Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

Formal caregivers' perceptions of quality of care for older people : associating factors

Background: Despite the growing number of studies concerning quality of care for older people, there is a lack of studies depicting factors associated with good quality of care from the formal caregivers' perspective. The aim was to describe formal caregivers' perceptions of quality of care for older people in the community and explore factors associated with these perceptions. In total, 70 nursing assistants, 163 enrolled nurses and 198 registered nurses from 14 communities in central Sweden participated in the study. They filled out the following questionnaires: a modified version of Quality from the Patient's Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items regarding education and competence, Health Index and Sense of coherence questionnaire. The overall response rate was 57 % (n = 431). Results: In the perceived reality of quality of care respondents assessed the highest mean value in the dimension medical-technical competence and physical technical conditions and lower values in the dimensions; identity-oriented approach, socio-cultural atmosphere and in the context specific dimension. The caregivers estimated their competence and health rather high, had lower average values in sense of coherence and organizational climate and low values in stress of conscience. Conculsions: The PR of quality of care were estimated higher among NA/ENs compared to RNs. Occupation, organizational climate and stress of conscience were factors associated with quality of care that explained 42 % of the variance. Competence, general health and sense of coherence were not significantly associated to quality of care. The mentioned factors explaining quality of care might be intertwined and showed that formal caregivers' working conditions are of great importance for quality of care.

Optimizing the Performance Evaluation Process for Non-Academic Staff

If conducted poorly and without support from all employee levels, performance management programs at institutions may devolve into annual evaluations that represent a staff burden rather than an ongoing career development opportunity. This brief analyzes the key components of successful performance evaluation systems for non-academic staff, incorporating insights from employers outside of the higher education sector as well. It examines the importance of midyear check-in meetings; employee goal-setting; simplified rating scales on evaluation forms; and core staff competencies that reflect institutional priorities. It also describes how institutions communicate modifications to the evaluation system and offers recommendations for the implementation of process change.

Two essays on education and governament policies

Whether human capital increases or decreases wage uncertainty is an open ques- tion from an empirical standpoint. Yet, most policy prescriptions regarding human capital formation are based on models that impose riskiness on this type of invest- ment. We slightly deviate from the rest of the literature by allowing for non-linear income taxes in a two period model. This enables us to derive prescriptions that are robust to the risk characteristics of human capital: savings should be discouraged, human capital investments encouraged and both types of investment driven to an e¢ cient level from an aggregate perspective. These prescriptions are also robust to what choices are observed, even though the policy instruments used to implement them are not.

Two Essays on the economics of Education

We develop a job-market signaling model where signals may convey two pieces of information. This model is employed to study the GED exam and countersignaling (signals non-monotonic in ability). A result of the model is that countersignaling is more expected to occur in jobs that require a combination of skills that differs from the combination used in the schooling process. The model also produces testable implications consistent with evidence on the GED: (i) it signals both high cognitive and low non-cognitive skills and (ii) it does not affect wages. Additionally, it suggests modifications that would make the GED a more effective signal.

Os recursos físicos para a educação formal na América Latina: uma análise de sua distribuição

Este estudo examina o modo como se encontram distribuídos os recursos humanos e materiais, destinados ao ensino formal de 1o e 2o Graus, em amostras de escolas de cinco países da América do Sul (Argentina, Bolívia, Brasil, Paraguai e Peru). Mediante o emprego de uma metodologia quantitativa, a distribuição dos recursos é estudada segundo a localizaçao geográfica, a dependência administrativa, o nível de ensino e a origem social da clientela das escolas. A ·análise dos dados indica a existência de flagrantes disparidades na dotação de recursos as escolas, cujas causas devem ser buscadas no sistema social mais amplo, e não apenas no contexto interno do sistema de ensino de cada país.

O migrante na escola: um estudo de caso

O trabalho se propoe a retratar a realidade da criança migrante na região de destino, mais especificamente no contexto escolar. Tomando por base observações realizadas numa escola do Municipio de Nova Iguaçu, são sugeridas modificações nos curriculos plenos com vistas a um melhor atendimento ao aluno migrante, enquanto sujeito ao processo educativo formal . A criança que migra para a Baixada Fluminense, geralmente, detem um código restrito e depara-se, na escola, com outro semelhante ao seu, utilizado pelo aluno não migrante e com um código elaborado veiculado por aquela instituiçao. Embora se considere o código linguistico um obstáculo de difícil transposição, ao fim de algum tempo, o aluno migrante consegue "imitar" o dos colegas que, tal como ele, integram a população de baixa renda. Já o código difundido pela escola é de dificil absorção pelos seus alunos que nao vivenciam experiências e condutas das classes dominantes que ele procura expressar e caracterizar. No processo de ajustamento e acomodação da criança à sociedade de classes, cabe ao curriculo escolar estabelecer relações de poder e controle expressas nos principios de classificação e emolduramento. A fim de propiciar uma educação voltada para a mudança, os curriculos plenos, muito embora desempenham um papel secundário, devem ser organizados com a participação de representantes de diferentes segmentos da escola buscando preservar valores e traços culturais distintos e estruturados a partir de uma reflexão sobre a realidade.

Trabalho infantil no Brasil: determinantes da redução entre 2003 e 2011 e efeitos sobre a escolaridade e o rendimento na vida adulta

The hypothesis that child labor impacts future income generation negatively, for it harms the formal acquisition of education, is widely accepted by the existing literature on this issue. However, some researchers agree that labor might be beneficial to teenagers once they can develop skills, acquire job experience, or even help them to afford their own education acquisition. Thus, the main goal of this study is to assess if there is an age which the negative impact of the early access to the labor market over income and the conclusion of high school, during the adulthood of Brazilian people, becomes positive. To do so, PNADs (Pesquisas Nacionais de Amostra de Domicílios), a National Census of Household Samples, issues 1992 to 2011, were utilized plus the employment of an econometric technique called pseudo-panel. For this analysis, generations of people born between 1982 and 1991 were observed from the ages 10 to 17 (child labor) and from the ages 20 to 29 (conclusion of high-school & income). The results show that starting at the age of 15, the negative effect of an early access to the labor market over income, between ages 20-29, becomes positive. As per high-school, it was observed that accessing the labor market before the age 15 diminishes the probability for an individual to conclude high school before the age 21. From this age on, labor does not have a negative impact anymore. The second goal of this study is to assess how much of the reduction of the child labor occurrence in Brazil for the past years is due to changes of economic and demographic characteristics of children and families. For these analyses PNADs - National Census of Household Samples, issues 2003 to 2011, were employed plus the methodology of decomposition that divides the variation of child labor into 2 components: (a) changing of the probability of children with the same characteristics (intragroup) to start working – access labor market & (b) changing of the distribution of characteristics (intergroups). The results show that the reduction of the child labor occurrence is due, mainly, to changes on the probabilities. In general terms, the occurrence of child labor took place, more significantly, among individuals of the ages 15 to 17 & household heads with less education. Besides the characteristics mentioned, the reduction between non-white individuals was also significant among individuals from 4-member families. The results show that the reduction of child labor took place, mainly, among children and teenagers from non-white and poor families.

Practices in social media in the travel education business

Praticas na midia social se refere a vista ou a percepcao de uma marca nao so com base em suas ofertas e servicos, mas tambem sobre seus valores e cultura como percebido principalmente pelos consumidores. As organizacoes podem utilizer a imagem que é interessante e aceitavel para os clients. Nos ultimos anos, uma das formas que as organizacoes de forma consistente comercializar ou publicitar a sua marca envolve midias sociais. O ojetivo deste estudo é explorer quais sao as praticas de midia social no negocio de educacao de viagens. Para obter os dados, a pesquisadora entrevistou pessoas de seis empresas de educacao de viagens e cotejadas informacoes sobre o tema a partir de fonts primarias e secundarias existentes. O pesquisador conduziu a pesquisa para determiner praticas de marketing de midia social em que se aplicam nos sectores do turismo e educacao. Com base nos dados obtidos pelo pesquisador, as praticas de marketing de midia social incluem a utilizacao de plataformas de midia social com um alcance internacional generalizada tipo Facebook, Twitter, Instagram e YouTube. Outra estratégia é para postar constantemente as atualizações que não são apenas interessante, mas também informativo sobre os produtos e serviços oferecidos por uma marca ou organização. As empresas ou organizações devem também interagir com os clientes ou clientes on-line, a fim de manter os interesses deste último em ofertas e serviços da ex. O envolvimento do cliente é uma das razões por que os clientes optam por seguir as empresas on-line através da mídia social. A pesquisa também revela outras vantagens e benefícios da mídia social que constituem as melhores práticas, tais como a conversão de não-clientes para os clientes, o aumento da presença da mídia para aumentar a popularidade, a comunicação eficaz das metas e objetivos organizacionais, bem como a formação de um bom relacionamento com os clientes. As organizações também podem usar turístico criado conteúdo (TCC) e outros tipos de conteúdo para orientar a tomada de decisão no desenvolvimento do produto gerado pelo usuário.

JML- Based formal development of a Java card application for managing medical appointments

Although formal methods can dramatically increase the quality of software systems, they have not widely been adopted in software industry. Many software companies have the perception that formal methods are not cost-effective cause they are plenty of mathematical symbols that are difficult for non-experts to assimilate. The Java Modelling Language (short for JML) Section 3.3 is an academic initiative towards the development of a common formal specification language for Java programs, and the implementation of tools to check program correctness. This master thesis work shows how JML based formal methods can be used to formally develop a privacy sensitive Java application. This is a smart card application for managing medical appointments. The application is named HealthCard. We follow the software development strategy introduced by João Pestana, presented in Section 3.4. Our work influenced the development of this strategy by providing hands-on insight on challenges related to development of a privacy sensitive application in Java. Pestana’s strategy is based on a three-step evolution strategy of software specifications, from informal ones, through semiformal ones, to JML formal specifications. We further prove that this strategy can be automated by implementing a tool that generates JML formal specifications from a welldefined subset of informal software specifications. Hence, our work proves that JML-based formal methods techniques are cost-effective, and that they can be made popular in software industry. Although formal methods are not popular in many software development companies, we endeavour to integrate formal methods to general software practices. We hope our work can contribute to a better acceptance of mathematical based formalisms and tools used by software engineers. The structure of this document is as follows. In Section 2, we describe the preliminaries of this thesis work. We make an introduction to the application for managing medical applications we have implemented. We also describe the technologies used in the development of the application. This section further illustrates the Java Card Remote Method Invocation communication model used in the medical application for the client and server applications. Section 3 introduces software correctness, including the design by contract and the concept of contract in JML. Section 4 presents the design structure of the application. Section 5 shows the implementation of the HealthCard. Section 6 describes how the HealthCard is verified and validated using JML formal methods tools. Section 7 includes some metrics of the HealthCard implementation and specification. Section 8 presents a short example of how a client-side of a smart card application can be implemented while respecting formal specifications. Section 9 describes a prototype tools to generate JML formal specifications from informal specifications automatically. Section 10 describes some challenges and main ideas came acrorss during the development of the HealthCard. The full formal specification and implementation of the HealthCard smart card application presented in this document can be reached at https://sourceforge.net/projects/healthcard/.

Contribuição ao desenvolvimento de ontologias para processos petroquímicos : estudo de caso em uma planta DEA

In the last decades, the oil, gas and petrochemical industries have registered a series of huge accidents. Influenced by this context, companies have felt the necessity of engaging themselves in processes to protect the external environment, which can be understood as an ecological concern. In the particular case of the nuclear industry, sustainable education and training, which depend too much on the quality and applicability of the knowledge base, have been considered key points on the safely application of this energy source. As a consequence, this research was motivated by the use of the ontology concept as a tool to improve the knowledge management in a refinery, through the representation of a fuel gas sweetening plant, mixing many pieces of information associated with its normal operation mode. In terms of methodology, this research can be classified as an applied and descriptive research, where many pieces of information were analysed, classified and interpreted to create the ontology of a real plant. The DEA plant modeling was performed according to its process flow diagram, piping and instrumentation diagrams, descriptive documents of its normal operation mode, and the list of all the alarms associated to the instruments, which were complemented by a non-structured interview with a specialist in that plant operation. The ontology was verified by comparing its descriptive diagrams with the original plant documents and discussing with other members of the researchers group. All the concepts applied in this research can be expanded to represent other plants in the same refinery or even in other kind of industry. An ontology can be considered a knowledge base that, because of its formal representation nature, can be applied as one of the elements to develop tools to navigate through the plant, simulate its behavior, diagnose faults, among other possibilities

Expansão canavieira e ocupação formal em empresas sucroalcooleiras do Centro-Sul do Brasil, entre 2007 e 2009

Considerando-se a região Centro-Sul do Brasil e com base nos dados do Ministério do Trabalho e Emprego e do Ministério da Agricultura, Pecuária e Abastecimento, comparou-se a evoluçãoda produção sucroalcooleira comonúmero e tipos de pessoas formalmente ocupadas em empresas do setor, de 2007 a 2009. Nas empresas dedicadas ao cultivo da cana-de-açúcar, o número de pessoas ocupadas caiu nesses três anos, enquanto aumentava nas empresas dedicadas à produção de açúcareetanol.Quantoàscategoriasdeocupação,constatou-seaumentononúmero de pessoas ocupadas em atividades industriais, administrativas, de apoio ou não sucroalcooleiras, enquanto diminuíam as pessoas ocupadas na agricultura. Neste caso, houve redução dos trabalhadores canavieiros não qualificados e crescimento dos trabalhadores da mecanização agrícola, fatos associados à intensificação da adoção da colheita mecânica de cana-de-açúcar. Não ocorreu mudança expressiva na sazonalidade de emprego dos trabalhadores canavieiros não qualificados, que permaneceu muito alta. O aumento mais intenso da produção do que do número de pessoas ocupadas refletiu em indicadores de produtividade, com crescimento da relação da produção de cana-de-açúcar, tanto com o total de pessoas ocupadas, quanto com o número de trabalhadores canavieiros não qualificados. Também foi constatada redução significativa na relação desse grupo de trabalhadores com a área colhida com cana-de-açúcar.

Simulation Tools of DC-DC Converters for Power Electronics Education

This paper presents interactive simulation tools to support the enhancement of power electronics education considering DC to DC converters. These interactive tools make use of the benefits of Java language to provide a dynamic and interactive visualization of simulations in steady-state for idealized non-isolated DC to DC converters. Additionally, this paper discusses the features and the usage of the interactive educational tools to serve as a first design tool for the laboratory experiments in the power electronics courses. In this way, some results were confronted with a well-known simulator package and with experimental results in order to validate the developed interactive simulation tools.