Living with digestive stomas: strategies to cope with the new bodily reality.

OBJECTIVE the objective in this study was to describe the strategies developed by digestive stoma patients to cope with their situation. METHOD a qualitative and descriptive study was undertaken, involving 21 stoma patients living in the provinces of Málaga and Granada (Spain). The informants were selected in accordance with criteria of appropriateness and diversity, through intentional sampling. The data were collected by means of semistructured interviews. RESULTS the content analysis revealed three categories around which the distinct strategies were developed: Self-care, Adaptation to the bodily change and Self-help. CONCLUSION the strategies developed are focusing on achieving the effective management of the stoma and are closely linked with the achievement of autonomy. Discovering the strategies applied is fundamental for the nursing professionals to offer high-quality care, centered on people and their process.

Historical review of clinical vaccine studies at Oswaldo Cruz Institute and Oswaldo Cruz Foundation - technological development issues

This paper presents, from the perspective of technological development and production, the results of an investigation examining 61 clinical studies with vaccines conducted in Brazil between 1938-2013, with the participation of the Oswaldo Cruz Institute (IOC) and the Oswaldo Cruz Foundation (Fiocruz). These studies have been identified and reviewed according to criteria, such as the kind of vaccine (viral, bacterial, parasitic), their rationale, design and methodological strategies. The results indicate that IOC and Fiocruz have accumulated along this time significant knowledge and experience for the performance of studies in all clinical phases and are prepared for the development of new vaccines products and processes. We recommend national policy strategies to overcome existing regulatory and financing constraints.

A historical perspective on malaria control in Brazil

Malaria has always been an important public health problem in Brazil. The early history of Brazilian malaria and its control was powered by colonisation by Europeans and the forced relocation of Africans as slaves. Internal migration brought malaria to many regions in Brazil where, given suitableAnopheles mosquito vectors, it thrived. Almost from the start, officials recognised the problem malaria presented to economic development, but early control efforts were hampered by still developing public health control and ignorance of the underlying biology and ecology of malaria. Multiple regional and national malaria control efforts have been attempted with varying success. At present, the Amazon Basin accounts for 99% of Brazil’s reported malaria cases with regional increases in incidence often associated with large scale public works or migration. Here, we provide an exhaustive summary of primary literature in English, Spanish and Portuguese regarding Brazilian malaria control. Our goal was not to interpret the history of Brazilian malaria control from a particular political or theoretical perspective, but rather to provide a straightforward, chronological narrative of the events that have transpired in Brazil over the past 200 years and identify common themes.

Understanding the development of the ESDP: Perspectives and insights from historical institutionalism and theories of learning

How can we best understand the emergence of the European Security and Defence Policy (ESDP)? This paper applies the theories of historical institutionalism and experiential learning to offer a dynamic conceptualisation of moves towards an ESDP which highlights some of the causal factors that a more temporally-restricted analysis would miss. It firstly shows how the institutional and functional expansion of European Political Cooperation (EPC) over the course of the 1970s and 80s gave rise to a context in which the development of a security and defence dimension came to be viewed as more logical and even necessary. It then goes on to analyse some of the external factors (in the form of actors, events and institutions) that further pushed in this direction and proved to influence the policy’s subsequent evolution. The paper is therefore intended to act as a first-step to understanding the ESDP’s development from this perspective.

Iowa Airport Directory, 2003 ***NOTE*** This document is for historical viewing, the internal information is no longer current or accurate! ***NOTE*** Current information can be found at http://www.iowadot.gov/aviation/aircraftregistration/registration.aspx ***NOTE***

Iowa has 8 commercial service airports and 105 general aviation airports, of which three serve as reliever airports. ***NOTE*** This document is for historical viewing, the internal information is no longer current or accurate! ***NOTE*** Current information can be found at http://www.iowadot.gov/aviation/aircraftregistration/registration.aspx ***NOTE***

Personality traits and virtual reality performance.

BACKGROUND: Surgeons' personalities have been described as different from those of the general population, but this was based on small descriptive studies limited by the choice of evaluation instrument. Furthermore, although the importance of the human factor in team performance has been recognized, the effect of personality traits on technical performance is unknown. This study aimed to compare surgical residents' personality traits with those of the general population and to evaluate whether an association exists between their personality traits and technical performance using a virtual reality (VR) laparoscopy simulator. METHODS: In this study, 95 participants (54 residents with basic, 29 with intermediate laparoscopic experience, and 12 students) underwent personality assessment using the NEO-Five Factor Inventory and performed five VR tasks of the Lap Mentor? basic tasks module. The residents' personality traits were compared with those of the general population, and the association between VR performance and personality traits was investigated. RESULTS: Surgical residents showed personality traits different from those of the general population, demonstrating lower neuroticism, higher extraversion and conscientiousness, and male residents showed greater openness. In the multivariable analysis, adjusted for gender and surgical experience, none of the personality traits was found to be an independent predictor of technical performance. CONCLUSIONS: Surgical residents present distinct personality traits that differ from those of the general population. These traits were not found to be associated with technical performance in a virtual environment. The traits may, however, play an important role in team performance, which in turn is highly relevant for optimal surgical performance.

Historical Development and Applications of the EPIC and APEX Models, June 2005

The development of the field-scale Erosion Productivity Impact Calculator (EPIC) model was initiated in 1981 to support assessments of soil erosion impacts on soil productivity for soil, climate, and cropping conditions representative of a broad spectrum of U.S. agricultural production regions. The first major application of EPIC was a national analysis performed in support of the 1985 Resources Conservation Act (RCA) assessment. The model has continuously evolved since that time and has been applied for a wide range of field, regional, and national studies both in the U.S. and in other countries. The range of EPIC applications has also expanded greatly over that time, including studies of (1) surface runoff and leaching estimates of nitrogen and phosphorus losses from fertilizer and manure applications, (2) leaching and runoff from simulated pesticide applications, (3) soil erosion losses from wind erosion, (4) climate change impacts on crop yield and erosion, and (5) soil carbon sequestration assessments. The EPIC acronym now stands for Erosion Policy Impact Climate, to reflect the greater diversity of problems to which the model is currently applied. The Agricultural Policy EXtender (APEX) model is essentially a multi-field version of EPIC that was developed in the late 1990s to address environmental problems associated with livestock and other agricultural production systems on a whole-farm or small watershed basis. The APEX model also continues to evolve and to be utilized for a wide variety of environmental assessments. The historical development for both models will be presented, as well as example applications on several different scales.

Assessment of construct validity of a virtual reality laparoscopy simulator.

BACKGROUND: The aim of this study was to assess whether virtual reality (VR) can discriminate between the skills of novices and intermediate-level laparoscopic surgical trainees (construct validity), and whether the simulator assessment correlates with an expert's evaluation of performance. METHODS: Three hundred and seven (307) participants of the 19th-22nd Davos International Gastrointestinal Surgery Workshops performed the clip-and-cut task on the Xitact LS 500 VR simulator (Xitact S.A., Morges, Switzerland). According to their previous experience in laparoscopic surgery, participants were assigned to the basic course (BC) or the intermediate course (IC). Objective performance parameters recorded by the simulator were compared to the standardized assessment by the course instructors during laparoscopic pelvitrainer and conventional surgery exercises. RESULTS: IC participants performed significantly better on the VR simulator than BC participants for the task completion time as well as the economy of movement of the right instrument, not the left instrument. Participants with maximum scores in the pelvitrainer cholecystectomy task performed the VR trial significantly faster, compared to those who scored less. In the conventional surgery task, a significant difference between those who scored the maximum and those who scored less was found not only for task completion time, but also for economy of movement of the right instrument. CONCLUSIONS: VR simulation provides a valid assessment of psychomotor skills and some basic aspects of spatial skills in laparoscopic surgery. Furthermore, VR allows discrimination between trainees with different levels of experience in laparoscopic surgery establishing construct validity for the Xitact LS 500 clip-and-cut task. Virtual reality may become the gold standard to assess and monitor surgical skills in laparoscopic surgery.

Evaluation of Virtual Reality Snowplow Simulator Training: A Literature Review, September 2006

Each winter, the Iowa Department of Transportation (Iowa DOT) maintenance operators are primarily responsible for plowing snow off federal and state roads. Drivers typically work long shifts under treacherous conditions. In addition to properly navigating the vehicle, drivers are required to operate several plowing mechanisms simultaneously, such as plow controls and salt sprayers. However, operators have few opportunities during the year to practice and refine their skills. An ideal training program would provide operators with the opportunity to practice these skills under realistic yet safe conditions, as well as provide basic training to novice or less-experienced operators. Recent technological advancements have made driving simulators a desirable training and research tool. This literature review discusses much of the recent research establishing simulator fidelity and espousing its applicability. Additionally, this report provides a summary of behavioral and eye tracking research involving driving simulators. Other research topics include comparisons between novice and expert drivers’ behavioral patterns, methods for avoiding cybersickness in virtual environments, and a synopsis of current personality measures with respect to job performance and driving performance. This literature review coincides with a study designed to examine the effectiveness of virtual reality snowplow simulator training for current maintenance operators, using the TranSim VS III truck and snowplow simulator recently purchased by the Iowa DOT.

Study of adaptation and validation of the Practice environment scale of the nursing work index for the portuguese reality

Objective: Testing the psychometric properties of the Portuguese version of the Practice Environment Scale of the Nursing Work Index. Method: A descriptive, analytical and cross-sectional study, for the cross-cultural adaptation and validation of the psychometric properties of the scale. The study participants were 236 nurses from two hospitals in the regions of Lisbon and Vale do Tejo. Results: The 0.92 Cronbach’s alpha was obtained for overall reliability and support of a five-dimension structure. Conclusion: The excellent quality of adjustment of analysis confirms the validity of the adapted version to hospital care settings, although there was no total coincidence of items in the five dimensions


Higher education in nursing: the faculty work process in different institutional contexts

Objective To analyze the characteristics of faculty work in nursing higher education. Method An exploratory qualitative study with a theoretical-methodological framework of dialectical and historical materialism. The faculty work process was adopted as the analytical category, grounded on conceptions of work and professionalism. Semi-structured interviews were conducted with 24 faculty members from three higher education institutions in the city of São Paulo, classified according to the typology of institutional contexts. Results The faculty members at these higher education institutions are a heterogeneous group, under different working conditions. Intensification and precarious conditions of the faculty work is common to all three contexts, although there are important distinctions in the practices related to teaching, research and extension. Conclusion Faculty professionalization can be the starting point for analyzing and coping with such a distinct reality of faculty work and practice.


BETWEEN DREAMS AND REALITY: Migration of Brazilian women to Switzerland

The general objective of this article was to study the process of illegal migration of Brazilian women to Switzerland and, more specifically, to analyze the motivations for migration, the difficulties found upon arrival, the circumstances that led them to get married and lastly an evaluation of the whole experience. The methodology was based in a qualitative approach. The participants were eight Brazilian women that illegally migrated to Switzerland but now are married with Swiss or European men. They responded to an interview focused in the objectives of the study. The appreciation of the data was realized with Minayo´s Content Analysis. The motivations were related to a bettering of the financial situation. In the difficulties encountered, we can bring out illegality, language and prejudice. Regarding marriage, they married to stay legally in the country. Finally, the evaluation of the experience was negative for most participants.

A importância da demonstração do fluxo de caixa e o paradigma da utilidade

No contexto mundial, em virtude da complexidade da economia, da expansão e competitividade dos mercados, verifica-se uma crescente necessidade das empresas em buscarem instrumentos que as auxiliem no planeamento e controle de seus recursos para que estes sejam usados de maneira adequada, a fim de salvaguardar a actividade empresarial e alcançar o objectivo almejado pela empresa. O sucesso empresarial demanda cada vez mais o uso de práticas financeiras apropriadas. A realidade aponta para gestores sedentos de informações relevantes que irão auxiliar o seu processo decisório. Assim sendo, o trabalho ora intitulado: A Importância do Fluxo de Caixa, e o paradigma da utilidade foi elaborado através de pesquisa bibliográfica e exploratória sobre o assunto em questão, tendo como base artigos, livros e dissertações. O seu objectivo principal é enfatizar a importância do demonstrativo de Fluxo de Caixa como ferramenta para os gestores obterem eficiência na administração financeira da sua entidade. Para tanto, iniciamos com uma resenha histórica do mapa em estudo. Num segundo momento fazemos um enquadramento teórico onde referimos ao conceito de fluxo de caixa, seus objectivos, as suas normas legais nacionais e internacionais, e a presença da demonstração de fluxo de caixa no mercado Cabo-verdiano antes de 2009. Em seguida temos a metodologia de elaboração do mapa, onde fazemos referências ao aspecto conceptual, aos métodos de elaboração o método directo e indirecto, as vantagens e desvantagens sem deixar de lado o paradigma da utilidade do mapa. Finalizando, apresentamos uma parte prática onde o objectivo é expressar em números tudo o que foi divulgado teoricamente. In the global context, along with the virtue of the economic complexity, from the expansion and the competition of the markets, there is an essential increase of the companies looking forward for instruments that will assist them in planning and control the resources so that these would be used in the most adequate way, in a way to guaranty company’s activity and to accomplish the objectives intended by the company. Company’s success requires more and more the use of appropriated financial practice. The reality demonstrates managers eager for relevant information that will support his/her process of decision. So therefore the work entitled “The Importance of Cash Flow” and its paradigm of utility was elaborated according to the bibliographic and exploratory research about the topic in question, having as support articles, books and dissertations. Its main objective is to emphasize the importance of the Cash Flow Statement as an instrument for the managers to obtain efficiency in the financial management of its corporation. For that, we start with an historical review of the statement in study. Secondly we make a theoretical approach where we reflect on the Cash Flow, its objectives, its national and international official standards and the statement of Cash Flows in Cape Verdean market before 2009. After that, there is the methodology of the design of the statement, where we refer to the conceptual aspects, the direct and indirect methods of design, the advantages and disadvantages without letting out the paradigm of utility of the statement. Finally, we present a practical case illustrating in numbers the whole thing that was presented theoretically.

Avaliação de necessidades de formação em professores do ensino secundário em Cabo Verde

II Resumo Cabo Verde é um país que tem acompanhado as grandes mudanças políticas, sociais, económicas e educativas, atribuindo um papel preponderante aos professores na educação/formação dos indivíduos. Neste sentido a formação inicial não pode constituir um acto “acabado” que não tem em linha de conta as mudanças que decorrem no seu seio. A formação contínua aparece com um processo de construção da mudança, apoiado no desenvolvimento profissional dos professores. A avaliação de necessidade de formação em professores do ensino secundário em Cabo Verde é o tema do trabalho de investigação, realizado nas escolas secundárias da ilha de Santo Antão, em Cabo Verde, no sentido de identificar questões problemáticas na formação inicial e contínua de professores e as suas implicações na qualidade educativa. Neste sentido, ao longo de 5 capítulos apresentamos os pontos desta investigação, estruturados de forma a se poder acompanhar a sua evolução. No 1º capítulo, apresenta-se a Problemática de Investigação, que constitui a parte inicial da dissertação, pela exposição do quadro conceptual do ensino secundário em Cabo Verde através da contextualização e identificação do problema, da formulação dos objectivos e questões de investigação. No 2º capítulo faz-se o percurso histórico/educativo de Cabo Verde, desde a época colonial, passando pela educação após a independência em 1975, à constituição da Lei de Bases do Sistema Educativo e a Reforma Educativa dos anos 90. No 3º capítulo, intitulado “A Formação Inicial e Continua de Professores em Cabo Verde”, é abordado o enquadramento teórico desta investigação, com referência à contextualização geral da formação e modelos de formação de professores, evoluindo para a realidade Cabo-verdiana, tendo em consideração as instituições de formação de professores e o contexto actual do ensino secundário em Cabo Verde. No 4º capítulo faz-se a apresentação da Metodologia de Investigação, adoptada num estudo extensivo, do qual abordamos a natureza da investigação e caracterizamos a amostra e respondentes. Como técnicas de recolha de dados, são utilizados: o inquérito por questionário (n=77), a professores do ensino secundário e o inquérito por entrevista (n=9), aos directores das escolas secundárias da ilha de Santo Antão e a formadores de professores em São Vicente. Como técnica de análise de dados, são utilizados diversos procedimentos estatísticos e a análise de conteúdo. O 5º capítulo corresponde a apresentação e discussão dos resultados da investigação desses três públicos analisados. Para finalizar, apresenta-se uma conclusão que corresponde a síntese dos resultados obtidos, propostas de sugestões de melhoria e limitações do estudo. Cabo Verde is a country willing to follow the great political, social, economic and educational changes. This important role have attributed to teachers to educate and train individuals. In this sense the initial training cannot be considered as a “finished” task without taking into consideration those changes. The in service training appears as a scientific and pedagogic autonomization towards the growing change. The Evaluation of Secondary School teacher training Needs in Cabo Verde constitutes an investigation work, carried out in Santo Antão's island Secondary schools, aiming to identify problems in initial and continuous teachers' training and their implications in the educational quality. In this sense, along five chapters we will present the points of this investigation, structured to facilitate the understanding of its evolution. In the first chapter we present the Problem of Investigation which is an introductory part of the dissertation, the conceptual theory of the Cabo Verde secondary education through the contextualization and identification of the problem, the formulation of the objectives and investigation issues. In the second chapter we present the Cabo Verde historical/educational background, from the colonial time, going through after independence in 1975, to the constitution of the Basic Educational Law of the System and the nineties Educational Reform. In the third chapter entitled “The Initial and in-service Teacher´s Training in Cabo Verde” brings the theoretical framework of this investigation, where we present a general contextualization of teachers' training and models, developed from the reality of Cabo Verde. In this regard we will consider the teachers' training institutions and the current secondary education context in Cabo Verde. In the fourth chapter we present the Research Methodology, adopted in an extensive study, of which we draw the nature of the investigation and we characterized the sample. We carried out questionnaire (n=77) to teachers, interviews (n=9) to headmasters from Santo Antão's island secondary schools and trainers from São Vicente. We used statistical analyses and content analyses as data analyse techniques. The fifth chapter deals with presentation the discussion of results of those three analyzed publics' investigation. Finally, we present a summary of the obtained results, suggestions for improvement and limitations of study.

Evaluation of Virtual Reality Snowplow Simulator Training, January 2007

Each winter, Iowa Department of Transportation (Iowa DOT) maintenance operators are responsible for plowing snow off federal and state roads in Iowa. Drivers typically work long shifts under treacherous conditions. In addition to properly navigating the vehicle, drivers are required to operate several plowing mechanisms simultaneously, such as plow controls and salt spreaders. There is little opportunity for practicing these skills in real-world situations. A virtual reality training program would provide operators with the opportunity to practice these skills under realistic yet safe conditions, as well as provide basic training to novice or less-experienced operators. In order to provide such training to snowplow operators in Iowa, the Iowa DOT purchased a snowplow simulator. The Iowa DOT commissioned a study through Iowa State University designed to (1) assess the use of this simulator as a training tool and (2) examine personality and other characteristics associated with being an experienced snowplow operator. The results of this study suggest that Iowa DOT operators of all ages and levels of experience enjoyed and seemed to benefit from virtual reality snowplow simulator training. Simulator sickness ratings were relatively low, implying that the simulator is appropriate for training a wide range of Iowa DOT operators. Many reported that simulator training was the most useful aspect of training for them.