Maturity models in the hospital information systems management initial research

Os modelos de maturidade são instrumentos facilitadores da gestão das organizações, incluindo a gestão da sua função sistemas de informação, não sendo exceção as organizações hospitalares. Neste artigo apresenta-se uma investigação inicial que visa o desenvolvimento de um abrangente modelo de maturidade para a gestão dos sistemas de informação hospitalares. O desenvolvimento deste modelo justifica-se porque os modelos de maturidade atuais no domínio da gestão dos sistemas informação hospitalares ainda se encontram numa fase embrionária de desenvolvimento, sobretudo porque são pouco detalhados, não disponibilizam ferramentas para determinação da maturidade e não apresentam as características dos estágios de maturidade estruturadas por diferentes fatores de influência.

Probabilistic models for mechanical properties of prestressing strands

This study focus on the probabilistic modelling of mechanical properties of prestressing strands based on data collected from tensile tests carried out in Laboratório Nacional de Engenharia Civil (LNEC), Portugal, for certification purposes, and covers a period of about 9 years of production. The strands studied were produced by six manufacturers from four countries, namely Portugal, Spain, Italy and Thailand. Variability of the most important mechanicalproperties is examined and the results are compared with the recommendations of the ProbabilisticModel Code, as well as the Eurocodes and earlier studies. The obtained results show a very low variability which, of course, benefits structural safety. Based on those results, probabilistic modelsfor the most important mechanical properties of prestressing strands are proposed.

Análise comparativa de sistemas de desidratação para ETAR caso de estudo: centrífugas versus filtros banda

Dissertação para obtenção do Grau de Mestre em Engenharia do Ambiente, perfil Engenharia Sanitária

Novos Padrões versus Velhos Hábitos de Prescrição de Albumina num Hospital Central

O presente estudo teve como objectivo aferir a adequação da prescrição de albumina humana num hospital central à evidência científica nesta área actualmente disponível. O estudo foi retrospectivo e analisou os pedidos de albumina aos serviços farmacêuticos entre Setembro de 2007 e Agosto de 2008. Analisadas 761 requisições de 619 doentes com idade média de 58,1 +/- 14,7 anos, 510 (77%) dos quais do sexo masculino. Foram avaliados parâmetros analíticos globais (proteínas totais, albumina sérica, creatinina e INR) à data da requisição de albumina, grandes grupos nosológicos e os motivos de prescrição. Dos 556.831 frascos de albumina requisitados, foram efectivamente administrados 5.033 (0,9%). Os doentes com patologia hepática foram o grupo nosológico mais representado (60%). Verificou-se que 36% dos pedidos correspondiam aos critérios científicos com suporte de evidência, sendo a hipoalbuminémia o motivo mais frequente de pedido (53%). Concluímos que é necessário um maior cuidado no fundamento dos pedidos de albumina, de forma a adequá-los à evidência científica. Normas restritivas dos serviços farmacêuticos para o fornecimento de albumina encontram-se justificadas.

Relatório de estágio em educação pré-escolar e ensino do 1º ciclo do ensino básico

presente relatório de qualificação profissional foi elaborado no âmbito da Unidade Curricular de Prática Pedagógica Supervisionada, inserida no plano de estudos do mestrado profissionalizante em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico. Intenta evidenciar o desenvolvimento de competências pessoais e profissionais pela estudante nos níveis educativos já referenciados, visando a construção de um perfil docente generalista. Em primeiro lugar, fundamenta-se o desenvolvimento uma ação dotada de intencionalidade num quadro teórico-concetual, construído ao longo do percurso formativo da mestranda, nos normativos legais em vigor, nas características dos contextos educativos que integrou e nos conhecimentos sobre cada criança. Posteriormente, apresenta-se através de uma análise crítica e reflexiva, o desenvolvimento vivenciado pela discente ao longo dos períodos de estágio que visava promover a progressiva autonomia e responsabilização pela ação docente. A metodologia de investigação-ação foi fundamental na construção das bases do perfil profissional da mestranda pois alicerçou o desenvolvimento da práxis e estruturou os processos de observação, planificação, ação, avaliação e reflexão. Esta metodologia e as estratégias e instrumentos formativos que a integram e que se adotaram nos dois níveis educativos fomentaram a transformação e a melhoria da prática educativa, através do desenvolvimento de competências reflexivas, investigativas e indagadoras. O processo vivenciado promoveu simultaneamente o desenvolvimento da estudante e a construção de aprendizagens por parte das crianças, constituindo-se como a primeira etapa de uma aprendizagem ao longo da vida com vista à constante adaptação e transformação do conhecimento praxeológico.

Relatório de estágio em 1º ciclo do ensino básico

No âmbito do Mestrado em Educação Pré-Escolar e Ensino do 1.º Ciclo do Ensino Básico, desenvolveu-se o presente relatório de caráter formativo, no qual foi analisada sob uma holística crítica e reflexiva, a Prática Pedagógica Supervisionada da mestranda, nos dois níveis educativos aos quais se propõe a uma profissionalidade futura – Educação Pré-Escolar e Ensino do 1.º Ciclo do Ensino Básico. Sendo que o estágio em Educação Pré-Escolar decorreu com um grupo de crianças com idades compreendidas entre os quatro e os cinco anos de idade e o estágio em 1.º Ciclo do Ensino Básico com uma turma do 3.º ano de escolaridade, no Colégio Novo da Maia. Neste documento foi desenvolvida uma descrição, análise e reflexão das competências profissionais e pessoais que a estudante desenvolveu ao longo das suas intervenções decorrentes num processo de formação profissional. Para isto, foi exposta a ação educativa da estudante, sustentada em quadros teórico e conceptuais já desenvolvidos; nos normativos legais; e características dos contextos educativos, ambiente educativo e respetivas crianças/alunos. Neste sentido, a mestranda fundamentou as suas práxis desenvolvidas em dois contextos de estágio diferentes, na metodologia de investigação-ação, numa constante postura crítica, reflexiva, investigativa e indagatória, nas diferentes fases que caraterizam esta metodologia. Ao longo da realização dos dois estágios procurou-se uma construção e reconstrução contínua de aprendizagens potenciadoras de um crescimento profissional enquanto docente generalista e de práticas geradoras de aprendizagens mais significativas por parte das crianças e alunos dos diferentes contextos

Eruca sativa: Benefits as antioxidants source versus risks of already banned pesticides

Eruca sativa (rocket salad) has been intensely consumed all over the world, insomuch as, this work was undertaken to evaluate the antioxidant status and the environmental contamination (positive and negative nutritional contribution) of leaves and stems from this vegetable. Antioxidant capacity of rocket salad was assessed by mean of optical methods, such as the total phenolic content (TPC), reducing power assay and DPPH radical scavenging activity. The extent of the environmental contamination was reached through the quantification of thirteen organochlorine pesticides (OCP) by using gas chromatography coupled with electron-capture detector (GC-ECD) and compound confirmations employing gas chromatography tandem mass-spectrometry (GC-MS/MS). The OCP residues were extracted by using Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) methodology.The extent of the environmental contamination was reached through the quantification of thirteen OCP by using gas chromatography coupled with electron-capture detector (GC-ECD) and compound confirmations employing GC-MS/MS. The OCP residues were extracted by using Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) methodology. This demonstrated that leaves presented more antioxidant activity than stems, emphasizing that leaves contained six times more polyphenolic compounds than stems. In what concerns the OCP occurrence, the average recoveries obtained at the three levels tested (40, 60 and 80 µg kg−1) ranged from 55% to 149% with a relative standard deviation of 11%, (except hexachrorobenzene). Three vegetables samples were collected from supermarkets and analysed following this study. According to data, only one sample achieved 16.21 of β-hexachlorocyclohexane, confirmed by GC-MS/MS. About OCP quantification, the data indicated that only one sample achieved 16.21 µg kg−1 of β-hexachlorocyclohexane, confirmed by GC-MS/MS, being the QuEChERS a good choice for the of OCPs extraction. Furthermore, the leaves consumption guaranty higher levels of antioxidants than stems.

A comparison between thin film solar cells made from co-evaporated CuIn1-xGaxSe2using a one-stage process versus a three-stage process

Until this day, the most efficient Cu(In,Ga)Se2 thin film solar cells have been prepared using a rather complex growth process often referred to as three-stage or multistage. This family of processes is mainly characterized by a first step deposited with only In, Ga and Se flux to form a first layer. Cu is added in a second step until the film becomes slightly Cu-rich, where-after the film is converted to its final Cu-poor composition by a third stage, again with no or very little addition of Cu. In this paper, a comparison between solar cells prepared with the three-stage process and a one-stage/in-line process with the same composition, thickness, and solar cell stack is made. The one-stage process is easier to be used in an industrial scale and do not have Cu-rich transitions. The samples were analyzed using glow discharge optical emission spectroscopy, scanning electron microscopy, X-ray diffraction, current–voltage-temperature, capacitance-voltage, external quantum efficiency, transmission/reflection, and photoluminescence. It was concluded that in spite of differences in the texturing, morphology and Ga gradient, the electrical performance of the two types of samples is quite similar as demonstrated by the similar J–V behavior, quantum spectral response, and the estimated recombination losses.

Non-linear time series models

The last three decades have seen quite dramatic changes the way we modeled time dependent data. Linear processes have been in the center stage in modeling time series. As far as the second order properties are concerned, the theory and the methodology are very adequate.However, there are more and more evidences that linear models are not sufficiently flexible and rich enough for modeling purposes and that failure to account for non-linearities can be very misleading and have undesired consequences.

A score test for non-nested hypotheses with applications to discrete data models

This paper suggests that a convenient score test against non-nested alternatives can be constructed from the linear combination of the likelihood functions of the competing models. It is shown that this procedure is essentially a test for the correct specification of the conditional distribution of the variable of interest.

Laparoscopic Assisted Vaginal Hysterectomy Versus Vaginal Hysterectomy

Introduction: Hysterectomy is the commonest gynecologic operation, performed for malignant and benign conditions. There are many approaches to hysterectomy for benign disease. Studies comparing the techniques have showed that vaginal hysterectomy has benefits in terms of reduced hospital stay, faster recovery and less operating time. Objective: The purpose of this study is to compare the surgical and immediate postoperative outcomes of Laparoscopic Assisted Vaginal Hysterectomy (LAVH) with those of Vaginal Hysterectomy (VH). Methods: Retrospective descriptive study, comparing two groups of women who underwent LAVH or VH in our department during a 24 months period, from January 2009 to December 2010. The two groups were compared regarding age, vaginal deliveries, previous abdominal surgery, uterine and adnexal pathology, intra-operative and post-operative complications, uterus weight, blood loss and number of days until discharge. Results: In our study 42 LAVH and 99 VH were included, with a patient mean age of 47 and 59, respectively. The most frequent indication for hysterectomy was fibroids (80%) for LAVH and POP(58.6%) for HV. In LAVH group 47.6% of patients had previous abdominal surgery, vs 28.2% in VH group. The medium operative time was 167 minutes for LAVH vs 99 minutes for HV. The intra-operative complications were one case (2%) of accidental incision of rectum in LAVH, and one bladder incision in the VH (1%). There were 3 conversions to laparotomy for difficult technique (7%) in LAVH group. There were no significant post-operative complications for LAVH. In VH group there were 2 cases of haemoperitoneum (2%) and 1 case requiring blood transfusion (1%). The mean time for discharge was 4.23 days for LAVH and 4.46 days for VH. Conclusions: In our study, the main advantage for VH was the reduced operative time. In terms of time to discharge there was no difference between the 2 groups. The main intra-operative complication of LAVH was the risk of conversion to laparotomy, but post-operatively this procedure had fewer complications than VH. In conclusion, LAVH is a safe option for women requiring hysterectomy in cases where VH is anticipated to be technically difficult.

Comparing the performance of geostatistical models with additional information from covariates for sewage plume characterization

In this work, kriging with covariates is used to model and map the spatial distribution of salinity measurements gathered by an autonomous underwater vehicle in a sea outfall monitoring campaign aiming to distinguish the effluent plume from the receiving waters and characterize its spatial variability in the vicinity of the discharge. Four different geostatistical linear models for salinity were assumed, where the distance to diffuser, the west-east positioning, and the south-north positioning were used as covariates. Sample variograms were fitted by the Mat`ern models using weighted least squares and maximum likelihood estimation methods as a way to detect eventual discrepancies. Typically, the maximum likelihood method estimated very low ranges which have limited the kriging process. So, at least for these data sets, weighted least squares showed to be the most appropriate estimation method for variogram fitting. The kriged maps show clearly the spatial variation of salinity, and it is possible to identify the effluent plume in the area studied. The results obtained show some guidelines for sewage monitoring if a geostatistical analysis of the data is in mind. It is important to treat properly the existence of anomalous values and to adopt a sampling strategy that includes transects parallel and perpendicular to the effluent dispersion.

Performance of state space and ARIMA models for consumer retail sales forecasting

Forecasting future sales is one of the most important issues that is beyond all strategic and planning decisions in effective operations of retail businesses. For profitable retail businesses, accurate demand forecasting is crucial in organizing and planning production, purchasing, transportation and labor force. Retail sales series belong to a special type of time series that typically contain trend and seasonal patterns, presenting challenges in developing effective forecasting models. This work compares the forecasting performance of state space models and ARIMA models. The forecasting performance is demonstrated through a case study of retail sales of five different categories of women footwear: Boots, Booties, Flats, Sandals and Shoes. On both methodologies the model with the minimum value of Akaike's Information Criteria for the in-sample period was selected from all admissible models for further evaluation in the out-of-sample. Both one-step and multiple-step forecasts were produced. The results show that when an automatic algorithm the overall out-of-sample forecasting performance of state space and ARIMA models evaluated via RMSE, MAE and MAPE is quite similar on both one-step and multi-step forecasts. We also conclude that state space and ARIMA produce coverage probabilities that are close to the nominal rates for both one-step and multi-step forecasts.

Análise Custo-Efectividade do Samário-153-EDTMP Versus Terapêutica Convencional da Dor em Doentes com Metástases Ósseas Múltiplas Dolorosas em Portugal

Introdução: O cancro da próstata é uma importante causa de morbilidade e mortalidade. Em Portugal, de acordo com um estudo publicado em 2003, a taxa de novos casos de cancro na próstata era de 53 por 100.000 homens, em 2000, com uma taxa de mortalidade padronizada pela idade de 28 por 100.000 (em 1995). As metástases ósseas múltiplas são uma das principais complicações associadas ao cancro de próstata avançado. O Samário-EDTMP mostrou ser uma alternativa segura e eficaz no tratamento paliativo da dor associada a metástases ósseas. O objectivo deste estudo económico é avaliar o custo-efectividade do tratamento da dor associada a metástases ósseas múltiplas com Samário-153-EDTMP versus terapêutica convencional da dor, no carcinoma da próstata hormono-refractário, em Portugal. Metodologia: Estudo de custo-efectividade que compara os custos directos do tratamento de doentes com múltiplas metástases ósseas dolorosas com Samário-153-EDTMP versus terapêutica convencional para a dor, na perspectiva do Sistema Nacional de Saúde, em Portugal, num horizonte temporal de quatro meses. Resultados: Os custos directos totais num período de quatro meses são 2.311,91 € para um doente tratado com Samário-153-EDTMP versus 2.450,74 € para um doente sob tratamento padrão. De acordo com o modelo, um doente tratado com Samário-153-EDTMP representa um decréscimo de custos de 138,83 €. Conclusão: O Samário-153-EDTMP é não só um método terapêutico muito eficaz mas também uma solução com custos reduzidos quando comparado à terapêutica convencional da dor, em doentes com dor devida a metástases ósseas múltiplas, em Portugal.

Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

PURPOSE: This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). METHODS: This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-μm nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. RESULTS: Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). CONCLUSIONS: PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.