Caminhos para a avaliação da formação em odontologia: desenvolvimento, validação e aplicação de critérios

The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators’ perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.

Construção e validação de instrumento de coleta de dados do casal grávido no âmbito da atenção básica

The research aimed to construct and validate a data collection instrument of pregnant couple as part of primary care. It was considered hypothesis that level of agreement from 70% among participants to validate the expert panel. The document has been based on the Theory of Human Needs by Horta and adjusted by Garcia and Cubas. It is a study of methodological type developed in four stages: identification of empirical indicators to pregnant women through an integrative literature review; evaluation of empirical indicators and their relation to human needs by focus group; structuring of the second version of instrument by categorization of indicators and appearance and content validation of the third version of instrument by judges, by use of Delphi technique. The collection of data was the first stage in months from August to October 2014 in the Journal of Midwifery and Women's Health and Scopus, PubMed, Lilacs, CINAHL, Cochrane databases. The remaining steps were carried out from November 2014 to February 2015. For the focus group was counted with participation of six experts through two meetings. As for the judges, it was obtained a population of 63 and final sample of 51 judges divided into 46 basic health units of Municipal City Health Natal/RN, Brazil. The study was approved by the Research Ethics Committee of Universidade Federal do Rio Grande do Norte, under Protocol number 876.200. For data analysis of the first stage it was used descriptive statistics and results are presented in tables and charts. At that stage were identified 162 empirical indicators and, when they were related to human needs, 64 by them were on psycobiological, 97 on psychosocial and one (1) on psychospiritual needs. Regarding the second and third stages, data were treated by process of categorizing and analyzing the Content Validity Index. The indicators obtained a 100% validation index. In appearance and content validation phase of instrument non-validated items were excluded and other items obtained index above 70%. Furthermore, it obtained 99% content validity index in the second version and 95.7% in the third version of the instrument as a whole and, therefore, validated tool. This instrument contains Health Institution, pregnant woman and her partner identification data, information on the human needs of the pregnant and items pertaining to systematize the collection of pregnant couple data during prenatal care. By the conclusion of the study, nurse shall have an instrument to collect the data of pregnant couple in primary care innovative by considering psychobiological, psychosocial and psychospiritual pregnant needs and insert health and sociodemographic data of pregnant partner in the context of pregnancy. Also, the document will serve as a tool for teaching and research in obstetrical nursing.

Prospecção tecnológica de células fotovoltaicas para energia solar

Solar energy presents itself as an excellent alternative for the generation of clean, renewable energy. This work aims to identify technological trends of photovoltaic cells for solar energy. The research is characterized, in relation to nature, to be applied; regarding the approach is qualitative and quantitative; with respect to the objectives, it is exploratory and descriptive; concerning the methodological procedure is considered a bibliographic research with a case study in the case of solar photovoltaic sector. The development of this research began with a literature review on photovoltaic solar energy and technology foresight. Then it led to the technology mapping of photovoltaic solar cells through the analysis of articles and patents. It was later performed the technological prospecting of photovoltaic cells for solar energy through the Delphi method, as well as the construction of the current plan and future technology of photovoltaic cells for the current scenario, 2020 and 2025. The results of this research show that the considered mature technologies (silicon mono and multicrystalline) will continue to be commercially viable within the prospected period (2020-2025). Other technologies that are currently viable (amorphous silicon, cadmium telluride and copper indium selenide / Copper indium gallium diselenide-), may not submit the same condition in 2025. Since the cells of silicon nanowires, dye-sensitized and based on carbon nanostructure, which nowadays are not commercially viable, may be part of the future map of photovoltaic technologies for solar energy.

Protocolo para assistência do enfermeiro ao paciente séptico em terapia intensiva: construção e validação de conteúdo

Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.

Protocolo para assistência do enfermeiro ao paciente séptico em terapia intensiva: construção e validação de conteúdo

Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.

Batterie d'évaluation du développement Talbot pour l'enfant de 0 à 6 ans : validité de contenu par analyse des items

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Perspetiva do fisioterapeuta sobre o Core Set da Classificação Internacional de Funcionalidade, Incapacidade e Saúde da Diabetes Mellitus

Introdução: Os core sets são desenvolvidos com o objetivo de identificar e agrupar categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e que caraterizam os principais problemas de funcionalidade dos indivíduos com uma condição clinica específica. Ao simplificar o número de categorias da CIF, facilita-se a sua aplicação na prática clínica. Objetivos: O comprehensive core set da CIF para a Diabetes Mellitus (DM) representa o conjunto típico de problemas de funcionalidade em utentes com DM. O objetivo deste estudo visa a exploração da validade do conteúdo deste core set e identificar os problemas mais comuns de utentes com DM a partir da perspetiva do fisioterapeuta através da utilização da CIF. Metodologia: Foi realizado um estudo qualitativo, com fisioterapeutas com experiência no tratamento de utentes com DM. Os dados foram recolhidos segundo o método de Delphi, através da realização de três questionários. As respostas foram analisadas por dois investigadores que procederam ao linking para as categorias da CIF. O grau de concordância foi efetuado utilizando a estatística de kappa. Resultados: Sete fisioterapeutas de 5 centros de saúde da região centro de Portugal foram questionados na primeira e segunda ronda; seis completaram a terceira ronda. Os fisioterapeutas chegaram ao consenso sobre o total de 26 categorias da CIF, sendo que 19 correspondem às categorias presentes no core set e 7 às não incluídas no core set da CIF para a DM. Seis componentes foram identificados como fatores pessoais. Conclusões: As categorias presentes no comprehensive core set da CIF para a DM pela perspetiva dos fisioterapeutas foram apoiadas. Contudo, algumas categorias adicionais foram propostas para inclusão no comprehensive core set da CIF para a DM.

Projeto de Desenvolvimento de um Sistema de Gestão de Destinos (SGD): O Caso das Entidades Regionais de Turismo em Portugal

Enquadramento: O presente projeto de investigação surge num contexto onde as tecnologias estão cada vez mais enraizadas nas sociedades e onde a web se tornou no canal preferido de distribuição para uma boa parte das Organizações de Gestão de Destinos (OGDs) e dos consumidores finais (Butler, 2002; Gretzel, Yuan, & Fesenmaier, 2000; Kramer, Modsching, ten Hagen, & Gretzel, 2007). As novas Tecnologias da Informação e Comunicação (TICs) afiguram-se, assim, como uma das áreas mais críticas para o sucesso do turismo, no presente e no futuro, sendo vitais para a forma como se promovem os destinos turísticos (Machado & Almeida, 2010). Descrição: Pretende-se apresentar uma proposta extensiva de desenvolvimento de um Sistema de Gestão de Destinos (SGD), de âmbito regional, devidamente orçada e economicamente viável, para ajudar as OGDs na gestão, promoção e distribuição holística do destino turístico Portugal. Objetivos: Desenvolvimento sustentável e integrado dos destinos turísticos portugueses, a nível regional; aposta nos canais digitais como forma de adaptação às novas tendências de mercado no setor do turismo; envolvimento de todos os stakeholders no projeto (entidades públicas e privadas), por forma a aumentar os índices de coesão nos destinos turísticos; satisfação das necessidades de planeamento e de reserva dos potenciais turistas/visitantes; e incremento da qualidade geral da experiência turística no destino Portugal. Investigação Empírica: Parte 1 – Realização de um estudo Delphi, com a participação de um painel de 12 especialistas nas áreas do turismo e das TICs, para aferição e hierarquização das principais barreiras à adoção de SGDs; Parte 2 – Estudo avaliativo da eficácia dos websites oficiais das 5 Entidades Regionais de Turismo (ERTs) portuguesas, por intermédio do modelo adaptado de ICTRT (na versão de Charoula et al., 2014), aplicado por um avaliador externo recrutado para o efeito. Resultados e Conclusões: Identificaram-se e hierarquizaram-se 55 barreiras à adoção de SGDs, para a realidade portuguesa; apresentaram-se e escrutinaram-se os índices de eficácia dos websites oficiais das 5 ERTs em Portugal; e apresentou-se uma proposta de desenvolvimento de um SGD devidamente orçada e economicamente viável. No final, discutiram-se os principais resultados, teceram-se considerações gerais sobre o projeto e enunciaram-se as principais limitações e possíveis futuras linhas de investigação.

Plato's Cretan Colony: Theology and Religion in the Political Philosophy of the Laws

The Laws is generally regarded as Plato’s attempt to engage with the practical realities of political life, as opposed to the more idealistic, or utopian, vision of the Republic. Yet modern scholars have often felt disquieted at the central role of religion in the Laws’ second-best city and regime. There are essentially the two dominant interpretations on offer today: either religion supports a repressive theocracy, which controls every aspect of the citizens’ lives to such an extent that even philosophy itself is discouraged, or religion is an example of the kind of noble lie, which the philosopher must deceive the citizens into believing—viz., that a god, not a man, is the author of the regime’s laws. I argue that neither of these interpretations do justice to the dialogue’s intricately dramatic structure, and therefore to Plato’s treatment of civil religion. What I propose is a third position in which Plato both takes seriously the social and political utility of religion, and views theology as a legitimate, and even necessary, subject of philosophical inquiry without going so far as to advocate theocracy as the second best form of regime.

I conclude that a proper focus on the dialogue form, combined with a careful historical analysis of Plato’s use of social and political institutions, reveals an innovative yet traditional form of civil religion, purified of the harmful influence of the poets, based on the authority of the oracle at Delphi, and grounded on a philosophical conception of god as the eternal source of order, wisdom, and all that is good. Through a union of traditional Delphic theology and Platonic natural theology, Plato gives the city of the Laws a common cult acceptable to philosopher and non-philosopher alike, and thus, not only bridges the gap between religion and philosophy, but also creates a sense of community, political identity, and social harmony—the prerequisites for political order and stability. The political theology of the Laws, therefore, provides a rational defense of the rule of law (νόμος) re-conceived as the application of divine Reason (νοῦς) to human affairs.

Dedication and Display of Portrait Statues in Hellenistic Greece: Spatial Practices and Identity Politics

This dissertation models a new approach to the study of ancient portrait statues—one that situates them in their historical, political, and spatial contexts. By bringing into conversation bodies of evidence that have traditionally been studied in discrete categories, I investigate how statue landscapes articulated and reinforced a complex set of political and social identities, how space was utilized and manipulated on a local and a regional level, and how patrons responded to the spatial pressures and visual politics of statue dedication within a constantly changing landscape.

Instead of treating sites independently, I have found it to be more productive—and, indeed, necessary—to examine broader patterns of statue dedication. I demonstrate that a regional perspective, that is, one that takes into account the role of choice and spatial preference in setting up a statue within a regional network of available display locations, can illuminate how space shaped the ancient practice of portrait dedication. This level of analysis is a new approach to the study of portrait statues and it has proved to be a productive way of thinking about how statues and context were used together to articulate identity. Understanding how individual monuments worked within these broader landscapes of portrait dedications, how statue monuments functioned within federal systems, and how monuments set up by individuals and social groups operated along side those set up by political bodies clarifies the important place of honorific statues as an expression of power and identity within the history of the site, the region, and Hellenistic Greece.

Batterie d'évaluation du développement Talbot pour l'enfant de 0 à 6 ans : validité de contenu par analyse des items

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

A Capability Maturity Model to Assess Supply Chain Performance

In an overcapacity world, where the customers can choose from many similar products to satisfy their needs, enterprises are looking for new approaches and tools that can help them not only to maintain, but also to increase their competitive edge. Innovation, flexibility, quality, and service excellence are required to, at the very least, survive the on-going transition that industry is experiencing from mass production to mass customization. In order to help these enterprises, this research develops a Supply Chain Capability Maturity Model named S(CM)2. The Supply Chain Capability Maturity Model is intended to model, analyze, and improve the supply chain management operations of an enterprise. The Supply Chain Capability Maturity Model provides a clear roadmap for enterprise improvement, covering multiple views and abstraction levels of the supply chain, and provides tools to aid the firm in making improvements. The principal research tool applied is the Delphi method, which systematically gathered the knowledge and experience of eighty eight experts in Mexico. The model is validated using a case study and interviews with experts in supply chain management. The resulting contribution is a holistic model of the supply chain integrating multiple perspectives, and providing a systematic procedure for the improvement of a company’s supply chain operations.

El oráculo griego en la época de la producibilidad escrita: la crisis de la autoridad mántica en "Aves" (960-996) de Aristófanes

Este artículo se propone analizar la escena del cresmólogo intruso en Aves, revalorizando la comedia aristofánica como fuente de conocimiento histórico. Este análisis se centra en la práctica oracular como una técnica de producción escrita vinculada a la autoridad religiosa. De esta manera, se exploran dos campos de estudios, como la comedia antigua y la adivinación griega, cuyo vínculo no ha sido explorado en profundidad. Para dar cuenta del momento crítico de la institución oracular durante la Guerra del Peloponeso, se reconstruyen perspectivas sobre dicho fenómeno en otras fuentes como Tucídides o Demóstenes. Esto no solo ofrece una mirada «cómica» sobre la adivinación, sino que también permite comprender la práctica oracular como técnica y, en consecuencia, qué elementos de su funcionamiento podían ser manipulados.

A global effort to advance systems change to address the needs of families where a parent has a mental illness.

As part of the Prato Collaborative I am undertaking a Delphi Study to explore the developmental journeys that nine different countries (including NI and Ireland) have undertaken to better meet the needs of families where a parent has a mental illness in adult mental health and children’s services. This research has potential to impact FFP in adult mental health and children's services.

STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail Adults with Limited Life Expectancy): Consensus Validation

Background: To validate STOPPFrail, a list of explicit criteria for potentially inappropriate medications (PIMs) in frailer older adults with limited life expectancy. A Delphi consensus survey of an expert panel (n = 17) comprising specialists in geriatric medicine, clinical pharmacology, palliative care, psychiatry of old age, clinical pharmacy and general practice.
Methods: STOPPFrail criteria was initially created by the authors based on clinical
experience and appraisal of the available literature. Criteria were organised according to physiological system. Each criterion was accompanied by an explanation. Panellists ranked their agreement with each criterion on a 5-point Likert scale and invited to provide written feedback. Criteria with a median Likert response of 4/5 (agree/strongly agree) and a 25th centile of ≥4 were included in the final criteria.
Results: Three Delphi rounds were required. All panellists completed all rounds. Thirty criteria were proposed for inclusion; 26 were accepted. No new criteria were added. The first two criteria suggest deprescribing medications with no indication or where compliance is poor. The remaining 24 criteria include lipid-lowering therapies, alpha-blockers for hypertension, anti-platelets, neuroleptics, proton pump inhibitors, H-2 receptor antagonists, anti-spasmodics, theophylline, leukotriene antagonists, calcium supplements, bone anti-resorptive therapy, selective oestrogen receptor modulators, non-steroidal antiinflammatories, corticosteroids, 5-alpha reductase inhibitors, alpha-1 selective blockers, muscarinic antagonists, oral diabetic agents, ACE-inhibitors, angiotensin receptor blockers, systemic oestrogens, multivitamins, nutritional supplements and prophylactic antibiotics. Anticoagulants and anti-depressants were excluded. Despite incorporation of panellists’ suggestions, memantine and acetyl-cholinesterase inhibitors remained inconclusive.
Conclusion: STOPPFrail comprises 26 criteria, which have been judged by broad consensus, to be potentially inappropriate in frailer older patients with limited life expectancy. STOPPFrail may assist in deprescribing medications in these patients.