Labour stress in nursing

Based on evidence found during the empirical study we can affirm that the nursing profession is affected by work stress. Objective: Evaluate stress and engagement levels among nurses in health units in Portugal and Spain and describe the stress-generating factors among the surveyed nurses. Methods: A comparative study on a transversal level. Sample of 867 nurses (504 Portuguese, 363 Spanish), female 83.6 % (78.6 % in Portugal, 90.6 % in Spain) and average age of 37. 77.2 % of the Portuguese and 39.4 % of the Spanish nurses work on average 40 hours per week. 60.6 % and 57.7 % of the Spanish and Portuguese respectively have exercised their profession for 10 years. Pamela Gray-Toft’s Nurs- ing Stress Scale (1981) [1] and Schaufeli & Bakker’s Utrecht Work En- gagement Scale (2003) [2] were used. Results: Globally, Portuguese nurses experience higher stress levels although the difference with Spanish nurses is not statistically significant. There are statistically significant differences between Portugal and Spain in “Lack of help from colleagues” and also in the psychological domain in general. Concerning Engagement, there are statistically significant differences in the three dimensions, the p-value of the Student t-test was under 5 %, highlighting that Spanish nurses are more vigorous, dedicated and absorbed by their work. Conclusions: Portuguese nurses perceive more psychological stress and mention having less help from colleagues. Spanish nurses feel more vigorous, dedicated and absorbed by their work.

From the human rights-based approach to an ecological approach on how to achieve successful inclusion in international disability education

The barriers that people with disabilities face around the world are not only inherent to the limitations resulting from the disability itself, but, more importantly, these barriers rest with the societal technologies of exclusion. Using a mixed methodology approach, I conduct a quest to revealing several societal factors that limit full participation of people with disabilities in their communities, which will contribute to understanding and developing a more comprehensive framework for full inclusion of people with disabilities into the society. First, I conduct a multiple regression analysis to seek whether there is a statistical relationship between the national level of development, the level of democratization, and the level of education within a country’s population on one hand, and expressed concern for and preparedness to improve the quality of life for people of disabilities on another hand. The results from the quantitative methodology reveal that people without disabilities are more prepared to take care of people with disabilities when the level of development of the country is higher, when the people have more freedom of expression and hold the government accountable for its actions, and when the level of corruption is under control. However, a greater concern for the well-being of people with disabilities is correlated with a high level of country development, a decreased value of political stability and absence of violence, a decreased level of government effectiveness, and a greater level of law enforcement. None of the dependent variables are significantly correlated with the level of education from a given country. Then, I delve into an interpretive analysis to understand multiple factors that contribute to the construction of attitudes and practices towards people with disabilities. In doing this, I build upon the four main principles outlined by the United Nations as strongly recommended to be embedded in all international programmes: (1) identification of claims of human rights and the corresponding obligations of governments, hence, I assess and analyze disability rights in education, looking at United Nation, United States, and European Union Perspectives Educational Rights Provisions for People with Disabilities (Ch. 3); (2) estimated capacity of individuals to claim their rights and of governments to fulfill their obligations, hence, I look at the people with disabilities as rights-holders and duty-bearers and discuss the importance of investing in special capital in the context of global development (Ch. 4); (3) programmes monitor and evaluate the outcomes and the processes under the auspices of human rights standards, hence, I look at the importance of evaluating the UN World Programme of Action Concerning People with Disabilities from multiple perspectives, as an example of why and how to monitor and evaluate educational human rights outcomes and processes (Ch. 5); and (4) programming should reflect the recommendations of international human rights bodies and mechanisms, hence, I focus on programming that fosters development of the capacity of people with disabilities, that is, planning for an ecology of disabilities and ecoducation for people with disabilities (Ch. 6). Results from both methodologies converge to a certain point, and they further complement each other. One common result for the two methodologies employed is that disability is an evolving concept when viewed in a broader context, which integrates the four spaces that the ecological framework incorporates. Another common result is that factors such as economic, social, legal, political, and natural resources and contexts contribute to the health, education and employment opportunities, and to the overall well-being of people with disabilities. The ecological framework sees all these factors from a meta-systemic perspective, where bi-directional interactions are expected and desired, and also from a human rights point of view, where the inherent value of people is upheld at its highest standard.

Implementação da norma IFS (International Featured Standard) na produção de Migas de Bacalhau da empresa frigoríficos da ermida

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança

Recommended reporting standards for test accuracy studies of infectious diseases of finfish, amphibians, molluscs and crustaceans: the STRADAS-aquatic checklist

Complete and transparent reporting of key elements of diagnostic accuracy studies for infectious diseases in cultured and wild aquatic animals benefits end-users of these tests, enabling the rational design of surveillance programs, the assessment of test results from clinical cases and comparisons of diagnostic test performance. Based on deficiencies in the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines identified in a prior finfish study (Gardner et al. 2014), we adapted the Standards for Reporting of Animal Diagnostic Accuracy Studies—paratuberculosis (STRADAS-paraTB) checklist of 25 reporting items to increase their relevance to finfish, amphibians, molluscs, and crustaceans and provided examples and explanations for each item. The checklist, known as STRADAS-aquatic, was developed and refined by an expert group of 14 transdisciplinary scientists with experience in test evaluation studies using field and experimental samples, in operation of reference laboratories for aquatic animal pathogens, and in development of international aquatic animal health policy. The main changes to the STRADAS-paraTB checklist were to nomenclature related to the species, the addition of guidelines for experimental challenge studies, and the designation of some items as relevant only to experimental studies and ante-mortem tests. We believe that adoption of these guidelines will improve reporting of primary studies of test accuracy for aquatic animal diseases and facilitate assessment of their fitness-for-purpose. Given the importance of diagnostic tests to underpin the Sanitary and Phytosanitary agreement of the World Trade Organization, the principles outlined in this paper should be applied to other World Organisation for Animal Health (OIE)-relevant species.

An extension of STARD statements for reporting diagnostic accuracy studies on liver fibrosis tests: the Liver-FibroSTARD standards

International audience

Online education, accrediting standards, and student success: An examination of the relationship between the southern association of colleges and schools commission on colleges standards for online education and student success

Prior to 2000, there were less than 1.6 million students enrolled in at least one online course. By fall 2010, student enrollment in online distance education showed a phenomenal 283% increase to 6.1 million. Two years later, this number had grown to 7.1 million. In light of this significant growth and skepticism about quality, there have been calls for greater oversight of this format of educational delivery. Accrediting bodies tasked with this oversight have developed guidelines and standards for online education. ^ There is a lack of empirical studies that examine the relationship between accrediting standards and student success. The purpose of this study was to examine the relationship between the presence of Southern Association of Colleges and Schools Commission on College (SACSCOC) standards for online education in online courses, (a) student support services and (b) curriculum and instruction, and student success. An original 24-item survey with an overall reliability coefficient of .94 was administered to students (N=464) at Florida International University, enrolled in 24 university-wide undergraduate online courses during fall 2014, who rated the presence of these standards in their online courses. The general linear model was utilized to analyze the data. The results of the study indicated that the two standards, student support services and curriculum and instruction were both significantly and positively correlated with student success but with small R2 and strengths of association less than .35 and .20 respectively. Mixed results were produced from Chi-square tests for differences in student success between higher and lower rated online courses when controlling for various covariates such as discipline, gender, race/ethnicity, GPA, age, and number of online courses previously taken. A multiple linear regression analysis revealed that the curriculum and instruction standard was the only variable that accounted for a significant amount of unique variance in student success. Another regression test revealed that no significant interaction effect exists between the two SACSCOC standards and GPA in predicting student success. ^ The results of this study are useful for administrators, faculty, and researchers who are interested in accreditation standards for online education and how these standards relate to student success.^

Validity and reliability of the international fItness scale (IFIS) in a population-based sample of schoolchildren in Bogota, Colombia: The FUPRECOL study

The International FItness Scale (IFIS) is a self-reported measure of physical fitness that could easily. This scale has been validated in children, adolescents, and young adults; however, it is unknown whether the IFIS represents a valid and reliable estimate of physical fitness in Latino-American youth population. In the present study we aimed to examine the validity and reliability of the IFIS on a population-based sample of schoolchildren in Bogota, Colombia. Participants were 1,875 Colombian youth (56.2% girls) aged 9 to 17.9 years old. We measured adiposity markers (body fat, waist-to-height ratio, skinfold thicknesses and BMI), blood pressure, lipids profile, fasting glucose, and physical fitness level (self reported and measured). Also, a validated cardiometabolic risk index was used. An age- and sex-matched sample of 229 Schoolchildren originally not included in the study sample fulfilled IFIS twice for reliability purposes. Our data suggest that both measured and self-reported overall fitness were associated inversely with adiposity indicators and a cardiometabolic risk score. Overall, schoolchildren who self-reported “good” and “very good” fitness had better measured fitness than those who reported “very poor” and “poor” fitness (all p<0.001). Test–retest reliability of IFIS items was also good, with an average weighted Kappa of 0.811. Therefore, our findings suggest that self-reported fitness, as assessed by IFIS, is a valid, reliable, and health-related measure, and it can be a good alternative for future use in large studies with Latin-schoolchildren from Colombia.

A study of the role of a technology-enhanced learning implementation group in mediating an institutional VLE minimum standards policy

Recent years have seen a focus on responding to student expectations in higher education. As a result, a number of technology-enhanced learning (TEL) policies have stipulated a requirement for a minimum virtual learning environment (VLE) standard to provide a consistent student experience. This paper offers insight into an under-researched area of such a VLE standard policy development using a case study of one university. With reference to the implementation staircase model, this study takes cue from the view that an institutional VLE template can affect lower levels directly, sidestepping the chain in the implementation staircase. The Group's activity whose remit is to design and develop a VLE template, therefore, becomes significant. The study, drawing on activity theory, explores the mediating role of such a Group. Factors of success and sources of tension are analysed to understand the interaction between the individuals and the collective agency of Group members. The paper identifies implications to practice for similar TEL development projects. Success factors identified demonstrated the importance of good project management principles, establishing clear rules and division of labour for TEL development groups. One key finding is that Group members are needed to draw on both different and shared mediating artefacts, supporting the conclusion that the nature of the group's composition and the situated expertise of its members are crucial for project success. The paper's theoretical contribution is an enhanced representation of a TEL policy implementation staircase.

The Financial Services Regime in International Economic Law: on the Difficult Relationship between Trade Liberalization and Prudential Measures

The PhD thesis analyses the financial services regime in international economic law from the perspective of the difficult relationship between trade liberalisation and prudential measures. Financial stability plays a fundamental role for the well-being and well-functioning of the global economy, but, it is at the same time a complex sector to regulate and supervise and, especially after the 2007-08 economic crisis, States have tightened up their regulation of financial services, introducing more severe and protectionist prudential measures. However, in an increasingly interconnected global economy, the harmonization of prudential regulation at the international level is an essential step to guarantee integrity, fairness and stability of financial markets and trade. The research analyses the tools at disposition to achieve this aim, the related problematic issues and the perspectives and possible solutions for the future, starting from the World Trade Organization (WTO) legal framework and its General Agreement on Trade in Services (GATS), devoted to discipline trade in services among the WTO Members. Then, the research moves to a second legal instrument, the Free Trade Agreements (FTAs), which has witnessed a remarkable spread in the last decades. Finally, the research addresses the international standards, developed by supranational entities and implemented by an increasing number of States, as they offer rules and guidelines adequate to update the international financial scenario. Nevertheless, the international standards alone cannot be the solution because, first, they are not mandatory, as governments decide voluntarily to apply them and, second, their decision-making process do not respect the requirements of transparency and representative membership. In light of this analysis, the thesis aims at providing an answer to its research question: how to give more certainty to States and economic operators in the planning of the domestic disciplines and business activities in order to provide a sound and stable international financial system.

An analysis of the regulatory chill hypothesis: environmental protection in international investment law

The goal of this thesis has been to find out whether ISDS and international investment law exert a chilling effect on more stringent environmental standards at the domestic level. Due to the lack of consistent empirical and statistical evidence uncovered during the analysis, this thesis largely dismisses the regulatory chill hypothesis. However, two exceptions are identified: first, there is evidence of the efforts made by domestic industrial groups and trade unions to prevent the implementation of stricter environmental standards; second, it has become apparent that unfounded beliefs, e.g. about ISDS, held by lawmakers and regulators can play an important role in chilling stricter environmental standards. For these reasons, a new and narrower definition of the regulatory chill phenomenon has been proposed, one that only encompasses those instances in which lawmakers, governments and government agencies refrain from adopting the laws and regulations that they deem the most appropriate because they believe that doing so would lead to adverse consequences at the international trade and investment level, despite a lack of consistent and robust evidence supporting their concerns. The second part of this thesis focusses on what could be done in international economic law to promote environmentally friendly FDI, while preventing the few instances in which regulatory chill may take place due to ill-founded beliefs held by lawmakers and regulators. Following an analysis that highlights the paramount role played by public participation and responsive institutions to achieve an appropriate level of environmental protection, this study ends with a proposal that recommends the adoption of a clause within IIAs that makes pre-investment environmental screening mandatory and free from ISDS oversight.

The Value Of The 2005 International Society Of Urological Pathology (isup) Modified Gleason Grading System As A Predictor Of Biochemical Recurrence After Radical Prostatectomy.

To compare time and risk to biochemical recurrence (BR) after radical prostatectomy of two chronologically different groups of patients using the standard and the modified Gleason system (MGS). Cohort 1 comprised biopsies of 197 patients graded according to the standard Gleason system (SGS) in the period 1997/2004, and cohort 2, 176 biopsies graded according to the modified system in the period 2005/2011. Time to BR was analyzed with the Kaplan-Meier product-limit analysis and prediction of shorter time to recurrence using univariate and multivariate Cox proportional hazards model. Patients in cohort 2 reflected time-related changes: striking increase in clinical stage T1c, systematic use of extended biopsies, and lower percentage of total length of cancer in millimeter in all cores. The MGS used in cohort 2 showed fewer biopsies with Gleason score ≤ 6 and more biopsies of the intermediate Gleason score 7. Time to BR using the Kaplan-Meier curves showed statistical significance using the MGS in cohort 2, but not the SGS in cohort 1. Only the MGS predicted shorter time to BR on univariate analysis and on multivariate analysis was an independent predictor. The results favor that the 2005 International Society of Urological Pathology modified system is a refinement of the Gleason grading and valuable for contemporary clinical practice.

Growth And Body Composition In Brazilian Female Rhythmic Gymnastics Athletes.

The aim was to analyse the physical growth and body composition of rhythmic gymnastics athletes relative to their level of somatic maturation. This was a cross-sectional study of 136 athletes on 23 teams from Brazil. Mass, standing height and sitting height were measured. Fat-free and fat masses, body fat percentages and ages of the predicted peak height velocity (PHV) were calculated. The z scores for mass were negative during all ages according to both WHO and Brazilian references, and that for standing height were also negative for all ages according to WHO reference but only until 12 years old according to Brazilian reference. The mean age of the predicted PHV was 12.1 years. The mean mass, standing and sitting heights, body fat percentage, fat-free mass and fat mass increased significantly until 4 to 5 years after the age of the PHV. Menarche was reached in only 26% of these athletes and mean age was 13.2 years. The mass was below the national reference standards, and the standing height was below only for the international reference, but they also had late recovery of mass and standing height during puberty. In conclusion, these athletes had a potential to gain mass and standing height several years after PHV, indicating late maturation.

What Is The Best Indication For Single-incision Ophira Mini Sling? Insights From A 2-year Follow-up International Multicentric Study.

The Ophira Mini Sling System involves anchoring a midurethral, low-tension tape to the obturator internus muscles bilaterally at the level of the tendinous arc. Success rates in different subsets of patients are still to be defined. This work aims to identify which factors influence the 2-year outcomes of this treatment. Analysis was based on data from a multicenter study. Endpoints for analysis included objective measurements: 1-h pad-weight (PWT), and cough stress test (CST), and questionnaires: International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Urinary Distress Inventory (UDI)-6. A logistic regression analysis evaluated possible risk factors for failure. In all, 124 female patients with stress urinary incontinence (SUI) underwent treatment with the Ophira procedure. All patients completed 1 year of follow-up, and 95 complied with the 2-year evaluation. Longitudinal analysis showed no significant differences between results at 1 and 2 years. The 2-year overall objective results were 81 (85.3%) patients dry, six (6.3%) improved, and eight (8.4%) incontinent. A multivariate analysis revealed that previous anti-incontinence surgery was the only factor that significantly influenced surgical outcomes. Two years after treatment, women with previous failed surgeries had an odds ratio (OR) for treatment failure (based on PWT) of 4.0 [95% confidence interval (CI) 1.02-15.57). The Ophira procedure is an effective option for SUI treatment, with durable good results. Previous surgeries were identified as the only significant risk factor, though previously operated patients showed an acceptable success rate.

[renal Tumors: The International Society Of Urologic Pathology (isup) 2012 Consensus Conference Recommendations].

During the last 30 years many advances have been made in kidney tumor pathology. In 1981, 9 entities were recognized in the WHO Classification. In the latest classification of 2004, 50 different types have been recognized. Additional tumor entities have been described since and a wide variety of prognostic parameters have been investigated with variable success; however, much attention has centered upon the importance of features relating to both stage and grade. The International Society of Urological Pathology (ISUP) recommends after consensus conferences the development of reporting guidelines, which have been adopted worldwide ISUP undertook to review all aspects of the pathology of adult renal malignancy through an international consensus conference to be held in 2012. As in the past, participation in this consensus conference was restricted to acknowledged experts in the field.