Implementação e integração do modelo de acreditação da Joint Commission International na unidade de imagiologia do Hospital Privado da Boavista

Este trabalho descreve a abordagem abrangente sobre a melhoria do sistema de gestão da qualidade na Unidade de Imagiologia do Hospital da Boavista através da implementação das normas de acreditação da Joint Commission International (JCI). Fundamental para a melhoria geral da qualidade é a redução contínua de riscos para os doentes e para os profissionais da Unidade. Tais riscos podem existir ao nível do ambiente físico assim como no circuito dos exames e dos doentes. A acreditação em Saúde é uma das prioridades estratégicas do Ministério da Saúde e tem como objetivo fortalecer a confiança dos cidadãos nos profissionais de saúde bem como nas instituições de saúde. É importante que Portugal cultive a melhoria da qualidade e segurança nas instituições de saúde mantendo uma relação adequada custo/benefício. A União Europeia tem feito um esforço para que a acreditação seja harmoniosa nos seus princípios, no entanto é respeitada sempre a prevalência da legislação de cada país, bem como as suas especificações culturais e religiosas (Shaw, 2006), responsabilizando-o pelo seu sistema de saúde O trabalho aqui apresentado tem como objetivo principal fundamentar a escolha do modelo de acreditação da JCI para o Hospital da Boavista, nomeadamente para a Unidade de Imagiologia, ver se os padrões estão de acordo com os procedimentos da Unidade, identificar falhas e apontar possiveis melhorias. Pretende-se ainda mostrar a importância da implementação dos sistemas de certificação e acreditação da gestão da qualidade, documentada pela experiência profissional, bem como o know-how do Hospital da Boavista, assim como a complementaridade dos programas da gestão da qualidade, certificação e acreditação. A escolha do modelo de acreditação da JCI, foi uma opção do Hospital da Boavista baseada na credibilidade e no grau de exigência que a entidade impõe. Foi imperativo que a Unidade de Imagiologia realizasse as suas funções de forma válida e fiável e que disponibilizasse produtos / serviços de qualidade. A monitorização e consequente controlo de qualidade do serviço prestado pela Unidade de Imagiologia, foi difícil mas simplificado, em parte, devido ao sistema de gestão da qualidade ISO 9001:2008 já implementado, tendo este sido consolidado com a implementação da acreditação da JCI, com padrões específicos bem definidos na gestão do controlo de qualidade na Unidade de Imagiologia do Hospital da Boavista.

Relatório de estágio na Caixa Geral de Depósitos

This report will describe the activities undertaken during my internship at the Personnel Department (DPE-UPE4.1) in Caixa Geral de Depósitos (CGD), Lisbon, between September 22, 2014, and February 28, 2015. I consider that it is important to note from the outset i) that the subject of my training was suggested by my supervisor in the DPE and accepted by me; and ii) that the internship consisted essentially of carrying out research and information gathering into the different social systems that coexist within the bank and the application of each legal system in solving concrete situations of the CGD employees. The research and analysis of information was important not only for my study but for the CGD itself, as it enables the department to have such an important matter, full of specific characteristics, condensed into a single document, i.e. this report. This is a complex reality. The various welfare systems differ according to the contractual agreement linking the employee to the employer at the date when the labour contract is signed, and also the unique/singular characteristics of the CGD. In the early stage I started by trying to understand the financial institution and its organization and role and the department where I worked. So I analyzed the CGD Statutes and the legal measures that crystallized the scheme for its employees and I also researched its domestic and international operations. The first month was devoted to the research and analysis of such legislation to understand the creation of the CGD and its path to date. In the second and third months I studied the legal social systems that are applied to different groups of CGD workers. This period was quite important to identify and understand the differences between those regimes of CGD employees as well as the procedure inherent in each case. I highlighted the non-implementation of “the social protection regime of convergence” to the workers of this institution; the differences regarding the allocation of sickness subsidies paid to workers who belong to Social Security and CGA contributors, as well as the enforcement of internal rules to all the workers when a work-related accident happens.Then I focused on to assessing and examining external legislation and several internal regulations in order to obtain solutions to questions raised and situations involving by the workers, in order to understand how the DPE solves these situations. Over the last three months of internship, after this more theoretical work, I began the analysis of concrete situations involving employees carrying out their duties in Portugal and abroad. Some of these situations had been received by the department before the beginning of my internship and others over this period. When I was “working” in the DPE I analyzed “cases” that had been solved and some others without a final solution because they were still in courts. As for the last ones (new cases) I was able to follow their assessment and sometimes their outcome. Some of them became study cases for me. Over these five months of my internship, several cases were analyzed and discussed by legal experts of DPE in which I could participate. I always worked hard. I know that this action contributed to elucidate me about the treatment of the issues, and allowed me to have a direct contact with some workers and be part of a dynamic work team. For these reasons, my internship report is not merely descriptive of activities. It consists of an analysis of rules (legislation) and a regulatory framework of activities and it is also a description of several specific situations solved or in a solution process. Through this work I intend to make known the particular reality of a modern Portuguese financial institution not only because of its importance in our country but also such a large number of employees work here (in Portugal and abroad). I should add that throughout my internship I was allowed to attend conferences, within the scope of the bank in order to get a broader view of some issues related to the daily life of the DPE and the CGD. So, I participated in I Jornadas Bancárias and the Conferência Internacional do Contrato a Termo, given that the CGD is a bank and the DPE deals with legal and labour relations.

A proactive approach o XY international expansion

This work project was conducted under a Direct Research internship (DRI) that consists on an individual dissertation established on a given organization. DRI has a problem solving format to an empirical question to be addressed, «Which country has the highest potential for the next step of XY internationalization process? ». In order to achieve the project’s purpose, it was conducted a scanning process using a top-down approach over an initial list of nine countries given by XY. To do so it was developed an international scanning framework based on different domains and weights that allowed to achieve the top two countries with highest potential. After an in depth analysis over the final set, it was recommended Switzerland as the best country to make the next step of XY internationalization in Europe.

Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria.

Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge.

Participation rates for organized colorectal cancer screening programmes: an international comparison.

OBJECTIVE: Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates. METHODS: Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round. RESULTS: Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation. CONCLUSION: Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.

International volunteers at a Costa Rican organic farm : sheepish volunteers, proud tourists and unwitting developers

This thesis analyzes the practices and experiences of two groups of Canadian volunteers who visited the organic fanning and "alternative development" project ofFinca la Flor (FLF) in central Costa Rica. Using both participant observation and in-depth interviews with volunteers and other people involved with FLF, I examine volunteers' understandings of their involvement with the fann. I argue that three discursive fonnations are instrumental in shaping this particular volunteering encounter. Specifically, interpretation of these Canadian volunteers' experiences inspires the argument that the emerging practice of international volunteering (or voluntourism) exists at the intersection of discourses of development, volunteering and tourism, all of which both reflect and maintain problematic North-South relationships. The analysis shows that in spite ofFLF's construction as an (alternative / sustainable) international-development project, and in spite of volunteers' initial conceptualization of their trip as "volunteering," volunteers tend to act and describe their time at FLF in ways that look more like tourism than like volunteer labor or international development. Likewise, although FLF claims to principally be focused on alternative development, and merely to open up this authentic development space to volunteers for their participation, the organization in both practice and discourse seems primarily to construct a tourist experience and cater to the needs of foreigners as tourists. Discourses of development and volunteering do infonn the practices offann personnel and volunteers at FLF, but they become subordinated to the more dominant discourse of tourism as the volunteers' and fann management's ideals of development and volunteering capitulate to become focused on satisfying volunteers' (perceived or "real") touristic desires. The FLF participants I studied may have entered the encounter as volunteers, but they departed the site having been tourists.

St. Catharines and District Labour Council fonds, 1957-1986

The St. Catharines and District Labour Council was founded in May 1957 by unionized workers from St. Catharines, Thorold, Merritton, Port Dalhousie and Grimsby. They sought to improve the social and economic welfare of workers; promote the organization of workers into unions for their mutual benefit, regardless of race, creed, colour, or national origin; encourage the sale of union-made goods and services; promote worker education; provide workers with a voice in politics; and safeguard the democratic nature of the labour movement. The Council, affiliated with both the Canadian Labour Congress and the Ontario Federation of Labour, was instrumental in assisting local workers with their labour disputes, including Canadian Pulp and Paper workers at Abitibi Provincial Paper in Thorold [1975-76], and Gallaher Paper [1999], workers at the St. Catharines Eaton’s store [1985], as well as smaller disputes such as that between the part-time secretarial staff and the Welland County Roman Catholic Separate School Board [1972] and workers of the Skyway Lumber Company [1972]. The Council also assisted the community at large by offering a Community Counseling Service [1971-1976] to help citizens with issues concerning various government agencies, social services and Acts, such as the Vacation Pay Act, Landlord and Tenant Act, Employment Standards Act, unemployment insurance claims and workman’s compensation claims. Other projects that the Council organized included an annual Education Institute [1958-1965] and the annual publication of Labour Review, a summary of the Council’s past year. The Labour Council continued to operate until 2010, when several local Labour Councils merged to form the Niagara Regional Labour Council.

Social Organization on the Web: How Sex workers Rights Organizations Engage in Activism and Advocacy Work Online

The purpose of this study was to examine how sex workers rights organizations use their websites as a site of activist and advocacy work and ask (i) how do various organizations conceptualize sex work on their websites, and to what extent do they incorporate an intersectional feminist perspective? (ii) what communication strategies are used by the four organizations to target audiences in the viewing public? (iii) what audiences do the four websites target? (iv) how do the four organizations discuss successes and challenges on their websites? (v) in what ways do sex worker right organizations use websites to further their goals? The websites of Maggie’s, POWER, and Stella attempt to embrace an intersectional feminist perspective of sex work, while PACE does not. The four organizations strategically use their websites to target audiences with diverse needs, specifically through advocacy efforts in educating the general public about the legitimacy of sexual labour. Additionally, to increase the use of the websites by sex workers, using social media platforms, such as Facebook and Twitter augment the untapped potential for creating action, mobilization, interaction, and dialogue on the websites.

Best Practices of Sport For Development: A Case Study of An African Organization

Sport-for-development is the active practice of achieving social ideals through the use of sport and other traditional development programs. The purpose of this thesis was to evaluate SFD best practices from the context of an African organization development project. The case was a development organization in Zambia, Africa that was utilizing sport within its strategy. The data collection and analysis framed using Curado and Bontis (2007) MIC Matrix, the Sport For Development International Working Group’s (2007) best practices model, and B. Kidd’s (2011) Sport-in-Development Logic Model. The research supports that a SFD project is multi-faceted and should include the employment of strategic community programming on the basis of collaborative and integrative sport, health care and education. Further, the researcher found that the best practices include setting specific goals and objectives, as well as instituting regular monitoring and evaluation strategies

Drivers of Local Firms’ Focus on Internal R&D in Emerging Economies and Their International Performance

Grounded on the resource-based view of the firm, the study of this thesis investigates the effect of four internal and external factors – engineer intensity, location, affiliation with the government, government funding – on Chinese firms’ decision to either invest in internal R&D activities or external R&D and the effect of this decision on the firms’ international market success. In addition, the moderating role of the presence of foreign firms in China is examined. To understand these relationships, the thesis’ theorization focuses on the issue of how firms can combine optimally the two options – “internal R&D” and “external R&D”. In this regard I juxtapose internal R&D and external R&D and compare their advantages and disadvantages. To test my model, I apply panel data from the Annual Industrial Survey Database provided by the Chinese National Bureau of Statistics. My results show that three of the four investigated factors affect Chinese firms’ resource allocation decisions; and effective resource allocation decisions lead effectively to international market success, strengthened by the presence of foreign firms in China. Moreover the findings bear several theoretical and managerial contributions. First I propose the last dimension of the “VRIO framework” – “organization” – as an endogenous component of the VRIO framework, as my study investigated how firms can effectively combine resources to generate a competitive advantage in terms of international market success. Previous academic literature so far focused on examining whether internal and external R&D are complements or substitutes. My study fills a gap in the literature by investigating the determinants of the efficient combination of the two strategies and the outcome of the combination. One of the managerial implications is that Chinese firms can learn from foreign companies that are present in China.

Le droit du commerce international des organismes génétiquement modifiés (OGM) agricoles médicaux : les perspectives d'encadrement normatif

"Thèse présentée à la Faculté des études supérieures de l'Université de Montréal en vue de l'obtention du grade de Docteur en droit (LL.D.)"

The placebo effect: international patent law and the protection of traditional plant medicine

Une préoccupation essentielle traverse cette thèse: l'indifférence systémique de la Loi internationale sur la propriété intellectuelle a l'égard des savoirs traditionnels autochtones. De manière générale, un écart semble d'ailleurs croissant entre l'importance des accords internationaux sur les questions d'intérêt commercial et ceux de nature sociale. Les savoirs traditionnels autochtones sur les plantes médicinales sont particulièrement désavantagés dans ce système dichotomique puisqu'ils sont non seulement à l'origine d'énormes profits commerciaux mais se trouvent aussi au cœur de multiples croyances propres à ces sociétés. L'Accord sur les aspects des droits de propriété intellectuelle qui touchent au commerce (ADPIC) de l'Organisation mondiale du commerce (OMC) a cristallisé le souci de la législation internationale à l'égard d'une protection efficace des intérêts commerciaux. Deux années auparavant, la Convention sur la diversité biologique (CDB) était signée, traduisant une préoccupation à l'égard du développement durable, et elle devenait le premier accord international à tenir compte des savoirs traditionnels autochtones. On considère souvent que ces deux accords permettent l'équilibre du développement commercial et durable, requis par l'économie internationale. Après plus ample examen, on a plutôt l'impression que l'idée d'une CDB défendant, avec succès et efficacité, la nécessité du développement durable et des savoirs traditionnels autochtones contre les pressions opposées de l'ADPIC et de l'OMC est, au mieux, simpliste. La thèse explore également la fonction de la Loi sur les brevets dans la création d’industries, notamment pharmaceutique, et la manière dont ces industries influencent la législation nationale et en particulier internationale. De même, elle traite du rôle que jouent les brevets dans l'affaiblissement et la dépossession des peuples autochtones dotés de savoirs traditionnels sur les plantes médicinales, conduisant à une situation ou ces savoirs sont marginalisés ainsi que leurs détenteurs. La thèse aborde les failles institutionnelles du système juridique international qui permet une telle situation et indique l'urgente nécessité d'examiner attentivement les inégalités économiques et sociales au Nord comme au Sud, et non seulement entre eux. Finalement, la thèse suggère que la législation internationale gagnerait à s'inspirer des diverses traditions juridiques présentes à travers le monde et, dans ce cas particulier, peut être les détenteurs des connaissances traditionnelles concernant les plantes médicinales seront mieux servi par le droit des obligations.

La convention collective : un instrument de responsabilité sociale des entreprises

La responsabilité sociale des entreprises (RSE) est un concept qui fait référence au volontariat, sans définition unique, et visant la prise en compte des intérêts des parties prenantes de l’entreprise. Pour celle-ci, les caractéristiques communes à ces différentes définitions est d’établir des balises allant au-delà de ce que la loi fixe comme règle. Pour mettre en oeuvre la RSE, plusieurs outils sont utilisés, le code de conduite étant le plus répandu. Quant aux multiples parties prenantes de l’organisation, celle des travailleurs ne semble pas invitée à participer aux décisions de l’entreprise en matière de RSE, malgré les intérêts importants que les travailleurs et le syndicat peuvent posséder auprès de cette dernière. Notre recherche porte sur la convention collective en tant qu’outil de responsabilité sociale des entreprises. Nous nous intéressons à savoir si cet outil traditionnel en relations du travail pourrait être utilisé, tout comme un code de conduite, pour stimuler la participation des syndicale aux décisions de l’entreprise. À l’aide du Portrait statistique des conventions collectives analysées au Québec en 2006, nous avons validé la fréquence, le sujet ainsi que le niveau de participation syndicale dans les comités conjoints conventionnés en comparant les entreprises dites RSE et non RSE. Il s’est avéré qu’il n’y a pas plus de participation syndicale indiquée dans les conventions collectives d’entreprises RSE que dans celles non RSE. Cependant, notre analyse précise que deux outils RSE autres que le code de conduite adoptés par l’entreprise coïncident avec la participation syndicale, soit la signature d’un accord-cadre international et la participation au Pacte Mondial de l’ONU.

Working Children: their Agency and self-organization

In recent years, ‘agency’ has appeared in academic writings as a new way of referring to active involvement from below in development interventions. The concept of ‘agency’ starts from the assumption that people are actually agents themselves, continuously acting in and reacting to circumstances. In child labour activism, this concept has been applied to working children in the understanding that, in order to improve their working conditions, children should be organised in organizations that are exclusively for and (ideally) run by working children. This paper aims to evaluate the extent to which child labourers can become agents of change through their own organizations. The paper will draw on two studies carried out by the IREWOC foundation. In 2002 a study was undertaken in Bolivia to give practical meaning to the concept of child agency. Secondly, in 2004/2005 an investigation was carried out on the functioning and impact of children’s organizations in Peru, Bolivia and Brazil. The applied research methods were mainly anthropological and used participant observation, (semi-) informal interviews and group interviewing with working children, their parents and adult representatives of the working children’s organizations. Both investigations show that in focussing on children as active participants, the structural constraints under which children have to live also need to be highlighted. One needs to understand how material poverty, mental deprivation and disempowerment help to shape resilience and defiance, but also anger, distrust and marginalisation.