A perspectiva dos profissionais de saúde nas inovações de gestão: Estudo de caso numa unidade de saúde

A necessidade de conciliar uma procura cada vez maior com as restrições de recursos humanos e financeiros levou a que se implementasse um conjunto de inovações que permitisse alcançar maior eficiência. No presente estudo aborda-se uma dessas iniciativas: os Hospitais SA. As implicações originadas por esta medida, ocorreram em termos de alterações de gestão e adopção de novos conceitos. Estas são algumas das dimensões estudadas. Em termos metodológicos pretende-se perceber como é que alguns dos profissionais de Saúde avaliam as modificações que ocorreram. Para tal, optou-se por levar a cabo um estudo de caso de um Hospital SA da região de Lisboa e Vale do Tejo, numa abordagem qualitativa, visando identificar a perspectiva dos profissionais de saúde nas inovações de gestão, relacionadas com as novas tecnologias, das quais se destacam: • Utilização da Internet; • Implementação e utilização da Intranet; • Desenvolvimento de Arquivos Digitais relativos a processos médicos; • Cartão Vital; • Aplicação Medivital. Para a recolha de dados será utilizada uma entrevista sarni-estruturada “que atribui maior liberdade ao investigador para conduzir a entrevista como achar ser mais conveniente, para a obtenção de dados que se revelem pertinentes" (Patton, 1990). Abstract; The need to conciliate the increasing search for healthcare over time with the restrictions of human and financial resources conducted to the implementation of a set of innovations that allowed a greater efficiency. ln the present study, one of those initiatives is presented: in the Hospitais SA. The implications of this measure occurred in terms of management modifications and in the adoption of new concepts. These are some of the studied dimensions. ln methodological terms, it’s intended to perceive how health professionals evaluate the modifications that occurred. For such, it was opted to present a case study of a Hospital SA from Lisboa e Vale do Tejo region, in a qualitative approach, aiming to identify the health professionals perspective of the management innovations related to the new technologies, from which the following, stand out: • Internet usage; • Implementation and use of Internet; • Development of Digital Archives related to medical processes; • Vital Card; • Medivital application. For data gathering a half-structuralized interview will be used "which gives greater freedom to the researcher to conduct the interview as he finds most convenient, in order to obtain relevant data" (Patton, 1990).

The Political and Social Dynamics of Poverty, Poor Relief and Health Care in Early-Modern Portugal

By the end of the fifteenth century most European countries had witnessed a profound reformation of their poor relief and health care policies. As this book demonstrates, Portugal was among them and actively participated in such reforms. Providing the first English language monograph on this topic, Laurinda Abreu examines the Portuguese experience and places it within the broader European context. She shows that, in line with much that was happening throughout the rest of Europe, Portugal had not only set up a systematic reform of the hospitals but had also developed new formal arrangements for charitable and welfare provision that responded to the changing socioeconomic framework, the nature of poverty and the concerns of political powers. The defining element of the Portuguese experience was the dominant role played by a new lay confraternity, the confraternity of the Misericórdia, created under the auspices of King D. Manuel I in 1498. By the time of the king's death in 1521 there were more than 70 Misericórdias in Portugal and its empire, and by 1640, more than 300. All of them were run according to a unified set of rules and principles with identical social objectives. Based upon a wealth of primary source documentation, this book reveals how the sixteenth-century Portuguese crown succeeded in implementing a national poor relief and health care structure, with the support of the Papacy and local elites, and funded principally through pious donations. This process strengthened the authority of the royal government at a time which coincided with the emergence of the early modern state. In so doing, the book establishes poor relief and public health alongside military, diplomatic and administrative authorities, as the pillars of centralisation of royal power.

Barriers to and facilitators of older adult’s adherence to health recommendations: Towards an EngAging two-way health communication

Non-adherence to health recommendations (e.g. medical prescriptions) presents potential costs for healthcare, which could be prevented or mitigated. This is often attributed to a person’s rational choice, to not adhere. However, this may also be determined by individual and contextual factors implied in the recommendations communication process. In accordance, this chapter focuses specifically on barriers to and facilitators of adherence to recommendations and engagement with the healthcare process, particularly concerning the communication between health professionals and patients. For this, the authors present examples of engagement increment through different degrees of participation, from a one-way/directive towards a two-way/engaging communication process. This focuses specifically on a vulnerable population group with increasing healthcare needs: older adults. Future possibilities for two-way engaging communications are discussed, aimed at promoting increased adherence to health recommendations and people’s self-regulation of their own health.

INTERNATIONAL EDUCATION & RESEARCH FOR OH. Experiences of international networks for collaborative education and research using the One Health approach.

The Authors describe first-hand experiences carried out within the framework of selected International projects aimed at developing collaborative research and education using the One Health (OH) approach. Special emphasis is given to SAPUVETNET, a series of projects co-financed under the EU-ALFA program, and aimed to support an International network on Veterinary Public Health (VPH) formed by Veterinary Faculties from Latin-America (LA) and Europe (EU). SAPUVETNET has envisaged a series of objectives/activities aimed at promoting and enhancing VPH research/training and intersectoral collaboration across LA and EU using the OH approach, as well as participating in research and/or education projects/networks under the OH umbrella, namely EURNEGVEC-European Network for Neglected Vectors & Vector-Borne Infections, CYSTINET-European Network on Taeniosis/Cysticercosis, and NEOH-Network for Evaluation of One Health; the latter includes expertise in multiple disciplines (e.g. ecology, economics, human and animal health, epidemiology, social and environmental sciences, etc.) and has the primary purpose of enabling quantitative evaluation of OH initiatives by developing a standardized evaluation protocol. The Authors give also an account of the ongoing creation of OHIN-OH International Network, founded as a spin-off result of SAPUVETNET. Finally, some examples of cooperation development projects characterised by an OH approach are also briefly mentioned.

Oral food perception and polyphenol-rich foods acceptance - the importance of knowing individuals saliva characteristics for promoting consumption

Polyphenols are widely present in fruits, vegetables, cereals and beverages. Their study gained scientific interest because of their beneficial effects on health. Although there is currently no official dietary recommendation for polyphenol intake, health professionals recommend the consumption of 5-8 daily portions of fruits and vegetables. This is not always achieved and, despite possible causes associated to practical schedule difficulties, the aversive bitter and astringent sensations associated to polyphenols may also lead to avoidance. As such, a better understanding on mechanisms responsible for differences among people, in polyphenol oral perception, is needed for promoting healthier choices. Saliva has been linked to polyphenol consumption. We have previously observed, in animal models, changes in salivary proteome induced by tannin-enriched diets. Moreover, differences in astringency perception were attributed to differences in salivary protein composition. In a recent experiment, we observed differences among individuals with dissimilar tannic-acid perception: people with high sensitivity for the oral sensations elicited by tannins have higher amounts of salivary cystatins and lower capacity to maintain their levels after tannic-acid ingestion. Additionally, and similarly to previous studies, salivary amylase was observed to be involved in tannin perception. In this presentation, oral cavity characteristics influencing the perception of polyphenol-containing foods will be discussed.

Quinn’s Leadership Roles: A Confirmatory Factor Analysis Study in Portuguese Health Services

Purpose: To evaluate psychometric properties of Quinn’s leadership questionnaire (CFV questionnaire; 1988) to the Portuguese health services. Design: Cross-sectional study, using the Quinn’s leadership questionnaire, administered to registered nurses and physicians in Portuguese health care services (N = 687). Method: Self-administered survey applied to two samples. In the first (of convenience; N = 249 Portuguese health professionals) were performed exploratory factor and reliability analysis to the CFV questionnaire. In the second sample (stratified; N = 50 surgical units of 33 Portuguese hospitals) was performed confirmatory factor analysis using LISREL 8.80. Findings: The first sample supported an eight-factor solution accounting for 65.46% of the variance, in an interpretable factorial structure (loadings> .50), with Cronbach’s α upper than .79. This factorial structure, replicated with the second sample, showed reasonable fit for each of the 8 leadership roles, quadrants, and global model. The models evidenced, generally, nomological validity, with scores between good and acceptable (.235 < x2/df < 2.055 e .00 < RMSEA < .077). Conclusions: Quinn’s leadership questionnaire presented good reliability and validity for the eight leadership roles, showing to be suitable for use in hospital health care context. Key-Words: Leadership; Quinn’s CVF questionnaire; health services; Quinn’s competing values.

the health and well-being of nursing students in clinical practice . what prevents it? what promotes it?

Introduction: The training of nursing students in the context of clinical practice, is characterized by educational experiences, subject to various emotional stress (stress, ambivalence, frustration, conflict), sometimes making it very vulnerable student.However not all students use the same strategies minimizing their meanings and negative effects on the level of your health and well-being Objetiv:To analyze the perception that nursing students have about the determinants of their health status and well-being in clinical practice Methods: Exploratory research Results:The results reveal the complexity of the teaching / learning process in clinical practice, identified determinants that limit and / or promote health and well-being of students, or not contributing to their motivation, self-confidence and learning. All students value the presence of the following dimensions: affective-emotional (humanization in learning experiences); relational dynamics (interactions developed with all stakeholders); methods used (professional competence of the clinical supervisor and teacher); school curriculum (adaptation of learning in theory); socialization to the profession (become nurse).Conclusions: The results indicate, that although all students evidencing the dimensions described as fundamental to learning in clinical practice, the study results are dichotomous and ambivalent. Students 2nd and 3ºanos refer a low perception in clinical practice, the indicated dimensions, and for these source of concern and uncertainty in learning, such as limiting their health condition and well-being. For students of the 4th year, these dimensions are percecionadas as gifts, and sources of motivation, learning and catalysts such as promoting their health and well-being.