Desenvolvimento de indicadores de comunicação em cuidados farmacêuticos : estudo piloto da sua aplicabilidade em farmácias comunitárias europeias

Tese de mestrado, Cuidados Farmacêuticos, Universidade de Lisboa, Faculdade de Farmácia, 2013

An In-depth Appraisal of Career Termination Experiences in Elite Cricket.

This qualitative study explored the career termination experiences of 9 male, retired professional cricketers, between the ages of 28 to 40 (M = 34, SD = 4.65). The participants took part in retrospective, semi-structured interviews. Data from the interviews were inductively content analysed within three transition phases of the retirement process: reasons for retirement, factors affecting adaptation, and reactions to retirement. The reasons for retirement were multicausal with the majority of the participants highlighting contractual pressures and a lack of communication as important precursors to retirement. Three main themes accounted for the factors affecting adaptation: a limited pursuit of other interests, developmental experiences and coping strategies. In terms of reactions to retirement, all of the participants reflected negatively on the termination of their career, with a sense of loss and resentment characterising the post-retirement period. The findings illustrated the sport-specific nature of career termination in professional cricket, and added further support to the emerging consensus that the distinction between voluntary and involuntary retirement is, at best, unclear.

Theorising and analysing digital labour: from global value chains to modes of production

This paper considers the following question—where do computers, laptops and mobile phones come from and who produced them? Specific cases of digital labour are examined—the extraction of minerals in African mines under slave-like conditions; ICT manufacturing and assemblage in China (Foxconn); software engineering in India; call centre service work; software engineering at Google within Silicon Valley; and the digital labour of internet prosumers/users. Empirical data and empirical studies concerning these cases are systematically analysed and theoretically interpreted. The theoretical interpretations are grounded in Marxist political economy. The term ‘global value chain’ is criticised in favour of a complex and multidimensional understanding of Marx’s ‘mode of production’ for the purposes of conceptualizing digital labour. This kind of labour is transnational and involves various modes of production, relations of production and organisational forms (in the context of the productive forces). There is a complex global division of digital labour that connects and articulates various forms of productive forces, exploitation, modes of production, and variations within the dominant capitalist mode of production.

Telling stories of culture through literature

Grounded on Raymond Williams‘s definition of knowable community as a cultural tool to analyse literary texts, the essay reads the texts D.H.Lawrence wrote while travelling in the Mediterranean (Twilight in Italy, Sea and Sardinia and Etruscan Places) as knowable communities, bringing to the discussion the wide importance of literature not only as an object for aesthetic or textual readings, but also as a signifying practice which tells stories of culture. Departing from some considerations regarding the historical development of the relationship between literature and culture, the essay analyses the ways D. H. Lawrence constructed maps of meaning, where the readers, in a dynamic relation with the texts, apprehend experiences, structures and feelings; putting into perspective Williams‘s theory of culture as a whole way of life, it also analyses the ways the author communicates and organizes these experiences, creating a space of communication and operating at different levels of reality: on the one hand, the reality of the whole way of Italian life, and, on the other hand, the reality of the reader who aspires to make sense and to create an interpretative context where all the information is put, and, also, the reality of the writer in the poetic act of writing. To read these travel writings as knowable communities is to understand them as a form that invents a community with no other existence but that of the literary text. The cultural construction we find in these texts is the result of the selection, and interpretation done by D.H.Lawrence, as well as the product of the author‘s enunciative positions, and of his epistemological and ontological filigrees of existence, structured by the conditions of possibility. In the rearticulation of the text, of the writer and of the reader, in a dynamic and shared process of discursive alliances, we understand that Lawrence tells stories of the Mediterranean through his literary art.

The impact of safety politics in the current globalization context

The globalization is a process of economical, social, cultural and political integration motivated by the needs generated by a consumption-orientated society and a set of factors that have led to its development, such as reducing transport costs, the technological advancement and the development of communication networks. However, the phenomenon of globalization has been accompanied by increasing levels of insecurity as a result of various types of threats and transnational crimes that the International Community seeks to control and minimize. Throughout this work, we examined how the globalization process has been developing and how nations are able to maintain security levels consistent with their economical status and social development, without disturbing the normal course of organizations’ economical activity and the well-being of people. From the investigation developed we concluded that, besides the confirmation that economic integration and the opening of markets have influence on internal consumption, market globalization and migrations have been causing modifications in the consumption habits. We also concluded that the security measures implemented by States or by the International Community affect international trade, but do not imply disproportionate costs or significant delays in transactions. Likewise, we concluded that the control measures implemented in international trade are sufficient to ensure the safety of the people and nations, enabling us to confirm two of the three conjectures raised in this study.

Energy and delay trade-off of the GTS allocation mechanism in IEEE 802.15.4 for wireless sensor networks

The IEEE 802.15.4 protocol proposes a flexible communication solution for Low-Rate Wireless Personal Area Networks (LR-WPAN) including wireless sensor networks (WSNs). It presents the advantage to fit different requirements of potential applications by adequately setting its parameters. When in beaconenabled mode, the protocol can provide timeliness guarantees by using its Guaranteed Time Slot (GTS) mechanism. However, power-efficiency and timeliness guarantees are often two antagonistic requirements in wireless sensor networks. The purpose of this paper is to analyze and propose a methodology for setting the relevant parameters of IEEE 802.15.4-compliant WSNs that takes into account a proper trade-off between power-efficiency and delay bound guarantees. First, we propose two accurate models of service curves for a GTS allocation as a function of the IEEE 802.15.4 parameters, using Network Calculus formalism. We then evaluate the delay bound guaranteed by a GTS allocation and express it as a function of the duty cycle. Based on the relation between the delay requirement and the duty cycle, we propose a power-efficient superframe selection method that simultaneously reduces power consumption and enables meeting the delay requirements of real-time flows allocating GTSs. The results of this work may pave the way for a powerefficient management of the GTS mechanism in an IEEE 802.15.4 cluster.

Inovação de técnicas administrativas para o melhoramento de desempenho das atividades organizacionais

Dissertação apresentada ao Instituto Politécnico do Porto - Instituto Superior de Contabilidade e Administração do Porto, para obtenção do Grau de Mestre em Assessoria e Administração de Organizações, sob orientação de Anabela Mesquita, PhD

Analyzing Geospatial patterns of syrian refugee flows in southeastern Turkey by use of remote sensing and complementary data

Crisis-affected communities and global organizations for international aid are becoming increasingly digital as consequence geotechnology popularity. Humanitarian sector changed in profound ways by adopting new technical approach to obtain information from area with difficult geographical or political access. Since 2011, turkey is hosting a growing number of Syrian refugees along southeastern region. Turkish policy of hosting them in camps and the difficulty created by governors to international aid group expeditions to get information, made such international organizations to investigate and adopt other approach in order to obtain information needed. They intensified its remote sensing approach. However, the majority of studies used very high-resolution satellite imagery (VHRSI). The study area is extensive and the temporal resolution of VHRSI is low, besides it is infeasible only using these sensors as unique approach for the whole area. The focus of this research, aims to investigate the potentialities of mid-resolution imagery (here only Landsat) to obtain information from region in crisis (here, southeastern Turkey) through a new web-based platform called Google Earth Engine (GEE). Hereby it is also intended to verify GEE currently reliability once the Application Programming Interface (API) is still in beta version. The finds here shows that the basic functions are trustworthy. Results pointed out that Landsat can recognize change in the spectral resolution clearly only for the first settlement. The ongoing modifications vary for each case. Overall, Landsat demonstrated high limitations, but need more investigations and may be used, with restriction, as a support of VHRSI.

Barriers preventing the successful integration of mental health services into Primary Health Care in Nigeria : a mixed methods approach

RESUMO: A Nigéria tem uma população estimada em cerca de 170 milhões de pessoas. O número de profissionais de saúde mental é muito diminuto, contando apenas com 150 psiquiatras o que perfaz aproximadamente um rácio de psiquiatra: população de mais de 1:1 milhão de pessoas. O Plano Nacional de Saúde Mental de 1991 reconheceu esta insuficiência e recomendou a integração dos serviços de saúde mental nos cuidados de saúde primários (CSP). Depois de mais de duas décadas, essa política não foi ainda implementada. Este estudo teve como objetivos mapear a estrutura organizacional dos serviços de saúde mental da Nigéria, e explorar os desafios e barreiras que impedem a integração bem-sucedida dos serviços de saúde mental nos cuidados de saúde primários, isto segundo a perspectiva dos profissionais dos cuidados de saúde primários. Com este objetivo, desenvolveu-se um estudo exploratório sequencial e utilizou-se um modelo misto para a recolha de dados. A aplicação em simultâneo de abordagens qualitativas e quantitativas permitiram compreender os problemas relacionados com a integração dos serviços de saúde mental nos CSP na Nigéria. No estudo qualitativo inicial, foram realizadas entrevistas com listagens abertas a 30 profissionais dos CSP, seguidas de dois grupos focais com profissionais dos CSP de duas zonas governamentais do estado de Oyo de forma a obter uma visão global das perspectivas destes profissionais locais sobre os desafios e barreiras que impedem uma integração bem-sucedida dos serviços de saúde mental nos CSP. Subsequentemente, foram realizadas entrevistas com quatro pessoas-chave, especificamente coordenadores e especialistas em saúde mental. Os resultados do estudo qualitativo foram utilizados para desenvolver um questionário para análise quantitativa das opiniões de uma amostra maior e mais representativa dos profissionais dos CSP do Estado de Oyo, bem como de duas zonas governamentais locais do Estado de Osun. As barreiras mais comummente identificadas a partir deste estudo incluem o estigma e os preconceitos sobre a doença mental, a formação inadequada dos profissionais dos CPS sobre saúde mental, a perceção pela equipa dos CSP de baixa prioridade de ação do Governo, o medo da agressão e violência pela equipa dos CSP, bem como a falta de disponibilidade de fármacos. As recomendações para superar estes desafios incluem a melhoria sustentada dos esforços da advocacia à saúde mental que vise uma maior valorização e apoio governamental, a formação e treino organizados dos profissionais dos cuidados primários, a criação de redes de referência e de apoio com instituições terciárias adjacentes, e o engajamento da comunidade para melhorar o acesso aos serviços e à reabilitação, pelas pessoas com doença mental. Estes resultados fornecem indicações úteis sobre a perceção das barreiras para a integração bem sucedida dos serviços de saúde mental nos CSP, enquanto se recomenda uma abordagem holística e abrangente. Esta informação pode orientar as futuras tentativas de implementação da integração dos serviços de saúde mental nos cuidados primários na Nigéria.------------ABSTRACT: Nigeria has an estimated population of about 170 million people but the number of mental health professionals is very small, with about 150 psychiatrists. This roughly translates to a psychiatrist:population ratio of more than 1:1 million people. The National Mental Health Policy of 1991 recognized this deficiency and recommended the integration of mental health into primary health care (PHC) delivery system. After more than two decades, this policy has yet to be implemented. This study aimed to map out the organizational structure of the mental health systems in Nigeria, and to explore the challenges and barriers preventing the successful integration of mental health into primary health care, from the perspective of the primary health care workers. A mixed methods exploratory sequential study design was employed, which entails the use of sequential timing in the combined methods of data collection. A combination of qualitative and uantitative approaches in sequence, were utilized to understand the problems of mental health services integration into PHC in Nigeria. The initial qualitative phase utilized free listing interviews with 30 PHC workers, followed by two focus group discussions with primary care workers from two Local Government Areas (LGA) of Oyo State to gain useful insight into the local perspectives of PHC workers about the challenges and barriers preventing successful integration of mental health care services into PHC. Subsequently, 4 key informant interviews with PHC co-ordinators and mental health experts were carried out. The findings from the qualitative study were utilized to develop a quantitative study questionnaire to understand the opinions of a larger and more representative sample of PHC staff in two more LGAs of Oyo State, as well as 2 LGAs from Osun State. The common barriers identified from this study include stigma and misconceptions about mental illness, inadequate training of PHC staff about mental health, low government priority, fear of aggression and violence by the PHC staff, as well as non-availability of medications. Recommendations for overcoming these challenges include improved and sustained efforts at mental health advocacy to gain governmental attention and support, organized training and retraining for primary care staff, establishment of referral and supportive networks with neighbouring tertiary facilities and community engagement to improve service utilization and rehabilitation of mentally ill persons. These findings provide useful insight into the barriers to the successful integration of mental health into PHC, while recommending a holistic and comprehensive approach. This information can guide future attempts to implement the integration of mental health into primary care in Nigeria.

¿La edad de la política? Balanche Historiográfico de los estudios sobre comunicación e información política en la sociedad ibérica moderna

Los estudios sobre política y su impacto y circulación entre la sociedad moderna, han solido limitar su expansión a un número reducido de personas del entorno más próximo a los grandes actores cortesanos frente a la tradicional “indiferencia” del común. Sin embargo, gracias a la renovación de la historiografía de lo político y a su interés por áreas culturales y sociales ajenas a su tradicional consideración, en las últimas décadas se ha descubierto un interesante terreno de experiencias políticas que nos puede servir como atalaya para conocer la difusión de la información sobre los hechos políticos también entre “gente corriente”. A nuestro juicio, es un momento adecuado para evaluar el desarrollo de un fenómeno historiográfico carente de cierta sistematicidad, razón por la que planteamos este balance crítico y analítico sobre la sociedad ibérica del Antiguo Régimen.

Impact of duration of chest tube drainage on pain after cardiac surgery.

OBJECTIVE: This study was designed to analyze the duration of chest tube drainage on pain intensity and distribution after cardiac surgery. METHODS: Two groups of 80 cardiac surgery adult patients, operated on in two different hospitals, by the same group of cardiac surgeons, and with similar postoperative strategies, were compared. However, in one hospital (long drainage group), a conservative policy was adopted with the removal the chest tubes by postoperative day (POD) 2 or 3, while in the second hospital (short drainage group), all the drains were usually removed on POD 1. RESULTS: There was a trend toward less pain in the short drainage group, with a statistically significant difference on POD 2 (P=0.047). There were less patients without pain on POD 3 in the long drainage group (P=0. 01). The areas corresponding to the tract of the pleural tube, namely the epigastric area, the left basis of the thorax, and the left shoulder were more often involved in the long drainage group. There were three pneumonias in each group and no patient required repeated drainage. CONCLUSIONS: A policy of early chest drain ablation limits pain sensation and simplifies nursing care, without increasing the need for repeated pleural puncture. Therefore, a policy of short drainage after cardiac surgery should be recommended.

Fast subplasma membrane Ca2+ transients control exo-endocytosis of synaptic-like microvesicles in astrocytes

Astrocytes are the most abundant glial cell type in the brain. Although not apposite for long-range rapid electrical communication, astrocytes share with neurons the capacity of chemical signaling via Ca(2+)-dependent transmitter exocytosis. Despite this recent finding, little is known about the specific properties of regulated secretion and vesicle recycling in astrocytes. Important differences may exist with the neuronal exocytosis, starting from the fact that stimulus-secretion coupling in astrocytes is voltage independent, mediated by G-protein-coupled receptors and the release of Ca(2+) from internal stores. Elucidating the spatiotemporal properties of astrocytic exo-endocytosis is, therefore, of primary importance for understanding the mode of communication of these cells and their role in brain signaling. We here take advantage of fluorescent tools recently developed for studying recycling of glutamatergic vesicles at synapses (Voglmaier et al., 2006; Balaji and Ryan, 2007); we combine epifluorescence and total internal reflection fluorescence imaging to investigate with unprecedented temporal and spatial resolution, the stimulus-secretion coupling underlying exo-endocytosis of glutamatergic synaptic-like microvesicles (SLMVs) in astrocytes. Our main findings indicate that (1) exo-endocytosis in astrocytes proceeds with a time course on the millisecond time scale (tau(exocytosis) = 0.24 +/- 0.017 s; tau(endocytosis) = 0.26 +/- 0.03 s) and (2) exocytosis is controlled by local Ca(2+) microdomains. We identified submicrometer cytosolic compartments delimited by endoplasmic reticulum tubuli reaching beneath the plasma membrane and containing SLMVs at which fast (time-to-peak, approximately 50 ms) Ca(2+) events occurred in precise spatial-temporal correlation with exocytic fusion events. Overall, the above characteristics of transmitter exocytosis from astrocytes support a role of this process in fast synaptic modulation.

Studies on coordination of systems development process

This thesis examines coordination of systems development process in a contemporary software producing organization. The thesis consists of a series of empirical studies in which the actions, conceptions and artifacts of practitioners are analyzed using a theory-building case study research approach. The three phases of the thesis provide empirical observations on different aspects of systemsdevelopment. In the first phase is examined the role of architecture in coordination and cost estimation in multi-site environment. The second phase involves two studies on the evolving requirement understanding process and how to measure this process. The third phase summarizes the first two phases and concentrates on the role of methods and how practitioners work with them. All the phases provide evidence that current systems development method approaches are too naïve in looking at the complexity of the real world. In practice, development is influenced by opportunity and other contingent factors. The systems development processis not coordinated using phases and tasks defined in methods providing universal mechanism for managing this process like most of the method approaches assume.Instead, the studies suggest that managing systems development process happens through coordinating development activities using methods as tools. These studies contribute to the systems development methods by emphasizing the support of communication and collaboration between systems development participants. Methods should not describe the development activities and phases in a detail level, butshould include the higher level guidance for practitioners on how to act in different systems development environments.

A phenomenological account of Merleau-Ponty's notion of style : from embodiment to flesh

Abstract This thesis is an investigation of Maurice Merleau-Ponty's notion of style via the individual, artwork, and the world. It aims to show that subject-object, self-other, and perceiver-perceived are not contrary, but are reverses of one another each requiring the other for meaningful experience. In experience, these cognitive contraries are engaged in relationships of communication and communion that render styles of interaction by which we have/are a world. A phenomenological investigation of Merleau-Ponty's notion of style via existential meaningfulness, corporeal and worldly understanding, stylistic nuances (with respect to the individual, the artwork, and the world), and the existential temporal dynamic provide the foundation for understanding our primordial connection with the world. This phenomenological unpacking follows Merleau-Ponty's thought from Phenomenology of Perception to "Cezanne's Doubt" and "Eye and Mind" through The Visible and the Invisible.

Out of the darkness and into the light : a study of inauthentic and authentic speech

Introduction Man can be described as the being who shows himself in speech, and from birth to death is continually speaking. Communication is so close to us, so woven into our very being, that we have little understanding of the way it is constituted; for it is as hard to obtain distance from communication as it is to obtain distance from ourselves. All communication is not alike. There are two basic modesl of communication, the inauthentic and the authentic, between which there occurs a constant tension. It is in the inauthentic mode, points out Heidegger, that we find ourselves "proximately and for the most part"; 1. Being and Time, pg. 68 Dasein decides as to the way it will comport itself in taking up its task of having being as an issue for it. " •.• it~, in its very being 'choose' itself and win itself; it can also lose itself and never win itself or only "seem" to do so. But only in so far as it is essentially something which can be authentic--that is, something of its own--can it have lost itself and not yet won itself." 2. therefore Heidegger also terms it "everydayness".2 Caught up in the world of everydayness, our speaking covers over and conceals3 our rootedness in being, leaving us in the darkness of untruth. The image of darkness may be inferred from Heidegger's use of the image of "clearing,,4 to depict being as 2. ibid. pg. 69 "Dasein's average everydayness, however, is not to be taken as a mere 'aspect'. Here too, and even in the mode of inauthenticity, the structure of existentiality lies ~ priori and here too Dasein's being is an issue for it in a definite way; and Dasein comports itself towards it the mode of average everydayness, even if this is only the mode of fleeing in the face of it and forgetfulness thereof." 3. ibid. pg. 59 "covering over" and "concealing" are 1;yays Dasein tries to flee its task of having being as an issue for itself. " ••• This being can be covered up so extensively that it becomes forgotten and no question arises about it or its meaning ••• n How everyday speaking accomplishes this will be taken up in detail in the second chapter which explores Dasein's everyday speech. 4. ibid, pg. 171 lI ••• we have in mind nothing other than the Existential - ontological structure of this entity (Dasein), that it is in such a way as to be its 'there'. To say that it is -' illuminated' [tlerleuchtet"] means that as Being-in-theworld it is cleared [gelichtetJ in itself7 not through any other entity, but in such a way that it is itself the clearing. Only for an entity which is eXistentially cleared in this way does what is present-at-hand become accessible in the light or hidden in the dark •••• " 3 dis-coveredness and truth. Our first task will be to explore the nature of communication in general and then to explore each of the modes manifested in turn. The structure of the inauthentic mode of communication can be explored by asking the following questions: What is this speaking about? Who is it that is speaking and who is spoken to? Does this speaking show man in his speech? The authentic mode is distinguished by the rarity with which we encounter it; as the inauthentic conceals, so the authentic reveals our rootedness in being. Yet this rarity makes it difficult to delineate its elusive structure clearly. Its constituent elements can be brought into focus by asking the same questions of this mode that we previously asked of the inauthentic mode. Our initial response to the disclosure of the authentic mode is to attempt to abandon the inauthentic mode and leave the darkness behind dwelling only in the "lighted place". All through the ages, some men pushing this to extreme, have, upon uncovering their relatedness to being, experienced a deep longing to dwell in such a "place" of pure truth and oft times denigrated or attempted to exclude the everyday world. Such 4. flight is twice mistaken: first it atbempts to fix truth as unchanging and static and secondly, it opposes this to untruth which it seeks to abolish. This is both the wrong view of truth and the wrong view of untruth as Heidegger points out in The Origin of The-Work of Art: The Way-to-be of truth, i.e., of discoveredness, is under the sway of refusal. But this refusal is no lack or privation, as if truth could be simply discoveredness rid of all covers. If it could be that, it would no longer be itself . ••• Truth in its way-to-be is untruth.5 Pure light is not the nature of Being nor is pure unconcealedness possible for man. Failure to remember this is the failure to realize that communication destroys itself in such flight because it no longer maintains the contingency of its task, i.e., the dis-closedness of being. We are reminded of the strong attraction this flight from darkness held for Plato. Light, truth and Being are all beyond the darkness and have nothing to do with it. In Book VII of the R~public, Socrates' explanation of the Allegory of the Cave to Glaucon points to a decided preference men have for the "lighted place". 5. The Origin Of The Work Of Art, pg. 42 5. Come then, I said, and join me in this further thought, and do not be surprised that those who attained to this height are not willing to occupy themselves with the affairs of men, but their souls ever feel the upward urge and yearning for that sojourn above. For this, I take it, is likely if in this point too the likeliness of our image holds. 6 Despite the attraction to pure truth, human communication is more complex than putting down one mode of communication and picking up another. Due to the fact that we are always on the way, the title of my thesis will have to be amended: OUT OF THE DARKNESS AND INTO THE LIGHT--AGAIN AND AGAIN. It must be this way because this is what it means to be human. This is the point made by Mephisto to Faust in pointing out that man, standing between God and the devil, needs both darkness and light: Er findet sich in einem ewigen Gl~t Uns hat er in die Finsternis gebracht, Und euch taugt einzig Tag und Nacht. 7 6. Republic z (517 c & d) It should be noted however, that while the philosopherking must be compelled to return to the cave for purely political reasons, once he has taken adequate view of the "brightest region of being" he has the full truth and his return to darkness adds nothing to the truth. 7. Faust, pg. 188 6. This thesis proposes to examine the grounds that give rise to communication, uncovering the structure of its inauthentic and authentic modes and paying close attention to tpeir interrelationship and to their relationship to language as "the house of Being": language that both covers and opens up man's rootedness in Being, transforming him as he moves along his way, taking up his "ownmost task" of becoming who he is. roots. He is the being who shows himself inn that reflects his forgetfulness or remembrance of his rootedness in being. Man comes into an already existent world and is addressedl through things in the world which are c