Ambientes favoráveis à prática de cuidados de enfermagem: factores determinantes

Mestrado em Intervenção Sócio-Organizacional na Saúde - Ramo de especialização: Políticas de Administração e Gestão de Serviços de Saúde

Comunidades de prática nas organizações de saúde: proposta de modelo numa organização hospitalar

Mestrado em Intervenção Sócio-Organizacional na Saúde - Ramo de especialização: Políticas de Administração e gestão de Serviços de Saúde

An implicit GTS allocation mechanism in IEEE 802.15.4 for time-sensitive wireless sensor networks: theory and practice

Timeliness guarantee is an important feature of the recently standardized IEEE 802.15.4 protocol, turning it quite appealing for Wireless Sensor Network (WSN) applications under timing constraints. When operating in beacon-enabled mode, this protocol allows nodes with real-time requirements to allocate Guaranteed Time Slots (GTS) in the contention-free period. The protocol natively supports explicit GTS allocation, i.e. a node allocates a number of time slots in each superframe for exclusive use. The limitation of this explicit GTS allocation is that GTS resources may quickly disappear, since a maximum of seven GTSs can be allocated in each superframe, preventing other nodes to benefit from guaranteed service. Moreover, the GTS may be underutilized, resulting in wasted bandwidth. To overcome these limitations, this paper proposes i-GAME, an implicit GTS Allocation Mechanism in beacon-enabled IEEE 802.15.4 networks. The allocation is based on implicit GTS allocation requests, taking into account the traffic specifications and the delay requirements of the flows. The i-GAME approach enables the use of one GTS by multiple nodes, still guaranteeing that all their (delay, bandwidth) requirements are satisfied. For that purpose, we propose an admission control algorithm that enables to decide whether to accept a new GTS allocation request or not, based not only on the remaining time slots, but also on the traffic specifications of the flows, their delay requirements and the available bandwidth resources. We show that our approach improves the bandwidth utilization as compared to the native explicit allocation mechanism defined in the IEEE 802.15.4 standard. We also present some practical considerations for the implementation of i-GAME, ensuring backward compatibility with the IEEE 801.5.4 standard with only minor add-ons. Finally, an experimental evaluation on a real system that validates our theoretical analysis and demonstrates the implementation of i-GAME is also presented

Radiographers practice concerning breast compression in mammography: gradual versus no gradual

Purpose: Evaluate the type of breast compression (gradual or no gradual) that provides less discomfort to the patient. Methods and Materials: The standard projections were simulated [craniocaudal/(CC) and mediolateral-oblique/(MLO)] with the two breast compressions in 90 volunteers women aged between 19 and 86. The women were organised in groups according to the breast density. The intensity of discomfort was evaluated using the scale that have represented several faces (0-10) proposed by Wong Baker in the end of each simulation. It was also applied an interview using focus group to debate the score that were attributed during pain evaluation and to identify the criteria that were considered to do the classification. Results: The women aged between 19-29y (with higher breast density) classified the pain during no gradual compression as 4 and the gradual compression as 2 for both projections. The MLO projection was considered the most uncomfortable. During the focus group interview applied to this group was highlighted that compression did not promoted pain but discomfort. They considered that the high expectations of pain did not correspond to the discomfort that they felt. Similar results were identified for the older women (30-50y; > 50y). Conclusion: The radiographers should considerer the technique for breast compression. The gradual compression was considered for the majority of the women as the most comfortable regardless of breast density. The MLO projection was considered as uncomfortable due to the positioning (axila and inclusion of pectoral muscle) and due to the higher breast compression compared to the CC projection.

Association between sleep quality and quality of life in nursing professionals working rotating shifts

OBJECTIVE To analyze the association between sleep quality and quality of life of nursing professionals according to their work schedules.METHODS A prospective, cross-sectional, observational study was conducted between January and December 2010, with 264 nursing professionals, drawn from 989 subjects at Botucatu General Hospital and stratified by professional category. The Pittsburg Sleep Quality Index and the WHOQOL-bref were administered to evaluate sleep quality and quality of life, respectively. Self-reported demographic data were collected with a standard form. Continuous variables were reported as means and standard deviations, and categorical variables were expressed as proportions. Associations were evaluated using Spearman’s correlation coefficient. The association of night-shift work and gender with sleep disturbance was evaluated by logistic regression analysis using a model adjusted for age and considering sleep disturbance the dependent variable. The level of significance was p < 0.05.RESULTS Night-shift work was associated with severe worsening of at least one component of sleep quality in the model adjusted for age (OR = 1.91; 95%CI 1.04;3.50; p = 0.036). Female gender was associated with sleep disturbance (OR = 3.40; 95%CI 1.37;8.40; p = 0.008). Quality of life and quality of sleep were closely correlated (R = -0.56; p < 0.001).CONCLUSIONS Characteristics of the nursing profession affect sleep quality and quality of life, and these two variables are associated.

Formal caregivers of older adults: reflection about their practice

OBJECTIVE To understand the job function of caregivers of older adults and contribute to the debate on the consolidation of this professional practice. METHODOLOGICAL PROCEDURES This is a descriptive, qualitative, and exploratory study. Four focal group sessions were performed in 2011 with 11 elderly companions, formal caregivers of older adults in the Programa Acompanhante de Idosos (Program for Caregivers of Older Adults), Sao Paulo, SP, Southeastern Brazil. These sessions, guided by a semi-structured script, were audio-recorded and fully transcribed. Data were analyzed using the Content Analysis technique, Thematic Modality. RESULTS In view of considering the caregivers of older adults as a new category of workers, it was difficult to define their duties. The elderly companions themselves as well as the care receivers, their families, and the professionals that comprised the team were unclear about their duties. The professional practice of these formal caregivers has been built on the basis of constant discussions and negotiations among them and other team members in Programa Acompanhante de Idosos during daily work. This was achieved via a recognition process of their job functions and by setting apart other workers’ exclusive responsibilities. CONCLUSIONS The delimitation of specific job functions for elderly companions is currently one of the greatest challenges faced by these workers to develop and consolidate their professional role as well as improve Programa Acompanhante de Idosos.

A satisfação profissional dos enfermeiros especialistas em enfermagem de reabilitação

Em termos profissionais, a satisfação no trabalho é sem dúvida um tema bastante debatido e atual. Neste sentido, este estudo teve como objetivo analisar a satisfação profissional dos enfermeiros especialistas em enfermagem de reabilitação e também averiguar se o local de trabalho ou o exercício de cuidados de especialidade influenciam a satisfação profissional deste grupo de enfermeiros. A satisfação profissional foi avaliada através da aplicação da “Escala de Avaliação da Satisfação no Trabalho dos Enfermeiros”, construída e validada por Frederico & Loureiro (2009) a 306 profissionais de Enfermagem, especialistas em enfermagem de reabilitação. O Alpha de Cronbach foi de 0,85, refletindo um bom nível de consistência interna. Foram analisadas seis dimensões da satisfação: satisfação com as chefias; satisfação com benefícios e recompensas; satisfação com a natureza do trabalho; satisfação com a comunicação; satisfação com a equipa e satisfação com os requisitos do trabalho. Foi realizado um estudo transversal analítico. Na análise estatística dos dados, recorreu-se à análise fatorial, ao coeficiente de correlação de Spearman, a testes paramétricos t-student para amostras independentes e One-Way ANOVA. Os resultados mostram que os enfermeiros especialistas em enfermagem de reabilitação encontram-se ligeiramente insatisfeitos. Os fatores de insatisfação estão relacionados com benefícios e recompensas, requisitos do trabalho e com a comunicação. A natureza do trabalho e o relacionamento com a equipa são fatores com os quais obtêm maior satisfação. Em relação às chefias existe uma aproximação à satisfação. Relativamente à avaliação do grau de satisfação profissional global, concluiu-se que os enfermeiros que exercem funções nos Cuidados de Saúde Primários encontram-se mais insatisfeitos profissionalmente, do que os que exercem a sua atividade profissional ao nível hospitalar. Os enfermeiros que exercem cuidados gerais apresentam-se mais insatisfeitos do que os que exercem cuidados de especialidade. Também a idade e a remuneração pelo cargo desempenhado são fatores determinantes. Os enfermeiros mais jovens são os que se apresentam mais insatisfeitos. Os enfermeiros que não são remunerados pelo cargo desempenhado demonstram maior insatisfação profissional.

The intersection of people, technology and local space. PPGIS and Web in practice for participatory planning

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

Innovation through virtual communities of practice: motivations and constraints in the knowledge-creation process

This paper appears in International Journal of Projectics. Vol 4(1), pp. 39-49

Soil attributes dynamics evaluation after prescribed burning practice in northwestern Portugal forest

The Portuguese northern forests are often and severely affected by wildfires during the summer season. These occurrences affect significant and rudely all ecosystems, namely soil, fauna and flora. Preventive actions such as prescribed burnings and clear-cut logging are frequently used and have showed a significant reduction of the natural wildfires occurrences. In Portugal, and due to some technical and operational conditions, prescribed burnings in forests are the most common preventive action used to reduce the existing fuel hazard. The overall impacts of this preventive action on Portuguese ecosystems are complex and not fully understood. This work reports to the study of a prescribed burning impact in soil chemical properties, namely pH, humidity and organic matter, by monitoring the soil self-recovery capacity. The experiments were carried out in soil cover over a natural site of Andaluzitic schist, in Gramelas, Caminha, Portugal, who was able to maintain itself intact from prescribed burnings from four years. The composed soil samples were collected from five plots at three different layers (0-3cm, 3-6cm and 6-18cm) 1 day before prescribed fire and after the prescribed fire. The results have shown that the dynamic equilibrium in soil was affected significantly.

Sustainable Development Action Plan at ISEP - From Concept to Engineering Practice

Some of the main challenges in Incorporating Sustainable Development practices into Engineering Education reside in establishing the bridge between concept and application. In particular the relation between value creation and the knowledge economy, innovation and entrepreneurship, as the main vehicles to a relevant application of the sustainable development concept, is not yet part of the majority of the engineering curricula in schools. Porto Polytechnical Engineering School (ISEP), a Global Reporting Initiative training partner in Portugal, as just presented its Sustainable Development Action Plan, with the main objective of creating a new kind of engineers, with Sustainable Development at the core of their degrees. The plan has several issues like publish an annual sustainability report, sustainable buildings, minimization of energy consumption and water policy, waste management, sustainable mobility, green procurement, EMAS certification, research and postgraduate activity and promotion of lectures and seminars in Sustainable Development.

Medication regimen complexity in institutionalized elderly people in an aging society

Background: Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective: To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting: Five nursing homes in mainland Portugal. Methods: A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure: Medication regimen complexity index. Results: The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion: Medication regimen complexity proved to be high. There is certainly potential for the pharmacist's intervention to reduce it as part as the medication review routine in all the patients.

Virtual Communities of Practice: Design and Development of Support Platforms and Participation Fostering

Mestrado em Engenharia Informática - Área de Especialização em Sistemas Gráficos e Multimédia

Ensemble: an innovative approach to practice computer programming

Currently, the teaching-learning process in domains, such as computer programming, is characterized by an extensive curricula and a high enrolment of students. This poses a great workload for faculty and teaching assistants responsible for the creation, delivery, and assessment of student exercises. The main goal of this chapter is to foster practice-based learning in complex domains. This objective is attained with an e-learning framework—called Ensemble—as a conceptual tool to organize and facilitate technical interoperability among services. The Ensemble framework is used on a specific domain: computer programming. Content issues are tacked with a standard format to describe programming exercises as learning objects. Communication is achieved with the extension of existing specifications for the interoperation with several systems typically found in an e-learning environment. In order to evaluate the acceptability of the proposed solution, an Ensemble instance was validated on a classroom experiment with encouraging results.