Satisfação dos utilizadores de sistemas de informação e documentação de enfermagem em suporte eletrónico no Centro Hospitalar Lisboa Norte, E.P.E.

RESUMO - Os registos de enfermagem no Centro Hospitalar Lisboa Norte, E.P.E. (CHLN) são feitos em suporte de papel ou através de sistemas de informação (SI) próprios de cada serviço, com a utilização de várias aplicações como o Alert, Picis, etc. Esta diversidade gera alguns constrangimentos em termos de fluxo de informação, em virtude da falta de interoperabilidade dos respetivos sistemas. Esta realidade pode ter impactos na área da qualidade e segurança do utente, com a possibilidade de ocorrência de erros e/ou eventos adversos. Podem ainda ser notórios na área da privacidade e confidencialidade dos dados clínicos, na tomada de decisão, na gestão clínica e financeira e na produção de informação útil para a investigação científica. No CHLN está em curso a implementação de um SI capaz de dar resposta aos registos de enfermagem, integrados num registo de saúde eletrónico focado no utente que obedece à metodologia do processo de enfermagem e utiliza a linguagem codificada da Classificação Internacional para a Prática de Enfermagem (CIPE). Com o desenvolvimento desta investigação, devidamente autorizada pelo Conselho de Administração do CHLN, pretendeu-se dar resposta à pergunta de partida:  Estarão os enfermeiros, utilizadores do Desktop de Enfermagem do CHLN, satisfeitos com esse sistema de informação? Com esse propósito, foi elaborada uma abordagem exploratória com recurso a pesquisa bibliográfica sobre os sistemas de informação de enfermagem e a sua avaliação, com base no “Modelo de Sucesso dos Sistemas de Informação de DeLone e McLean”, tendo sido desenvolvido um estudo de caso com uma abordagem quantitativa, mediante a aplicação de um inquérito por questionário aos 262 enfermeiros do CHLN, nos serviços onde já utilizavam o referido SI, entre maio e junho de 2014, com uma taxa de resposta de 84%. Os resultados da aplicação do questionário, objeto de análise estatística univariada e bivariada com recurso a procedimentos descritivos e inferenciais, visando a produção de sínteses dirigidas aos objetivos do estudo, permitiram caracterizar o nível de satisfação dos enfermeiros, enquanto utilizadores do “desktop de enfermagem”, suportados por Tecnologias de Informação e Comunicação. Na escala utilizada (de 1 a 5), o nível médio de satisfação global (2,78) foi ligeiramente inferior ao seu ponto médio (3). No entanto, a maioria dos inquiridos (81,5%) não pretende abandonar o SI que utilizam. Os resultados obtidos permitem demonstrar que a satisfação dos enfermeiros face à implementação e utilização do SIE se trata de uma estratégia bem sucedida do CHLN, ainda que haja áreas onde foram evidenciados menores níveis de satisfação, tais como a “velocidade de processamento”, o “equipamento informático” e o “apoio técnico”, que podem ser alvo de uma maior atenção e reflexão pela gestão de topo, numa estratégia de melhoria contínua da qualidade, com importantes benefícios para a governação da instituição, para os profissionais e para os utentes, no futuro.

Controlo da qualidade de betões

Dissertação de mestrado em Construção e Reabilitação Sustentáveis

Bioactive dihydroxyfuranonaphthoquinones from the bark of Tabebuia incana A.H. Gentry (Bignoniaceae) and HPLC analysis of commercial pau d'arco and certified T.incana bark infusions

Tabebuia incana A.H. Gentry (Bignoniaceae) is a tree from the Brazilian Amazon having medicinal uses and is one several Tabebuia spp. known as pau d'arco or palo de arco in this region. Fractionation of the bark ethanolic extract afforded a mixture of 5 and 8-hydroxy-2-(1-hydroxyethyl)naphtho[2,3-b]furan-4,9-diones (1 and 2, respectively) identified on the basis of nuclear magnetic resonance (NMR), infrared (IR) and mass (MS) spectra, whose in vitro antimalarial and antitumor activity have been shown previously. This is the first study on T. incana bark, and 2 are described in this species for the first time. Also, high performance liquid chromatography (HPLC) analysis of T. incana bark tea revealed the presence of the 1 + 2 mixture peak corresponding to a concentration in the range 10-6-10-5 M. The chromatograms of teas prepared from commercial pau d' arco and T. incana bark were also studied and the presence of the 1 + 2 peak has potential for quality control of commercial plant materials.

Discrimination of Brazilian propolis according to the seasoning using chemometrics and machine learning based on UV-Vis scanning data

Propolis is a chemically complex biomass produced by honeybees (Apis mellifera) from plant resins added of salivary enzymes, beeswax, and pollen. The biological activities described for propolis were also identified for donor plants resin, but a big challenge for the standardization of the chemical composition and biological effects of propolis remains on a better understanding of the influence of seasonality on the chemical constituents of that raw material. Since propolis quality depends, among other variables, on the local flora which is strongly influenced by (a)biotic factors over the seasons, to unravel the harvest season effect on the propolis chemical profile is an issue of recognized importance. For that, fast, cheap, and robust analytical techniques seem to be the best choice for large scale quality control processes in the most demanding markets, e.g., human health applications. For that, UV-Visible (UV-Vis) scanning spectrophotometry of hydroalcoholic extracts (HE) of seventy-three propolis samples, collected over the seasons in 2014 (summer, spring, autumn, and winter) and 2015 (summer and autumn) in Southern Brazil was adopted. Further machine learning and chemometrics techniques were applied to the UV-Vis dataset aiming to gain insights as to the seasonality effect on the claimed chemical heterogeneity of propolis samples determined by changes in the flora of the geographic region under study. Descriptive and classification models were built following a chemometric approach, i.e. principal component analysis (PCA) and hierarchical clustering analysis (HCA) supported by scripts written in the R language. The UV-Vis profiles associated with chemometric analysis allowed identifying a typical pattern in propolis samples collected in the summer. Importantly, the discrimination based on PCA could be improved by using the dataset of the fingerprint region of phenolic compounds ( = 280-400m), suggesting that besides the biological activities of those secondary metabolites, they also play a relevant role for the discrimination and classification of that complex matrix through bioinformatics tools. Finally, a series of machine learning approaches, e.g., partial least square-discriminant analysis (PLS-DA), k-Nearest Neighbors (kNN), and Decision Trees showed to be complementary to PCA and HCA, allowing to obtain relevant information as to the sample discrimination.

Attachment to parents: the mediating role of inhibition of exploration and individuality on health behaviors

This study’s goal was to analyze whether the quality of university students’ relationship with their parents mediated the association between mental health and physical symptoms and health behavior. Participants were 250 university students (66% female and 34% male), aged between 17 and 29 years old (M = 20.88, SD = 2.03) that answered the Father/Mother Attachment Questionnaire (FMAQ), the Physical Symptoms Scale from the Rotterdam Symptom Checklist (RSCL), the Health Behavior Questionnaire (HBQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the indirect effect of physical symptoms on health behavior was significantly mediated by the father’s and mother’s inhibition of exploration and individuality (IEI). Also the indirect effect of psychological distress on health behavior was significantly mediated by the father’s and mother’s IEI. These results suggest that young adults who had more restrictions to their individuality show worse health behaviors. Separation Anxiety and Dependence (SAD) and Quality of Emotional Bond (QEB), the other 2 attachment scales, were not mediators of the relationship between physical symptoms/ psychological distress and health behavior. This study shows the importance of promoting positive parenting practices that contribute to healthier behavior choices and less risky behaviors, as well as the need for more studies that clearly identify these practices in young adult populations.

Tocopherol profile of Brazil nut oil from different geographic areas of the Amazon region

The tocopherol content of Brazil nut oil from different Amazon regions (Manicoré-AM, Rio Preto da Eva-AM, São João da Baliza-RR, Caroebe-RR, Belém-PA, and Xapurí-AC) was investigated by normal-phase high-performance liquid chromatography. For all authentic oils, two isomers: α- and γ-tocopherols were observed (37.92-74.48 µg g-1, 106.88-171.80 µg g-1, respectively), and their levels were relatively constant among the oils having these geographic origins, which would enable to distinguish Brazil nut oil from other plant oils for authentication purposes. Commercial Brazil nut oils were also evaluated, and some of these oils demonstrated a tocopherol content that was very different from that of the authentic oils. Therefore, we suggest that the tocopherol profile of Brazil nut oil can be useful chemical marker for quality control and authentication.

Controlo e gestão da produção no setor de corte térmico

Dissertação de mestrado integrado em Engenharia Mecânica

Controlo de qualidade e inspeção visual por imagem: definição de uma aplicação para registo de alterações e avaliação de desempenho

Dissertação de mestrado em Engenharia e Gestão da Qualidade

Fluência no betão desde as primeiras idades: um estudo experimental

Dissertação de mestrado integrado em Engenharia Civil

Desenvolvimento de métodos analíticos para controlo de qualidade de resinas naturais

Dissertação de mestrado em Técnicas de Caracterização e Análise Química

Implementação de métodos para análise de produtos acabados e matérias-primas no laboratório da empresa TMG Automotive

Dissertação de mestrado em Técnicas de Caraterização e Análise Química

Ensaios de controlo de qualidade em sabões e sabonetes

Dissertação de mestrado em Técnicas de Caracterização e Análise Química

Enhancing text classification to improve information filtering

Text classification, information filtering, semi-supervised learning, quality control

Predictors of Arrhythmic Events Detected by Implantable Loop Recorders in Renal Transplant Candidates

AbstractBackground:The recording of arrhythmic events (AE) in renal transplant candidates (RTCs) undergoing dialysis is limited by conventional electrocardiography. However, continuous cardiac rhythm monitoring seems to be more appropriate due to automatic detection of arrhythmia, but this method has not been used.Objective:We aimed to investigate the incidence and predictors of AE in RTCs using an implantable loop recorder (ILR).Methods:A prospective observational study conducted from June 2009 to January 2011 included 100 consecutive ambulatory RTCs who underwent ILR and were followed-up for at least 1 year. Multivariate logistic regression was applied to define predictors of AE.Results:During a mean follow-up of 424 ± 127 days, AE could be detected in 98% of patients, and 92% had more than one type of arrhythmia, with most considered potentially not serious. Sustained atrial tachycardia and atrial fibrillation occurred in 7% and 13% of patients, respectively, and bradyarrhythmia and non-sustained or sustained ventricular tachycardia (VT) occurred in 25% and 57%, respectively. There were 18 deaths, of which 7 were sudden cardiac events: 3 bradyarrhythmias, 1 ventricular fibrillation, 1 myocardial infarction, and 2 undetermined. The presence of a long QTc (odds ratio [OR] = 7.28; 95% confidence interval [CI], 2.01–26.35; p = 0.002), and the duration of the PR interval (OR = 1.05; 95% CI, 1.02–1.08; p < 0.001) were independently associated with bradyarrhythmias. Left ventricular dilatation (LVD) was independently associated with non-sustained VT (OR = 2.83; 95% CI, 1.01–7.96; p = 0.041).Conclusions:In medium-term follow-up of RTCs, ILR helped detect a high incidence of AE, most of which did not have clinical relevance. The PR interval and presence of long QTc were predictive of bradyarrhythmias, whereas LVD was predictive of non-sustained VT.

mRNA metabolism: nonsense mediated mRNA decay as a tool for gene therapy and the role of human DIS3L2 in transcript degradation

Tese de mestrado em Biologia Humana e Ambiente, apresentada à Universidade de Lisboa, através da Faculdade de Ciências, 2015