687 resultados para Practice Development


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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AIMS AND OBJECTIVES: To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.

BACKGROUND: Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care.

DESIGN: A qualitative study using semi-structured interviews and thematic analysis to examine data.

METHODS: 24 registered nurses caring for people dying with advanced dementia were recruited from ten nursing homes, three hospices, and two acute hospitals across a region of the United Kingdom. Interviews were conducted between June 2014 and September 2015.

RESULTS: Three core themes were identified: challenges administering analgesia, the nurse-physician relationship, and interactive learning and practice development. Patient-related challenges to pain management were universal across care settings; nurse- and organisation-related barriers differed between settings. A need for interactive learning and practice development, particularly in pharmacology, was identified.

CONCLUSIONS: Achieving pain management in practice was highly challenging. A number of barriers were identified; however, the manner and extent to which these impacted on nurses differed across hospice, nursing home and acute care settings. Needs-based training to support and promote practice development in pain management in end-stage dementia is required.

RELEVANCE TO CLINICAL PRACTICE: Nurses considered pain management fundamental to end of life care provision; however, nurses working in acute care and nursing home settings may be under-supported and under-resourced to adequately manage pain in people dying with advanced dementia. Nurse-to-nurse mentoring and ongoing needs-assessed interactive case-based learning could help promote practice development in this area. Nurses require continuing professional development in pharmacology. This article is protected by copyright. All rights reserved.

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Relatório EPE - Relatório de estágio em Educação Pré-Escolar: O presente relatório de estágio de qualificação profissional surge no âmbito da unidade curricular de Prática Pedagógica Supervisionada na Educação Pré- Escolar, por forma a evidenciar o desenvolvimento pessoal e profissional da mestranda ao longo da prática pedagógica. Neste sentido, a mestranda foi desenvolvendo um conjunto de competências, tendo em vista a construção dos seus saberes profissionais, atendendo a uma postura de pendor reflexiva e indagadora, capaz de tomar decisões adequadas de acordo com o contexto educativo onde está inserida, uma vez que o mesmo se carateriza por ser imprevisível. O desenvolvimento dos saberes profissionais foi possibilitado através da adoção da metodologia de investigação-ação, sendo que a mesma se processa numa espiral cíclica de observação, planificação, ação e reflexão, pelo que a reflexão é intrínseca e implícita em todas as fases. Efetivamente, foram várias as estratégias que fomentaram o desenvolvimento desta metodologia, nomeadamente: elaboração de planificações, realização de narrativas colaborativas, elaboração do diário de formação, construção dos guiões de préobservação, reestruturação do Projeto Curricular de Grupo e as reuniões realizadas com o supervisor institucional. Importa, ainda, referir que o desenvolvimento da prática pedagógica em díade de formação, potenciou momentos de reflexão partilhada que contribuíram para a transformação das práticas. A elaboração deste relatório assumiu um papel fulcral, uma vez que despoletou na mestranda uma reflexão crítica sobre as práticas, confluindo na identificação da evolução das suas competências pessoais e profissionais, bem como das dificuldades que ainda predominam, por forma a contorná-las futuramente.

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In this paper Peter will consider some contemporary discourses of spirituality, the potential dangers of some spirituality, and then discuss how spirituality can contribute to an ‘enchanted’ framework of community development.

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The Systems Theory Framework was developed to produce a metatheoretical framework through which the contribution of all theories to our understanding of career behaviour could be recognised. In addition it emphasises the individual as the site for the integration of theory and practice. Its utility has become more broadly acknowledged through its application to a range of cultural groups and settings, qualitative assessment processes, career counselling, and multicultural career counselling. For these reasons, the STF is a very valuable addition to the field of career theory. In viewing the field of career theory as a system, open to changes and developments from within itself and through constantly interrelating with other systems, the STF and this book is adding to the pattern of knowledge and relationships within the career field. The contents of this book will be integrated within the field as representative of a shift in understanding existing relationships within and between theories. In the same way, each reader will integrate the contents of the book within their existing views about the current state of career theory and within their current theory-practice relationship. This book should be required reading for anyone involved in career theory. It is also highly suitable as a text for an advanced career counselling or theory course.

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The role of sport-specific practice in the development of decision-making expertise in the sports of field hockey, netball, and basketball was examined. Fifteen expert decision-makers and 13 experienced non-expert athletes provided detailed information about the quantity and type of sport-specific and other related practice activities they had undertaken throughout their careers. Experts accumulated more hours of sport-specific practice from age 12 years onwards than did non-experts, spending on average some 13 years and 4,000 hours on concentrated sport-specific practice before reaching international standard. A significant negative correlation existed between the number of additional activities undertaken and the hours of sportspecific training required before attaining expertise, suggesting a functional role for activities other than sport-specific training in the development of expert decision-making.

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Some of the main challenges in Incorporating Sustainable Development practices into Engineering Education reside in establishing the bridge between concept and application. In particular the relation between value creation and the knowledge economy, innovation and entrepreneurship, as the main vehicles to a relevant application of the sustainable development concept, is not yet part of the majority of the engineering curricula in schools. Porto Polytechnical Engineering School (ISEP), a Global Reporting Initiative training partner in Portugal, as just presented its Sustainable Development Action Plan, with the main objective of creating a new kind of engineers, with Sustainable Development at the core of their degrees. The plan has several issues like publish an annual sustainability report, sustainable buildings, minimization of energy consumption and water policy, waste management, sustainable mobility, green procurement, EMAS certification, research and postgraduate activity and promotion of lectures and seminars in Sustainable Development.

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Mestrado em Engenharia Informática - Área de Especialização em Sistemas Gráficos e Multimédia

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Background: Little is known about the risk of progression to hazardous alcohol use in people currently drinking at safe limits. We aimed to develop a prediction model (predictAL) for the development of hazardous drinking in safe drinkers. Methods: A prospective cohort study of adult general practice attendees in six European countries and Chile followed up over 6 months. We recruited 10,045 attendees between April 2003 to February 2005. 6193 European and 2462 Chilean attendees recorded AUDIT scores below 8 in men and 5 in women at recruitment and were used in modelling risk. 38 risk factors were measured to construct a risk model for the development of hazardous drinking using stepwise logistic regression. The model was corrected for over fitting and tested in an external population. The main outcome was hazardous drinking defined by an AUDIT score >= 8 in men and >= 5 in women. Results: 69.0% of attendees were recruited, of whom 89.5% participated again after six months. The risk factors in the final predictAL model were sex, age, country, baseline AUDIT score, panic syndrome and lifetime alcohol problem. The predictAL model's average c-index across all six European countries was 0.839 (95% CI 0.805, 0.873). The Hedge's g effect size for the difference in log odds of predicted probability between safe drinkers in Europe who subsequently developed hazardous alcohol use and those who did not was 1.38 (95% CI 1.25, 1.51). External validation of the algorithm in Chilean safe drinkers resulted in a c-index of 0.781 (95% CI 0.717, 0.846) and Hedge's g of 0.68 (95% CI 0.57, 0.78). Conclusions: The predictAL risk model for development of hazardous consumption in safe drinkers compares favourably with risk algorithms for disorders in other medical settings and can be a useful first step in prevention of alcohol misuse.

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BACKGROUND: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. METHOD: The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. RESULTS: The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. CONCLUSIONS: Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts