The Dublin Lock Hospital: Medicine, Morality, Disease and Sin

Anecdotal evidence has it that when Dublin’s venereal disease hospital closed its doors for the last time in the 1950s, its administrative staff began to burn its records, starting with the most recent. This attempt to conceal the results of sexual profligacy is perhaps understandable in the rarefied climate of mid-century Catholic Ireland. However, the sense of shame attached to this institution has been pervasive. For example, of all Dublin’s major hospitals, the lock hospital remains the only one without a dedicated history. And, throughout its two centuries of existence, the ‘lock’ had often been a site of controversy and approbation.

The institution began in the eighteenth century as the most peripatetic, poor relation of the city’s voluntary hospitals, wandering indiscriminately through a series of temporary premises before finally achieving a permanent home and official recognition as a military-sponsored medical hospital in 1792. It also gained architectural extensions by both Richard and Francis Johnston and in the following decades. This new-found status and a growing re-conceptualisation of venereal disease as a legitimate medical problem rather than a matter of morality was, however, somewhat compromised by the choice of site at Townsend Street. The institution occupied a hidden part of city, appropriating the vacated home of the Hospital for Incurables, another marginalised group whose presence in the city had been viewed through the lens of superstition and fear. For the rest of its existence, the lock hospital would share this experience occupying a nebulous position between medicine and morality; disease and sin.

Using what’s left of the hospital’s records and a series of original architectural drawings, this paper discusses the presence and role of the lock hospital in the city in the eighteenth and early nineteenth century, tracking how changes in its administration and architectural form reflected wider attitudes towards disease, sexuality and gender in Georgian Dublin.

Factors influencing the success of rural cataract surgery programs in China:The study of hospital administration and relative productivity (SHARP)

PURPOSE. To explore factors potentially influencing the success or failure of rural Chinese hospitals in increasing cataract surgical output and quality. METHODS. Focus groups (FGs, n = 10) were conducted with hospital administrators, doctors, and nurses at 28 county hospitals in Guangdong Province. Discussions explored respondents' views on increasing surgical volume and quality and improving patient satisfaction. Respondents numerically ranked possible strategies to increase surgical volume and quality and patient satisfaction. FG transcripts were independently coded by two reviewers utilizing the constant comparative method following the grounded theory approach, and numerical responses were scored and ranked. RESULTS. Ten FGs and 77 ranking questionnaires were completed by 33 administrators, 23 doctors, and 21 nurses. Kappa values for the two coders were greater than 0.7 for all three groups. All groups identified a critical need for enhanced management training for hospital directors. Doctors and nurses suggested reducing surgical fees to enhance uptake, although administrators were resistant to this. Although doctors saw the need to improve equipment, administrators felt current material conditions were adequate. Respondents agreed that patient satisfaction was generally high, and did not view increasing patient satisfaction as a priority. CONCLUSIONS. Our findings highlight agreements and disagreements among the three stakeholder groups about improving surgical output and quality, which can inform strategies to improve cataract programs in rural China. Respondents' beliefs about high patient satisfaction are not in accord with other studies in the area, highlighting a potential area for intervention. © 2013 The Association for Research in Vision and Ophthalmology, Inc.

Supra-treatment threshold neonatal jaundice: Incidence in HIV-exposed compared to non-exposed neonates at Queen Elizabeth Central Hospital in Blantyre, Malawi

INTRODUCTION: Jaundice is the yellowish pigmentation of the skin, sclera, and mucous membranes resulting from bilirubin deposition. Children born to mothers with HIV are more likely to be born premature, with low birth weight, and to become septic-all risk factors for neonatal jaundice. Further, there has been a change in the prevention of mother-to-child transmission (PMTCT) of HIV guidelines from single-dose nevirapine to a six-week course, all of which theoretically put HIV-exposed newborns at greater risk of developing neonatal jaundice.

AIM: We carried out a study to determine the incidence of severe and clinical neonatal jaundice in HIV-exposed neonates admitted to the Chatinkha Nursery (CN) neonatal unit at Queen Elizabeth Central Hospital (QECH) in Blantyre.

METHODS: Over a period of four weeks, the incidence among non-exposed neonates was also determined for comparison between the two groups of infants. Clinical jaundice was defined as transcutaneous bilirubin levels greater than 5 mg/dL and severe jaundice as bilirubin levels above the age-specific treatment threshold according the QECH guidelines. Case notes of babies admitted were retrieved and information on birth date, gestational age, birth weight, HIV status of mother, type of feeding, mode of delivery, VDRL status of mother, serum bilirubin, duration of stay in CN, and outcome were extracted.

RESULTS: Of the 149 neonates who were recruited, 17 (11.4%) were HIV-exposed. One (5.88%) of the 17 HIV-exposed and 19 (14.4%) of 132 HIV-non-exposed infants developed severe jaundice requiring therapeutic intervention (p = 0.378). Eight (47%) of the HIV-exposed and 107 (81%) of the non-exposed neonates had clinical jaundice of bilirubin levels greater than 5 mg/dL (p < 0.001).

CONCLUSIONS: The study showed a significant difference in the incidence of clinical jaundice between the HIV-exposed and HIV-non-exposed neonates. Contrary to our hypothesis, however, the incidence was greater in HIV-non-exposed than in HIV-exposed infants.

Interactive management control via analytic hierarchy process (AHP). An empirical study in a public university hospital

Management control in public university hospitals is a challenging task because of continuous changes due to external pressures (e.g. economic pressures, stakeholder focuses and scientific progress) and internal complexities (top management turnover, shared leadership, technological evolution, and researcher oriented mission). Interactive budgeting contributed to improving vertical and horizontal communication between hospital and stakeholders and between different organizational levels. This paper describes an application of Analytic Hierarchy Process (AHP) to enhance interactive budgeting in one of the biggest public university hospital in Italy. AHP improved budget allocation facilitating elicitation and formalization of units' needs. Furthermore, AHP facilitated vertical communication among manager and stakeholders, as it allowed multilevel hierarchical representation of hospital needs, and horizontal communication among staff of the same hospital, as it allowed units' need prioritization and standardization, with a scientific multi-criteria approach, without using complex mathematics. Finally, AHP allowed traceability of a complex decision making processes (as budget allocation), this aspect being of paramount importance in public sectors, where managers are called to respond to many different stakeholders about their choices.

The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease

Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.

Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.

Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

A Escola da vida: reconhecimento e validação dos adquiridos experienciais em Portugal. Fragmentos de uma década (2000-2010)

Este livro assume-se como um contributo para o conhecimento do dispositivo de Reconhecimento e Validação dos Adquiridos Experienciais que, em Portugal se denominou Processo de RVCC (Reconhecimento Validação e Certificação de Competências)

Relação escola/família:de que modo o educador pode proporcionar atividades que envolvam a família?

Relatório de estágio apresentado para a obtenção do grau de Mestre na Especialidade Profissional de Educação Pré-escolar. Orientador: Professor Ramiro Marques

O Projeto Educativo como documento orientador da vida na escola

Dissertação apresentada na Escola Superior de Educação, para obtenção do grau de Mestre em Administração Educacional. Orientadora: Professora Doutora Maria João Cardona

A qualidade do serviço prestado pelos Serviços Académicos da Escola Superior ABC

A globalização dos mercados transformou a realidade em que vivem as nossas organizações criando a necessidade de, face à concorrência cada vez mais agressiva, lutar por uma posição de destaque no mercado onde se encontram, sendo a “qualidade” cada vez mais o fator de destaque. A qualidade vai muito além de um produto, hoje em dia a qualidade estende-se ao ensino passando pelos serviços. A qualidade preocupa não só a indústria como todas as atividades económicas, inclusive os serviços, quer estes sejam prestados por entidades privadas quer por entidades públicas. Dentro desta visão de “qualidade” de serviços, pretende este projeto de intervenção estudar a qualidade do serviço prestado, pelos serviços académicos de uma escola de ensino superior público e elaborar uma proposta de medidas de melhoria. Numa primeira fase estudámos a satisfação dos alunos face ao serviço prestado tendo sido recolhida a opinião de 120 alunos. De seguida analisámos os processos e procedimentos dos SAC e posteriormente elaborámos uma proposta de melhoria para obtermos um serviço que vá ao encontro das necessidades do seu público-alvo, correspondendo em tempo e formato às suas expectativas, por forma a obter qualidade contínua no serviço prestado. Durante a elaboração deste projeto conseguimos colocar em prática algumas das medidas propostas, sobre as quais obtivemos resultados e opiniões muito positivas.-Market globalization has transformed the reality in which our organizations live, thus creating an increasingly aggressive competition and the need to fight for a position in the market in which they are where "quality" has become an increasingly prominent factor. Quality goes far beyond a product. Nowadays, quality extends to education and even services. Quality concerns not only the industry and all economic activities including services, whether they are provided by private or by public entities. Within this vision of "quality" in services, this project aims to study the quality of the services provided by the academic department of a higher education school and develop a proposal for improvement measures. At the beginning we studied the extent to which students were satisfied with the service provided and we collected the opinions of 120 students. Then we examined the processes and procedures of SAC and subsequently drafted a proposal aiming to improve and to obtain a service which would meet the needs of our target audience, with time and format corresponding to their expectations, in order to achieve continuous quality in service. During the preparation of this project we were able to put some of the measures into practice, during obtained very positive results and opinions.

Avaliação da Escola - Resultados Escolares e a procura da Qualidade

Trabalho de Projeto apresentado para a obtenção do grau de Mestre na especialidade em Administração Educacional. Orientador:Prof. Doutor João Sebastião

A diversidade linguístico-cultural no jardim de infância e na escola : perceções de educadores e professores

Relatório de estágio para a obtenção do grau de Mestre em educação pré-escolar e em ensino do 1.º ciclo do ensino básico

Trabalhar com grupos de diferentes idades – no jardim de infância e na escola : a influência da heterogeneidade, em termos etários, na aprendizagem das crianças

Relatório de estágio apresentado para obtenção do grau de Mestre em educação pré-escolar e ensino do 1º ciclo do ensino básico

ESCOLAS POPULARES NO ALENTEJO: OS CASOS DA ESCOLA POPULAR DA UNIVERSIDADE DE ÉVORA E DA ESCOLA COMUNITÁRIA DE SÃO MIGUEL DE MACHEDE

A Educação Popular tem assumido, na região Alentejo, uma grande importância, na medida em que tem adoptado várias modalidades, diferentes protagonistas e promotores. Na realidade, nesta região, vários factores concorreram para este papel da Educação Popular.