Main features of the labour policy in Portugal

In this working paper is presented information on the Portuguese labour market developed with the support of the European project WORKS-“Work organisation and restructuring in the knowledge society”. Is still a on the process article and thus commentaries are welcome. The structure is based on the following topics: a) The employment policy (Time regimes - time use, flexibility, part-time work, work-life balance -, and the work contracts regimes – wages, contract types, diversity); b) Education and training (skilling outcomes, rules on retraining and further training, employability schemes, transferability of skills); c) Equal opportunities (relevance of equal opportunity regulation for restructuring outcomes, the role of gender and age regulation); d) Restructuring effects (policy on transfer of personnel, policy on redundancies, and participation or voice in restructuring).

Política(s) de saúde no trabalho : um inquérito sociológico às empresas portuguesas

Resumo Política(s) de saúde no trabalho: um inquérito sociológico às empresas portuguesas A literatura portuguesa sobre políticas, programas e actividades de Segurança, Higiene e Saúde no Trabalho (abreviadamente, SH&ST) é ainda escassa. Com este projecto de investigação pretende-se (i) colmatar essa lacuna, (ii) melhorar o conhecimento dos sistemas de gestão da saúde e segurança no trabalho e (iii) contribuir para a protecção e a promoção da saúde dos trabalhadores. Foi construída uma tipologia com cinco grupos principais de políticas, programas e actividades: A (Higiene & Segurança no Trabalho / Melhoria do ambiente físico de trabalho); B (Avaliação de saúde / Vigilância médica / Prestação de cuidados de saúde); C (Prevenção de comportamentos de risco/ Promoção de estilos de vida saudáveis); D (Intervenções a nível organizacional / Melhoria do ambiente psicossocial de trabalho); E (Actividades e programas sociais e de bem-estar). Havia uma lista de mais de 60 actividades possíveis, correspondendo a um índice de realização de 100%. Foi concebido e desenhado, para ser auto-administrado, um questionário sobre Política de Saúde no Local de Trabalho. Foram efectuados dois mailings, e um follow-up telefónico. O trabalho de campo decorreu entre a primavera de 1997 e o verão de 1998. A amostra (n=259) é considerada representativa das duas mil maiores empresas do país. Uma em cada quatro é uma multinacional. A taxa de sindicalização rondava os 30% da população trabalhadora, mas apenas 16% dos respondentes assinalou a existência de representantes dos trabalhadores eleitos para a SH&ST. A hipótese de investigação principal era a de que as empresas com um sistema integrado de gestão da SH&ST seriam também as empresas com um (i) maior número de políticas, programas e actividades de saúde; (ii) maior índice de saúde; (iii) maior índice de realização; e (iv) maior percentagem dos encargos com a SH&ST no total da massa salarial. As actividades de tipo A e B, tradicionalmente associadas à SH&ST, representavam, só por si, mais de 57% do total. Os resultados, correspondentes às respostas da Secção C do questionário, apontam, para (i) a hipervalorização dos exames de medicina do trabalho; e por outro para (ii) o subaproveitamento de um vasto conjunto de actividades (nomeadamente as de tipo D e E), que são correntemente levadas a cabo pelas empresas e que nunca ou raramente são pensadas em termos de protecção e promoção da saúde dos trabalhadores. As actividades e os programas de tipo C (Prevenção de comportamentos de risco/Promoção de estilos de vida saudáveis), ainda eram as menos frequentes entre nós, a seguir aos Programas sociais e de bem-estar (E). É a existência de sistemas de gestão integrados de SH&ST, e não o tamanho da empresa ou outra característica sociodemográfica ou técnico-organizacional, que permite predizer a frequência de políticas de saúde mais activas e mais inovadores. Os três principais motivos ou razões que levam as empresas portuguesas a investir na protecção e promoção da saúde dos seus trabalhadores eram, por ordem de frequência, (i) o absentismo em geral; (ii) a produtividade, qualidade e/ou competitividade, e (iii) a filosofia de gestão ou cultura organizacional. Quanto aos três principais benefícios que são reportados, surge em primeiro lugar (i) a melhoria da saúde dos trabalhadores, seguida da (ii) melhoria do ambiente do ambiente de trabalho e, por fim, (iii) a melhoria da produtividade, qualidade e/ou competitividade.Quanto aos três principais obstáculos que se põem, em geral, ao desenvolvimento das iniciativas de saúde, eles seriam os seguintes, na percepção dos respondentes: (i) a falta de empenho dos trabalhadores; (ii) a falta de tempo; e (iii) os problemas de articulação/ comunicação a nível interno. Por fim, (i) o empenho das estruturas hierárquicas; (ii) a cultura organizacional propícia; e (iii) o sentido de responsabilidade social surgem, destacadamente, como os três principais factores facilitadores do desenvolvimento da política de saúde no trabalho. Tantos estes factores como os obstáculos são de natureza endógena, susceptíveis portanto de controlo por parte dos gestores. Na sua generalidade, os resultados deste trabalho põem em evidência a fraqueza teóricometodológica de grande parte das iniciativas de saúde, realizadas na década de 1990. Muitas delas seriam medidas avulsas, que se inserem na gestão corrente das nossas empresas, e que dificilmente poderão ser tomadas como expressão de uma política de saúde no local de trabalho, (i) definida e assumida pela gestão de topo, (ii) socialmente concertada, (iii) coerente, (iv) baseada na avaliação de necessidades e expectativas de saúde dos trabalhadores, (v) divulgada, conhecida e partilhada por todos, (vi) contingencial, flexível e integrada, e, por fim, (vii) orientada por custos e resultados. Segundo a Declaração do Luxemburgo (1997), a promoção da saúde engloba o esforço conjunto dos empregadores, dos trabalhadores, do Estado e da sociedade civil para melhorar a segurança, a saúde e o bem-estar no trabalho, objectivo isso que pode ser conseguido através da (i) melhoria da organização e das demais condições de trabalho, da (ii) participação efectiva e concreta dos trabalhadores bem como do seu (iii) desenvolvimento pessoal. Abstract Health at work policies: a sociological inquiry into Portuguese corporations Portuguese literature on workplace health policies, programs and activities is still scarce. With this research project the author intends (i) to improve knowledge on the Occupational Health and Safety (shortly thereafter, OSH) management systems and (ii) contribute to the development of health promotion initiatives at a corporate level. Five categories of workplace health initiatives have been identified: (i) Occupational Hygiene and Safety / Improvement of Physical Working Environment (type A programs); (ii) Health Screening, Medical Surveillance and Other Occupational Health Care Provision (type B programs); (iii) Preventing Risk Behaviours / Promoting Healthy Life Styles (type C programs); (iv) Organisational Change / Improvement of Psycho-Social Working Environment (type D programs); and (v) Industrial and Social Welfare (type E programs). A mail questionnaire was sent to the Chief Executive Officer of the 1500 largest Portuguese companies, operating in the primary and secondary sectors (≥ 100 employees) or tertiary sector (≥ 75 employees). Response rate has reached about 20% (259 respondents, representing about 300 companies). Carried out between Spring 1997 and Summer 1998, the fieldwork has encompassed two direct mailings and one phone follow-up. Sample is considered to be representative of the two thousand largest companies. One in four is a multinational. Union membership rate is about 30%, but only 16% has reported the existence of a workers’ health and safety representative. The most frequent workplace health initiatives were those under the traditional scope of the OSH field (type A and B programs) (57% of total) (e.g., Periodical Medical Examinations; Individual Protective Equipment; Assessment of Working Ability). In SMEs (< 250) it was less likely to find out some time-consuming and expensive activities (e.g., Training on OSH knowledge and skills, Improvement of environmental parameters as ventilation, lighting, heating).There were significant differences in SMEs, when compared with the larger ones (≥ 250) concerning type B programs such as Periodical medical examinations, GP consultation, Nursing care, Other medical and non-medical specialities (e.g., psychiatrist, psychologist, ergonomist, physiotherapist, occupational social worker). With regard to type C programs, there were a greater percentage of programs centred on Substance abuse (tobacco, alcohol, and drug) than on Other health risk behaviours. SMEs representatives reported very few prevention- oriented programs in the field of Drug abuse, Nutrition, Physical activity, Off- job accidents, Blood pressure or Weight control. Frequency of type D programs included Training on Human Resources Management, Training on Organisational Behaviour, Total Quality Management, Job Design/Ergonomics, and Workplace rehabilitation. In general, implementation of this type of programs (Organisational Change / Improvement of Psychosocial Working Environment) is not largely driven by health considerations. Concerning Industrial and Social Welfare (Type E programs), the larger employers are in a better position than SMEs to offer to their employees a large spectrum of health resources and facilities (e.g., Restaurant, Canteen, Resting room, Transport, Infra-structures for physical activity, Surgery, Complementary social protection, Support to recreational and cultural activities, Magazine or newsletter, Intranet). Other workplace health promotion programs like Training on Stress Management, Employee Assistance Programs, or Self-help groups are uncommon in the Portuguese worksites. The existence of integrated OSH management systems, not the company size, is the main variable explaining the implementation of more active and innovative workplace health policies in Portugal. The three main prompting factors reported by employers for health protection and promotion initiatives are: (i) Employee absenteeism; (ii) Productivity, quality and/or competitiveness; and (iii) Corporate culture/management philosophy. On the other hand, (i) Improved staff’s health, (ii) Improved working environment and (iii) Improved productivity, quality and/or competitiveness were the three main benefits reported by companies’ representatives, as a result of successful implementation of workplace health initiatives. (i) Lack of staff commitment; (ii) Lack of time; and (iii) Problems of co-operation and communication within company or establishment (iii) are perceived to be the main barriers companies must cope with. Asked about the main facilitating factors, these companies have pointed out the following ones: (i) Top management commitment; (ii) Corporate culture; and (iii) Sense of social responsibility. This sociological research report shows the methodological weaknesses of workplace health initiatives, carried out by Portuguese companies during the last ‘90s. In many cases, these programs and actions were not part of a corporate health strategy and policy, (i) based on the assessment of workers’ health needs and expectancies, (ii) advocated by the employer or the chief executive officer, (ii) planned and implemented with the staff consultation and participation or (iv) evaluated according to a cost-benefit analysis. In short, corporate health policy and action were still rather based on more traditional OSH approaches and should be reoriented towards Workplace Health Promotion (WHP) approach. According to the Luxembourg Declaration of Workplace Health Promotion in the European Union (1997), WHP is “a combination of: (i) improving the work organisation and environment; (ii) promoting active participation; (iii) encouraging personal development”.Résumée Politique(s) de santé au travail: une enquête sociologique aux entreprises portugaises Au Portugal on ne sait presque rien des politiques de santé au travail, adoptés par les entreprises. Avec ce projet de recherche, on veut (i) améliorer la connaissance sur les systèmes de gestion de la santé et de la sécurité au travail et, au même temps, (ii) contribuer au développement de la promotion de la santé des travailleurs. Une typologie a été usée pour identifier les politiques, programmes et actions de santé au travail: A. Amélioration des conditions de travail / Sécurité au travail; B. Médecine du travail /Santé au travail; C. Prévention des comportements de risque / Promotion de styles de vie sains; D. Interventions organisationnelles / Amélioration des facteurs psychosociaux au travail; E. Gestion de personnel et bien-être social. Un questionnaire postal a été envoyé au représentant maximum des grandes entreprises portugaises, industrielles (≥ 100 employés) ou des services (≥ 75 employés). Le taux de réponse a été environ 20% (259 répondants, concernant trois centaines d’entreprises et d’établissements). La recherche de champ, conduite du printemps 1997 à l’été 1998, a compris deux enquêtes postales et un follow-up téléphonique. L´échantillon est représentatif de la population des deux miles plus grandes entreprises. Un quart sont des multinationales. Le taux de syndicalisation est d’environ 30%. Toutefois, il y a seulement 16% de lieux de travail avec des représentants du personnel pour la santé et sécurité au travail. Les initiatives de santé au travail les plus communes sont celles concernant le domaine plus traditionnel (types A et B) (57% du total): par exemple, les examens de médecine du travail, l’équipement de protection individuelle, les tests d’aptitude au travail. En ce qui concerne les programmes de type C, les plus fréquents sont le contrôle et la prévention des addictions (tabac, alcool, drogue). Les interventions dans le domaine de du système technique et organisationnelle du travail peuvent comprendre les courses de formation en gestion de ressources humaines ou en psychosociologie des organisations, l’ergonomie, le travail posté ou la gestion de la qualité totale. En général, la protection et la promotion de la santé des travailleurs ne sont pas prises en considération dans l’implémentation des initiatives de type D. Il y a des différences quand on compare les grandes entreprises et les moyennes en matière de politique de gestion du personnel e du bien-être (programmes de type E, y compris l’allocation de ressources humaines ou logistiques comme, par exemple, restaurant, journal d’entreprise, transports, installations et équipements sportifs). D’autres activités de promotion de la santé au travail comme la formation en gestion du stress, les programmes d’ assistance aux employés, ou les groupes de soutien et d’auto-aide sont encore très peu fréquents dans les entreprises portugaises. C’est le système intégré de gestion de la santé et de la sécurité au travail, et non pas la taille de l’entreprise, qui aide à prédire l’existence de politiques actives et innovatrices dans ce domaine. Les trois facteurs principaux qui encouragent les actions de santé (prompting factors, en anglais) sont (i) l’absentéisme (y compris la maladie), (ii) les problèmes liés à la productivité, qualité et/ou la compétitivité, et aussi (iii) la culture de l’entreprise/philosophie de gestion. Du coté des bénéfices, on a obtenu surtout l’amélioration (i) de la santé du personnel, (ii) des conditions de travail, et (iii) de la productivité, qualité et/ou compétitivité.Les facteurs qui facilitent les actions de santé au travail sont (i) l’engagement de la direction, (ii) la culture de l’entreprise, et (iii) le sens de responsabilité sociale. Par contre, les obstacles à surmonter, selon les organisations qui ont répondu au questionnaire, seraient surtout (i) le manque d’engagement des travailleurs et de leur représentants, (ii) le temps insuffisant, et (iii) les problèmes de articulation/communication au niveau interne de l’entreprise/établissement. Ce travail de recherche sociologique montre la faiblesse méthodologique des services et activités de santé et sécurité au travail, mis en place par les entreprises portugaises dans les années de 1990, à la suite des accords de concertation sociale de 1991. Dans beaucoup de cas, (i) ces politiques de santé ne font pas partie encore d’un système intégré de gestion, (ii) il n’a pas d’évaluation des besoins et des expectatives des travailleurs, (iii) c’est très bas ou inexistant le niveau de participation du personnel, (iv) on ne fait pas d’analyse coût-bénéfice. On peut conclure que les politiques de santé au travail sont plus proches de la médecine du travail et de la sécurité au travail que de la promotion de la santé des travailleurs. Selon la Déclaration du Luxembourg sur la Promotion de la Santé au Lieu de Travail dans la Communauté Européenne (1997), celle-ci « comprend toutes les mesures des employeurs, des employés et de la société pour améliorer l'état de santé et le bien être des travailleurs » e « ceci peut être obtenu par la concentration des efforts dans les domaines suivants: (i) amélioration de l'organisation du travail et des conditions de travail ; (ii) promotion d'une participation active des collaborateurs ; (iii) renforcement des compétences personnelles ».

Patterns of Associational Life in Western Europe, 1800-2000

Thesis submitted for assessment with a view to obtaining the degree of Doctor of Political and Social Science of the European University Institute

Prevalência do consumo de drogas ilícitas nas Forças Armadas estudo epidemiológico num dos ramos

RESUMO: Desde 1976 que as Forças Armadas desenvolvem acções de prevenção do consumo de drogas e álcool. Na década de 80 foi criada capacidade laboratorial e deu-se início a um programa de rastreios toxicológicos. No quinquénio 2001 a 2005, as proporções de resultados positivos, associando todos os tipos de rastreio, variaram entre 3,7% e 1,5%. De Outubro de 2006 a Julho de 2007 realizou-se um estudo analítico transversal, para estimar a prevalência do consumo de drogas (canabinóides, opiáceos, cocaína e anfetaminas) num dos Ramos das Forças Armadas, com base nos despistes realizados pelo seu laboratório. Foi utilizada uma amostra aleatória simples de 1039 militares, profissionais (QP) e contratados (RC), no activo e de ambos os sexos. Desde a nomeação dos militares a rastrear, passando pela cadeia de custódia das amostras até à obtenção do resultado foi utilizado apoio informático específico. O processo de pesquisa utilizou duas técnicas de triagem por imunoensaio e tecnologia de confirmação por GC/MS, de acordo com as recomendações europeias, permitindo estabelecer uma metodologia standard para organizações e empresas. A prevalência estimada, de consumidores de droga, foi de 3,8/1.000, para um erro de 0,37%. O número de casos registado (4) não permitiu a utilização de testes estatísticos que conduzissem à identificação de características determinantes da positividade, mas não deixou de revelar aspectos inesperados. A observação de séries de casos e a realização regular de estudos epidemiológicos, que ajudem a redefinir grupos alvo e a perceber a dimensão, as determinantes e as consequências do consumo de drogas é sugerida, em conclusão.--------------------------------------- RÉSUMÉ: Depuis 1976, les Forces Armées mettent au point des mesures visant à prévenir la consommation de drogues et d'alcool. En 1980, fut créé capacité laboratoriel et ont ensuite commencé un programme de dépistage toxicologique. Au cours des cinq années allant de 2001 à 2005, les proportions de consommateurs, impliquant tous les types de dépistage, allaient de 3,7% à 1,5 %. D'octobre 2006 à juillet 2007, une étude analytique transversale a été organisée pour évaluer la prévalence de l’usage de drogues (cannabis, opiacés, cocaïne et amphétamines) dans une branche de les Forces Armées, basée sur les dépistages faites par un laboratoire militaire, à l'aide d'un échantillon aléatoire de 1039 militaires, professionnels (QP) et sous contract (RC), à l’actif et des deux sexes. Tout au long du procès, de la nomination des donneurs, en passant par la chaine de garde des échantillons, jusqu’à obtention du résultat, il fut employé un appui informatique sécurisé. Le processus de recherche employa deux techniques de tri par imunoessay et la technologie de confirmation GC/MS, selon les recommandations européennes, permettant d'établir une méthodologie standard pour les organisations et les entreprises. La prévalence estimée fut de 3,8/1.000 pour une marge d’erreur de 0,37%. Le nombre de cas enregistrés (4) n'autorise pas l'utilisation de testes statistiques de menant à l'identification de caractéristiques déterminant de la positivité, mais il permet à révéler des aspects inattendus. L'observation de séries de cas et la tenue régulière d’études épidémiologiques, qui contribuent à redéfinir les groupes cibles et de comprendre l'ampleur, les déterminants et les conséquences de l'usage de drogues, est suggéré, en fin de compte.--------------------------------------- ABSTRACT: Since 1976, the Armed Forces, have been developing measures to prevent the use of drugs and alcohol. In 1980, was created laboratory facility which then started a program of toxicological screenings. In the five years running from 2001 to 2005, the proportions of consumers, involving all types of screening, ranged from 3,7% to 1,5%. From October 2006 to July 2007, a cross-sectional study was held to estimate the prevalence of drug use (cannabinoids, opiates, cocaine and amphetamines) in one branch of the Portuguese Armed Forces, based on laboratory screenings, using a random sample of 1039 military, professional (QP) and enlisted (RC), active-duty and of both sexes. Specific computer support was used all the way, from the appointment, including the chain of custody of samples, to the obtaining of the result. The process of search used two techniques for sorting by immunoassay and confirmation technology GC/MS, according to European recommendations, allowing to establish a standard methodology for organizations and companies. The estimated prevalence of drug users was 3.8/1.000 for a 0.37% error (95% confidence interval). The number of cases registered (4) does not permit use of statistical testing leading to the identification of characteristics weighing in the establishing to extrapolate for the population, but it allows revealing unexpected aspects. The observation of series of cases and the regular holding of epidemiological studies, which help redefine target groups and to understand the extent, the determinants and consequences of drug use, is suggested, in conclusion.

Avaliação dos serviços de saúde mental em Moçambique

RESUMO: O instrumento de avaliação de sistemas de saúde mental da organização mundial de saúde (WHO-AIMS)foi usado para a recolha de informações sobre o Programa Nacional de Saúde Mental de Moçambique. O presente estudo tem como objectivo melhorar o Programa Nacional de Saúde Mental e fornecer um ponto de partida para a monitorização das mudanças. Os resultados do estudo permitirão a Moçambique fortalecer a sua capacidade para desenvolver planos de saúde mental baseados em informações com pontos de partida e metas bem definidos. O relatório será também útil para a monitorização do progresso da implementação de reformas nas políticas de saúde mental, na disponibilização de serviços de base comunitária, e no envolvimento dos utentes, seus familiares e outros actores na promoção, prevenção,cuidados e reabilitação em saúde mental. Tendo em conta os antecedentes históricos da saúde mental em Moçambique, a realidade actual clama por reformas profundas voltadas para uma intervenção mais humanizada e com enfoque nos cuidados primários. É nesse contexto que o estudo realizado apresenta resultados relacionados com as políticas, legislação, estratégias e planos de acção e financiamento para a saúde mental; serviços de saúde mental;cuidados primários; recursos humanos e ligação com outros sectores chave. A saúde mental foi avaliada desde o sistema de gestão até ao nível comunitário. Relativamente aos órgãos de gestão, a principal constatação é que existem instrumentos legais para sustentar as iniciativas desta área e influenciar os meios políticos em prol da saúde mental. Todavia, o caminho a percorrer ainda é longo uma vez que não está ainda aprovada nenhuma lei de saúde mental e os financiamentos para a área não permitem a implementação das reformas necessárias. Os serviços ao nível clínico debatem-se com a problemática dos recursos humanos (constituídos principalmente por técnicos de psiquiatria) e disponibilidade de psicofármacos. O modelo biopsicossocial ainda não é implementado integralmente uma vez que são poucos os serviços que oferecem apoio psicossocial (que inclui a reabilitação e reintegração) para além da intervenção farmacológica. Esta pode ser considerada uma das principais causas de recaídas identificadas em todas as províncias. Há uma necessidade urgente de se realizarem pesquisas e levantamentos epidemiológicos que possam servir de suporte para a advocacia em saúde mental com vista a melhoria dos cuidados a prestar aos pacientes e comunidade. Os instrumentos de recolha de informação de rotina não são adequados limitando a fidelidade dos dados recolhidos e a possibilidade de uma gestão dos serviços de saúde mental que responda as reais necessidades da população. Em suma, os resultados aqui apresentados mostram que Moçambique tem uma base que pode ser considerada uma mais valia para a reforma do sistema de saúde mental. Existem, ainda que escassos, recursos como humanos, infra-estruturas e legislação para a prestação dos serviços clínicos. É preciso investir na saúde mental para que os recursos existentes sejam melhorados e expandidos, apostando na criação de equipas multidisciplinares e qualificação das equipas de gestão e equipas clínicas. --------ABSTRACT: The World Health Organization Assessment Instrument for Mental Health Services (WHO-AIMS) was used to collect information about the National Mental Health Program of Mozambique. The present study aims to improve the National Mental Health Program and provide a starting point for monitoring change. The study results will allow Mozambique to strengthen its capacity to develop mental health plans based on information with starting points and well-defined goals. The report will also be useful for monitoring the progress of implementation of reforms in mental health policies, the provision of community-based services, and involvement of users, their families and other stakeholders in the promotion, prevention, care and rehabilitation in mental health. Given the historical background of mental health in Mozambique, the current situation calls for reforms aimed at a more humane intervention focused on primary care. In this context, the study presents results related to policies, legislation, strategies and action plans and funding for mental health; mental health services; primary care; human resources and liaison with other key sectors. Mental health was assessed from the management system to the community level. With regard to the management, the main observation is that there are legal instruments to support the initiatives in this area and to influence the political means on behalf of mental health. However, the pathway is still long as it is not yet approved any Mental Health Law and the funding for the area do not allow the implementation of necessary reforms. Services at the clinical level are struggling with the issue of human resources (consisting primarily of psychiatrist technicians) and availability of psychotropic drugs. The biopsychosocial model is not yet fully implemented since there are few services providing psychosocial support (including rehabilitation and reintegration) in addition to pharmacological intervention. This can be considered a major cause of relapse identified in all provinces. There is an urgent need to conduct research and epidemiological surveys which could provide support for advocacy in mental health in order to improve the mental health car for the patients and community. The routine data collection instruments are not appropriate limiting the fidelity of the data collected and the possibility of a management of mental health services that meets the real needs of the population. In summary, the results presented here show that Mozambique has a groundwork that can be considered an asset for the reform of mental health system. There are, though scarce, human resources, infrastructure and legislation for the provision of clinical services. It’s necessary to invest in mental health so that existing resources are improved and expanded, and to invest on the creation of multidisciplinary teams and qualification of management teams and clinical teams.

Effects of a mental health training program on health care worker's knowledge and attitude and practice in Belize

ABSTRACT This study was conducted to assess mental health knowledge, attitude and practices among health care workers in Belize before and immediately after a competency based training program in mental health. A baseline Knowledge, Attitudes and Practices (KAP) survey was given to health personnel, mainly nurses, working primary and secondary care. The intervention was a 13-week face-to-face training course for health care professionals with the objective of increasing their competency in mental health and reducing stigma. After the training a post intervention KAP survey was conducted among the original respondents. 88 health care workers completed the baseline survey and 61 of those respondents completed the post-intervention questionnaire. The results showed that the level of knowledge of the participants had improved by the training intervention and that in general, the intervention was effective in correcting some misconceptions about mental illness and reducing stigmatizing attitudes among the participants.

Attitudes towards mentally ill in professionals working in Ndera neuropsychiatric hospital in Rwanda

ABSTRACT: This quantitative study investigated the attitudes toward the mentally ill in professionals working in Ndera neuropsychiatric hospital. The research questions explored were centered on the attitudes of directly involved and supportive professionals toward mentally ill clients and also on the difference between the attitudes of directly involved and supportive professionals toward mentally ill clients and demographic variables. The purpose of this study was to determine whether there are differences in attitude between direct care providers and supportive professionals toward the mentally ill clients. The Community Attitudes towards Mentally Ill (CAMI) scale (Dear & Taylor, 1982; Taylor, Dear & Hall, 1979; Taylor & Dear, 1981) was used. A total of 72 members of the staff, including 55 directly involved staff and 17 supportive staff members, participated in the survey. A summary interpretation of the main findings in this thesis reinforces the assumption that negative attitudes towards people with mental illness received in Ndera neuropsychiatric hospital are in existence, even though the majority have favorable attitudes towards the mentally ill. This suggests that persons with mental illness may encounter stigmatizing attitudes from mental health professionals. This study represents one of the first to explore professionals’ attitudes towards the mentally ill. It is hoped that this work will highlight the need to explore the influence of attitudes in the delivery of high quality healthcare. The provider–patient relationship is at the heart of effective treatment and the detrimental impact of prejudicial judgments on this relationship should not be ignored. This study also demonstrates that professionals with different roles report different attitudes and this suggest that they would behave differently towards patients with mental illness. The directly involved professionals have been found to have more positive attitudes than the supportive professional and this seems to show that as individuals improve their ability to interact with persons with mental illness, they become more tolerant. The present study demonstrates that the sociodemographic variables tested have no impact on the attitudes of the professionals working in Ndera neuropsychiatric hospital. The extent of mental health training (as part of general health training) and duration of experience of working in mental health settings did not influence attitudes. Finally, this study demonstrates that there is no correlation between the attitudes towards mentally ill patients and their inclusion in the process of decision-making.

Ajudantes de acção directa : percepções sobre formação profissional e impacto da formação na prestação de cuidados a idosos dependentes internados

RESUMO: A transferência de indivíduos dependentes é uma das tarefas mais realizadas pelos ajudantes de acção directa (AAD) na prestação de cuidados a idosos, sendo crucial haver formação nesta área. No entanto, os programas de formação em transferências raramente são avaliados em termos de desempenho na realização deste tipo de tarefas. Objectivo: Este estudo teve como objectivos analisar o impacto da formação de AAD no desempenho da transferência de idosos internados na Residência São João de Ávila (RSJA) e identificar as percepções dos AAD relativamente à importância da formação profissional, formação em transferências e dificuldade sentida na sua realização. Métodos: Realizou-se um estudo com duas etapas: na primeira procedeu-se a um estudo descritivo exploratório (através de um questionário auto-administrado a 25 AAD); na segunda realizou-se um estudo quase experimental de observação com duas fases, entre as quais decorreu uma “Formação em Princípios e Conceitos Básicos em Reabilitação Física” (observação directa de 18 AAD durante a realização da transferência “deitado-sentado-cadeira” de idosos, através de uma grelha de observação). Resultados: O desempenho dos AAD na transferência melhorou após a formação. Os ajudantes manifestaram ter uma percepção positiva sobre a importância da formação profissional e da formação em transferências. Aproximadamente dois terços dos AAD revelaram não sentir dificuldades na realização de transferências. Conclusões: A formação teve um impacto positivo no desempenho dos AAD na transferência de idosos. Concluiu-se que há uma sensibilização generalizada por parte dos AAD para a importância da formação na sua profissão e, especificamente, para a formação em transferências. ---------------ABSTRACT: The transfers of dependent patients by healthcare assistants are tasks commonly used in elderly care. Therefore, it is crucial that healthcare assistants are trained to perform these tasks. However, training programs are rarely evaluated in terms of performance of these tasks. Aim: The aims of this study were 1) to determine the impact of healthcare assistant training in the transfers of the Residência São João de Ávila (RSJA) elderly patients; and 2) to analyze healthcare assistant’s perceptions about their education, their specialized training on the transfer technique, and their difficulty in performing transfers. Methods: The study was divided in two parts: an exploratory and descriptive study (self-report questionnaire applied to 25 healthcare assistants); and a quasi-experimental observation study, which involved a “training session on basic concepts and principles of physical rehabilitation” (direct observation of 18 healthcare assistants during the “bed-sitting-chair” transfer, using an observation table). Results: Healthcare assistant performance of the “bed-sitting-chair” transfer improved after training. The healthcare assistants showed positive perceptions about their education and specialized training on the transfer technique. Approximately two thirds of the assistants felt no difficulties in performing transfer tasks. Conclusions: The training had a positive influence in healthcare assistant performance. The healthcare assistants were aware of the importance of training in their profession and more specifically in transfer tasks.

Burnout em oncologia : o síndrome de burnout vivenciado por enfermeiros que trabalham numa unidade de administração de quimioterapia de um instituto oncológico

RESUMO - O burnout é um síndrome caracterizado, de forma mais frequente, por exaustão emocional, despersonalização elevadas e realização pessoal baixa. Normalmente, a pessoa sente-se fatigada e frustrada com as suas acções e sente que as suas expectativas não estão a ser correspondidas. Estando este fenómeno associado, possivelmente, com o ambiente laboral e com os factores de stresse existentes no local de trabalho, é habitual que surja em qualquer profissional, de qualquer classe profissional. Este trabalho de projecto concentrou-se no estudo de uma das profissões de ajuda mais conectadas a este síndrome, pela sua especificidade, a enfermagem, na área da oncologia, e o objectivo fulcral, é compreender que quadros de burnout apresentam os profissionais de enfermagem que trabalham num instituto oncológico e compreender, ainda, se existe associação entre a saúde mental, a satisfação profissional destes profissionais e as suas características sócio-demográficas. Este trabalho teve, ainda, como objectivo testar a metodologia utilizada com a aplicação dos seguintes instrumentos: Maslach Burnout Inventory (M.B.I.), Mental Health Inventory (M.H.I.) e o Questionário de Satisfação Profissional de GRAÇA (1999). Neste seguimento, utilizou-se um caso piloto de 20 enfermeiros que trabalham num serviço de administração de quimioterapia de um instituto oncológico, pretendendo-se, futuramente, desenvolver este estudo a nível institucional e numa amostra significativa, salientando, desde já, que todo o processo metodológico consistiu numa simulação, cujos resultados obtidos não poderão ser extrapoláveis e generalizados. Numa perspectiva da Protecção e Promoção da Saúde e Prevenção da doença, esta equipa identifica factores geradores de stresse e sugere algumas estratégias importantes para fortalecer estes ideais, que consistem, acima de tudo, em saber reconhecer o fenómeno e criar grupos de terapia e de reflexão. As organizações e superiores hierárquicos deverão, também, estar atentos a esta problemática, tornando os recursos humanos e materiais ajustados e proporcionado as tais estratégias que possibilitem um clima de harmonia e uma melhor qualidade dos cuidados.

Portuguese Ministers, 1851-1999: Social Background and Paths to Power

Disponível em: http://193.136.113.6/Opac/Pages/Search/Results.aspx?SearchText=UID=bb8aa8d5-c6b6-466a-81bb-fe8a67693cee&DataBase=10449_UNLFCSH

Exposição a ozono em cabinas de avião

RESUMO - O ozono é o principal componente da poluição fotoquímica do ar. Como agente irritante do aparelho respiratório, os seus efeitos sobre a saúde caracterizam-se, essencialmente, por tosse, dispneia, desconforto torácico e alterações da função pulmonar, encontrando-se também associadas à exposição ambiental a O3 tanto uma maior frequência e gravidade de crises de asma como a ocorrência de quadros clínicos de irritação conjuntival. É sobretudo a partir dos anos 50, com a descoberta de concentrações elevadas de ozono em ambientes de trabalho respeitantes à actividade de soldadura «a arco», que aquele gás passa a ser encarado como factor profissional de risco. No início dos anos 60 surgem os primeiros estudos de exposição a O3 em cabinas de avião, suscitados pela ocorrência, em tripulantes e passageiros, de queixas clínicas de irritação do tracto respiratório. Esta sintomatologia era, até então, atribuída à acção de outros factores, designadamente o sistema de ventilação e o baixo teor de humidade do ar. Posteriormente, alguns estudos revelaram que, em voos comerciais subsónicos, os teores elevados de O3 observados no interior das cabinas poderiam ser provocados pela sua insuficiente destruição nos sistemas de entrada de ar.O presente estudo, efectuado em voos de longo curso realizados em aeronaves Airbus A340-300 numa única rota comercial, teve por objectivo avaliar a exposição a ozono no ar interior em cabina de avião. Os teores médios de concentração de ozono observados foram inferiores aos valores susceptíveis de provocarem efeitos adversos sobre o aparelho respiratório. Como valor máximo instantâneo, foi atingida a concentração de 152 ppb. Adicionalmente, foi constatada a influência das estações do ano nos teores de O3. O conjunto dos resultados obtidos permite concluir que as concentrações de ozono no ar interior nas cabinas de avião estudadas são inferiores às correspondentes concentrações máximas admissíveis, tendo, em todos os voos, sido observado o cumprimento da norma da FAA respeitante à protecção da exposição ao ozono em cabinas de aeronaves de aviação comercial.

Enterprise reference lexicon building from business models

Nowadays, a significant increase on the demand for interoperable systems for exchanging data in business collaborative environments has been noticed. Consequently, cooperation agreements between each of the involved enterprises have been brought to light. However, due to the fact that even in a same community or domain, there is a big variety of knowledge representation not semantically coincident, which embodies the existence of interoperability problems in the enterprises information systems that need to be addressed. Moreover, in relation to this, most organizations face other problems about their information systems, as: 1) domain knowledge not being easily accessible by all the stakeholders (even intra-enterprise); 2) domain knowledge not being represented in a standard format; 3) and even if it is available in a standard format, it is not supported by semantic annotations or described using a common and understandable lexicon. This dissertation proposes an approach for the establishment of an enterprise reference lexicon from business models. It addresses the automation in the information models mapping for the reference lexicon construction. It aggregates a formal and conceptual representation of the business domain, with a clear definition of the used lexicon to facilitate an overall understanding by all the involved stakeholders, including non-IT personnel.

Internationalization strategy of Skypro Shoes to Japan

Skypro is a footwear brand targeted at the aviation professionals’ niche market, explored by the Portuguese microenterprise Abotoa Lda..The saturation of the Portuguese market led Skypro to expand to different worldwide countries and to be a footwear supplier of Airlines from the USA, Qatar or Australia, among others. Abotoa aims for its 2014’s exports to represent around 80% of total sales and this Internationalization Plan for Japan represents the possibility of further exploring the Asian market. Japan appears as the 2nd worldwide footwear importer and the 5th footwear consumer, with a high purchasing power – GDP per capita (PPP). This country possesses two enormous Airlines (ANA and JAL) that employ more than 15000 on-board personnel, the world’s 4th busiest Airport in 2013 (Tokyo’s Haneda International Airport) and a geographic structure with more than 6500 islands, implying high frequency of aerial transportation in the medium-run. These aspects make Japan an adequate country to invest in. At the course of this Work Project, trustworthy recommendations are provided for the current state of Abotoa and for the introduction and implementation of this Internationalization Plan. These findings strongly suggest that Skypro should indeed penetrate Japan’s market.

Relatório de estágio na Caixa Geral de Depósitos

This report will describe the activities undertaken during my internship at the Personnel Department (DPE-UPE4.1) in Caixa Geral de Depósitos (CGD), Lisbon, between September 22, 2014, and February 28, 2015. I consider that it is important to note from the outset i) that the subject of my training was suggested by my supervisor in the DPE and accepted by me; and ii) that the internship consisted essentially of carrying out research and information gathering into the different social systems that coexist within the bank and the application of each legal system in solving concrete situations of the CGD employees. The research and analysis of information was important not only for my study but for the CGD itself, as it enables the department to have such an important matter, full of specific characteristics, condensed into a single document, i.e. this report. This is a complex reality. The various welfare systems differ according to the contractual agreement linking the employee to the employer at the date when the labour contract is signed, and also the unique/singular characteristics of the CGD. In the early stage I started by trying to understand the financial institution and its organization and role and the department where I worked. So I analyzed the CGD Statutes and the legal measures that crystallized the scheme for its employees and I also researched its domestic and international operations. The first month was devoted to the research and analysis of such legislation to understand the creation of the CGD and its path to date. In the second and third months I studied the legal social systems that are applied to different groups of CGD workers. This period was quite important to identify and understand the differences between those regimes of CGD employees as well as the procedure inherent in each case. I highlighted the non-implementation of “the social protection regime of convergence” to the workers of this institution; the differences regarding the allocation of sickness subsidies paid to workers who belong to Social Security and CGA contributors, as well as the enforcement of internal rules to all the workers when a work-related accident happens. Then I focused on to assessing and examining external legislation and several internal regulations in order to obtain solutions to questions raised and situations involving by the workers, in order to understand how the DPE solves these situations. Over the last three months of internship, after this more theoretical work, I began the analysis of concrete situations involving employees carrying out their duties in Portugal and abroad. Some of these situations had been received by the department before the beginning of my internship and others over this period. When I was “working” in the DPE I analyzed “cases” that had been solved and some others without a final solution because they were still in courts. As for the last ones (new cases) I was able to follow their assessment and sometimes their outcome. Some of them became study cases for me. Over these five months of my internship, several cases were analyzed and discussed by legal experts of DPE in which I could participate. I always worked hard. I know that this action contributed to elucidate me about the treatment of the issues, and allowed me to have a direct contact with some workers and be part of a dynamic work team. For these reasons, my internship report is not merely descriptive of activities. It consists of an analysis of rules (legislation) and a regulatory framework of activities and it is also a description of several specific situations solved or in a solution process. Through this work I intend to make known the particular reality of a modern Portuguese financial institution not only because of its importance in our country but also such a large number of employees work here (in Portugal and abroad). I should add that throughout my internship I was allowed to attend conferences, within the scope of the bank in order to get a broader view of some issues related to the daily life of the DPE and the CGD. So, I participated in I Jornadas Bancárias and the Conferência Internacional do Contrato a Termo, given that the CGD is a bank and the DPE deals with legal and labour relations.

Relatório de estágio na Caixa Geral de Depósitos

This report will describe the activities undertaken during my internship at the Personnel Department (DPE-UPE4.1) in Caixa Geral de Depósitos (CGD), Lisbon, between September 22, 2014, and February 28, 2015. I consider that it is important to note from the outset i) that the subject of my training was suggested by my supervisor in the DPE and accepted by me; and ii) that the internship consisted essentially of carrying out research and information gathering into the different social systems that coexist within the bank and the application of each legal system in solving concrete situations of the CGD employees. The research and analysis of information was important not only for my study but for the CGD itself, as it enables the department to have such an important matter, full of specific characteristics, condensed into a single document, i.e. this report. This is a complex reality. The various welfare systems differ according to the contractual agreement linking the employee to the employer at the date when the labour contract is signed, and also the unique/singular characteristics of the CGD. In the early stage I started by trying to understand the financial institution and its organization and role and the department where I worked. So I analyzed the CGD Statutes and the legal measures that crystallized the scheme for its employees and I also researched its domestic and international operations. The first month was devoted to the research and analysis of such legislation to understand the creation of the CGD and its path to date. In the second and third months I studied the legal social systems that are applied to different groups of CGD workers. This period was quite important to identify and understand the differences between those regimes of CGD employees as well as the procedure inherent in each case. I highlighted the non-implementation of “the social protection regime of convergence” to the workers of this institution; the differences regarding the allocation of sickness subsidies paid to workers who belong to Social Security and CGA contributors, as well as the enforcement of internal rules to all the workers when a work-related accident happens.Then I focused on to assessing and examining external legislation and several internal regulations in order to obtain solutions to questions raised and situations involving by the workers, in order to understand how the DPE solves these situations. Over the last three months of internship, after this more theoretical work, I began the analysis of concrete situations involving employees carrying out their duties in Portugal and abroad. Some of these situations had been received by the department before the beginning of my internship and others over this period. When I was “working” in the DPE I analyzed “cases” that had been solved and some others without a final solution because they were still in courts. As for the last ones (new cases) I was able to follow their assessment and sometimes their outcome. Some of them became study cases for me. Over these five months of my internship, several cases were analyzed and discussed by legal experts of DPE in which I could participate. I always worked hard. I know that this action contributed to elucidate me about the treatment of the issues, and allowed me to have a direct contact with some workers and be part of a dynamic work team. For these reasons, my internship report is not merely descriptive of activities. It consists of an analysis of rules (legislation) and a regulatory framework of activities and it is also a description of several specific situations solved or in a solution process. Through this work I intend to make known the particular reality of a modern Portuguese financial institution not only because of its importance in our country but also such a large number of employees work here (in Portugal and abroad). I should add that throughout my internship I was allowed to attend conferences, within the scope of the bank in order to get a broader view of some issues related to the daily life of the DPE and the CGD. So, I participated in I Jornadas Bancárias and the Conferência Internacional do Contrato a Termo, given that the CGD is a bank and the DPE deals with legal and labour relations.