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.

Parental predictors of poor visual outcome with occlusion treatment for unilateral amblyopia

Aim: Visual acuity outcome of amblyopia treatment depends on the compliance. This study aimed to determine parental predictors of poor visual outcome with occlusion treatment in unilateral amblyopia and identify the relationship between occlusion recommendations and the patient's actual dose of occlusion reported by the parents. Methods: This study comprised three phases: refractive adaptation for a period of 18 weeks after spectacle correction; occlusion of 3 to 6 hours per day during a period of 6 months; questionnaire administration and completion by parents. Visual acuity as assessed using the Sheridan-Gardiner singles or Snellen acuity chart was used as a measure of visual outcome. Correlation analysis was used to describe the strength and direction of two variables: prescribed occlusion reported by the doctor and actual dose reported by parents. A logistic binary model was adjusted using the following variables: severity, vulnerability, self-efficacy, behaviour intentions, perceived efficacy and treatment barriers, parents' and childrens' age, and parents' level of education. Results: The study included 100 parents (mean age 38.9 years, SD approx 9.2) of 100 children (mean age 6.3 years, SD approx 2.4) with amblyopia. Twenty-eight percent of children had no improvement in visual acuity. The results showed a positive mild correlation (kappa = 0.54) between the prescribed occlusion and actual dose reported by parents. Three predictors for poor visual outcome with occlusion were identified: parents' level of education (OR = 9.28; 95%CI 1.32-65.41); treatment barriers (OR = 2.75; 95%CI 1.22-6.20); interaction between severity and vulnerability (OR = 3.64; 95%CI 1.21-10.93). Severity (OR = 0.07; 95%CI 0.00-0.72) and vulnerability (OR = 0.06; 95%CI 0.05-0.74) when considered in isolation were identified as protective factors. Conclusions: Parents frequently do not use the correct dosage of occlusion as recommended. Parents' educational level and awareness of treatment barriers were predictors of poor visual outcome. Lower levels of education represented a 9-times higher risk of having a poor visual outcome with occlusion treatment.

A comparison of two attenuation correction methods in 111In-Pentetriotide abdominal SPECT

Tomographic image can be degraded, partially by patient based attenuation. The aim of this paper is to quantitatively verify the effects of attenuation correction methods Chang and CT in 111In studies through the analysis of profiles from abdominal SPECT, correspondent to a uniform radionuclide uptake organ, the left kidney.

Particularidades do ensino do canto a adolescentes no contexto da Escola de Música do Conservatório Nacional: relatório de estágio

Resumo I - O presente Relatório de Estágio foi elaborado no âmbito da Unidade Curricular (UC) de Estágio do Ensino Especializado (EEE) do Mestrado em Ensino da Música da Escola Superior de Música de Lisboa, ramo de especialização em Canto. Incide sobre a Prática Pedagógica desenvolvida com três alunos de Canto da Escola de Música do Conservatório Nacional (EMCN), no ano letivo de 2012/2013, em diferentes níveis de desenvolvimento vocal, adolescentes, ou tendo saído há pouco tempo da adolescência. Nesta secção, encontram-se enumeradas as principais linhas pedagógicas seguidas, assim como os principais motivos das opções tomadas. Descreve-se também a forma como foi organizado e planeado o trabalho técnico e musical desenvolvido com os alunos, adequado à fase de desenvolvimento físico e vocal de cada um, além do conjunto de atividades escolares realizadas, as quais tiveram como finalidade promover o seu desenvolvimento artístico.

Nuclear medicine technologist education and training in Europe: literature and web-based findings

Purpose - The education and training of a nuclear medicine technologist (NMT) is not homogeneous among European countries, which leads to different scope of practices and, therefore, different technical skills are assigned. The goal of this research was to characterize the education and training of NMT in Europe. Materials and methods - This study was based on a literature research to characterize the education and training of NMT and support the historical evolution of this profession. It was divided into two different phases: the first phase included analysis of scientific articles and the second phase included research of curricula that allow health professionals to work as NMT in Europe. Results - The majority of the countries [N=31 (89%)] offer the NMT curriculum integrated into the high education system and only in four (11%) countries the education is provided by professional schools. The duration in each education system is not equal, varying in professional schools (2-3 years) and high education level system (2-4 years), which means that different European Credit Transfer and Accumulation System, such as 240, 230, 222, 210 or 180 European Credit Transfer and Accumulation System, are attributed to the graduates. The professional title and scope of the practice of NMT are different in different countries in Europe. In most countries of Europe, nuclear medicine training is not specific and curriculum does not demonstrate the Nuclear Medicine competencies performed in clinical practice. Conclusion - The heterogeneity in education and training for NMT is an issue prevalent among European countries. For NMT professional development, there is a huge need to formalize and unify educational and training programmes in Europe.

The impact of Sinogram-Affirmed Iterative Reconstruction on patient dose and image quality compared to filtered back projection: a narrative review

Objective: Summarize all relevant findings in published literature regarding the potential dose reduction related to image quality using Sinogram-Affirmed Iterative Reconstruction (SAFIRE) compared to Filtered Back Projection (FBP). Background: Computed Tomography (CT) is one of the most used radiographic modalities in clinical practice providing high spatial and contrast resolution. However it also delivers a relatively high radiation dose to the patient. Reconstructing raw-data using Iterative Reconstruction (IR) algorithms has the potential to iteratively reduce image noise while maintaining or improving image quality of low dose standard FBP reconstructions. Nevertheless, long reconstruction times made IR unpractical for clinical use until recently. Siemens Medical developed a new IR algorithm called SAFIRE, which uses up to 5 different strength levels, and poses an alternative to the conventional IR with a significant reconstruction time reduction. Methods: MEDLINE, ScienceDirect and CINAHL databases were used for gathering literature. Eleven articles were included in this review (from 2012 to July 2014). Discussion: This narrative review summarizes the results of eleven articles (using studies on both patients and phantoms) and describes SAFIRE strengths for noise reduction in low dose acquisitions while providing acceptable image quality. Conclusion: Even though the results differ slightly, the literature gathered for this review suggests that the dose in current CT protocols can be reduced at least 50% while maintaining or improving image quality. There is however a lack of literature concerning paediatric population (with increased radiation sensitivity). Further studies should also assess the impact of SAFIRE on diagnostic accuracy.

Quality indicators in the education of children with profound Intellectual and multiple disabilities

Todas as crianças, independentemente das suas necessidades, deveriam ter acesso a uma educação de qualidade e a serem incluídas nas suas famílias e comunidades. Esta afirmação inclui as crianças mais vulneráveis, em particular as crianças com dificuldades intelectuais e multideficiência. Os resultados da investigação sobre a educação de crianças com dificuldades intelectuais e multideficiência ainda não produziram até ao momento informação suficiente que possa ser usada para desenvolver indicadores de qualidade para a avaliação das práticas e dos serviços. A investigação nesta área é limitada por constrangimentos éticos, dificuldades na determinação de amostras e desafios metodológicos, sendo reduzido o número de estudos capaz de produzir a informação necessária. Este artigo tem como objetivo discutir fatores que contribuam para a qualidade do envolvimento de crianças com dificuldades intelectuais e multideficiência em atividades educativas, com base na experiência das autoras e na informação disponível que tem sido publicada sobre este assunto. Com base nesta discussão é sugerido um conjunto de indicadores que poderão ajudar os profissionais a dirigir as suas observações para a qualidade da oferta educativa e para aspetos significativos dos desempenhos das crianças quando envolvidas em atividades curriculares.

Education for health: alcohol and young aged school teenagers

Introduction: Alcohol consumption starts at an early age in Portuguese people. Health problems and risk behavior associated with excessive consumption can be prevented or highly reduced through effective school programs. Health professionals, such as biomedical scientists, (BSc), are important in promoting healthy lifestyles through the transmission of knowledge. Objective: Explore the role of the BSc in promoting health via intervention and clarification actions, (ICA), with 9th grade students from Agrupamento de Escolas da Portela e Moscavide (AEPM) and Visconde Juromenha (AEVJ); Verify the relationship between participating in the ICA and the level of knowledge acquired from it. Methods: Behaviors and beliefs concerning alcohol consumption and knowledge about the repercussions of it in the human body, mainly regarding the liver, were assessed by questionnaire. The questionnaire was completed before and after the ICA, by the control group (CG) and the study group (SG), respectively. The answers concerning knowledge were given points, later converted to a score from 0 to 100%. Data was analyzed applying descriptive statistics and the t-student test using SPSS 20.0. Results: After statistical analysis, it was found an average score of 48.8% for SG and 46.2% for CG. The difference between groups was statistically significant only in AEPM where ICA included a practical methodology (microscopic and macroscopic observation of pork livers), contrary to AEVJ. Conclusions: BSc intervention through ICA’s improves teenagers’ knowledge. Theoretical knowledge associated with practical approaches improves the retention of information and the development of a conscious behavior about the consumption of alcohol.