Assessment of nursing students and nurses' orientation towards patient-centeredness

Background - Being patient centered is a core value for nursing. Patient centered-care has been related to patient and health provider satisfaction, better health outcomes, higher quality of care and more efficient health care delivery. Objectives - The purpose was to assess the orientation adopted by nurses and students in patient care, using The Patient-Practitioner Orientation Scale, as well as to compare the results between resident nurses and students from different academic years. Settings - Public School of Nursing and a Central Hospital, in Lisbon (Portugal). Participants - Students in the first, second and fourth year of nursing school and nurses participated in the study. Methods - For data collection, we used The Patient-Practitioner Orientation Scale (European Portuguese version), an instrument designed to measure individual preferences toward the dimension of caring a sharing in health professional-patient relationship. Students and nurses also filled out two additional questions about their perception of competence in technical and communication skills. Additional demographic information was also collected, including gender, age, academic year and length of professional experience. Results - A total of 525 students (84.7% female) and 108 nurses (77.8% female) participated in this study. In general, caring sub-scores, measuring the preference of about attending to patient emotional aspects, were higher than sharing sub-scores, measuring beliefs about giving information and perceiving patient as a member of the health team. Students were significantly more patient-centered throughout their nursing education (p<0.001). Comparing to students in the second and fourth academic years (p<0.001) nurses' scores were significantly lower both in total PPOS and in caring and sharing subscales. Conclusions - These results reinforce the idea that patient centeredness may be developed in academic context. The scores obtained highlight the importance of studies that aim to identify factors that may explain the decrease of patient centeredness in professional practice.

Design of improved rail-to-rail low-distortion and low-stress switches in advanced CMOS technologies

This paper describes the efficient design of an improved and dedicated switched-capacitor (SC) circuit capable of linearizing CMOS switches to allow SC circuits to reach low distortion levels. The described circuit (SC linearization control circuit, SLC) has the advantage over conventional clock-bootstrapping circuits of exhibiting low-stress, since large gate voltages are avoided. This paper presents exhaustive corner simulation results of a SC sample-and-hold (S/H) circuit which employs the proposed and optimized circuits, together with the experimental evaluation of a complete 10-bit ADC utilizing the referred S/H circuit. These results show that the SLC circuits can reduce distortion and increase dynamic linearity above 12 bits for wide input signal bandwidths.

Aumento de capacidade em sistemas MIMO coordenados para advanced LTE com utilização de repetidores fixos

Com vista a revolucionar o sector das comunicações móveis, muito à custa dos elevados débitos prometidos, a tecnologia LTE recorre a uma técnica que se prevê que seja bastante utilizada nas futuras redes de comunicações móveis: Relaying. Juntamente com esta técnica, o LTE recorre à técnica MIMO, para melhorar a qualidade da transmissão em ambientes hostis e oferecer elevados ritmos de transmissão. No planeamento das próximas redes LTE, o recurso à técnica Relaying é frequente. Esta técnica, tem como objectivo aumentar a cobertura e/ou capacidade da rede, e ainda melhorar o seu desempenho em condições de fronteira de célula. A performance de uma RS depende da sua localização, das condições de propagação do canal rádio a que tanto a RS como o EU estão sujeitos, e ainda da capacidade que a RS tem de receber, processar e reencaminhar a informação. O objectivo da tese é estudar a relação existente entre o posicionamento de uma RS e o seu desempenho. Desta forma, pretende-se concluir qual a posição ideal de uma RS (tanto do tipo AF como SDF). Para além deste estudo, é apresentado um comparativo do desempenho dos modos MIMO TD e OL-SM, onde se conclui em que condições deverão ser utilizados, numa rede LTE equipada com FRSs.

Proof in classroom social practice

How does the construction of proof relate to the social practice developed in the mathematics classroom? This report addresses the role of diagrams in order to focus the complementarity of participation and reification in the process of constructing a proof and negotiating its meaning. The discussion is based on the analysis of the mathematical practice developed by a group of four 9th grade students and is inspired by the social theory of learning

Advanced side information creation techniques and framework for Wyner-Ziv video coding

Recently, several distributed video coding (DVC) solutions based on the distributed source coding (DSC) paradigm have appeared in the literature. Wyner-Ziv (WZ) video coding, a particular case of DVC where side information is made available at the decoder, enable to achieve a flexible distribution of the computational complexity between the encoder and decoder, promising to fulfill novel requirements from applications such as video surveillance, sensor networks and mobile camera phones. The quality of the side information at the decoder has a critical role in determining the WZ video coding rate-distortion (RD) performance, notably to raise it to a level as close as possible to the RD performance of standard predictive video coding schemes. Towards this target, efficient motion search algorithms for powerful frame interpolation are much needed at the decoder. In this paper, the RD performance of a Wyner-Ziv video codec is improved by using novel, advanced motion compensated frame interpolation techniques to generate the side information. The development of these type of side information estimators is a difficult problem in WZ video coding, especially because the decoder only has available some reference, decoded frames. Based on the regularization of the motion field, novel side information creation techniques are proposed in this paper along with a new frame interpolation framework able to generate higher quality side information at the decoder. To illustrate the RD performance improvements, this novel side information creation framework has been integrated in a transform domain turbo coding based Wyner-Ziv video codec. Experimental results show that the novel side information creation solution leads to better RD performance than available state-of-the-art side information estimators, with improvements up to 2 dB: moreover, it allows outperforming H.264/AVC Intra by up to 3 dB with a lower encoding complexity.

Visual Screening Competencies Questionnaire (VSCQ) and orthoptic practice

The identification of core competencies which are important for undertaking accurate visual screening by orthoptists is considered in this study. The aim was to construct and validate a questionnaire for orthoptists to assess visual screening competency. This study comprised three steps. The first step involved a 69-item self-assessment questionnaire constructed to assess orthoptists' perception of their competencies in visual screening programs for children. This questionnaire was constructed with statements from the Orthoptic Benchmark Statement for Health Care Programmes (Quality Assurance Agency for Higher Education, UK) and included three competency dimensions: interpersonal (IP), instrumental (IT) and systemic (ST). The second step involved questionnaire translation.

Matrix Converter-Based Unified Power-Flow Controllers: Advanced Direct Power Control Method

This paper presents a direct power control (DPC) for three-phase matrix converters operating as unified power flow controllers (UPFCs). Matrix converters (MCs) allow the direct ac/ac power conversion without dc energy storage links; therefore, the MC-based UPFC (MC-UPFC) has reduced volume and cost, reduced capacitor power losses, together with higher reliability. Theoretical principles of direct power control (DPC) based on sliding mode control techniques are established for an MC-UPFC dynamic model including the input filter. As a result, line active and reactive power, together with ac supply reactive power, can be directly controlled by selecting an appropriate matrix converter switching state guaranteeing good steady-state and dynamic responses. Experimental results of DPC controllers for MC-UPFC show decoupled active and reactive power control, zero steady-state tracking error, and fast response times. Compared to an MC-UPFC using active and reactive power linear controllers based on a modified Venturini high-frequency PWM modulator, the experimental results of the advanced DPC-MC guarantee faster responses without overshoot and no steady-state error, presenting no cross-coupling in dynamic and steady-state responses.

Historical Heritage: A Study to Conservation

Considering ancient monuments and historical buildings, it seems that these mortars have proved to be durable and reliable materials. The restoration and maintenance of old renders is one of the key aspects of correct rehabilitation practice. The ideal course of action is to replace the damaged material by a material with compatible characteristics.The study in development presents the chemical, physical and morphologic analysis performed for ancient air lime mortars belonging to historical monuments: Santa Marta Fortress in the coast line Lisbon-Cascais dated from XVII century and Defense Wall of Lisbon dated from XI century, which layout could be associated to roman period. It is important to underline that the studied samples of ancient portuguese air lime mortars, have been submitted during centuries to very severe maritime environment that includes daily cycles of wet/dry, wind, friction and the constant presence of salts, generally aggressive. However, they show very good performance and conservation state, unlike most of the new air lime mortars, which are generally considered weak, not very durable, materials. This work is included in a study intending to determine key factors to the durability of these ancient materials in presence of water. Visible reaction rims around some aggregates suggests the occurrence of pozzolanic reactions between aggregates and the lime binder that creates neoformation products, such as calcium-silico-aluminates, which seems be, besides the pores filling, the responsible for the resistance and cohesion of these ancient mortars submitted to aggressive humid environments.

Scalable Unified Transform Architecture for Advanced Video Coding Embedded Systems

A novel high throughput and scalable unified architecture for the computation of the transform operations in video codecs for advanced standards is presented in this paper. This structure can be used as a hardware accelerator in modern embedded systems to efficiently compute all the two-dimensional 4 x 4 and 2 x 2 transforms of the H.264/AVC standard. Moreover, its highly flexible design and hardware efficiency allows it to be easily scaled in terms of performance and hardware cost to meet the specific requirements of any given video coding application. Experimental results obtained using a Xilinx Virtex-5 FPGA demonstrated the superior performance and hardware efficiency levels provided by the proposed structure, which presents a throughput per unit of area relatively higher than other similar recently published designs targeting the H.264/AVC standard. Such results also showed that, when integrated in a multi-core embedded system, this architecture provides speedup factors of about 120x concerning pure software implementations of the transform algorithms, therefore allowing the computation, in real-time, of all the above mentioned transforms for Ultra High Definition Video (UHDV) sequences (4,320 x 7,680 @ 30 fps).

Expert opinion on best practice guidelines and competency framework for visual screening in children

PURPOSE: Screening programs to detect visual abnormalities in children vary among countries. The aim of this study is to describe experts' perception of best practice guidelines and competency framework for visual screening in children. METHODS: A qualitative focus group technique was applied during the Portuguese national orthoptic congress to obtain the perception of an expert panel of 5 orthoptists and 2 ophthalmologists with experience in visual screening for children (mean age 53.43 years, SD ± 9.40). The panel received in advance a script with the description of three tuning competencies dimensions (instrumental, systemic, and interpersonal) for visual screening. The session was recorded in video and audio. Qualitative data were analyzed using a categorical technique. RESULTS: According to experts' views, six tests (35.29%) have to be included in a visual screening: distance visual acuity test, cover test, bi-prism or 4/6(Δ) prism, fusion, ocular movements, and refraction. Screening should be performed according to the child age before and after 3 years of age (17.65%). The expert panel highlighted the influence of the professional experience in the application of a screening protocol (23.53%). They also showed concern about the false negatives control (23.53%). Instrumental competencies were the most cited (54.09%), followed by interpersonal (29.51%) and systemic (16.4%). CONCLUSIONS: Orthoptists should have professional experience before starting to apply a screening protocol. False negative results are a concern that has to be more thoroughly investigated. The proposed framework focuses on core competencies highlighted by the expert panel. Competencies programs could be important do develop better screening programs.

Criatividade em Dança : conceções, métodos e processos de Composição Coreográfica no ensino da Dança

Preprint. Título do artigo editado:"Criatividade em Dança : conceções, métodos e processos de Composição Coreográfica no ensino da Dança". Publicação na Revista Portuguesa de Educação Artística, 2013 (3), pp. 47-59.

Análisis de la adecuación de libros de texto de E. Primaria a la enseñanza a estudiantes de altas capacidades matemáticas

Un problema al que se enfrentan los profesores de matemáticas de Enseñanza Primaria es la necesidad de hacer adaptaciones en sus programaciones para ofrecer una educación adecuada a sus alumnos de altas capacidades matemáticas. Las editoriales de libros de texto de matemáticas de estos niveles educativos ofrecen diversas soluciones que, usualmente, consisten en incluir, en el libro del alumno, algunos problemas más difíciles y, en la documentación del profesor, una propuesta de problemas de ampliación. Una cuestión que se plantea al analizar un libro de texto de matemáticas es valorar cómo de útil puede ser el material proporcionado por la editorial (libro de texto y materiales complementarios) para un profesor que necesita una programación específica para sus alumnos de altas capacidades matemáticas. En este artículo proponemos diversas variables con las que valorar el grado de adecuación a estudiantes de altas capacidades matemáticas de los documentos proporcionados a los profesores por las editoriales. Después ponemos en práctica esta propuesta analizando el tema dedicado a los cuadriláteros en 4º curso de Enseñanza Primaria de una editorial de amplia difusión en España. Las conclusiones globales son que los materiales del profesor analizados prestan poca atención a los estudiantes de altas capacidades matemáticas y que la metodología de análisis que hemos empleado permite identificar direcciones para plantear actividades interesantes para estos estudiantes.

The histopathological approach to inflammatory bowel disease: a practice guide

Inflammatory bowel diseases (IBDs) are lifelong disorders predominantly present in developed countries. In their pathogenesis, an interaction between genetic and environmental factors is involved. This practice guide, prepared on behalf of the European Society of Pathology and the European Crohn's and Colitis Organisation, intends to provide a thorough basis for the histological evaluation of resection specimens and biopsy samples from patients with ulcerative colitis or Crohn's disease. Histopathologically, these diseases are characterised by the extent and the distribution of mucosal architectural abnormality, the cellularity of the lamina propria and the cell types present, but these features frequently overlap. If a definitive diagnosis is not possible, the term indeterminate colitis is used for resection specimens and the term inflammatory bowel disease unclassified for biopsies. Activity of disease is reflected by neutrophil granulocyte infiltration and epithelial damage. The evolution of the histological features that are useful for diagnosis is time- and disease-activity dependent: early disease and long-standing disease show different microscopic aspects. Likewise, the histopathology of childhood-onset IBD is distinctly different from adult-onset IBD. In the differential diagnosis of severe colitis refractory to immunosuppressive therapy, reactivation of latent cytomegalovirus (CMV) infection should be considered and CMV should be tested for in all patients. Finally, patients with longstanding IBD have an increased risk for the development of adenocarcinoma. Dysplasia is the universally used marker of an increased cancer risk, but inter-observer agreement is poor for the categories low-grade dysplasia and indefinite for dysplasia. A diagnosis of dysplasia should not be made by a single pathologist but needs to be confirmed by a pathologist with expertise in gastrointestinal pathology.

Between theory and practice – teaching maths to elementary school students in Poland

The development of children's school achievements in mathematics is one of the most important aims of education in Poland. The results of research concerning monitoring of school achievements in maths is not optimistic. We can observe low levels of children’s understanding of the merits of maths, self-developed strategies in solving problems and practical usage of maths skills. This article frames the discussion of this problem in its psychological and didactic context and analyses the causes as they relate to school practice in teaching maths

Assessment of genotoxic effects in nurses handling cytostatic drugs

Several antineoplastic drugs have been classified as carcinogens by the International Agency for Research on Cancer (IARC) on the basis of epidemiological findings, animal carcinogenicity data, and outcomes of in vitro genotoxicity studies. 5-Fluorouracil (5-FU), which is easily absorbed through the skin, is the most frequently used antineoplastic agent in Portuguese hospitals and therefore may be used as an indicator of surface contamination. The aims of the present investigation were to (1) examine surface contamination by 5-FU and (2) assess the genotoxic risk using cytokinesis-block micronucleus assay in nurses from two Portuguese hospitals. The study consisted of 2 groups: 27 nurses occupationally exposed to cytostatic agents (cases) and 111 unexposed individuals (controls). Peripheral blood lymphocytes (PBL) were collected in order to measure micronuclei (MN) in both groups. Hospital B showed a higher numerical level of contamination but not significantly different from Hospital A. However; Hospital A presented the highest value of contamination and also a higher proportion of contaminated samples. The mean frequency of MN was significantly higher in exposed workers compared with controls. No significant differences were found among MN levels between the two hospitals. The analysis of confounding factors showed that age is a significant variable in MN frequency occurrence. Data suggest that there is a potential genotoxic damage related to occupational exposure to cytostatic drugs in oncology nurses.