Management of pregnancy in a University Hospital: a 6-year study

In order to evaluate the obstetric care in the Obstetric Clinic of the Gynaecology and Obstetrics Department of University of São Paulo, the authors present a survey of the management of pregnancy during the 6-year period from 1993 to 1998. The number of deliveries increased during the study by 45% over the 6 years. During this same period the number of fetal deaths was 526 (4.48%), but there was a significant decrease (p < 0.05) in the incidence of fetal death. However, there was no concomitant increase in the proportion of pregnant women with prenatal care that could explain this improvement. Incidence of premature labor also decreased considerably. The authors believe that the increment in the number of deliveries was due mainly to the increasing number of pregnant women referred to our service. The efforts made by the service towards decreasing the time of hospitalization of both newborns in the nursery and the mothers in the hospital made this possible. Despite the increasing number of deliveries, there was a significant improvement in the management of pregnancy during the period of study. This improvement may be a consequence of the standardization of a protocol of management of pregnancy based on the recent progress in scientific and technological knowledge.

The World Health Organization Multi-Professional Patient Safety Curriculum : implementation of key modules and its impact on patient safety knowledge, skills, and attitudes of medical students at the University of Algarve

ABSTRACT - Objectives: We attempted to show how the implementation of the key elements of the World Health Organization Patient Safety Curriculum Guide Multi-professional Edition in an undergraduate curriculum affected the knowledge, skills, and attitudes towards patient safety in a graduate entry Portuguese Medical School. Methods: After receiving formal recognition by the WHO as a Complementary Test Site and approval of the organizational ethics committee , the validated pre-course questionnaires measuring the knowledge, skills, and attitudes to patient safety were administered to the 2nd and3rd year students pursuing a four-year course (N = 46). The key modules of the curriculum were implemented over the academic year by employing a variety of learning strategies including expert lecturers, small group problem-based teaching sessions, and Simulation Laboratory sessions. The identical questionnaires were then administered and the impact was measured. The Curriculum Guide was evaluated as a health education tool in this context. Results: A significant number of the respondents, 47 % (n = 22), reported having received some form of prior patient safety training. The effect on Patient Safety Knowledge was assessed by using the percentage of correct pre- and post-course answers to construct 2 × 2 contingency tables and by applying Fishers’ test (two-tailed). No significant differences were detected (p < 0.05). To assess the effect of the intervention on Patient Safety skills and attitudes, the mean and standard deviation were calculated for the pre and post-course responses, and independent samples were subjected to Mann-Whitney’s test. The attitudinal survey indicated a very high baseline incidence of desirable attitudes and skills toward patient safety. Significant changes were detected (p < 0.05) regarding what should happen if an error is made (p = 0.016), the role of healthcare organizations in error reporting (p = 0.006), and the extent of medical error (p = 0.005). Conclusions: The implementation of selected modules of the WHO Patient Safety Curriculum was associated with a number of positive changes regarding patient safety skills and attitudes, with a baseline incidence of highly desirable patient safety attitudes, but no measureable change on the patient safety knowledge, at the University of Algarve Medical School. The significance of these results is discussed along with implications and suggestions for future research.

Cost of drugs manufactured by the University Hospital - role of the Central Pharmacy

The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of pharmaceutical formulations was a cost-effective alternative in the described setting.

Experience with the first Internet-based course at the Faculty of Medicine, University of São Paulo

PURPOSE: The Internet expands the range and flexibility of teaching options and enhances the ability to process the ever-increasing volume of medical knowledge. The aim of this study is to describe and discuss our experience with transforming a traditional medical training course into an Internet-based course. METHOD: Sixty-nine students were enrolled for a one-month course. They answered pre- and post-course questionnaires and took a multiple-choice test to evaluate the acquired knowledge. RESULTS: Students reported that the primary value for them of this Internet-based course was that they could choose the time of their class attendance (67%). The vast majority (94%) had a private computer and were used to visiting the Internet (75%) before the course. During the course, visits were mainly during the weekends (35%) and on the last week before the test (29%). Thirty-one percent reported that they could learn by reading only from the computer screen, without the necessity of printed material. Students were satisfied with this teaching method as evidenced by the 89% who reported enjoying the experience and the 88% who said they would enroll for another course via the Internet. The most positive aspect was freedom of scheduling, and the most negative was the lack of personal contact with the teacher. From the 80 multiple-choice questions, the mean of correct answers was 45.5, and of incorrect, 34.5. CONCLUSIONS: This study demonstrates that students can successfully learn with distance learning. It provides useful information for developing other Internet-based courses. The importance of this new tool for education in a large country like Brazil seems clear.

Use of licit and illicit drugs at the university of Alfenas

This paper reports the study of drug consumption carried out within the population of undergraduate students from 2 colleges of Alfenas, in the state of Minas Gerais state. Both licit and illicit drugs were studied, including alcohol, tobacco, marijuana, cocaine, heroin, crack, inhalants, glue, tranquilizers, stimulants, and others. METHODOLOGY: The research included a wide bibliographical search and the application of a questionnaire to approximately 23% of the students (total of 6500 students). RESULTS: A total of 1500 students participated in this investigation. The results demonstrated that there was a significant consumption of both licit and illicit drugs. The pattern of drug consumption in the research sample was similar to other investigations conducted in Brazil and in other countries. DISCUSSION: It was observed that 55% of the university students use drugs. However, the most surprising finding was that most of the students (88%) answered "yes" to the inquiry, "Have you already tried any type of drug, including alcohol and cigarettes?" The students revealed that they had taken drugs even prior to the admission to the university. The results suggest clearly that the university environment does not necessarily represent the starting point for student drug consumption.

Hypertension in employees of a University General Hospital

PURPOSE: To find out the prevalence of hypertension in employees of the Hospital and relate it to social demographic variables. METHODS: Blood pressure measurement was performed with a mercury sphygmomanometer, using an appropriate cuff size for arm circumference, weight, and height in a population sample of 864 individuals out of the 9,905 employees of a University General Hospital stratified by gender, age, and job position. RESULTS: Hypertension prevalence was 26% (62% of these reported being aware of their hypertension and 38% were unaware but had systolic/diastolic blood pressures of >140 and/or >90 mm Hg at the moment of the measurement). Of those who were aware of having hypertension, 51% were found to be hypertensive at the moment of the measurement. The prevalence was found to be 17%, 23%, and 29% (P <.05) in physicians, nursing staff, and "others", respectively. The univariate analysis showed a significant odds ratio for the male gender, age >50 years, work unit being the Institute of Radiology and the Administration Building, educational level 10 years, and body mass index >30 kg/m². The multivariate logistic regression model revealed a statistically significant association of hypertension with the following variables: gender, age, skin color, family income, and body mass index. CONCLUSIONS: Hypertension prevalence was high, mainly in those who were not physicians or members of the nursing staff. High-risk groups (obese, non-white, men, low family income) should be better advised of prevention and early diagnosis of hypertension by means of special programs.

Analysis of factors and drivers in graduates success among Portugal, India and Italy- extracurricular activities before university

Field lab: Business project

A confraria do comentário do futebol na TV: evolução dos programas televisivos feitos com adeptos dos maiores clubes portugueses

Em Portugal, os programas de televisão feitos com adeptos notáveis de três grandes clubes de futebol correspondem a um formato com menos de uma década e meia de existência: apareceram primeiro na RTP2 e, logo a seguir, na SIC. Os canais generalistas rapidamente os adoptaram como conteúdos privilegiados para atrair audiência. Hoje constituem âncoras das grelhas dos três canais temáticos de informação, rivalizando entre si nos comentadores permanentes que conseguem fixar em estúdio. Apresentados por jornalistas, estes programas criam momentos de grande polémica e, com isso, marcam, de certa forma, a agenda do campo do futebol. Neste artigo, explicamos a génese destes formatos, traçamos o seu percurso na TV portuguesa e, através de entrevistas aos seus responsáveis editoriais, analisamos a estratégia que seguem na construção do alinhamento, discutimos a distância que mantêm dos clubes que comentam e perspectivamos formas de evolução deste tipo de conteúdos televisivos. Uma linha sobressai neste trabalho: quem participa nestes programas é uma elite de comentadores que se apresentam como adeptos do Futebol Clube do Porto, do Sporting e do Benfica, mas que mais não são do que uma confraria do comentário do futebol que semanalmente contribui para a construção de um espaço público cada vez mais rarefeito em torno daquilo que se discute no futebol.

Da falsa integração do espectador na TV informativa

As actuais potencialidades tecnológicas abrem, perante o (tele)spectador, a promessa de um ilusório empowered user que se vai construindo alicerçado na narrativa mítica da omnipotência, tornada modo verbal e complemento directo da promessa moderna da omnividência. No entanto, os plateaux informativos da televisão portuguesa do século XXI ainda não vêem no telespectador um elemento estruturante do seu trabalho. São escassos os programas que abrem o alinhamento à participação do público e aqueles que o fazem atiram-no para margens que pouco ou nada interferem no desenvolvimento das emissões. Neste artigo, analisamos a integração dos telespectadores em 1673 emissões informativas, distribuídas por seis canais de televisão (RTP1, SIC, TVI, SICN, RTPN, TVI 24). Trata-se de uma investigação que desenvolvemos no âmbito do projecto “Jornalismo televisivo e cidadania”.

O ecrã da (hiper) televisão: novos olhares a partir das emissões dedicadas ao Euro 2012 na TV portuguesa

Dando continuidade a uma série de estudos já realizados no âmbito do projecto de investigação em que se insere, o presente trabalho questiona a evolução do ecrã televisivo como dispositivo supostamente convergente. Contrariando uma tendência discursiva dominante, quer na esfera dos media quer na própria produção académica sobre o medium televisivo, clarificam-se aqui alguns dos desenvolvimentos teóricos mais significativos, resultantes dos anos de trabalho que este projecto de investigação já tem. Propõe-se, pois, uma distinção conceptual entre o ecrã prometido pela cultura da convergência, que designamos como ecrã convergente, e o ecrã verdadeiramente resiliente da instituição-televisão, o ecrã centrípeto, que ainda obedece aos princípios de sequência e fluxo enunciados por Raymond Williams nos anos 1970.

Primusinter (ím)pares - análise da presença dos académicos nos plateaux informativos da TV portuguesa

Os académicos estão a tornar-se uma presença cada vez mais visível nos plateaux informativos da TV portuguesa. Não são um grupo muito diversificado. Pelo contrário. Apresentam-se como uma confraria que é oriunda das universidades de Lisboa e pertence a um reduzido número de campos de saberes. Aos plateaux televisivos portugueses dificilmente chegará o fazer-ciência concreto. O que chega são alguns dos seus actores, o que não significa que o consigam por um efeito de reconhecimento inter pares, mas, antes, por um efeito de verdadeiras imparidades: porque já adquiriram suficiente capital simbólico em zonas exteriores ao campo científico. Zonas mais limítrofes, como o campo institucional-académico, ou zonas mais afastadas, como o campo comunicacional.

A TV do Mundial

No último ano da primeira década do século XXI, quase a entrar na era da televisão digital, importa saber que modelo de TV existe em Portugal. A análise da programação informativa destinada a acompanhar o Campeonato do Mundo de Futebol 2010 ajudará, decerto, a encontrar respostas. Neste artigo, apresentamos um estudo que incidiu em formatos informativos sobre este grande evento mediático, emitidos nos canais generalistas e temáticos entre os dias 11 de Junho e 11 de Julho de 2010 (datas de arranque e fecho do Mundial de Futebol da África do Sul). Essa análise, que incidiu em 604 emissões, procurou conhecer as formas de integração do telespectador nas emissões televisivas e quem foi chamado aos estúdios televisivos para participar nos debates aí promovidos. Os dados apurados demonstram claramente que esta TV do Mundial continua pouco aberta à participação do público e circunscrita a um grupo restrito de convidados, a maior parte dos quais oriundos da classe jornalística. Não é possível falar-se numa terceira fase do audiovisual. A hiper-televisão pode esperar.

Changes in institutional governance and management of higher education in Laos: National University of Laos

PhD thesis in Educational Sciences (specialization in Politics of Education).

Measuring university-to-work success: development of a new scale

Purpose – The purpose of this paper is to develop a subjective multidimensional measure of early career success during university-to-work transition. Design/methodology/approach – The construct of university-to-work success (UWS) was defined in terms of intrinsic and extrinsic career outcomes, and a three-stage study was conducted to create a new scale. Findings – A preliminary set of items was developed and tested by judges. Results showed the items had good content validity. Factor analyses indicated a four-factor structure and a second-order model with subscales to assess: career insertion and satisfaction, confidence in career future, income and financial independence, and adaptation to work. Third, the authors sought to confirm the hypothesized model examining the comparative fit of the scale and two alternative models. Results showed that fits for both the first- and second-order models were acceptable. Research limitations/implications – The proposed model has sound psychometric qualities, although the validated version of the scale was not able to incorporate all constructs envisaged by the initial theoretical model. Results indicated some direction for further refinement. Practical implications – The scale could be used as a tool for self-assessment or as an outcome measure to assess the efficacy of university-to-work programs in applied settings. Originality/value – This study provides a useful single measure to assess early career success during the university-to-work transition, and might facilitate testing of causal models which could help identify factors relevant for successful transition.