Satisfação dos utilizadores de sistemas de informação e documentação de enfermagem em suporte eletrónico no Centro Hospitalar Lisboa Norte, E.P.E.

RESUMO - Os registos de enfermagem no Centro Hospitalar Lisboa Norte, E.P.E. (CHLN) são feitos em suporte de papel ou através de sistemas de informação (SI) próprios de cada serviço, com a utilização de várias aplicações como o Alert, Picis, etc. Esta diversidade gera alguns constrangimentos em termos de fluxo de informação, em virtude da falta de interoperabilidade dos respetivos sistemas. Esta realidade pode ter impactos na área da qualidade e segurança do utente, com a possibilidade de ocorrência de erros e/ou eventos adversos. Podem ainda ser notórios na área da privacidade e confidencialidade dos dados clínicos, na tomada de decisão, na gestão clínica e financeira e na produção de informação útil para a investigação científica. No CHLN está em curso a implementação de um SI capaz de dar resposta aos registos de enfermagem, integrados num registo de saúde eletrónico focado no utente que obedece à metodologia do processo de enfermagem e utiliza a linguagem codificada da Classificação Internacional para a Prática de Enfermagem (CIPE). Com o desenvolvimento desta investigação, devidamente autorizada pelo Conselho de Administração do CHLN, pretendeu-se dar resposta à pergunta de partida:  Estarão os enfermeiros, utilizadores do Desktop de Enfermagem do CHLN, satisfeitos com esse sistema de informação? Com esse propósito, foi elaborada uma abordagem exploratória com recurso a pesquisa bibliográfica sobre os sistemas de informação de enfermagem e a sua avaliação, com base no “Modelo de Sucesso dos Sistemas de Informação de DeLone e McLean”, tendo sido desenvolvido um estudo de caso com uma abordagem quantitativa, mediante a aplicação de um inquérito por questionário aos 262 enfermeiros do CHLN, nos serviços onde já utilizavam o referido SI, entre maio e junho de 2014, com uma taxa de resposta de 84%. Os resultados da aplicação do questionário, objeto de análise estatística univariada e bivariada com recurso a procedimentos descritivos e inferenciais, visando a produção de sínteses dirigidas aos objetivos do estudo, permitiram caracterizar o nível de satisfação dos enfermeiros, enquanto utilizadores do “desktop de enfermagem”, suportados por Tecnologias de Informação e Comunicação. Na escala utilizada (de 1 a 5), o nível médio de satisfação global (2,78) foi ligeiramente inferior ao seu ponto médio (3). No entanto, a maioria dos inquiridos (81,5%) não pretende abandonar o SI que utilizam. Os resultados obtidos permitem demonstrar que a satisfação dos enfermeiros face à implementação e utilização do SIE se trata de uma estratégia bem sucedida do CHLN, ainda que haja áreas onde foram evidenciados menores níveis de satisfação, tais como a “velocidade de processamento”, o “equipamento informático” e o “apoio técnico”, que podem ser alvo de uma maior atenção e reflexão pela gestão de topo, numa estratégia de melhoria contínua da qualidade, com importantes benefícios para a governação da instituição, para os profissionais e para os utentes, no futuro.

Local diversity of tropical and temperature ant faunas (Hymenoptera, Formicidae)

Qualitative and quantitative collections of ants made in the region of Manaus, Brazil (evergreen tropical humid forest), and in western North Carolina, USA (deciduous temperate/wet forest), were undertaken to investigate. latitudinal patterns of ant diversity and community organization on regional and local scales. We have found to date 307 ant species in the Municipality of Manaus. Totals ranging from 134 to 270+ species have been reported in the literature for other tropical regions of less than 10,000km2. In contrast, temperate ant surveys generally report only SO to 150 species in similar or larger areas. Sampling at sardine baits set 10m apart on square grids, we found forest ecosystems near Manaus to be much richer and more diverse in ants than those sampled in North Carolina: 28 species vs. 5-10 species in 50 collections and 16 vs. 3 previously unrecorded species discovered with each doubling of sample size. Room's (1975a) results from climatically simllar Papua New Guinea forest agree closely with those from Manaus. We suggest that one important factor contributing to the increased diversity of tropical, omnivorous ants may be greater variety of nest sites available for specialization.

Amazon landforms and soils in relation to biological diversity

Thirteen main landform units are distinguished for the whole of the forested Amazon region, each with its specific soil pattern and vegetation structure. These landform-soil-vegetation units are delineated on a small-scale map and illustrated by a schematic cross-section. Floristic diversity of the gamma type is to be highest on the steepland-and-valley complexes of the Andean fringe, on the crystalline shield uplands, on the inselberg complexes, and on the eutric variant of the western sedimentary plains. Endemism is expected to be highest on the sandy plains, and parts of the table lands and inselberg complexes. Speciation, linked to the concept of forest refuge areas, is likely to be highest on the sandstone table lands, on the stretches of Amazon planalto, and in the areas of relict valleys, in view of the prolonged geomorphological stability of these units.

Generic system for human-computer gesture interaction: applications on sign language recognition and robotic soccer refereeing

Hand gestures are a powerful way for human communication, with lots of potential applications in the area of human computer interaction. Vision-based hand gesture recognition techniques have many proven advantages compared with traditional devices, giving users a simpler and more natural way to communicate with electronic devices. This work proposes a generic system architecture based in computer vision and machine learning, able to be used with any interface for human-computer interaction. The proposed solution is mainly composed of three modules: a pre-processing and hand segmentation module, a static gesture interface module and a dynamic gesture interface module. The experiments showed that the core of visionbased interaction systems could be the same for all applications and thus facilitate the implementation. For hand posture recognition, a SVM (Support Vector Machine) model was trained and used, able to achieve a final accuracy of 99.4%. For dynamic gestures, an HMM (Hidden Markov Model) model was trained for each gesture that the system could recognize with a final average accuracy of 93.7%. The proposed solution as the advantage of being generic enough with the trained models able to work in real-time, allowing its application in a wide range of human-machine applications. To validate the proposed framework two applications were implemented. The first one is a real-time system able to interpret the Portuguese Sign Language. The second one is an online system able to help a robotic soccer game referee judge a game in real time.

Vision-based portuguese sign language recognition system

Vision-based hand gesture recognition is an area of active current research in computer vision and machine learning. Being a natural way of human interaction, it is an area where many researchers are working on, with the goal of making human computer interaction (HCI) easier and natural, without the need for any extra devices. So, the primary goal of gesture recognition research is to create systems, which can identify specific human gestures and use them, for example, to convey information. For that, vision-based hand gesture interfaces require fast and extremely robust hand detection, and gesture recognition in real time. Hand gestures are a powerful human communication modality with lots of potential applications and in this context we have sign language recognition, the communication method of deaf people. Sign lan- guages are not standard and universal and the grammars differ from country to coun- try. In this paper, a real-time system able to interpret the Portuguese Sign Language is presented and described. Experiments showed that the system was able to reliably recognize the vowels in real-time, with an accuracy of 99.4% with one dataset of fea- tures and an accuracy of 99.6% with a second dataset of features. Although the im- plemented solution was only trained to recognize the vowels, it is easily extended to recognize the rest of the alphabet, being a solid foundation for the development of any vision-based sign language recognition user interface system.

Floristic composition and diversity of Amazonian rainforest bryophytes in the state of Acre, Brazil

Bryophyte diversity in Amazonian Brazil is high, presently recorded at 514 species distributed among 36 families and 89 genera. Comparisions of species richness among the Amazonian states of Brazil suggests that the bryoflora of Acre is still underestimated, presently recorded at 106 species distributed among 33 families and 63 genera. After two field trips, the diversity increased 50% showing that the bryoflora is still poorly known. Collection data and comments on morphology, ecology and distribution are given for sixty-two species of bryophytes collected in the state of Acre, Brazil, which are new (fifty-two species) or interesting floristic records (ten species). Microlejeunea crenulifolia (Gottsche) Steph. and Stictolejeunea balfourdii Mitt. are new records for Brazil and fifty species are new records for Acre.

Fishing territoriality and diversity between the ethnic populations Ashaninka and Kaxinawá ,Breu river, Brazil/Peru

This study describes the diversity and the subsistence fishing territoriality of traditional populations of a village Ashaninka and two Kaxinawá living at the margins of Breu River (Brasil/Peru). In general, samplings in the dwellings were carried out late in the afternoon, as the fishermen arrived in the village. The data were analysed in an exploratory way through the index of pondered dominance (ID%), by analysis of variance and by a correspondence analysis in order to determine the associations of the fish species and the fishing spots between the villages of the Indigenous Reserve. The results of the analysis of variance demonstrated that differences exist between the fish diversities of the catches. However, post-hoc tests only detected differences in diversities between the hand fishhook and the other fishing gears (bow and arrow, castnets and rotenone tingui). Although the use of bow and arrow resulted in a low capture (Kg), this fishing strategy is associated with a high fishing diversity, in terms of number of species. These results demonstrate that there is no overlap in the frequency of the visits to the fishing spots between the Ashaninka and Kaxinawá populations. This pattern is the same found for the correspondence analysis for the fish species, which describes the relationship between the deep pools environments exploited by the fishermen Ashaninka and Kaxinawá of Mourão. These ethnic populations still continue to maintain a strong cultural and cosmological tradition, with their territories defined in an informal way of the upper Juruá area.

Tree species diversity in a seasonally-dry forest: the case of the Pinkaití site, in the Kayapó Indigenous Area, Southeastern limits of the Amazon

This study investigates patterns of forest structure and tree species diversity in an anthropogenic palm grove and undisturbed areas at the seasonally-dry Pinkaití research station, in the Kayapó Indigenous Area. This site, managed by the Conservation International do Brasil, is the most southeastern site floristically surveyed in the Amazon until now. The secondary and a nearby undisturbed forest were sampled in a group of 52 floristic plots of 0.0625-ha (25x25-m) where all trees with DBH > 10 cm were measured and identified. The analyses were complemented with other two floristic plots of 1-ha (10x1000-m). The present study has shown that the Pinkaití, like other seasonally-dry forests, have great heterogeneity in forest structure and composition, associated with biotic characteristics of the most important tree species, natural disturbance and history of land-use. The palm grove, moderately dominated by the arborescent palm Attalea maripa (Aubl.) Mart., presented high tree species diversity and was floristically similar to undisturbed forests at the study site. It is discussed the importance of large arborescent palms for the seasonally-dry Amazon forests regeneration.

A domain-specific language for ETL patterns specification in Data Warehousing Systems

During the last few years many research efforts have been done to improve the design of ETL (Extract-Transform-Load) systems. ETL systems are considered very time-consuming, error-prone and complex involving several participants from different knowledge domains. ETL processes are one of the most important components of a data warehousing system that are strongly influenced by the complexity of business requirements, their changing and evolution. These aspects influence not only the structure of a data warehouse but also the structures of the data sources involved with. To minimize the negative impact of such variables, we propose the use of ETL patterns to build specific ETL packages. In this paper, we formalize this approach using BPMN (Business Process Modelling Language) for modelling more conceptual ETL workflows, mapping them to real execution primitives through the use of a domain-specific language that allows for the generation of specific instances that can be executed in an ETL commercial tool.

Using a domain-specific language to enrich ETL schemas

Today it is easy to find a lot of tools to define data migration schemas among different types of information systems. Data migration processes use to be implemented on a very diverse range of applications, ranging from conventional operational systems to data warehousing platforms. The implementation of a data migration process often involves a serious planning, considering the development of conceptual migration schemas at early stages. Such schemas help architects and engineers to plan and discuss the most adequate way to migrate data between two different systems. In this paper we present and discuss a way for enriching data migration conceptual schemas in BPMN using a domain-specific language, demonstrating how to convert such enriched schemas to a first correspondent physical representation (a skeleton) in a conventional ETL implementation tool like Kettle.

Diversity of the land resources in the Amazonian State of Rondônia, Brazil

Conflicting opinions are recorded in the literature concerning the suitability of Amazon lands for sustainable agriculture following deforestation. This article has been written to shed light on this question by summarizing climate, landform, soil and vegetation features from the findings of a land resource study of the Brazilian state of Rondônia in south-west Amazonia. The work, which followed the World Soils and Terrain Digital Database (SOTER) methodology, was financed by the World Bank. During the course of the survey special emphasis was given to studying soils; 2914 profiles were analyzed and recorded. The study identified a complex pattern of land units with clear differences in climate, landform, soils and native vegetation. Forested areas mosaic with lesser areas of natural savannas. The latter occur on both poorly-drained and well-drained, albeit nutrient deficient sandy soils. The tallest and most vigorous forests or their remnants were seen growing on well-drained soils formed from nutrient-rich parent materials. Many of these soils could, or are being used for productive agriculture. Soils developed on nutrient-poor parent materials support forests that are significantly lower in height, and would require large lime and fertilizer inputs for agriculture. Low forests with high palm populations and minor areas of wet land savannas cover the poorly drained soils. It is evident that forest clearing in the past was indiscriminant; this cannot be condoned. The diversity of land conditions found throughout Rondônia would suggest that many past studies in the Amazon have simply been too broad to identify significant soil differences.

Development of an integral viscoelastic flow solver in OpenFOAM®

The usual high cost of commercial codes, and some technical limitations, clearly limits the employment of numerical modelling tools in both industry and academia. Consequently, the number of companies that use numerical code is limited and there a lot of effort put on the development and maintenance of in-house academic based codes. Having in mind the potential of using numerical modelling tools as a design aid, of both products and processes, different research teams have been contributing to the development of open source codes/libraries. In this framework, any individual can take advantage of the available code capabilities and/or implement additional features based on his specific needs. These type of codes are usually developed by large communities, which provide improvements and new features in their specific fields of research, thus increasing significantly the code development process. Among others, OpenFOAM® multi-physics computational library, developed by a very large and dynamic community, nowadays comprises several features usually only available in their commercial counterparts; e.g. dynamic meshes, large diversity of complex physical models, parallelization, multiphase models, to name just a few. This computational library is developed in C++ and makes use of most of all language capabilities to facilitate the implementation of new functionalities. Concerning the field of computational rheology, OpenFOAM® solvers were recently developed to deal with the most relevant differential viscoelastic rheological models, and stabilization techniques are currently being verified. This work describes the implementation of a new solver in OpenFOAM® library, able to cope with integral viscoelastic models based on the deformation field method. The implemented solver is verified through the comparison of the predicted results with analytical solutions, results published in the literature and by using the Method of Manufactured Solutions.

A new integral viscoelastic flow solver in OpenFOAM®

The usual high cost of commercial codes, and some technical limitations, clearly limits the employment of numerical modelling tools in both industry and academia. Consequently, the number of companies that use numerical code is limited and there a lot of effort put on the development and maintenance of in-house academic based codes . Having in mind the potential of using numerical modelling tools as a design aid, of both products and processes, different research teams have been contributing to the development of open source codes/libraries. In this framework, any individual can take advantage of the available code capabilities and/or implement additional features based on his specific needs. These type of codes are usually developed by large communities, which provide improvements and new features in their specific fields of research, thus increasing significantly the code development process. Among others, OpenFOAM® multi-physics computational library, developed by a very large and dynamic community, nowadays comprises several features usually only available in their commercial counterparts; e.g. dynamic meshes, large diversity of complex physical models, parallelization, multiphase models, to name just a few. This computational library is developed in C++ and makes use of most of all language capabilities to facilitate the implementation of new functionalities. Concerning the field of computational rheology, OpenFOAM® solvers were recently developed to deal with the most relevant differential viscoelastic rheological models, and stabilization techniques are currently being verified. This work describes the implementation of a new solver in OpenFOAM® library, able to cope with integral viscoelastic models based on the deformation field method. The implemented solver is verified through the comparison of the predicted results with analytical solutions, results published in the literature and by using the Method of Manufactured Solutions

Cross-language influences on new second language vocabulary acquisition: the effect of learning method

Dissertação de mestrado integrado em Psicologia

Triagem universal de alunos em risco de apresentarem dificuldades de aprendizagem específicas na leitura: um estudo quantitativo no 3º ano do 1º Ciclo do Ensino Básico

Doutoramento em Estudos da Criança (área de especialização em Educação Especial).