, shopping experience and offer. Therefore, market players should be adapted to market specifications, as to succeed

Proyecto para el Desarrollo de un Hotel Limited-Service Ubicado en el Sector del Nuevo Aeropuerto Mariscal Sucre en Tababela: Hotel Samana

Since the new Airport Mariscal Sucre started operating, it led to the development of many economic sectors. Tourism being one of the most important. In the coming years it is expected a large increase in profits generated by tourism activities. However, since in Tababela the predominant activities were agricultural and floricultural, there is no evidence of a range of hotels to supply the demand that would be generated in the future. Which is why, this project is about the development of a limited-service hotel able to accommodate 10% of current demand since it has a strategic location just five minutes from the airport. Samana Hotel is focused on satisfying transit passengers, executives and general travelers who value comfort, safety in a cozy atmosphere like home away from home.El inicio de las operaciones del nuevo Aeropuerto Mariscal Sucre en el sector de Tababela dio lugar al desarrollo de varios sectores económicos, siendo el sector turístico uno de los de mayor impulso. En los próximos años se prevé un amplio aumento de ganancias generados por actividades turísticas. Sin embargo, debido a que anteriormente en Tababela las actividades predominantes eran agrícolas y florícolas, no existe evidencia de una oferta hotelera que abastezca la demanda que se generaría en un futuro. Razón por la cual, este proyecto trata del desarrollo de un hotel de servicios limitados capaz de acoger al 10% de la demanda actual ya que cuenta con una ubicación estratégica a tan solo cinco minutos del aeropuerto. El Hotel Samana está enfocado en satisfacer a pasajeros en tránsito, ejecutivos y viajeros en general que valoren la comodidad, seguridad en un ambiente acogedor como el de casa pero lejos de ésta

Cuidados de enfermería en neonatos relacionados con termorregulación

La mantención de la temperatura normal en el prematuro permite reducir significativamente la morbimortalidad neonatal. El conocimiento por parte del personal que cumple funciones en el servicio de neonatología es fundamental para brindar un ambiente térmico adecuado al recién nacido. Por lo que el siguiente trabajo de investigación tiene como objetivo principal determinar cuál es nivel de conocimiento y capacitación de los enfermeros del Servicio de Neonatología del Hospital Luis Lagomaggiore sobre termorregulación de los recién nacidos a término y pre término y sobre el uso del soporte tecnológico (incubadoras, servo cunas, calentadores y humificadores) durante el primer semestre de 2015. Es un estudio de tipo cuantitativo, descriptivo, aplicable y de corte transversal. Del total de la población del personal que trabaja en dicho sector 70 enfermeros (licenciados, profesionales y auxiliares), se tomó una muestra de 20 de ellos, a los que se les realizó una encuesta.Fil: Jaimes, Liliana Analía. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..Fil: Madrid, Silvana Beatriz. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..Fil: Miranda, Erica Analía. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería.