Transition from Children’s to Adult Services forYoung People with Life-limiting Conditions: Findings from a Questionnaire Survey in Northern Ireland

Research aims: 
To describe service provision for the transition from children’s to adult services for young people with life-limiting conditions in Northern Ireland, and to identify organisational factors that promote or inhibit effective transition. 
Study population: 
Health, social, educational and charitable organisations providing transition services to young people with life-limiting conditions in Northern Ireland. 
Study design and methods: 
A questionnaire has been developed by the research team drawing on examples from the literature and the advice of an expert advisory group. The questionnaire was piloted with clinicians,academics and researchers in June 2013. The questionnaire focuses on components of practice which may promote continuity in the transition from child to adult care for young people with a life-limiting condition. The survey will be distributed throughout Northern Ireland to an estimated 75 organisations, following the Dillman total design survey method. Numerical data will be analysed using PASW Statistical software to generate descriptive statistics along with a thematic analysis of data generated by open-ended questions. 
Results and interpretations: 
The survey will provide a description of services, transition policies, approaches to managing transition, categories of service users, the ages at which transition starts and completes, experiences with minority ethnic groups, the input of service users to the process, organisational factors promoting or hindering effective transition, links between services, and service providers’ recommendations for improvements in services.The outcomes will be an overview of the transition services currently provided in Northern Ireland identifying models of good practice and the key factors influencing the quality, safety and continuity of care. Survey results are due early in 2014.

Alcohol, Tobacco and Pharmacy Students: Usage and Views on Professional Issues

Introduction/background: This study aimed to ascertain pharmacy students’ use and views on cigarettes and alcohol (including in relation to provision of health promotion advice) and to establish if alcohol intake affected academic performance. Within the United Kingdom (UK), there has been limited research conducted in this area
Methods: Following ethical approval, pharmacy students (n=581) were invited to participate in a pre-piloted electronic questionnaire, consisting of 21 questions on smoking and alcohol. Descriptive statistics and non-parametric tests were used for data analyses.
Results: A response rate of 64.5% (375/581) was obtained (69.9% female, 30.2% male). Many respondents (77.9%) reported that they drank alcohol; whereas only 3.7% stated they currently smoked cigarettes. Students who drank alcohol were more likely to fail elements of the program than those who did not. Less than half (47.8%) were in agreement that it was hypocritical for a pharmacist to give health promotion advice and then get drunk outside of work.
Discussion/conclusions: Students seem to consider that lifestyle recommendations are less relevant for themselves and also that a pharmacist’s responsibility centers on providing advice, rather than being a role-model. Alcohol consumption appears to negatively influence academic achievement.

Patient-reported outcomes in randomised controlled trials on age-related macular degeneration

BACKGROUND/AIMS: The purpose of this systematic review was to identify the frequency and type of patient-reported outcome measures (PROMs) used in recent randomised controlled trials (RCTs) for age-related macular degeneration (AMD).

METHODS: The authors conducted a systematic search between January 2010 and November 2013 in MEDLINE, EMBASE, Scopus, Cochrane Library (Central) and the clinical trials registries (http://www.controlled-trials.com and http://www.ClinicalTrials.gov) according to defined inclusion criteria (RCTs on AMD in English). Two independent reviewers evaluated studies for inclusion. One reviewer extracted data of included studies, and a second masked reviewer assessed 10% to confirm accuracy in data collection. Reference lists of included papers and appendices of relevant Cochrane systematic reviews were scanned to identify other relevant RCTs. Information collected on extracted outcomes was analysed using descriptive statistics.

RESULTS: Literature and registry search yielded 3816 abstracts of journal articles and 493 records from trial registries. A total of 177 RCTs were deemed to have met inclusion criteria. Of the 858 outcomes reported, 38 outcomes were identified as PROMs (4.4%). Of the 177 RCTs examined, PROMs were used in 25 trials (14.1%). The National Eye Institute Visual Function Questionnaire-25 was the most frequently used PROM instrument (64% of RCTs with PROMs included).

CONCLUSIONS: This review highlights that a small proportion of AMD RCTs included PROMs as outcome measures and that there was a variety in the instruments used.

“If I Were Nick”: Men’s Responses to an Interactive Video Drama Series to Support Smoking Cessation

Background: Men continue to smoke in greater numbers than women; however, few interventions have been developed and tested to support men’s cessation. Men also tend to rely on quitting strategies associated with stereotypical manliness, such as willpower, stoicism and independence, but may lack the self‐efficacy skills required to sustain a quit. In this article we describe the development of and reception to an interactive video drama (IVD) series, composed of 7 brief scenarios, to support and strengthen men’s smoking cessation efforts. The value of IVD in health promotion is predicated on the evidence that viewers engage with the material when they are presented characters with whom they can personally identify. The video dramatizes the challenges unfolding in the life of the main character, Nick, on the first day of his quit and models the skills necessary to embark upon a sustainable quit. 
Objective: The objective was to describe men’s responses to the If I were Nick IVD series as part of a pilot study of QuitNow MenTM, an innovative smoking cessation website designed for men. Specific objectives were to explore the resonance of the main character of the IVD series with end‐users, and men’s perceptions of the effectiveness of the IVD series for supporting their quit self‐management. 
Methods: Seven brief IVD scenarios were developed, filmed with a professional actor and uploaded to a new online smoking cessation website, QuitNow MenTM.  A sample of 117 men who smoked were recruited into the study and provided baseline data prior to access to the QuitNow MenTM website for a 6 month period. During this time, 47 men chose to view the IVDs. Their responses to questions about the IVDs were collected in 3‐month and 6‐month online follow‐up surveys and analyzed using descriptive statistics. 
Findings: The majority of participants indicated they related to the main character, Nick. Participants who “strongly agreed” they could relate to Nick perceived significantly higher levels of support from the IVDs than the “neutral” and “disagree” groups (P <.001, d =2.0, P <.001 d =3.1). The “agree” and “neutral” groups were significantly higher on rated support from the videos than the “disagree” (P <.001 d =2.2, P =.01 d = 1.5). Participants’ perception of the main character was independent of participant age, education attainment or previous quit attempts. 
Conclusions: The findings suggest that IVD interventions may be an important addition to men’s smoking cessation programs. Given that the use of IVD scenarios in health promotion is in its infancy, the positive outcomes from this pilot study signal the potential for IVD and warrant ongoing evaluation in smoking cessation and, more generally, men’s health promotion.  

Consensus on Outcome Measures for Glaucoma Effectiveness Trials: Results From a Delphi and Nominal Group Technique Approaches

PURPOSE: Comparing the relative effectiveness of interventions across glaucoma trials can be problematic due to differences in definitions of outcomes. We sought to identify a key set of clinical outcomes and reach consensus on how best to measure them from the perspective of glaucoma experts.

METHODS: A 2-round electronic Delphi survey was conducted. Round 1 involved 25 items identified from a systematic review. Round 2 was developed based on information gathered in round 1. A 10-point Likert scale was used to quantify importance and consensus of outcomes (7 outcomes) and ways of measuring them (44 measures). Experts were identified through 2 glaucoma societies membership-the UK and Eire Glaucoma Society and the European Glaucoma Society. A Nominal Group Technique (NGT) followed the Delphi process. Results were analyzed using descriptive statistics.

RESULTS: A total of 65 participants completed round 1 out of 320; of whom 56 completed round 2 (86%). Agreement on the importance of outcomes was reached on 48/51 items (94%). Intraocular pressure (IOP), visual field (VF), safety, and anatomic outcomes were classified as highly important. Regarding methods of measurement of IOP, "mean follow-up IOP" using Goldmann applanation tonometry achieved the highest importance, whereas for evaluating VFs "global index mean deviation/defect (MD)" and "rate of VF progression" were the most important. Retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) was identified as highly important. The NGT results reached consensus on "change of IOP (mean of 3 consecutive measurements taken at fixed time of day) from baseline," change of VF-MD values (3 reliable VFs at baseline and follow-up visit) from baseline, and change of RNFL thickness (2 good quality OCT images) from baseline.

CONCLUSIONS: Consensus was reached among glaucoma experts on how best to measure IOP, VF, and anatomic outcomes in glaucoma randomized controlled trials.

Physical activity and sport participation for people with long-term illness

Purpose:Physical activity is recommended for optimal prevention of cardiovascular disease(CVD) and participation in sport is associated with improved well-being. However, people with long-standing illness/disability are less likely to participate in sport than others. Evidence of factors associated with their participation is limited and the best approach to encourage participation is unknown. This study aimed to identify sport participation levels and their correlates, among adults with long standing illness/disability in Northern Ireland, where CVD prevalence is high. Method:Using routinely collected data in annual surveys of population samples from 2007 to 2011, descriptive statistics were derived. Chi-squared tests were used to compare characteristics of those with a long-term illness/disability and those without long-term health problems. Uni-variate binary regression analysis for the whole sample and those with a long-standing illness/disability, using sport participation as the dependent variable, was performed and variables with a p-value of 0.1 or less were taken into a multi-variate analysis. Results:The sample included 13,683 adults; 3550(26%) reported having long-term illness/disability. Fewer of those with, than without, long-term illness/disability reported sport participation in the previous year (868/3550(24.5%) v 5615/10133(55.6%)). Multi-variate analysis showed that, for those with long-standing illness/disability, being single and less socio-economically deprived correlated positively with sport participation. For both those with long-standing illness/disability and the full sample, sport participation correlated positively with being male, aged <56 years, access to a household car/van, sports club membership, health ‘fairly good’ or ‘good’ in the previous year, doing paid/unpaid work, and living in an urban location. For the full sample but not those with long-standing illness/disability, sport participation correlated positively with being a non-smoker, higher educational status and personal internet access. Of note, personal internet access was less for those with, than without, long-term illness/disability (41% v 70%). Conclusions:Efforts to promote physical activity in sport for those with long-standing illness/disability should target older people, married females, those who live rurally, and those who are socio-economically deprived and report their health as ‘not good’. Implementation of initiatives should not rely on the internet, to which these people may not have ready access, to help support their sport participation and physical activity in optimal CVD prevention.

Pharmacy students' use and views on over-the-counter (OTC) medicines; a questionnaire study

Introduction
The role of the pharmacist centers on ensuring the safe and effective use of medicines, including over-the-counter (OTC) medicines. It is important to ascertain pharmacy students’ use and opinions on OTC medicines, given that they are the pharmacists of the future and that this market continues to expand. This study aimed to investigate Queen’s University Belfast (QUB) final year pharmacy students’ use and views on OTC medicines. Scarce work has been conducted in this area to date.

Methods
Following ethical approval and a pilot study, all students (n=155) were invited to participate in a self-completed questionnaire (n=20 questions), distributed at a mandatory class. Descriptive statistics and non-parametric tests (Chi-squared and Mann Whitney U-test) were used for data analyses.

Results
The response rate was 99.4% (154/155). The majority (153/155) reported using OTC medicines; the key consideration during personal product selection was effectiveness. Most [96.1% (147/153)] were in agreement that safety was the over-riding concern during OTC consultations. While 96.1% (149/155) considered that using an evidence-based approach improved the quality of patient care, 68.0% (104/153) would be prepared to sell a product that lacks evidence of effectiveness, provided it would not cause harm.

Conclusions
The importance of evidence of effectiveness was acknowledged, yet many students in this study were prepared to recommend unproven products. Further strategies are required at QUB to ensure this routine consideration alongside safety in practice.

O ensino e aprendizagem online da estatística descritiva

Tendo em conta que a Universidade Eduardo Mondlane é a primeira instituição, em Moçambique, a oferecer cursos completamente baseados na Web, o presente estudo constitui uma das primeiras investigações com a qual se pretende perceber qual o impacto de um módulo assente na compreensão de conceitos e na resolução de tarefas, fortemente apoiadas por uma Folha de Cálculo, estruturado numa lógica de webquest e lecionado a distância, rentabilizando-se potencialidades da plataforma virtual Aulanet, no desenvolvimento de competências tecnológicas e de conhecimentos, capacidades e atitudes relacionados com a Estatística descritiva. Para dar resposta às questões de investigação formuladas, optou-se por uma abordagem qualitativa e por uma estratégia de estudo de caso que se desenvolveu num contexto próximo da lógica da investigação - ação. Os principais participantes foram alunos do Curso de Licenciatura em Gestão de Negócios da UEM em Moçambique, a frequentar a disciplina de Estatística Aplicada. Para a recolha de dados, privilegiaram-se as técnicas da inquirição, análise documental e observação direta e participante, e diversos instrumentos como questionários e entrevistas, produções dos alunos, intervenções no fórum de debate, no Chat, testes e trabalhos, diário de bordo e notas de campo, com vista à triangulação metódica. A análise estatística e de conteúdo dos dados recolhidos permite constatar que a aprendizagem, à distância, de Estatística Descritiva, explorando-se meios tecnológicos de informação e de comunicação online e folha de cálculo Excel, inscritos numa estratégia de webquest ,potencia o desenvolvimento de competências tecnológicas e de conhecimentos, capacidades e atitudes relacionados com o tema. Paralelamente, permitiu refletir sobre as condições de ensino e de aprendizagem que podem favorecer tais práticas.

Diversidade linguística e educação para um futuro sustentável: que potencialidades nos primeiros anos de escolaridade?

Este estudo pretende analisar as relações entre a educação para a sustentabilidade e a sensibilização à diversidade linguística e cultural no currículo dos primeiros anos de escolaridade através do desenvolvimento de um projeto de intervenção pedagógico-didática. Para tal, refletiu-se sobre as noções de educação para o desenvolvimento sustentável e de sensibilização à diversidade linguística e cultural, explicitando o modo como se podem cruzar. Com este enquadramento, e numa lógica de investigação-ação, desenvolveuse o projeto de intervenção “Do meu mundo vejo o outro e o seu mundo”, em 21 sessões, numa turma do 4º ano do 1º Ciclo do Ensino Básico, de forma colaborativa com a respetiva professora titular, numa escola do distrito de Aveiro, durante o ano letivo de 2008/2009. Recolheram-se dados através da observação direta do(a)s aluno(a)s durante as sessões e de inquéritos por questionário e por entrevista ao(à)s aluno(a)s e à professora participante. Os dados recolhidos durante as sessões foram analisados com recurso à Escala de nível de envolvimento de Leuven (Laevers, 1994) e os inquéritos por questionário e entrevista foram alvo de uma análise estatística descritiva e de uma análise de conteúdo. Identificaram-se os efeitos do projeto no(a)s aluno(a)s em termos do seu nível de envolvimento nas atividades e do desenvolvimento das suas atitudes, conhecimentos e capacidades. A partir das vozes dos participantes, analisouse ainda a apreciação que realizaram do projeto na sua globalidade. Os resultados da análise apontam no sentido de que o projeto de intervenção desenvolvido contribuiu para: ajudar a derrubar barreiras disciplinares entre as àreas do currículo; justificar a necessidade de contemplar a sensibilização à diversidade linguística e cultural em processos de educação para o desenvolvimento sustentável; desenvolver materiais didáticos diversificados construídos numa lógica interdisciplinar, reconhecidos pela professora como inovadores e importantes para aprendizagens significativas e contextualizadas; transformar atitudes do(a)s aluno(a)s face à diversidade e à sustentabilidade, na preparação para uma cidadania planetária; e desenvolver no(a)s aluno(a)s uma consciência sistémica evidenciada na capacidade de relacionamento do global e do local em temas de diferentes áreas do conhecimento. Este estudo apresenta um conjunto de argumentos para a integração do tratamento da diversidade linguística e cultural no quadro de uma educação para um futuro mais sustentável nos primeiros anos de escolaridade, pela consideração de quatro grandes preocupações educativas: educar para compreender o mundo, educar para agir no mundo; educar para conviver com os outros e educar para o nunca-mais.

Avaliação de competências relacionadas com a literacia de informação: um estudo no contexto de pós-graduações em educação

A literatura da especialidade indica que os estudantes do Ensino Superior (ES) demonstram falta de competências de pesquisa, seleção e tratamento de informação científica com recurso às Tecnologias da Informação e Comunicação (TIC), nomeadamente as ferramentas da Web 2.0. A maioria dos estudos sobre esta temática envolve estudantes de 1.º Ciclo do Ensino Superior, sendo poucos os que se baseiam em referenciais de avaliação destas competências. Visando obter subsídios práticos e teóricos sobre a avaliação dessas competências, ter conhecimento das competências nesta área que os estudantes do ES, em nível de pós-graduação, possuem, e das suas necessidades de formação neste domínio, desenvolveu-se um estudo que foi desenvolvido em três fases. Na primeira fase após a identificação do problema a ser estudado, a falta de competências relacionadas com a Literacia de Informação (LI) de estudantes de pós-graduação, foi realizada a revisão da literatura para a determinação dos conceitos basilares e a sustentação teórica das fases subsequentes, que prendem-se com as competências relacionadas com a LI e como estas têm sido avaliadas. A segunda fase ocupou-se da avaliação de estudantes dos 2.º e 3.º Ciclos do Departamento de Educação da Universidade de Aveiro (UA). Com base na revisão da literatura e em colaboração com os bibliotecários da UA foi definido o referencial de avaliação das competências que definem as dimensões de pesquisa, seleção e tratamento de informação científica, com recurso às TIC. A confiabilidade deste referencial (primeira questão de investigação) foi estabelecida a partir dos contributos de docentes/bibliotecários de Instituições de Ensino Superior (IES), de Portugal e do Brasil. Optou-se pela técnica de estatística descritiva e análise de conteúdo para o estudo das informações destes profissionais. Deste modo, esta investigação permitiu a construção de um referencial de avaliação das competências relacionadas com a LI, com recurso às TIC. O referencial é um fundamento para a construção de instrumentos de avaliação em razão de evidenciar as competências que os estudantes do ES devem possuir de pesquisa, seleção e tratamento de informação científica, com recurso às TIC. Assim, foi permitido, com base no referencial de avaliação e no instrumento de recolha de dados utilizado com os profissionais de IES, desenvolver um questionário que foi aplicado aos estudantes de pós-graduação do Departamento de Educação da UA. Pelas respostas, obteve-se o conhecimento da perceção que possuem a respeito das suas competências de pesquisa, seleção e tratamento de informação científica, com recurso às TIC, e das suas necessidades de formação neste domínio (segunda e terceira questões de avaliação). Para esta análise optou-se pela técnica de estatística descritiva. A terceira fase ocupou-se da escrita da tese, que foi desenvolvida ao longo de toda a investigação, sendo mais intensa nos últimos seis meses. Os resultados da avaliação indicam não só que a maior parte dos estudantes aponta saber utilizar ferramentas digitais mas também têm a perceção de possuir competências relacionadas com a LI, com recurso às TIC, a nível elevado e muito elevado. As repostas da avaliação foram confrontadas com a literatura consultada. De modo igual, indicam que os estudantes do ES superestimam suas competências nesta área, embora não apresentem ações eficazes que demonstrem dominar as competências que supõem ter, sendo um indicativo da necessidade de formação destes estudantes. Recomenda-se que a academia leve em conta o confronto diário com estas tecnologias, que permeiam o modo de aprendizagem de estudantes. Os intervenientes do ambiente académico devem trabalhar em colaboração contínua, para que a partir de ações bem planejadas se possam colmatar as lacunas apresentadas. Devem-se atender as necessidades de formação de estudantes de pós-graduação identificadas por meio de avaliações, com base num referencial. É decursiva, para trabalhos futuros, a necessidade de analisar a confiabilidade do questionário que foi aplicado aos estudantes dos 2.º e 3.º Ciclos do Departamento de Educação da UA e os resultados da sua aplicação, fazendo-o evoluir de acordo com o feedback da sua utilização e a evolução das TIC.

Patient´s knowledge about radiation and radiological protection

Purpose: To obtain and analyse patient´s knowledge and perceptions regarding radiation exposure, from both natural and man-made radiation of medical procedures and interventions. Verify if patients worry about their exposure when undergoing medical exams, are aware of associated risks and means of radiological protection and if their knowledge on medical radiation exposure affects their own decisions. Methods and Materials: On a medical environment a self-applied questionnaire was used as instrument and assigned to patients who would undergo medical imaging exams involving ionising radiation. A total of 300 valid questionnaires were interpreted and statistically analysed through descriptive statistics and Phi & Cramer´s V correlation tests. Results: 44.3% of patients believe most of their exposure derives from electronic appliances and 25% from medical imaging exams, while patient´s with higher education levels tend to consider is comes from the environment. The great majority of patients (95%) consider that only certified personnel should operate medical imaging equipment, but 74% never ask for their qualifications. 66.3% of patients claim that Technologists have more education on radiological protection and about 60% of patients rarely or never worry about radiation exposure when undergoing medical imaging exams. Conclusion: Patients overestimate the risks of industrial radiation exposure while they underestimate the associated risks of medical radiation exposure and the Technologist´s ability to reduce the inherent radiation exposure of medical imaging exams. Patient´s knowledge on radiation and radiological protection is based more on perceptions and beliefs, rather than factual knowledge.

The Role of Teacher Presence during Computer Supported Online Collaborative Sessions in an Adult Education Course.

The convenience sample for this study was taken from an A.E.C. (Attestation of Collegial Studies) Communication course of the Continuing Education Technical Support Program. A key component of this course competency is for students to develop the skill to write business letters for various purposes and to apply the three-step writing process during the crafting of the correspondence. This is achieved with a number of writing assignments which are carried out by students working in teams and completing the writing assignments out-of-class. the out-of-class work was convened using the PrimaryPad program to complete two of the writing assignments, which formed the basis of the research. This research uses a case study design that employed a repeated measures method with two conditions (teacher scaffolding vs. no teacher scaffolding). The possibility of an order effect was controlled for by using a counterbalancing of treatment design. A post-treatment questionnaire was used to gather descriptive statistics.

Radiographers perceptions of magnetic resonance imaging: a study of the causes that lead to the exams repetition

Purpose: To know how often occur the repetitions of MRI exams and sequences in radiology departments. Methods and Materials: A self applied-questionnaire was used as instrument and assigned to 57 radiographers who performed MRI exams to determine which were the causes that lead to the repetition. The questionnaires were interpreted and statistically analyzed through descriptive statistics and Spearman’s rho correlations. Results: At a 95% confidence interval, the major results suggest that the patient’s movement during de MRI exams is the main cause to repeat this exams (mean of 3.88 on a 5 points likert scale). However, there are causes related to the radiographer’s and the results showed that the introduction of wrong imaging parameters by the performer are a major cause too (N=26). Spearman rho correlations between radiographer’s time of experience and frequency of MRI exams repetitions were poor and not significant (r=0.141; p=0.297). The correlations between radiographer’s tiredness and frequency of MRI exams repetitions were negative, weak and not significant (r= -0.151; p=0.263). Conclusion: The patients’ movement may disrupt the examination or degrade the images with artifacts. The level of experience doesn’t influence the repetitions of MRI exams, it seems that seniors radiographers don’t have improvements in performance as it should be expected. It’s recommendable to do training courses regularly to improve the performance and systematically evaluate. Several features will need to be identified which would decrease the MRI exams repetitions.

Inappropriate medication use in long-term care facility residents with advanced Alzheimer’s disease and other dementias

Les personnes atteintes de démence sévère, résidant dans un centre d’hébergement et de soins de longue durée (CHSLD) et approchant la fin de leur vie, ne reçoivent pas systématiquement des soins palliatifs, malgré que ce niveau de soins soit le plus approprié. La plupart de ces personnes reçoivent également un grand nombre de médicaments dont les effets indésirables peuvent contribuer à des souffrances évitables. Une approche axée sur les soins palliatifs serait possiblement associée à une réduction de la charge médicamenteuse et, du même coup, à une prescription plus appropriée. Les objectifs de ce projet de recherche étaient de décrire l’usage des médicaments chez les résidents atteints de démence sévère en CHSLD, de comparer leur usage de médicaments à des critères de pertinence et d’évaluer si la mise en œuvre d’une approche axée sur les soins palliatifs était associée aux médicaments prescrits. Cette étude décrit l’usage des médicaments chez 215 sujets atteints de démence sévère et en fin de vie qui ont participé à une étude d’intervention quasi expérimentale menée dans quatre CHSLD du Québec sur la mise en œuvre d’une approche axée sur les soins palliatifs. L’utilisation des médicaments a été comparée à trois listes de critères pertinents publiés, soit ceux de Holmes, Rancourt et Kröger, en utilisant des statistiques descriptives. Les analyses sur l’usage de 412 médicaments différents chez 120 sujets du groupe expérimental et 95 sujets du groupe témoin ont montré que cette approche axée sur les soins palliatifs n’est pas associée à une prescription plus appropriée des médicaments chez ces personnes particulièrement vulnérables.

O ensino online nas instituições de ensino superior privado. As perspetivas : docente e discente e as implicações na tomada de decisão institucional

Tese de doutoramento, Educação (Tecnologias da Informação e Comunicação na Educação), Universidade de Lisboa, Instituto de Educação, 2014