2,905 research outputs found

    Anticoagulantes orais: terapêutica clássica versus novos anticoagulantes

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    Os novos anticoagulantes orais representam uma inovação terapêutica anticoagulante, tendo obtido recentemente aprovação para várias indicações clínicas. A varfarina foi um dos primeiros anticoagulantes orais a ser desenvolvido, no entanto acarreta inúmeras inconveniências tais como, interações medicamentosas e alimentares, margem terapêutica reduzida, monitorização frequente e variações de resposta entre indivíduos, que comprometem a eficácia do tratamento. Consequentemente, foi necessário investigar outras alternativas surgindo assim os novos anticoagulantes orais, dabigatrano, apixabano e rivaroxabano que detêm menos limitações e a mesma eficácia que os AVK. Estes anticoagulantes são eficientes na profilaxia e tratamento tromboembolismo venoso e na prevenção de AVC em pacientes com fibrilação auricular, contudo também apresentam as suas desvantagens como custo elevado e ausência de antídoto específico. Nesta revisão bibliográfica serão abordadas as propriedades farmacológicas, mecanismos de ação, vantagens e desvantagens, custos terapêuticos dos anticoagulantes clássicos e novos anticoagulantes, sendo feita uma comparação entre estes de modo a perceber qual será a melhor opção terapêutica.The new oral anticoagulants represent an innovation in anticoagulant therapy, which has been recently approved for various clinical indications. Warfarin was the first oral anticoagulants to be developed, however entails numerous drawbacks such as drug and food interactions, narrow therapeutic index, frequent monitoring and interindividual response variations that compromise the effectiveness of treatment. Consequently, it was necessary to investigate other alternatives that lead to the discover of new oral anticoagulants, dabigatran, rivaroxaban and apixaban who hold fewer limitations and the same efficacy as the AVK. These anticoagulants are effective in the treatment and prevention of venous thromboembolism and for the prevention of stroke in patients with atrial fibrillation, but also have their disadvantages such as high cost and lack of specific antidote. In this literature review the pharmacological properties will be addressed as well as mechanisms of action, advantages and disadvantages, therapeutic costs of classic and new anticoagulants and a comparison between them in order to understand what the best treatment option is

    Balanced scorecard, modelo de excelência EFQM e common assessment framework, como instrumentos integrados de gestão de qualidade nos serviços públicos

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    Vários autores têm-se debruçado sobre o conceito de qualidade nos serviços, como um instrumento que visa promulgar a eficácia e eficiência desses mesmos serviços. A aplicação de instrumentos de gestão privada no seio da Administração Pública preconiza a introdução de uma nova gestão pública, atenta à qualidade, à auto-avaliação e por conseguinte à promoção da mudança nos serviços. Neste âmbito, a aplicação coordenada do Balanced Scorecard (BSC), do modelo de Excelência da European Foundation for Quality Managemen (EFQM) e da Common Assessement Framework (CAF),que poderá ser uma estratégia a que os organismos públicos podem recorrer para promoverem a melhoria contínua. Com base no enquadramento teórico elaborado na revisão de literatura, o objectivo deste estudo pressupõe a definição e análise de uma estrutura integrada, BSC-CAF, que permite efectuar uma aplicação conjunta destas ferramentas. Constatou-se que o emprego em simultâneo das ferramentas enunciadas, permite fomentar a criatividade e a gestão dos recursos de que as organizações dispõem, de modo a melhorar o seu desempenho organizacional

    The development and application of a measurement tool for assessing children’s vocal performance

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    UID/EAT/00693/2013Research on the influence of text and neutral syllable on children’s vocal performance has shown inconsistent results. Furthermore, the influence of teaching songs starting with melody and words or with the melody sang in neutral syllable, adding the words later, has not been addressed in depth. The purpose of this study was to develop two valid and reliable rating scales to assess children’s vocal achievement in two songs presented in both manners. These rating scales comprised two dimensions (tonal and rhythm) with five criteria each. Children aged 4 to 10 (N = 135) attending regular music classes in a city private school were individually audio recorded in two moments: (a) after an instruction phase of four weeks singing song A with neutral syllable and song B with text; and (b) three weeks later singing song A with the text presented over this period and song B again with text. Three judges rated children’s performances after being provided with samples of good, average, and poor performances on each dimension and having discussed the application of each criterion. Content and construct validity were assured by both authors according to a Music Learning Theory based-curriculum. Item analysis revealed that all items from difficulty and discrimination indices were within an acceptable range in both moments for both songs. Inter-rater reliabilities were high, ranging from ICC(2, k) = .878 to .951. Results are discussed in terms of the use of rating scales to investigate progression on children’s performance depending on the song-teaching strategy.publishersversionpublishe

    The influence of two song-teaching strategies on vocal performance among kindergarten children and its relationship with their use of voice registers

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    UID/EAT/00693/2013 PD/BD/114489/2016Research on the influence of teaching songs starting with melody and words or with the melody sang in neutral syllable, adding the words later, on children’s vocal performances has not been addressed in depth. Furthermore, research on vocal development has shown that singing is also affected by children’s ability to access their full voice (Rutkowski, 2015; Welch, 2006). However, even accessing all the voice registers, singing accuracy may be compromised due to a vocal-motor deficit. This study aims to determine (a) if children sing better depending on the teaching strategy, (b) if the inaccurate first pitches for both songs fall into the registers of the children’s Singing Voice Development Measure (SVDM) classification, and (c) if there is a relationship between the tonal dimension scores for both songs and SVDM classification. Forty-one kindergarten children attending a private school in an urban area participated in a two-phase study. Phase one occurred over a period of eight weeks in regular music sessions presenting a song A with melody and words and a song B with neutral syllable, adding the words after five sessions. Phase two consisted in individual singing of both songs with the teacher providing an auditory cue. Results showed significant differences between the mean of ratings on both songs (t(40)= 4.907; p < .001), better for song A. 53.4% of the inaccurate first pitches fell into the range measured by SVDM, with 17.2% of the children classified as singers. There was a positive and moderate correlation between the tonal dimension scores and SVDM classification (song A: r(41) = .528, p < .001; song B: r(41) = .549, p < .001). Results reveal that teaching songs with words seems to benefit kindergarten children’s vocal performance. Also, children can be more accurate if they sing in their usable voice register.publishersversionpublishe

    Auditory Cues in Social Transmission of Fear

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    When an animal faces a threat, both behavioral and physiological changes occur that promote the avoidance of the menace. Individuals in the surroundings of the fearful animal (both con and heterospecifics) may detect some of these changes, that become cues that signal an impending danger. The detection of such cues can therefore trigger defense behaviors in observers, in a phenomenon called Social Transmission of Fear.(...)Fundação ChampalimaudFundação BialInstituto Gulbenkian de Ciênci

    When Melody and Words Come Together

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    UIDB/00693/2020 UIDP/00693/2020For the past decades, the study of the binomial music and language has been of interest in several branches of cognitive sciences, including psychology, linguistics, anthropology, musicology, cognitive neuroscience, and education. Undoubtedly, songs are the perfect medium to study the relationship between both domains. This article will explore some contributions from neurosciences that could be deemed interesting to the field of music education, focusing on the relationship between melody and words in songs. The influence of these components on song perception and production is an ongoing matter of debate both in neurosciences and music education. The background for this discussion will be set by first mentioning the evolutionary commonalities between music and language, and a discussion on the shared leaning mechanisms for music and language. Since pitch and rhythm are important songs’ components, the comparative research of these elements across music and language will also be approached. In the intertwining of both fields, a special focus will be given to Music Learning Theory, a framework proposed by Edwin Gordon, who advocates the use of songs presented both with text and neutral syllable since infancy. Considering that songs are one of the most used resources in music education, it is questioned if the scientific advances in the neurosciences can inform musical pedagogy, thus new paths of investigation are suggested at the intersection of the two disciplines.publishersversionpublishe
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