Quality in Hospital Administrative Databases

The clinical content of administrative databases includes, among others, patient demographic characteristics, and codes for diagnoses and procedures. The data in these databases is standardized, clearly defined, readily available, less expensive than collected by other means, and normally covers hospitalizations in entire geographic areas. Although with some limitations, this data is often used to evaluate the quality of healthcare. Under these circumstances, the quality of the data, for instance, errors, or it completeness, is of central importance and should never be ignored. Both the minimization of data quality problems and a deep knowledge about this data (e.g., how to select a patient group) are important for users in order to trust and to correctly interpret results. In this paper we present, discuss and give some recommendations for some problems found in these administrative databases. We also present a simple tool that can be used to screen the quality of data through the use of domain specific data quality indicators. These indicators can significantly contribute to better data, to give steps towards a continuous increase of data quality and, certainly, to better informed decision-making.

Comunidade real, comunidade imaginada: observação participante em contexto de estágio numa associação cultural: relatório de estágio

Relatório de Estágio submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro - especialização em Teatro e Comunidade.

Contribuição para a análise tectono-sedimentar do Fosso de Aljezur (SW de Portugal)

The Aljezur "graben" is a crucial piece in understanding the Caenozoic evolution of the SW atlantic portuguese edge. Detailed study of the sedimentary filling and bordering accidents allows the identification of several evolution steps since the Miocene. The graben is bordered by accidents that dislocate geomorphologic surfaces (Littoral Platform to the W, Interior Platform to the E), and also Neogene sedimentary units. The sedimentary filling is composed by conglomerates and sands grading into clays and bioclastic limestones (Burdigalian to Serravalian), upon which lie unconformably fine reddish sands, sometimes with abundant micas. Genetic and geometric relationships between these sands, those in higher surfaces outside the "graben" and the main bordering faults, are discussed. As a conclusion, the reconstruction of the tectono-sedimentary evolution is attempted, integrating it in a "pull-apart" context associated with the Messejana-fault system and it's reactivation by the differently orientated alpine compressions.

Thermodynamic and kinetic modelling of the redox properties of tetrahaem cytochromes C3

Dissertação apresentada para obtenção do grau de Doutor em Bioquímica,especialidade Bioquímica-Física, pela Universidade Nova de Lisboa, Faculdade de Cincias e Tecnologia

Y Trinuclear Cu-II structural isomers coordination, magnetism, electrochemistry and catalytic activity towards the oxidation of alkanes

The reaction of the Schiff base (3,5-di-tert-butyl-2-hydroxybenzylidene)-2-hydroxybenzohydrazide (H3L) with copper(II) nitrate, acetate or metaborate has led to the isomeric complexes [Cu-3(L)(2)(MeOH)(4)] (1), [Cu-3(L)(2)(MeOH)(2)]2MeOH (2) and [Cu-3(L)(2)(MeOH)(4)] (3), respectively, in which the ligand L exhibits dianionic (HL2-, in 1) or trianionic (L3-, in 2 and 3) pentadentate 1O,O,N:2N,O chelation modes. Complexes 1-3 were characterized by elemental analysis, IR spectroscopy, single-crystal X-ray crystallography, electrochemical methods and variable-temperature magnetic susceptibility measurements, which indicated that the intratrimer antiferromagnetic coupling is strong in the three complexes and that there exists very weak ferromagnetic intermolecular interactions in 1 but weak antiferromagnetic intermolecular interactions in both 2 and 3. Electrochemical experiments showed that in complexes 1-3 the Cu-II ions can be reduced, in distinct steps, to Cu-I and Cu-0. All the complexes act as efficient catalyst precursors under mild conditions for the peroxidative oxidation of cyclohexane to cyclohexyl hydroperoxide, cyclohexanol and cyclohexanone, leading to overall yields (based on the alkane) of up to 31% (TON = 1.55x10(3)) after 6 h in the presence of pyrazinecarboxylic acid.

A importância da internacionalização: candidaturas à União Europeia: trabalho de projecto

Trabalho de Projecto submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro, especialização em Produção.

Adesão ao regime terapêutico na pessoa com enfarte agudo do miócardio: contributo dos enfermeiros no internamento hospita

RESUMO: O Enfarte Agudo do Miocárdio (EAM) representa um dos principais problemas de saúde pública em Portugal. A rápida intervenção nos factores de risco determinantes da saúde cardíaca pode ter um impacto positivo em vários indicadores de saúde. O objectivo final dessa intervenção passa por capacitar a pessoa, para que, autonomamente, adopte um conjunto de comportamentos de saúde, baseados em estilos de vida protectores da saúde cardíaca, que favorecem positivamente o processo de reabilitação. Esta procura e aquisição do comportamento de saúde, adesão ao regime terapêutico, deve ser desenvolvido em parceria com os profissionais de saúde. O hospital representa a porta de entrada da pessoa com EAM no sistema de saúde. É neste contacto que se inicia uma intervenção de sensibilização e promoção da adesão ao regime terapêutico. Sendo os enfermeiros um grupo profissional que estabelece uma relação continua com a pessoa, importa conhecer um conjunto de dimensões do desempenho dos enfermeiros na promoção da adesão ao regime terapêutico. Breve referência ao desenho de estudo. Foram incluídas no estudo 143 enfermeiros de 9 serviços hospitalares da Região de Saúde de Lisboa e Vale do Tejo. Os dados foram obtidos através de um questionário auto-preenchido. Os dados mostraram que a população de enfermeiros é jovem (M= 30,5: dp= 8,0), 49% têm uma idade £ 26 anos e apresenta pouca experiência profissional (M=7,7; dp= 7,6), 48,2% exerce a profissão há menos de 3 anos. A antiguidade no serviço actual é reduzida (M= 4,7; dp= 4,6), 48,9% estão no serviço há menos de 2 anos. Os enfermeiros acreditam que deviam intervir com mais frequência nos factores de risco fisiológicos e comportamentais que nos factores psicossociais e ambientais; a confiança que têm nas capacidades para intervir nos factores de risco fisiológicos e comportamentais é maior que nos factores psicossociais e ambientais e no último ano, intervieram mais frequentemente nos factores de risco fisiológicos e comportamentais que nos psicossociais e ambientais. O “ensaio” da validação da escala de Will scale de Anderson et al (2004), sobre a capacidade de intervenção na saúde cardíaca, mostrou que o teste de Esfericidade de Bartlett e Medida de adequação da amostragem de Kaiser-Meyer- Olkin (KMO) permitiram a realização da análise factorial em componentes principais (AFCP). Da AFCP emergiram 16 factores, os mesmos que no estudo original de Anderson et al (2004), que revelaram boa consistência interna, com valores de alpha de Cronbach que variaram entre 0,71 a 0,98. Os resultados revelam a necessidade de sensibilizar os enfermeiros para valorizar a intervenção no âmbito dos factores de risco psicossociais e ambientais para promover a adesão ao regime terapêutico. Sugerem ainda que a intervenção baseada na evidência pode ser potenciada de forma a melhorar as práticas de cuidados dos enfermeiros. ABSTRACT: Myocardial infarction (MI) is one of the most important problems in public health in Portugal. A prompt intervention in cardiac health determinants means a positive impact in health outcomes, individually and collectively. The main purpose of this intervention lays on patient’s empowerment so he or she becomes able to choose healthy behaviours, based on heart health protective life styles, and therefore to manage his/hers therapeutic regime. This search and acquisition of health behaviours leading to therapeutic regime adherence may positively have an influence on the whole rehabilitation process and it must be developed in partnership with health workers. MI patients’ first contact with the Health System usually happens at the Hospital. Here the first steps are taken to start an intervention in order to promote therapeutic regime adherence. Nurses are a group of health workers who establish a unique and continuous relation with patients, so it matters to have knowledge of their performance skills that can actually promote a healthy behaviours and increase therapeutic regime adherence. Short Study design The study sample includes 143 nurses working on 9 different hospital wards, belonging to the Lisboa and Tejo’s Valley Health Region, in the district of Lisbon. Data were collected trough a self-administered questionnaire. It revealed that the nurses sample is a young population (M=30,5; dp=8,0), 49% of whom are aged less than 26 years old and has little professional experience (M=7,7; dp= 7,6); 48,2% work has nurses for less than 3 years. There’s a low percentage of seniority (M=4,7; dp=4,6), 48,9% of nurses work in these wards for less than 2 years. Nurses believe they should have intervene more frequently in physiological and behaviour risk factors than in psychological, social and environmental factors; they have greater confidence in their ability to intervene in physiological and behaviour risk factors than to intervene in psychological, social and environmental factors. In last year they took interventions more frequently in physiological and behaviour risk factors than in the other health determinants. The Scale Validation “essay” on Will Scale (Anderson et al, 2004), about heart health intervention capacity, revealed that the Bartlett’s test sphericity and the Kaiser-Meyer- Olkin’s (KMO) appropriate sample measure allowed the factorial analysis on main components (FAMC). From FAMC emerged 16 factors, the same number found on Anderson’s et al (2004) study, revealing good internal consistence, with Cronbach’s alpha values that varied between 0,71 and 0,98. The results point a need for nurses to attribute bigger value to other health determinants intervention - such as psychological, social and environmental determinants - so they’ll take part in promoting therapeutic regime adherence. The results also suggest t

Antimicrobial resistance and plasmid detection in strains of the Bacteroides fragilis group

Resistant populations of the Bacteroides fragilis group bacteria (two reference ones and two isolated from human and Callithrix penicillata marmoset) were obtained by the gradient plate technique, to clindamycin, penicillin G, metronidazole and mercuric chloride. All the four tested strains were originaly susceptible to the four antimicrobial drugs at the breakpoint used in this study. MICs determination for the four cultures gave constant values for each antimicrobial, on the several steps by the gradient plate technique. The intestinal human B. fragilis strains showed three DNA bands, that could be representative of only two plasmids in the closed covalently circular (CCC) form with molecular weights of approximately 25 and 2.5 Md. The results do not permit an association between the presence of plasmid in the human strain with the susceptibility to the studied drugs. The four strains were ß-lactamase negative in the two methods used, and no particular chromosomal genetic resistance marker was demonstred. The resistance (MIC) observed, after contact with penicillin G and mercuric chloride, were two-fold in the four tested strains

Sustainability Evaluation of Biodiesel Produced from Microalgae Chlamydomonas sp Grown in Brewery Wastewater

This study performs a sustainability evaluation of biodiesel from microalga Chlamydomonas sp. grown in 20 % (v/v) of brewery’s wastewater, blended with pentose sugars (xylose, arabinose or ribose resulting from the hydrolysis of brewer’s spent grains (BSG). The life cycle steps considered for the study are: microalgae cultivation, biomass processing and lipids extraction at the brewery site, and its conversion to biodiesel at a dedicated external biofuel’s plant. Three sustainability indicators (LCEE, FER and GW) were considered and calculated using experimental data. Literature data was used, whenever necessary, to complement life cycle data, thus allowing a more accurate sustainability evaluation. A comparative analysis of the biodiesel life cycle steps was also conducted, with the main goal of identifying which steps need to be improved. Results show that biomass processing, especially cell harvesting, microalgae cultivation, and lipids extraction are the main process bottlenecks. It is also analysed the influence on the microalgae biodiesel sustainability of adding each pentose sugar to the cultivation media, concluding that it strongly influences the biomass and lipid productivity. In particular, the addition of xylose is preferable in terms of lipid productivity, but from a sustainability point of view, ribose is the best, though the difference from xylose is not significant. Nevertheless, culture without pentose addition presents the best sustainability results.

A gestão e coordenação de projecto e obra: considerações gerais sobre duas abordagens em casos concretos

Trabalho de Projecto Relatório de Estágio para obtenção do grau de Mestre em Engenharia Civil

TRFS: desenvolvimento de um protótipo para simulação microscópica de tráfego

Dissertação para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Vias de Comunicação e Transportes

Traveled Distance Estimation Algorithm for Indoor Localization

This paper presents an ankle mounted Inertial Navigation System (INS) used to estimate the distance traveled by a pedestrian. This distance is estimated by the number of steps given by the user. The proposed method is based on force sensors to enhance the results obtained from an INS. Experimental results have shown that, depending on the step frequency, the traveled distance error varies between 2.7% and 5.6%.

Projeto de estruturas de um edifício em betão armado com recurso ao programa de cálculo automático ETABS

Trabalho de Projeto para obtenção do grau de mestre em Engenharia Civil

Visitas imersivas em contexto turístico

Engenharia Informática, Área de Especialização em Sistemas Gráficos e Multimédia

Determinantes do sucesso das iniciativas empresariais apoiadas pelo microcrédito

Dissertação de Mestrado apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Contabilidade e Finanças sob orientação de: Amélia Ferreira da Silva “Esta versão contém as críticas e sugestões dos elementos do júri”