Evaluation of the improvements on pharmacy technicians' work practices after implementation of operational procedures

Several antineoplasic drugs have been demonstrated to be carcinogenic or to have mutagenic and teratogenic effects. The greatest protection is achieved with the implementation of administrative and engineering controls and safety procedures. Objective: to evaluate the improvements on pharmacy technicians' work practices, after the implementation of operational procedures related to individual protection, biologic safety cabinet disinfection and cytotoxic drug preparation. Method: case-study in a hospital pharmacy undergoing a certification process. Six pharmacy technicians were observed during their daily activities. Characterization of the work practices was made using a checklist based on ISOPP and PIC guidelines. The variables studied concerning cleaning/disinfection procedures, personal protective equipment and procedures for preparing cytotoxic drugs. The same work practices were evaluated after four months of operational procedures implementation. Concordance between work practices and guidelines was considered to be a quality indicator (guidelines concordance practices number/total number of practices x 100). Results: improvements were observed after operational procedures implementation. An improvement of 6,25% in personal protective equipment practice was achieved by changing second pair of gloves every thirty minutes. The major progress, 10%, was obtained in disinfection procedure, where 80% of tasks are now realized according to guidelines.By now, we hot an improvement of only 1% at drug preparation procedure by placing one cytotoxic drug at a time inside the biological safety cabinet. Then, 85% of practices are according to guidelines. Conclusion: before operational procedures implementation 80,3% of practices were according to the guidelines, while now is 84,4%. This indicates that is necessary to review the procedures frequently in the benefit to reduce the risks associated with handling cytotoxic drugs and maintenance of drug specifications.

Mobi_System: A Personal Travel Assistance for Electrical Vehicles in Smart Cities

In this work it is proposed the design of a mobile system to assist car drivers in a smart city environment oriented to the upcoming reality of Electric Vehicles (EV). Taking into account the new reality of smart cites, EV introduction, Smart Grids (SG), Electrical Markets (EM), with deregulation of electricity production and use, drivers will need more information for decision and mobility purposes. A mobile application to recommend useful related information will help drivers to deal with this new reality, giving guidance towards traffic, batteries charging process, and city mobility infrastructures (e. g. public transportation information, parking places availability and car & bike sharing systems). Since this is an upcoming reality with possible process changes, development must be based on agile process approaches (Web services).

Drug therapy complexity: the importance of pharmacotherapeutic follow-up

Nowadays, the phenomenon of population ageing represents an worldwide problem, which assumes particular significance in Portugal. As they get older, individuals present more comorbidities and consequently consume an increasing number of drugs, which contributes to a growing drug therapy complexity. The institutionalized elders are particularly affected by this occurrence. Drug therapy complexity is defined as the conciliator of several characteristics of the pharmacotherapy and can affect patient’s safety and medication adherence. It can be measured with Medication Regimen Complexity Index (MRCI). This study aims to determine the drug therapy complexity of institutionalized elders in order to assess the need of pharmacotherapeutic follow-up.

Mulheres em morte-cor: os objetos que fazem e desfazem corpos e cancros metastáticos

Este texto sintetiza o último capítulo da investigação de doutoramento – Objetos feitos de cancro: a cultura material como pedaço de doença em histórias de mulheres contadas pela arte. Através de uma reflexão em torno dos objetos e materialidades que ganham forma e relevo em projetos artísticos referentes à experiência feminina do cancro, esta tese propõe conceitos alternativos de cultura material e de doença oncológica. Rejeita-se uma separação ou diferenciação entre dimensões materiais e intangíveis na doença, entendendo-se os objetos de cultura material como pedaços de cancro, ou seja, enquanto partes constitutivas das ideias, sensações, emoções e gestos que fazem a experiência do corpo doente. Objetos hospitalares, domésticos e pessoais, de uso coletivo ou individual, onde se incluem materialidades descartáveis, vestuário, mobiliário, equipamento e máquinas, compõem uma lista de realidades que se encastram nas experiências do corpo em diagnóstico, internamento, tratamento, reconstrução, remissão, recorrência, metastização e morte. Dando nome a esta continuidade indivisa, propus os conceitos “objeto nosoencastrável” e “doença modular”, pretendendo, na forma como defino as coisas, os mesmos encaixes que existem na realidade vivida. Para compreender a ação, os usos e os sentidos dos objetos que fazem e são pedaços de cancro(s), o campo de trabalho desta investigação abrangeu as imagens e os textos explicativos de cento e cinquenta projetos artísticos produzidos por ou com mulheres que viveram a experiência desta doença. Expostos na Internet, os exercícios criativos, amadores ou profissionais, de fotografia comercial e artística, pintura, desenho, colagem, modelagem, escultura, costura e tricô serviram de terreno narrativo e visual, permitindo-me encontrar a versão émica dos encaixes entre cultura material e doença. Tocar a continuidade entre objetos e cancros, juntando os saberes do corpo, da arte e da antropologia, assentou numa abordagem teórica e metodológica onde ensaiei o potencial heurístico daquilo a que chamo a “terceira metade das coisas e do conhecimento”.

A student personal system for Bologna process mobility

The Bologna Process aimed to build a European Higher Education Area with the objective of promoting students mobility. The adoption of Bologna Declaration directives requires a decentralized approach that accelerates student's mobility, based on frequently updated legislation. This paper proposes a student personal system to manage student's academic information. This system is supported by a flexible model that integrates, for instance, knowledge about the student attended courses or about a course that the student wishes to apply. Essentially, this model holds a (i) Student's Academic Record with skills acquired in academic course units, professional experience or training and an (ii) Individual Studies Plan, which places the student in a particular (iii) Course Plan setting the curricular structure that the student wishes to apply.

An Interface to Retrieve Personal Memories Using an Iconic Visual Language

Relevant past events can be remembered when visualizing related pictures. The main difficulty is how to find these photos in a large personal collection. Query definition and image annotation are key issues to overcome this problem. The former is relevant due to the diversity of the clues provided by our memory when recovering a past moment and the later because images need to be annotated with information regarding those clues to be retrieved. Consequently, tools to recover past memories should deal carefully with these two tasks. This paper describes a user interface designed to explore pictures from personal memories. Users can query the media collection in several ways and for this reason an iconic visual language to define queries is proposed. Automatic and semi-automatic annotation is also performed using the image content and the audio information obtained when users show their images to others. The paper also presents the user interface evaluation based on tests with 58 participants.

A transição de aluno a professor: dificuldades e desafios

Dissertação apresentada à Escola Superior de Educação de Lisboa para a obtenção do Grau de Mestre em Ciências da Educação - especialidade Supervisão em Educação

A estrutura da narrativa na escrita dos alunos surdos

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ciências da Educação - Especialização em Educação Especial

Profissionais de relações públicas: história oral de vida

Este estudo tem como objetivo descrever o método de história de vida, bem como a história de vida através da oralidade como importantes métodos a serem utilizados nas investigações em Relações Públicas. O método de história de vida é parte da abordagem biográfica, apresentando os conceitos-chave que fazem parte dos métodos e pontos de partida para uma investigação com o profissional de Relações Públicas decorrentes da aplicação dos métodos. O estudo incide sobre a análise das narrativas contadas pelos profissionais de Relações Públicas tendo por base a sua própria “História de Vida”. Centra-se inicialmente no “como”, no “porquê” e no “quando” de uma profissão vistos através da “História Oral de Vida” dos seus profissionais. Está assente em “Como os profissionais chegaram ao exercício da atividade de Relações Públicas?”, “O porquê de seguirem esta escolha?” e “Quando seguiram esta escolha?”. A História Oral de Vida tem sido aplicada noutras áreas, agora sendo relevante para trazer à tona as narrativas dos profissionais de Relações Públicas. A valorização da narrativa pessoal/profissional dos praticantes de Relações Públicas na constituição do profissional, para que se possa estudá-lo para além das organizações. Um dos objetivos relevantes é a possível caracterização da escolha profissional e até que ponto pode contribuir-se para a formação de outros profissionais da área. O papel central do profissional de Relações Públicas que habitualmente fala em nome de uma organização, passa a ser posto à parte para que o profissional seja o sujeito-narrador da sua própria história. O estudo salienta a importância dos profissionais de Relações Públicas através da relevância dada às narrativas. Ao fazer-se a “História Oral de Vida” estamos a trazer à área um novo contributo para aprofundar o conhecimento sobre a atividade.

Travelling to India: Eliza Fay’s narrative account of her voyages

Eliza Fay’s Original Letters from India (1817), initially sold to the Calcutta Gazette to pay off her debts, aroused the curiosity and interest of Edward M. Forster, while he was doing research for his best-selling novel, A Passage to India. In his own words, “Eliza Fay is a work of art.” (apud Fay 7) The value of E. Fay’s travelogue, comprising not one, but three voyages to India (in 1779, 1784, 1796) can be easily explained if we take into account the scope of its geographical coverage, the hardships of its historical context (the political chaos brought about by the fall of the Mughal empire and the consolidation of the British rule in the Indian subcontinent) and the heroism of the first person-narrator that emerges behind the descriptive sketches and the scenes of adversity and imminent danger. Thus the current analysis will focus on the E. Fay’s adventurous mode of narrating, e.g., the discursive situatedness of the traveller visà- vis the Other(s) (European and non-European peoples and loci) and the constraints imposed by the patriarchal idealization of the domestic Woman and their alleged feebleness.

An evaluation of SAFIRE’s potential to reduce the dose received by paediatric patients undergoing CT: a narrative review

Introduction: The purpose of this review is to gather and analyse current research publications to evaluate Sinogram-Affirmed Iterative Reconstruction (SAFIRE). The aim of this review is to investigate whether this algorithm is capable of reducing the dose delivered during CT imaging while maintaining image quality. Recent research shows that children have a greater risk per unit dose due to increased radiosensitivity and longer life expectancies, which means it is particularly important to reduce the radiation dose received by children. Discussion: Recent publications suggest that SAFIRE is capable of reducing image noise in CT images, thereby enabling the potential to reduce dose. Some publications suggest a decrease in dose, by up to 64% compared to filtered back projection, can be accomplished without a change in image quality. However, literature suggests that using a higher SAFIRE strength may alter the image texture, creating an overly ‘smoothed’ image that lacks contrast. Some literature reports SAFIRE gives decreased low contrast detectability as well as spatial resolution. Publications tend to agree that SAFIRE strength three is optimal for an acceptable level of visual image quality, but more research is required. The importance of creating a balance between dose reduction and image quality is stressed. In this literature review most of the publications were completed using adults or phantoms, and a distinct lack of literature for paediatric patients is noted. Conclusion: It is necessary to find an optimal way to balance dose reduction and image quality. More research relating to SAFIRE and paediatric patients is required to fully investigate dose reduction potential in this population, for a range of different SAFIRE strengths.

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.

The effects of clinical support surfaces on pressure as a risk factor in the development of pressure ulcers, from a radiographical perspective: a narrative literature review

Purpose: Pressure ulcers are a high cost, high volume issue for health and medical care providers, having a detrimental effect on patients and relatives. Pressure ulcer prevention is widely covered in the literature, but little has been published regarding the risk to patients in the radiographical setting. This review of the current literature is to identify findings relevant to radiographical context. Methods: Literature searching was performed using Science Direct and Medline databases. The search was limited to articles published in the last ten years to remain current and excluded studies containing participants less than 17 years of age. In total 14 studies were acquired; three were excluded as they were not relevant. The remaining 11 studies were compared and reviewed. Discussion: Eight of the studies used ‘healthy’ participants and three used symptomatic participants. Nine studies explored interface pressure with a range of pressure mat technologies, two studies measured shear (MRI finite element modelling, and a non-invasive instrument), and one looked at blood flow and haemoglobin oxygenation. A range of surfaces were considered from trauma, nursing and surgical backgrounds for their ability to reduce pressure including standard mattresses, high specification mattresses, rigid and soft layer spine boards, various overlays (gel, air filled, foam). Conclusion: The current literature is not appropriate for the radiographic patient and cannot be extrapolated to a radiologic context. Sufficient evidence is presented in this review to support the need for further work specific to radiography in order to minimise the development of PU in at risk patients.

A narrative review on the reduction of effective dose to a paediatric patient by using different combinations of kVp, mAs and additional filtration whilst maintaining image quality

This paper reviews the literature for lowering of dose to paediatric patients through use of exposure factors and additional filtration. Dose reference levels set by The International Commission on Radiological Protection (ICRP) will be considered. Guidance was put in place in 1996 requires updating to come into line with modern imaging equipment. There is a wide range of literature that specifies that grids should not be used on paediatric patients. Although much of the literature advocates additional filtration, contrasting views on the relative benefits of using aluminium or copper filtration, and their effects on dose reduction and image quality can vary. Changing kVp and mAs has an effect on the dose to the patient and image quality. Collimation protects adjacent structures whilst reducing scattered radiation.

Herb-drug interactions among commonly used psychoactive substances by healthcare students

The concurrent use of herbs and/or nutritional supplements with psychoactive effect and prescription medications is common among college students. College students are a particularly vulnerable population, for they are under less social/familiar surveillance and seek greater independence, as well as under greater intellectual effort, stress, anxiety and depression, which predispose them to a higher consumption of psychoactive substances. Herbs, vitamins, and other dietary supplements may influence the effects of prescription and nonprescription drugs leading to adverse consequences, by increasing the potential for interactions. However, documented interactions between herbal medicinal products and prescribed drugs are rare. Objective: determine the prevalence of concomitant use of psychoactive substances among healthcare students in the Lisbon School of Health Technology, Portugal, in order to assess the risk of potential herb-drug interactions.