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Background This systematic review aims to synthesise the qualitative evidence exploring parents’ experiences of children with acquired brain injury (ABI) undergoing neurorehabilitation during the first year post-injury.Methods A systematic review of qualitative research was conducted using thematic synthesis with Thomas and Harden’s approach. The population, exposure and outcome model was used for the search strategy. The electronic databases Ovid Embase, Ovid MEDLINE, CINAHL, Scopus and PsycINFO were searched from 2009 to 2023. The review included qualitative and mixed-method studies published in English only. Grey literature was excluded. There were no geographical restrictions. Reporting within the review followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guideline. The studies’ quality was appraised using the Critical Appraisal Skills Programme tool.Results Three studies met the inclusion criteria and were included in the synthesis, representing the experiences of 30 parents. The quality assessment showed that the three included studies met most quality indicators. Following thematic synthesis, four analytical themes were identified: school unpreparedness, parents as advocates and navigators, parents as monitors, and parents recognising the impact of ABI on their child. The reviewers proposed a group of recommendations for services reviewing their parental support.Conclusion This review highlights some challenges parents of children diagnosed with ABI experience during their child’s neurorehabilitation journey. This review has suggested potential improvements that could be made in paediatric neurorehabilitation services when reviewing their parental support and care pathways. These will ultimately influence parents’ and children’s experience of paediatric neurorehabilitation services.

Abstract Background Continuous electroencephalography (cEEG) is increasingly utilized in hospitalized patients to detect and treat seizures. Epidemiologic and observational studies using administrative datasets can provide insights into the comparative and cost effectiveness of cEEG utilization. Defining patient cohorts that underwent acute inpatient cEEG from administrative datasets is limited by the lack of validated codes differentiating elective epilepsy monitoring unit (EMU) admissions from acute inpatient hospitalization with cEEG utilization. Our aim was to develop hospital administrative data-based models to identify acute inpatient admissions with cEEG monitoring and distinguish them from EMU admissions. Methods This was a single center retrospective cohort study of adult (≥ 18 years old) inpatient admissions with a cEEG procedure (EMU or acute inpatient) between January 2016-April 2022. The gold standard for acute inpatient cEEG vs. EMU was obtained from the local EEG recording platform. An extreme gradient boosting model was trained to classify admissions as acute inpatient cEEG vs. EMU using administrative data including demographics, diagnostic and procedure codes, and medications. Results There were 9,523 patients in our cohort with 10,783 hospital admissions (8.5% EMU, 91.5% acute inpatient cEEG); with average age of 59 (SD 18.2) years; 46.2% were female. The model achieved an area under the receiver operating curve of 0.92 (95% CI [0.91–0.94]) and area under the precision-recall curve of 0.99 [0.98–0.99] for classification of acute inpatient cEEG. Conclusions Our model has the potential to identify cEEG monitoring admissions in larger cohorts and can serve as a tool to enable large-scale, administrative data-based studies of EEG utilization.

Abstract Background/ objective To evaluate the association of CGM parameters and HbA1c with diabetes complications in patients with Type 1 Diabetes (T1D). Methods Patients with T1D using the CGM system Freestyle Libre were included in this analysis. The association of CGM-metrics and HbA1c with diabetes complications (any complication, microvascular complications, or macrovascular complications) was assessed using logistic regression unadjusted and adjusted for age, sex, and diabetes duration (model 1), and further adjusted for hypertension and dyslipidemia (model 2). Results One hundred and sixty-one patients with T1D were included. The mean (± SD) age was 37.4 ± 13.4 years old and the median T1D duration was 17.7 ± 10.6 years. Time in range (TIR) was associated with any complication and microvascular complications in the unadjusted model and in the adjusted models. TIR was associated with retinopathy in the unadjusted model as well as in model 1, and was associated with macrovascular complications only in the unadjusted model. HbA1c was associated with any complications, microvascular complications, and retinopathy in the unadjusted model but not in the adjusted models. HbA1c was associated with macrovascular complications in the unadjusted model and in the adjusted model 1. Conclusions In this cross-sectional analysis of patients with T1D using intermittent scanned CGM, TIR, and HbA1c were associated with complications of diabetes. TIR may be a better predictor than HbA1c of any complication and microvascular complications, while HbA1c may be a better predictor of macrovascular complications.

Objetivo: Mapear a evidência científica relativa ao impacto do teletrabalho na qualidade de vida antes, durante e após a pandemia covid-19. Critérios de inclusão: Serão considerados todos os estudos que avaliaram o impacto do teletrabalho antes, durante e após a pandemia, redigidos em português, inglês, espanhol e francês e disponíveis em free full text. Metodologia: Trata-se de um protocolo de revisão de escopo, de acordo com a metodologia do Joanna Briggs Institute e as recomendações do PRISMA-ScR® para registro. A pesquisa foi realizada nas seguintes bases de dados: CINAHL®; MEDLINE Complete®; Nursing & Allied Health Collection: Comprehensive®; Cochrane Central Register of Controlled Trials®; Library, Information Science & Technology Abstracts e MedicLatina® (via EBSCOhost). A seleção dos artigos será realizada por dois revisores independentes pela plataforma Rayyan, recorrendo-se a um terceiro revisor em caso de discordância. Os dados dos estudos serão extraídos através de ferramentas construídas pelos autores para o efeito. ABSTRACT Objective: To map the scientific evidence regarding the impact of teleworking on quality of life before, during and after the covid-19 pandemic. Inclusion criteria: All studies that assessed the impact of teleworking before, during and after the pandemic will be considered; written in Portuguese, English, Spanish and French and available in free full text. Methodology: This is a scoping review protocol, in accordance with the Joanna Briggs Institute methodology and PRISMA-ScR® recommendations for registration. The search was carried out in the following databases: CINAHL®; MEDLINE Complete®; Nursing & Allied Health Collection: Comprehensive®; Cochrane Central Register of Controlled Trials®; Library, Information Science & Technology Abstracts and MedicLatina® (via EBSCOhost). The selection of articles will be carried out by two independent reviewers using the Rayyan platform, using a third reviewer in case of disagreement. Data from the studies will be extracted using tools built by the authors for this purpose.

Este trabalho analisa a formação inicial de estudantes em cursos de licenciaturas de uma instituição federal no Estado de São Paulo durante o ensino remoto emergencial e problematiza suas condições de estudo, bem como suas opiniões sobre a qualidade do processo de ensino-aprendizagem durante o período de pandemia de COVID-19, no qual as aulas presenciais foram paralisadas. Os dados foram coletados a partir de um questionário semiestruturado respondido por 104 estudantes. Os dados das questões fechadas foram tratados estatisticamente e aqueles das questões abertas categorizados segundo análise de conteúdo temática. As análises permitiram vislumbrar limitações institucionais no enfrentamento dos desafios em relação ao ensino remoto, dificuldades pedagógicas e tecnológicas do corpo docente e barreiras socioeconômicas que limitaram o engajamento dos estudantes nos estudos.

Introduction Children with moderate to severe acquired brain injury frequently require a period of demanding medical and rehabilitative care to optimise their long-term capabilities and quality of life. Usually, the initial acute care is provided in tertiary centres and can last up to 12 months following the original injury. Parents of children with acquired brain injury share that experience with their child and face many different challenges encountered as their child’s long-term needs become apparent. Parents are essential partners in care, hence there is a need to better understand their experiences to support them as they face those challenges and adapt to the needs of their child. We aim to synthesise the qualitative evidence exploring parents’ experiences of children undergoing neuro-rehabilitative care.Methods and analysis The Enhancing Transparency in Reporting the Synthesis of Qualitative Research guideline was used in the design of this protocol. The Population, Exposure and Outcome model was used to define inclusion and exclusion criteria and refine search terms. The databases Ovid Embase, Ovid MEDLINE, CINAHL, Scopus and PsychINFO will be searched from 2009 to 2022. Two independent reviewers will review studies, assess quality using the Critical Appraisal Skills Programme and scrutinise and extract the data. Disagreements will be resolved after discussion with the third reviewer. Thematic synthesis using Thomas and Harden’s approach will be undertaken to provide the evidence to develop a model for parental support during the first year of their child’s neuro-rehabilitation.Ethics and dissemination Ethical committee approval will not be required as no new data will be collected. The findings will be disseminated through presentations at professional conferences, publications in peer-reviewed journals and shared with the public through relevant charities and local family support groups and networks.PROSPERO registration number CRD42022333182.

How to analyse the omissions of thermal regulations and evaluate methodologies that provide building execution or thermal certificates that do not correspond to reality and usually incur costs? We can start by analysing different simulation methods and shading calculations that provide solar gains and shadow optimisation. After evaluating how the regulations define the calculation assumptions and how this calculation is performed, the discrepancies (simplifications) that the regulations allow or ignore are presented, and it is exemplified using two case studies. Using the Portuguese regulation as a case study, it leads to incorrect conclusions or assumptions due to unequal access to solar radiation or the shading factor calculation that experiences the omission of angles or time periods. Therefore, the aim is to propose a calculation process (premises) that minimises the discrepancies between simulation (optimisation strategy) and reality (applicability of strategies) for sustainable output.

Several studies report the potential of bacterial cellulose (BC) in the fashion and leather industries. This work aimed at the development of BC-based composites containing emulsified acrylated epoxidized soybean oil (AESO) that are polymerized with the redox initiator system hydrogen peroxide (H2O2) and L-ascorbic acid and ferrous sulfate as a catalyst. BC was fermented under static culture. The polymerization of the emulsified organic droplets was tested before and after their incorporation into BC by exhaustion. The composites were then finished with an antimicrobial agent (benzalkonium chloride) and dyed. The obtained composites were characterized in terms of wettability, water vapor permeability (WVP), mechanical, thermal and antimicrobial properties. When AESO emulsion was polymerized prior to the exhaustion process, the obtained composites showed higher WVP, tensile strength and thermal stability. Meanwhile, post-exhaustion polymerized AESO conferred the composite higher hydrophobicity and elongation. The composites finished with the antimicrobial agent showed activity against S. aureus. Finally, intense colors were obtained more uniformly when they were incorporated simultaneously with the emulsified AESO with all the dyes tested.

BackgroundDelirium in hospitalized patients is a syndrome of acute brain dysfunction. Diagnostic (International Classification of Diseases [ICD]) codes are often used in studies using electronic health records (EHRs), but they are inaccurate. ObjectiveWe sought to develop a more accurate method using natural language processing (NLP) to detect delirium episodes on the basis of unstructured clinical notes. MethodsWe collected 1.5 million notes from >10,000 patients from among 9 hospitals. Seven experts iteratively labeled 200,471 sentences. Using these, we trained three NLP classifiers: Support Vector Machine, Recurrent Neural Networks, and Transformer. Testing was performed using an external data set. We also evaluated associations with delirium billing (ICD) codes, medications, orders for restraints and sitters, direct assessments (Confusion Assessment Method [CAM] scores), and in-hospital mortality. F1 scores, confusion matrices, and areas under the receiver operating characteristic curve (AUCs) were used to compare NLP models. We used the φ coefficient to measure associations with other delirium indicators. ResultsThe transformer NLP performed best on the following parameters: micro F1=0.978, macro F1=0.918, positive AUC=0.984, and negative AUC=0.992. NLP detections exhibited higher correlations (φ) than ICD codes with deliriogenic medications (0.194 vs 0.073 for ICD codes), restraints and sitter orders (0.358 vs 0.177), mortality (0.216 vs 0.000), and CAM scores (0.256 vs –0.028). ConclusionsClinical notes are an attractive alternative to ICD codes for EHR delirium studies but require automated methods. Our NLP model detects delirium with high accuracy, similar to manual chart review. Our NLP approach can provide more accurate determination of delirium for large-scale EHR-based studies regarding delirium, quality improvement, and clinical trails.

Challenge Based Innovation (CBI) is a university programme where student teams create innovative design projects in collaboration with CERN. Each university participating in CBI creates its version of the program. Thus, this is not a closed program, but open to different curricula, periods and student backgrounds. Despite the impact on the participants and potential of the program, it is not as internationally recognised as it could be. This paper presents results of an experimental project that rebrands and redesigns the graphic identity of CBI in order to increase its recognition, better communicate its goals and project outcomes. The process involved an understanding of the problem, provided by interviews with the main stakeholders, along with the identity development attained through brainstorming, sketching, experimental prototyping and iterating. The result aims to be a distinct modular brand, that represents the openness of the programme and its connection with technology and society.

Research on pupillometry provides an increasing evidence for associations between pupil activity and memory processing. The most consistent finding is related to an increase in pupil size for old items compared with novel items, suggesting that pupil activity is associated with the strength of memory signal. However, the time course of these changes is not completely known, specifically, when items are presented in a running recognition task maximizing interference by requiring the recognition of the most recent items from a sequence of old/new items. The sample comprised 42 healthy participants who performed a visual word recognition task under varying conditions of retention interval. Recognition responses were evaluated using behavioral variables for discrimination accuracy, reaction time, and confidence in recognition decisions. Pupil activity was recorded continuously during the entire experiment. The results suggest a decrease in recognition performance with increasing study-test retention interval. Pupil size decreased across retention intervals, while pupil old/new effects were found only for words recognized at the shortest retention interval. Pupillary responses consisted of a pronounced early pupil constriction at retrieval under longer study-test lags corresponding to weaker memory signals. However, the pupil size was also sensitive to the subjective feeling of familiarity as shown by pupil dilation to false alarms (new items judged as old). These results suggest that the pupil size is related not only to the strength of memory signal but also to subjective familiarity decisions in a continuous recognition memory paradigm.

Summary This research aimed at producing malleable, breathable and water impermeable bacterial cellulose‐based nanocomposites, by impregnating bacterial cellulose (BC) membranes with two commercial hydrophobic polymers used in textile finishing, Persoftal MS (polydimethylsiloxane) and Baygard EFN (perfluorocarbon), by an exhaustion process. These hydrophobic products penetrated the BC membranes and adsorbed tightly onto the surface of the nanofibres, across the entire depth of the material, as demonstrated by Scanning Electron Microscopy and Fourier Transform Infrared spectroscopy studies. The water static contact angles, drop absorption over time and vapour permeability values showed that the composites were impermeable to liquid water but permeable to water vapour. The mechanical properties of the BC‐nanocomposites were improved after incorporation of the hydrophobic products, in some of the formulations tested, overall presenting a satisfactory performance. Thus, through a simple and cost‐effective process, hydrophobized, robust, malleable and breathable nanocomposites based on BC were obtained, featuring promising properties for application in the textile and shoe industries.

Nanotechnology is a powerful tool for engineering functional materials that has the potential to transform textiles into high-performance, value-added products. In recent years, there has been considerable interest in the development of functional textiles using metal nanoparticles (MNPs). The incorporation of MNPs in textiles allows for the obtention of multifunctional properties, such as ultraviolet (UV) protection, self-cleaning, and electrical conductivity, as well as antimicrobial, antistatic, antiwrinkle, and flame retardant properties, without compromising the inherent characteristics of the textile. Environmental sustainability is also one of the main motivations in development and innovation in the textile industry. Thus, the synthesis of MNPs using ecofriendly sources, such as polysaccharides, is of high importance. The main functions of polysaccharides in these processes are the reduction and stabilization of MNPs, as well as the adhesion of MNPs onto fabrics. This review covers the major research attempts to obtain textiles with different functional properties using polysaccharides and MNPs. The main polysaccharides reported include chitosan, alginate, starch, cyclodextrins, and cellulose, with silver, zinc, copper, and titanium being the most explored MNPs. The potential applications of these functionalized textiles are also reported, and they include healthcare (wound dressing, drug release), protection (antimicrobial activity, UV protection, flame retardant), and environmental remediation (catalysts).

The risk stratification of patients in the emergency department begins at triage. It is vital to stratify patients early based on their severity, since undertriage can lead to increased morbidity, mortality and costs. Our aim was to present a new approach to assist healthcare professionals at triage in the stratification of patients and in identifying those with higher risk of ICU admission. Adult patients assigned Manchester Triage System (MTS) or Emergency Severity Index (ESI) 1 to 3 from a Portuguese and a United States Emergency Departments were analyzed. Variables routinely collected at triage were used and natural language processing was applied to the patient chief complaint. Stratified random sampling was applied to split the data in train (70%) and test (30%) sets and 10-fold cross validation was performed for model training. Logistic regression, random forests, and a random undersampling boosting algorithm were used. We compared the performance obtained with the reference model-using only triage priorities-with the models using additional variables. For both hospitals, a logistic regression model achieved higher overall performance, yielding areas under the receiver operating characteristic and precision-recall curves of 0.91 (95% CI 0.90-0.92) and 0.30 (95% CI 0.27-0.33) for the United States hospital and of 0.85 (95% CI 0.83-0.86) and 0.06 (95% CI 0.05-0.07) for the Portuguese hospital. Heart rate, pulse oximetry, respiratory rate and systolic blood pressure were the most important predictors of ICU admission. Compared to the reference models, the models using clinical variables and the chief complaint presented higher recall for patients assigned MTS/ESI 3 and can identify patients assigned MTS/ESI 3 who are at risk for ICU admission.

Emergency department triage is the first point in time when a patient's acuity level is determined. The time to assign a priority at triage is short and it is vital to accurately stratify patients at this stage, since under-triage can lead to increased morbidity, mortality and costs. Our aim was to present a model that can assist healthcare professionals in triage decision making, namely in the stratification of patients through the risk prediction of a composite critical outcome-mortality and cardiopulmonary arrest. Our study cohort consisted of 235826 adult patients triaged at a Portuguese Emergency Department from 2012 to 2016. Patients were assigned to emergent, very urgent or urgent priorities of the Manchester Triage System (MTS). Demographics, clinical variables routinely collected at triage and the patients' chief complaint were used. Logistic regression, random forests and extreme gradient boosting were developed using all available variables. The term frequency-inverse document frequency (TF-IDF) natural language processing weighting factor was applied to vectorize the chief complaint. Stratified random sampling was used to split the data into train (70%) and test (30%) data sets. Ten-fold cross validation was performed in train to optimize model hyper-parameters. The performance obtained with the best model was compared against the reference model-a regularized logistic regression trained using only triage priorities. Extreme gradient boosting exhibited good calibration properties and yielded areas under the receiver operating characteristic and precision-recall curves of 0.96 (95% CI 0.95-0.97) and 0.31 (95% CI 0.26-0.36), respectively. The predictors ranked with higher importance by this model were the Glasgow coma score, the patients' age, pulse oximetry and arrival mode. Compared to the reference, the extreme gradient boosting model using clinical variables and the chief complaint presented higher recall for patients assigned MTS-3 and can identify those who are at risk of the composite outcome.

O artigo analisa aspectos relacionados com a escolha da carreira docente em Física por estudantes de um Instituto Federal de Educação, Ciência e Tecnologia de São Paulo. Para a coleta de dados, foram aplicados 4 questionários com os objetivos de (1) delinear o perfil dos estudantes; (2) compreender as razões e influências na escolha do curso de Licenciatura em Física; (3) analisar as marcas na trajetória escolar que colaboraram para esta escolha e (4) identificar, na visão dos estudantes, as experiências de formação que têm contribuído para despertar/aumentar o desejo pela carreira docente em Física. Os dados foram submetidos à análise categorial temática. Os resultados evidenciam, entre outros, que a localização próxima à residência dos alunos e a escassez de cursos gratuitos na região têm forte relação com a escolha do curso. Menos da metade dos estudantes apontou ter escolhido o curso em decorrência da identificação com a Física e do desejo de lecionar. Ainda, um pouco mais da metade afirmou ter recebido algum tipo de influência na escolha do curso e demonstrou o desejo de lecionar após se formar.

This study aims to evaluate and compare the clinical outcome after dental extractions of cats with FCGS infected with feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). A retrospective case series included cats with diagnosis of FCGS, availability of detailed clinical records, full-mouth dental radiographs, and retroviral disease test results. Effectiveness of surgical treatment (EOT) was registered. Three groups were defined: control, FIV and FeLV. In this study, 111 cats were included: 60 controls, 29 FIV- and 22 FeLV-positive cats. When compared with control cases, FeLV-positive cats had significantly less proliferative stomatitis lesions, and they tended to have more lingual ulcers. Concurrently, FeLV-positive cats had significantly less tooth resorptive lesions. No other significant differences in FCGS clinical signs were found between groups. FeLV-positive cats had a significantly worse outcome after dental extractions compared to the other groups. In fact, FeLV-positive cats had 7.5 times more chances of having no improvement after dental extractions. This study concludes that the response to dental extractions in FeLV-positive cats is significantly worse, when comparing to cats that do not carry retroviral disease. Therefore, it is important to acknowledge the effect of FeLV status on the prognosis of these cats.

O presente texto problematiza os diferentes modelos de letramento vigentes nos estudos da linguagem para se pensar as práticas sociais na educação superior a distância no Brasil. O estudo aponta o modelo teórico dos transletramentos como uma referência útil à reflexão sobre e ação de apropriação tecnológica crítica do aparato tecnológico da EAD online, por estar tal modelo inserido em um novo paradigma sociocultural e contribuir para a superação de práticas e concepções com viés instrumentalista, determinista e utilitarista na educação a distância. Ao qualificar as práticas e modos de produção de sentido como atravessamentos de papéis, mídias e linguagens por sujeitos que buscam superar a dimensão meramente funcional dos letramentos contemporâneos, o modelo dos transletramentos favorece o desenvolvimento dos atores educacionais envolvidos na docência em EaD em uma outra lógica, mais progressista e crítica, voltada para qualificar o processo formativo a distância e romper com programas de formação com viés puramente mercadológico.

RESUMO: Objetivos – Avaliar o efeito de um programa de exercícios direcionado para os músculos do core e membros inferiores no equilíbrio em idosos residentes na comunidade. Método – Foram recrutados 11 indivíduos (10M; 1H), com média de idades de 80±6,9 anos, independentes e residentes na comunidade. Foram avaliadas as seguintes variáveis: equilíbrio através do teste clínico modificado de interação sensorial no equilíbrio (MCTSIB) na plataforma Balance Master®; o risco de queda com a Escala de Equilíbrio de Berg; o medo de cair com a Falls Efficacy Scale; a força dos membros inferiores com o Sit-to-Stand 30 segundos; a resistência e força dos músculos do core com o Supine Bridge e o Abdominal Stage Test e a mobilidade com o 8-foot Up and Go Test. Foi implementado um programa bissemanal de exercícios para os músculos do core durante seis semanas. Resultados – Após a intervenção registaram-se diferenças estatisticamente significativas nos testes Sit-to-Stand, Supine Bridge e MCTSIB Foam-Eyes Closed. Conclusões – A realização de um programa de exercícios direcionado para o treino dos músculos do core e dos membros inferiores não mostrou efeitos significativos no equilíbrio numa amostra de idosos residentes na comunidade, verificando-se, no entanto, um aumento da força dos membros inferiores e da resistência dos músculos do core.

In the following study, three different dairy by-products, previously concentrated by ultrafiltration (UF), were used as ingredients in the production of reduced-fat (RF) washed curd cheeses in order to improve their characteristics. Conventional full-fat (FF) cheeses (45% fat, dry basis (db)) and RF cheeses (20–30% fat, db) were compared to RF cheeses produced with the incorporation of 5% concentrated whey (RF + CW), buttermilk (RF + CB) or sheep second cheese whey (RF + CS). Protein-to-fat ratios were lower than 1 in the FF cheeses, while RF cheeses ranged from 1.8 to 2.8. The tested by-products performed differently when added to the milk used for cheese production. The FF cheese showed a more pronounced yellow colour after 60 and 90 days of ripening, indicating that fat plays an important role regarding this parameter. As far as the texture parameters are concerned, after 60 days of ripening, RF cheeses with buttermilk presented similar results to FF cheeses for hardness (5.0–7.5 N) and chewiness (ca. 400). These were lower than the ones recorded for RF cheeses with added UF concentrated whey (RF + CW) and second cheese whey (RF + CS), which presented lower adhesiveness values. RF cheeses with 5% incorporation of buttermilk concentrated by UF presented the best results concerning both texture and sensory evaluation.

O texto discute os desafios enfrentados por atores educacionais que exercem sua prática pedagógica em ambiente virtual de aprendizagem e problematiza concepções que tutores possuem sobre aspectos da formação a distância. Um questionário foi aplicado em 386 tutores de diferentes regiões do Brasil que trabalham com formação de professores em nível superior a distância. Os resultados mostram que a maioria dos tutores acredita na potencialidade da Educação a Distância (EaD) para uma formação de qualidade, apresenta-se dividida quanto a responsabilidade da tutoria para o sucesso do curso, considera ser mais complexo exercer a docência a distância e evidencia em suas concepções que o mercado de trabalho ainda possui forte preconceito com a EaD.

An exchange perspective of the relationship customer-grocery recognizes the important role that both the seller and the shopper assume in their relationships. Today consumers are increasingly considering green consumption, which has led to a situation where retailers expend substantial resources in response to this challenge. However, this consumption has remained lackluster justifying the need for greater knowledge about consumers’ behaviour. The purpose of this paper is to characterize groups of customers based on their perceptions of value, satisfaction with retailers as well as on risk perceived associated with their environmentally consumption practices. As a result of cluster analysis, we obtained a consumers’ typology differing in their relational benefits, satisfaction and risks perceptions. Some suggestions are given to retailers and also recommendations about the need to closely consider their product offerings to ascertain what aspects contribute to the value considered by shoppers.

O texto apresenta os resultados de uma investigação sobre o papel e a prática de professores tutores de diferentes regiões do país que trabalham com a formação de professores a distância. Um questionário foi aplicado a 386 professores tutores para avaliar os diferentes papéis que ocupam e a intensidade com que se percebem neles, bem como as funções desenvolvidas por esses sujeitos. Os dados foram submetidos a análises descritivas e cruzamentos. Os resultados evidenciam que o tutor carece de identidade profissional e que, apesar da variedade de papéis ocupados simultaneamente, exerce com maior intensidade o papel de motivador. Suas funções revelam transitoriedade entre uma prática pedagógica e uma prática administrativa.

El artículo presenta los principales resultados del proyecto «M-Learning: Una implantación innovadora» , desarrollado por el Laboratorio de Innovación Tecnológica Aplicado a la Educación lantec/unicamp. Éste proyecto ha tenido como objetivo desarrollar un ambiente colaborativo de aprendizaje para los profesores de matemáticas de enseñanza obligatoria, pertenecientes a centros educativos con un Índice de Desarrollo de la Educación Básica (ideb) inferior o igual a 4. Se ha realizado un cuestionario semi-estructurado para evaluar la percepción de los profesores-alumnos sobre la contribución del curso para el desarrollo de procesos colaborativos entre los participantes. Se buscaba asimismo la producción de conocimientos que puedan transformar cualitativamente las prácticas escolares de los profesores. Han participado en la investigación 123 individuos de diferentes regiones de Brasil. Los datos recogidos han sido sometidos a un análisis descriptivo y de contenido. Los resultados han mostrado que a lo largo del curso, los profesores han intensificado su interacción con sus compañeros, mejorando en el dominio de los recursos tecnológicos y en su uso e intercambio con los colegas de profesión. De esta forma se ha posibilitado la creación de nuevas modalidades de enseñanza y de aprendizaje de las matemáticas en la escuela.

O texto discute o processo de implementação do Sistema Nacional de Avaliação da Educação Superior por meio de análise de textos, leis e decretos que marcaram sua trajetória. Problematiza as contribuições/contradições, avanços/retrocessos observados neste processo e recupera os significados da categoria de contra-regulação como possibilidade de resistência propositiva no campo de regulação da qualidade da educação superior brasileira. Ancorada nos processos de auto-avaliação institucional e no protagonismo dos atores locais aponta esta estratégia como possibilidade institucional para pensar e agir consoante aos princípios progressistas observados na Lei do SINAES em sua proposta original, enfrentando as tensões inerentes ao campo da avaliação.

O texto discute o processo de implementação do Sistema Nacional de Avaliação da Educação Superior por meio de análise de textos, leis e decretos que marcaram sua trajetória. Problematiza as contribuições/contradições, avanços/retrocessos observados neste processo e recupera os significados da categoria de contra-regulação como possibilidade de resistência propositiva no campo de regulação da qualidade da educação superior brasileira. Ancorada nos processos de auto-avaliação institucional e no protagonismo dos atores locais aponta esta estratégia como possibilidade institucional para pensar e agir consoante aos princípios progressistas observados na Lei do SINAES em sua proposta original, enfrentando as tensões inerentes ao campo da avaliação.

Introdução: A fibrilhação auricular é a arritmia sustentada mais prevalente. Está provada a eficácia da anticoagulação oral na prevenção do acidente vascular cerebral nestes doentes. Contudo, este parece ser um tratamento subutilizado. Objectivos: determinar a prevalência de fibrilhação auricular conhecida numa população dos Cuidados de Saúde Primários; identificar as principais comorbilidades, a terapêutica antitrombótica em curso e avaliar a sua adequação segundo as recomendações da European Society of Cardiology. Material e Métodos: Estudo observacional transversal analítico. População: todos os utentes com idade igual ou superior a 30 anos, inscritos em oito Unidades de Saúde Familiar de Vila Nova de Gaia, com diagnóstico de fibrilhação auricular. Resultados: A prevalência de fibrilhação auricular foi de 1,29% (n = 940), sendo superior no género masculino (p = 0,01) e aumentando com a idade (p < 0,001). As comorbilidades mais frequentes foram a hipertensão arterial (76,4%), a insuficiência cardíaca (32,0%) e a diabetes mellitus (28,2%). Um total de 52% realizava terapêutica anticoagulante, 29% antiagregantes plaquetários e 4% ambas as terapêuticas. Dos utentes com baixo risco trombótico, 63,6% estava a fazer erradamente algum tipo de terapêutica antitrombótica; dos utentes com elevado risco ou doença valvular 56,8% estava adequadamente sob terapêutica anticoagulante. Conclusão: A prevalência de fibrilhação auricular bem como a frequência das principais comorbilidades estão de acordo com a maioria dos estudos. Apesar de a maioria dos doentes se encontrar sob anticoagulação oral, apenas 56,8% dos utentes com fibrilhação auricular fazia terapêutica antitrombótica adequada segundo as recomendações da European Society of Cardiology, verificando-se uma subutilização acentuada deste tratamento. Palavras-chave: Fibrilhação Auricular; Anticoagulantes; Acidente Vascular Cerebral; Cuidados de Saúde Primários; Portugal.

Objectivos: Caracterizar as referenciações efectuadas pelos Cuidados de Saúde Primários (CSP) à consulta da Unidade de Psiquiatria da Infância e da Adolescência (UPIA) do Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNG/E); avaliar a comunicação entre os dois níveis de cuidados. Tipo de Estudo: Observacional descritivo transversal. Local: UPIA do Serviço de Psiquiatria e Saúde Mental do CHVNG/E. População: A amostra incluiu todas as referenciações dirigidas à referida unidade provenientes dos CSP, via ALERT P1®, durante os anos de 2010 e 2011. Métodos: Procedeu-se à análise descritiva das variáveis género, idade, motivo de referenciação, prioridade da referenciação, prioridade atribuída pelo triador, motivo de recusa/devolução do pedido, tempo de espera, comparência do utente e qualidade da carta de referenciação. Resultados: A análise incluiu 980 referenciações (61,5% do género masculino). A faixa etária entre os 6-10 anos foi a mais referenciada (41,4%). O motivo mais referenciado foi “Sinais/sintomas do comportamento da criança” (31,9%). De todos os pedidos, 16,9% foram considerados urgentes pelo médico de família. Destes, 11,6% foram considerados prioritários pelo triador. De todas as referenciações, 11,3% foram recusadas/devolvidas, maioritariamente devido a informação insuficiente (36,1%). Cerca de 90% das referenciações consideradas prioritárias foram agendadas num prazo ≤ 60 dias e quase 100% das restantes referenciações foram marcadas num prazo ≤ 150 dias. Das 853 primeiras consultas marcadas, 10,5% das crianças faltaram à consulta e não pediram remarcação da mesma. Cerca de 20% das referenciações foram consideradas de boa qualidade e cerca de 14% de má qualidade. Conclusões: Os resultados sugerem que a articulação e a comunicação entre o médico de família e o psiquiatra da infância e da adolescência são eficazes, embora alguns aspectos possam ser melhorados, nomeadamente a adequação das prioridades atribuídas e a qualidade da informação dos pedidos de consulta.

O texto apresenta o perfil dos tutores do programa Unesp/Univesp e discute as concepções que esses sujeitos possuem sobre aspectos da formação a distância. Para tanto, foi aplicado um questionário em 41 tutores. Os resultados mostram que, de maneira geral, os tutores acreditam na EaD para uma formação de qualidade de professores e consideram o trabalho de tutoria fundamental para garantir a qualidade da interação entre os alunos. Os materiais instrucionais ocupam um lugar de destaque no processo de aprendizagem para um número considerável de sujeitos. Suas concepções também evidenciam que o preconceito com a EaD ainda é forte no mercado de trabalho.

Abstract Background: Estimative of left ventricular ejection fraction (LVEF) is a major indication for echocardiography. Speckle tracking echocardiography (STE) allows analysis of LV contraction mechanics which includes global longitudinal strain (GLS) and twist/torsion, both the most widely used. Direct comparison of correlations between these novel parameters and LVEF has never been done before. Objective: This study aims to check which one has the highest correlation with LVEF. Methods: Patients with normal LVEF (> 0,55) and systolic dysfunction (LVEF