Predicting pre-triage waiting time in a maternity emergency room through data mining

An unsuitable patient flow as well as prolonged waiting lists in the emergency room of a maternity unit, regarding gynecology and obstetrics care, can affect the mother and child’s health, leading to adverse events and consequences regarding their safety and satisfaction. Predicting the patients’ waiting time in the emergency room is a means to avoid this problem. This study aims to predict the pre-triage waiting time in the emergency care of gynecology and obstetrics of Centro Materno Infantil do Norte (CMIN), the maternal and perinatal care unit of Centro Hospitalar of Oporto, situated in the north of Portugal. Data mining techniques were induced using information collected from the information systems and technologies available in CMIN. The models developed presented good results reaching accuracy and specificity values of approximately 74% and 94%, respectively. Additionally, the number of patients and triage professionals working in the emergency room, as well as some temporal variables were identified as direct enhancers to the pre-triage waiting time. The imp lementation of the attained knowledge in the decision support system and business intelligence platform, deployed in CMIN, leads to the optimization of the patient flow through the emergency room and improving the quality of services.

Careers, identities and professionalization. A study on doctors about their social representations related to the labor market today and its foreseeable future

This study is in line with the analyses of university and working career in their interaction in relation with conditioning factors. It comprises two central issues: the issue of identity bound to the issue of professionalization within the domain of training and employment. Nowadays, professionalization of the individuals, inside a troubled occupational world, demands the implementation of mechanisms favoring the development of both the individuals and the institution in which they work. All this has an impact at the local, regional and even national levels. Three levels of analysis interplay from a sui generis perspective: macro-meso-micro-macro (Aparicio, 2005; 2007a; 2007b, 2013a, 2014, 2015 b, d – See the Three- Dimensional Spiral of Sense Theory). The aim was to be aware of the doctors’ representations regarding the value of such degree under the present “degree devaluation”, and its impact on the professional future as well as on the core issues of the labor market which need urgent measures with a view to a belter interaction between the two systems. The methodology used was quanti-qualitative (semi-structured questionnaires, interviews, and hierarchical evocations). The population consisted of doctors (2005-2012) from the National University of Cuyo, in Argentina. The results helped us understand the nucleus of such representations and the peripheral aspects by career and institution, thus revealing professional and disciplinary identities. The professional identities show the situated needs in terms of professionalization within the different contexts and, particularly, within the labor market.

Stress, cognitive appraisal, and psychological health: testing instruments for health professionals

The job of health professionals, including nurses, is considered inherently stressful (Lee & Wang, 2002; Rutledge et al., 2009), and thus it is important to improve and develop specific measures that are sensitive to the demands that health professionals face. This study analysed the psychometric properties of three instruments that focus on the professional experiences of nurses in aspects related to occupational stress, cognitive appraisal, and mental health issues. The evaluation protocol included the Stress Questionnaire for Health Professionals (SQHP; Gomes, 2014), the Cognitive Appraisal Scale (CAS; Gomes, Faria, & Gonçalves, 2013), and the General Health Questionnaire-12 (GHQ-12; Goldberg, 1972). Validity and reliability issues were considered with statistical analysis (i.e. confirmatory factor analysis, convergent validity, and composite reliability) that revealed adequate values for all of the instruments, namely, a six-factor structure for the SQHP, a five-factor structure for the CAS, and a two-factor structure for the GHQ-12. In conclusion, this study proposes three consistent instruments that may be useful for analysing nurses’ adaptation to work contexts.

Self-perception and dissatisfaction with weight does not depend on the frequency of physical activity

OBJECTIVE: To evaluate the level of satisfaction with body weight and the self-perception of the weight/height ratio and to verify the influence of the frequency of present and past physical activity on these variables. METHODS: Using questionnaires or interviews, we obtained height data, reported and desired weight, self-perception of the weight/height ratio, and the frequency of current physical activity in 844 adults (489 women). Of these, evaluated the frequency of physical activity during high school of 193 individuals,and we measured their height and weight. RESULTS: Less than 2/3 of the individuals had body mass index between 20 and 24.9 kg/m2. A tendency existed to overestimate height by less than 1 cm and to underestimate weight by less than 1kg. Desired weight was less than that reported (p<0.001), and only 20% were satisfied with their current weight. Only 42% of men and 25% of women exercised regularly. No association was found between the frequency of physical activity and the variables height, weight, and body mass index, and the level of satisfaction with current weight. CONCLUSION: Height and weight reported seem to be valid for epidemological studies, and great dissatisfaction with body weight and a distorted self-perception of height/weight ratio exists, especially in women, regardless of the frequency of physical activity.

The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake

OBJECTIVE: To assess the relation between blood pressure control and the following: the Morisky-Green test, the patient's consciousness regarding high blood pressure, the patient's attitude in face of medicine intake, the patient's attendance at medical consultations, and the subjective physician's judgment. METHODS: We studied 130 hypertensive patients with the following characteristics: 73% females, 60±11 years, 58% married, 70% white, 45% retired, 45% with incomplete elementary schooling, 64% had a familial income of 1 to 3 minimum wages, body mass index of 30±7 kg/m², consciousness regarding the disease for a mean period of 11±9.5 years, and mean treatment duration of 8 ±7 years. RESULTS: Only 35% of the hypertensive individuals had blood pressure under control and a longer duration of treatment (10±7 vs 7±6.5 years; P<0.05). The retiree predominated. The result of the Morisky-Green test did not relate to blood pressure control. In evaluating the attitude in face of medicine intake, the controlled patients achieved significantly higher scores than did the noncontrolled patients (8±1.9 vs 7 ±2, P<0.05). The hypertensive patients had higher levels of consciousness regarding their disease and its treatment, and most (70%) patients attended 3 or 4 medical consultations, which did not influence blood pressure control. The physicians attributed significantly higher scores regarding adherence to treatment to controlled patients (6±0.8 vs 5±1.2; P<0.05). CONCLUSION: Consciousness regarding the disease, the Morisky-Green test, and attendance to medical consultations did not influence blood pressure control.

O teatro do oprimido enquanto estratégia de promoção do empowerment em populações socialmente vulneráveis - estudo de caso do Grupo de Teatro do Oprimido de Lisboa

Dissertação de Mestrado em Política Social

O planeamento civil de emergência no novo paradigma da segurança

Dissertação de Mestrado em Estratégia

Fatalidade ou missão:estudo exploratório sobre as estratégias utilizadas pelas Ajudantes de Lar, para fazer face às exigências da sua profissão

Dissertação de Mestrado em Políticas de Desenvolvimento de Recursos Humanos

Satisfacción laboral y percepción de riesgos del trabajo en profesionales de enfermería. Laboural satisfaction and job risk awareness of nursing professionals.

Los profesionales de enfermería sufren en este momento histórico el impacto de la crisis económica y los cambios en el contexto político y social en lo que se refiere a las políticas de empleo y ajustes salariales. El ambiente de trabajo en las unidades de hospitalización suele ser agobiante y las actividades que realizan los exponen a riesgos específicos tales como: los propios del ambiente, condiciones y tipo de trabajo y las relaciones interpersonales. Definimos la satisfacción laboral como el resultado de la apreciación que cada individuo tiene de su trabajo y la importancia para satisfacer sus necesidades básicas.Objetivo General: Conocer y describir el nivel de satisfacción laboral y la percepción de riesgos en el trabajo que manifiestan los profesionales de Enfermería.Objetivos Específicos: - Describir la percepción de riesgos del ambiente de trabajo - Mostrar el nivel de satisfacción laboral según el tipo y número de pacientes que atienden, antigüedad en la profesión, estabilidad laboral, sexo, edad, situación de pareja, número de hijos,- Describir la satisfacción laboral en cuanto a los recursos con los que cuenta para el cuidado y la seguridad laboral de la institución, al salario que recibe y la cantidad de empleos que tiene, - Determinar la satisfacción laboral con respecto al estímulo que reciben de los superiores, al reconocimiento de los pares, equipo de salud y usuarios.El encuadre metodológico es el siguiente:El tipo de estudio elegido es el considerado correlacional simple ya que busca posibles vínculos entre dos o más variables.El universo lo componen los profesionales de enfermería que se desempeñan en instituciones públicas de salud de la ciudad de Río Cuarto y Córdoba Capital.La técnica de recolección de datos es la encuesta en su modalidad de cuestionario autoadministrado.

Polish immigrants in Ireland's black economy: a phenomenological investigation

The purpose of this thesis is to answer the research question ‗why do some Polish migrants engage in shadow employment in the Republic of Ireland?‘ The individual and group interviews, which were conducted in August 2011 with thirteen Polish migrants, living and working in Ireland, generated the answer to the research question. Interviewees‘ responses were analysed from the point of view of the literature that examines the various factors within the topics of migration and the black economy. The thesis begins with theoretical background information regarding the enlargement of the European Union and the economic situation of Poland and Ireland. Then migration theories are explained and Polish and Irish migration history is presented. Next, the issue of the black economy and shadow employment is developed with a focus on its presence in Poland and Ireland. The following section is dedicated to the research methodology that was adopted to ensure effective collection of the information. The issues of the qualitative and quantitative research, phenomenological approach to the research and interviews as data collection are raised in that section. The last part of the thesis is based on an analysis of the respondents‘ statements. It explores interviewees‘ experience of life and work in Ireland. The main part of that section develops the reasons why do Polish workers engage in shadow employment in the Republic of Ireland. Simultaneously, it provides the answers to the research question of this thesis.

Silent voices : the recreational needs of disabled young people : an emancipatory approach

The recreational needs of young people with.disabilities in Sligo county were examined using an emancipatory approach that provided an accurate reflection on the perspectives of the disabled young people. The aim of this study included a comparison of access to and attitudes towards leisure activities as between disabled and non-disabled young people in the Sligo area. The hypothesis set out by the researcher was the expectation that findings would include a degree of disadvantage in access and participation in leisure activities for young people with disabilities vis a vis their counterparts. The way in which this was tested was by focus groups and interviews. This hypothesis was adequately proven along with an in-depth range of recommendations for improvement that were made by participants. The study’s emancipatory research methods ensured that the voice of the participants was heard regarding their recreational needs and the disabling barriers that needed to be removed.

The appraisal of mesophilic anaerobic digestion and thermophilic aerobic digestion in the treatment of municipal sludge in Ireland

It has been well documented that the optimum feedstock for anaerobic digesters consists of readily biodegradable compounds, as found in primary sludge or even a mixed substrate of primary and excess activated sludge. Due to the requirements of the Urban Wastewater Treatment Plant Directive of 1991, the quantities of secondary sludge generated is set to increase substantially. A pilot scale study was undertaken to evaluate the performance of both Mesophilic Anaerobic Digestion and Thermophilic Aerobic digestion in the treatment of secondary sludge. The results indicated that the anaerobic pilot scale digester achieved a greater solids destruction than the aerobic pilot plant averaging at 28% T.S. removal verses 20% for the aerobic digester, despite the fact that secondary sludge is the optimum feedstock for aerobic digestion. This can, however, be attributed to the greater biomass yield experienced with aerobic systems, and to the absence of Autothermal conditions. At present, the traditional technique of Mesophilic Anaerobic Digestion is in widespread application throughout Ireland, for the stabilisation of sewage sludge. There is only one Autothermal Thermophilic Aerobic Digester at present situated in Killarney, Co. Kerry. A further objectives of the study was to compare full-scale applications of Mesophilic Anaerobic Digestion to ATAD. Two Sludge Treatment plants, situated in Co. Kerry, were used for this purpose, and were assessed mainly under the following headings; process stability, solids reduction on average, the ATAD plant in Killarney has the advantage of producing a “Class A” Biosolid in terms of pathogen reduction, and can effectively treat double the quantity of sludge. In addition, economically the ATAD plant is cheaper to run, costing €190 / t.d.s verses €211 / t.d.s. for the anaerobic digester in Tralee. An overview of additional operational Anaerobic Digestion Plants throughout Ireland is also presented.

The appraisal of anaerobic digestion in Ireland to develop improved designs and operational practice

Mesophilic Anaerobic Digestion treating sewage sludge was investigated at five full-scale sewage treatment plants in Ireland. The anaerobic digestion plants are compared and evaluated in terms of design, equipment, operation, monitoring and management. All digesters are cylindrical, gas mixed and heated Continuously Stirred Tank Reactors (CSTR), varying in size from 130m3 to 800m3. Heat exchanger systems heat all digesters. Three plants reported difficulties with the heating systems ranging from blockages to insufficient insulation and design. Exchangers were modified and replaced within one year of operation at two plants. All but one plant had Combined Heat and Power (CHP) systems installed. Parameter monitoring is a problem at all plants mainly due to a lack of staff and knowledge. The plant operators consider pH and temperature the most important parameters to be measured in terms of successful monitoring of an anaerobic digester. The short time taken and the ease at which pH and temperature can be measured may favour these parameters. Three laboratory scale pilot anaerobic digesters were operated using a variety of feeds over at 144-day period. Two of the pilots were unmixed and the third was mechanically mixed. As expected the unmixed reactors removed more COD by retention of solids in the digesters but also produced greater quantities of biogas than the mixed digester, especially when low solids feed such as whey was used. The mixed digester broke down more solids due to the superior contact between the substrate and the biomass. All three reactors showed good performance results for whey and sewage solids. Scum formation occurred giving operational problems for mixed and unmixed reactors when cattle slurry was used as the main feed source. The pilot test was also used to investigate which parameters were the best indicators of process instability. These trials clearly indicated that total Volatile Fatty Acid (VFA) concentrations was the best parameter to show signs of early process imbalance, while methane composition in the biogas was good to indicate possible nutrient deficiencies in the feed and oxygen shocks. pH was found to be a good process parameter only if the wastewater being treated produced low bicarbonate alkalinities during treatment.

Development of Anatomophysiologic Knowledge Regarding the Cardiovascular System: From Egyptians to Harvey

Our knowledge regarding the anatomophysiology of the cardiovascular system (CVS) has progressed since the fourth millennium BC. In Egypt (3500 BC), it was believed that a set of channels are interconnected to the heart, transporting air, urine, air, blood, and the soul. One thousand years later, the heart was established as the center of the CVS by the Hippocratic Corpus in the medical school of Kos, and some of the CVS anatomical characteristics were defined. The CVS was known to transport blood via the right ventricle through veins and the pneuma via the left ventricle through arteries. Two hundred years later, in Alexandria, following the development of human anatomical dissection, Herophilus discovered that arteries were 6 times thicker than veins, and Erasistratus described the semilunar valves, emphasizing that arteries were filled with blood when ventricles were empty. Further, 200 years later, Galen demonstrated that arteries contained blood and not air. With the decline of the Roman Empire, Greco-Roman medical knowledge about the CVS was preserved in Persia, and later in Islam where, Ibn Nafis inaccurately described pulmonary circulation. The resurgence of dissection of the human body in Europe in the 14th century was associated with the revival of the knowledge pertaining to the CVS. The main findings were the description of pulmonary circulation by Servetus, the anatomical discoveries of Vesalius, the demonstration of pulmonary circulation by Colombo, and the discovery of valves in veins by Fabricius. Following these developments, Harvey described blood circulation.