Comportamento à compressão e tracção da cortiça: estudo numérico

Mestrado em Engenharia MecânicaA cortiça tem vindo a adquirir nos últimos anos uma grande importância e notoriedade ao nível industrial, já que ela exibe características que a tornam única, diferenciando-a dos restantes materiais celulares. Industrialmente, são fabricados variados produtos cujas aplicações se encontram associadas a alguns sectores conhecidos: vinícola, construção civil, automóvel, decoração, entre outros. Embora o produto com maior percentagem de produção corresponda às rolhas naturais, os aglomerados apresentam por sua vez valores bastante significativos no meio da indústria corticeira. No presente trabalho, o estudo incidirá apenas na caracterização mecânica de aglomerados de cortiça, submetendo-os à acção de dois esforços mecânicos principais: compressão e tracção. O principal objectivo deste trabalho está associado ao estudo do comportamento da estrutura, assim como da elaboração de modelos numéricos à escala microscópica, através dos quais seja permitido determinar o módulo de Young do material constituinte da parede celular que consiga representar o módulo de Young do aglomerado. Em paralelo, foram realizados ensaios experimentais, que serviram de base às simulações numéricas, já que através destas foi possível determinar o módulo de Young do aglomerado. ABSTRACT: Cork has been acquiring a great importance and notoriety at the industrial level; it presents unique characteristics, differentiating it from all the rest of the molecular materials. Various products are industrially made for the winery production, civil construction, car industry, decoration and other products. Although the product is majorly used for corks, the agglomerates show very significant values in the cork industry. The present work will be mainly about the mechanical characterization of the agglomerates, submitting them to the action of two main mechanical processes: compression and traction. The main goal is associated with the study of the structure’s behaviour, thus the elaboration of numerical models to a microscopically scale can determine the Young module of the constituent material of the cellular wall, that can represent the Young module of the agglomerate. In parallel, it was done some experimental procedures that were based on the numerical simulations, thus it was possible to determine the Young module of the agglomerate

Training Nurses for the Cardiopulmonary Resuscitation of the Adult and Older Adult in a Surgery Service

Health organizations must have nurses qualified to respond to people’s different problems, which also include advanced skills in approaching people in cardiac arrest. Early and adequate intervention by nurses in emergency situations prevent health complications in adults and the older adult, as well as guarantees better future conditions for their well-being and for a healthier aging process. Aims: To evaluate nurses’ perception of the difficulties in assisting people with Cardiorespiratory Arrest; evaluate the effectiveness of continuous training to overcome difficulties in assisting people with Cardiorespiratory Arrest. Methodology: A descriptive, correlational and longitudinal study was performed, using a quantitative approach. Data collection was performed trough questionnaire was applied to 21 nurses from a Surgery Service. Results: The results of the study indicated that the training had an impact on improving the performance of the nursing team. The performance in Cardiopulmonary Resuscitation was highlighted through the consolidation of knowledge by the sample, improving the training of nurses. Conclusions: We conclude that in-service training is an essential contribution to the training of nurses in Cardiorespiratory Arrest contexts, cooperating to update knowledge and develop skills adapted to increasingly technological and complex environments. Considering that nurses are the professionals who detect Cardiorespiratory Arrest earlier, there is an indisputable need to carry out continuous training and implement strategies based on scientific evidence to improve the skills of clinical practice. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.info:eu-repo/semantics/publishedVersio

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment

Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.info:eu-repo/semantics/publishedVersio

Morphological and Postural changes in the foot during pregnancy and puerperium : a longitudinal study

The aim of this study is to observe the morphological and postural changes to the foot that take place during pregnancy and the puerperium. Method: In this descriptive, observational, longitudinal study, we analysed 23 pregnant women, with particular attention to morphological and postural aspects of the foot, at three time points during and after pregnancy: in weeks 9-13 of gestation, weeks 32-35 of gestation and weeks 4-6 after delivery. The parameters considered were changes in foot length, the Foot Posture Index (FPI) and the Hernández Corvo Index, which were analysed using a pedigraph and taking into account the Body Mass Index (BMI). The same procedure was conducted in each review. Results: The statistical analyses obtained for each foot did not differ significantly between the three measurement times. A pronator-type footprint was most frequently observed during the third trimester of pregnancy; it was predominantly neutral during the postpartum period. Statistically significant differences between the measurement times were obtained in the right foot for cavus vs. neutral foot type (between the first and third trimesters and also between the first trimester and the puerperium) (in both cases, p < 0.0001). Conclusions: Foot length increases in the third trimester and returns to normal in the puerperium. According to FPI findings, the third trimester of pregnancy is characterised by pronation, while the posture returns to neutrality during the postpartum period. During pregnancy, the plantar arch flattens, and this persists during the puerperium. The incidence of cavus foot increases significantly in the third trimester and in the puerperium

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

Development and validation of combined symptom‐medication scores for allergic rhinitis*

Background: Validated combined symptom-medication scores (CSMSs) are needed to investigate the effects of allergic rhinitis treatments. This study aimed to use real-life data from the MASK-air® app to generate and validate hypothesis- and data-driven CSMSs. Methods: We used MASK-air® data to assess the concurrent validity, test-retest reliability and responsiveness of one hypothesis-driven CSMS (modified CSMS: mCSMS), one mixed hypothesis- and data-driven score (mixed score), and several data-driven CSMSs. The latter were generated with MASK-air® data following cluster analysis and regression models or factor analysis. These CSMSs were compared with scales measuring (i) the impact of rhinitis on work productivity (visual analogue scale [VAS] of work of MASK-air® , and Work Productivity and Activity Impairment: Allergy Specific [WPAI-AS]), (ii) quality-of-life (EQ-5D VAS) and (iii) control of allergic diseases (Control of Allergic Rhinitis and Asthma Test [CARAT]). Results: We assessed 317,176 days of MASK-air® use from 17,780 users aged 16-90 years, in 25 countries. The mCSMS and the factor analyses-based CSMSs displayed poorer validity and responsiveness compared to the remaining CSMSs. The latter displayed moderate-to-strong correlations with the tested comparators, high test-retest reliability and moderate-to-large responsiveness. Among data-driven CSMSs, a better performance was observed for cluster analyses-based CSMSs. High accuracy (capacity of discriminating different levels of rhinitis control) was observed for the latter (AUC-ROC = 0.904) and for the mixed CSMS (AUC-ROC = 0.820). Conclusion: The mixed CSMS and the cluster-based CSMSs presented medium-high validity, reliability and accuracy, rendering them as candidates for primary endpoints in future rhinitis trials

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

Desenvolvimento de Competências em Enfermagem à Pessoa em Situação Crítica – Melhoria da Qualidade dos Cuidados à Pessoa internada – necessidades formativas em situações de emergência e reanimação

O presente relatório emerge no âmbito do Ciclo de Mestrado em Enfermagem Médico- Cirúrgica – área de especialização em Enfermagem à Pessoa em Situação Crítica (PSC), cujo objetivo visa a obtenção do grau de Mestre, encontrando-se dividido em 2 partes distintas. Na Parte I, evidencia-se o desenvolvimento de competências através de uma metodologia descritiva, analítica e crítico-reflexiva sobre as atividades desenvolvidas, as experiências vivenciadas, e as dificuldades vividas no percurso do desenvolvimento das competências como Mestre, das competências comuns do Enfermeiro Especialista (EE) e das especificas do Enfermeiro Especialista em Enfermagem Médico-cirúrgica na área de Enfermagem à PSC (EEEMCPSC). Destacamos a promoção do desenvolvimento substancial do raciocínio crítico, o aumento dos conhecimentos e o fortalecimento de um suporte efetivo para as futuras tomadas de decisão. A intervenção de enfermagem baseada em evidencia científica é estruturante à diferenciação do Mestre e do EE, bem como a construção de conhecimentos científicos colaboram para fundamentar a tomada de decisão, tanto no domínio da prestação de cuidados à pessoa, como nos restantes domínios de intervenção do enfermeiro. Nos EC sentimos que o EE deve mobilizar todos os conhecimentos e competências adquiridas para a pratica diária de cuidados, e ainda promover a prática baseada na evidência, contribuindo para uma prática de excelência. Naturalmente, na área especializada dos cuidados à PSC, também as competências comuns assumem um valor crucial para obter ganhos em saúde para a pessoa e família, equipa e instituição. A Parte II teve por base um projeto de investigação-ação num serviço de internamento do Serviço Nacional de Saúde (SNS), que pretendia responder à questão: “Quais as necessidades formativas em situações de emergência e reanimação?”. Partindo da hipótese: As dificuldades que os profissionais de saúde sentem na assistência à Paragem Cardiorrespiratória (PCR) Intra-Hospitalar variam em função de variáveis sociodemográficas e fatores como a experiência profissional, o contexto profissional e a formação académica. Assim, foi implementada a Escala de Perceção de Dificuldades na Assistência à PCR Intra-Hospitalar (EPDAPI) (Catalão, 2017) a 21 enfermeiros em dois momentos distintos. Os resultados mostraram que é possível melhorar os cuidados e os conhecimentos dos profissionais através da formação. A aquisição de habilidades profissionais específicas deve dar resposta às necessidades de cuidados de saúde das populações. É necessário que o enfermeiro fundamente a sua intervenção em evidência científica

Homenagem Casa dos Estudantes do Império - 50 Anos | Testemunhos, Vivências, Documentos

Os textos incluídos nesta obra são transcrições das intervenções feitas pelos participantes nas diversas sessões da homenagem à Casa dos Estudantes do Império, realizadas entre 2014 e 2015. Estas intervenções foram gravadas através de meios audiovisuais e posteriormente editadas para efeitos de publicação. A presente edição segue a grafia do Acordo Ortográfico, exceto nos casos em que os autores quiseram manter a antiga grafia.CML – Câmara Municipal de Lisboa; Camões – Instituto da Cooperação e da Língua; Fundação Calouste Gulbenkianinfo:eu-repo/semantics/publishedVersio