Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

An assessment of computer usage within the Bahamian public school system and recommended guidelines towards the development of a strategic national computer plan

Computers have dramatically changed the way we live, conduct business, and deliver education. They have infiltrated the Bahamian public school system to the extent that many educators now feel the need for a national plan. The development of such a plan is a challenging undertaking, especially in developing countries where physical, financial, and human resources are scarce. This study assessed the situation with regard to computers within the Bahamian public school system, and provided recommended guidelines to the Bahamian government based on the results of a survey, the body of knowledge about trends in computer usage in schools, and the country's needs. ^ This was a descriptive study for which an extensive review of literature in areas of computer hardware, software, teacher training, research, curriculum, support services and local context variables was undertaken. One objective of the study was to establish what should or could be relative to the state-of-the-art in educational computing. A survey was conducted involving 201 teachers and 51 school administrators from 60 randomly selected Bahamian public schools. A random stratified cluster sampling technique was used. ^ This study used both quantitative and qualitative research methodologies. Quantitative methods were used to summarize the data about numbers and types of computers, categories of software available, peripheral equipment, and related topics through the use of forced-choice questions in a survey instrument. Results of these were displayed in tables and charts. Qualitative methods, data synthesis and content analysis, were used to analyze the non-numeric data obtained from open-ended questions on teachers' and school administrators' questionnaires, such as those regarding teachers' perceptions and attitudes about computers and their use in classrooms. Also, interpretative methodologies were used to analyze the qualitative results of several interviews conducted with senior public school system's officials. Content analysis was used to gather data from the literature on topics pertaining to the study. ^ Based on the literature review and the data gathered for this study a number of recommendations are presented. These recommendations may be used by the government of the Commonwealth of The Bahamas to establish policies with regard to the use of computers within the public school system. ^

Pelvic-floor-muscle-training adherence “modifiers” : a review of primary qualitative studies : 2011 ICS State-of-the-Science Seminar research paper III of IV

Aims This review aims to locate and summarize the findings of qualitative studies exploring the experience of and adherence to pelvic floor muscle training (PFMT) to recommend future directions for practice and research. Methods Primary qualitative studies were identified through a conventional subject search of electronic databases, reference-list checking, and expert contact. A core eligibility criterion was the inclusion of verbatim quotes from participants about PFMT experiences. Details of study aims, methods, and participants were extracted and tabulated. Data were inductively grouped into categories describing “modifiers” of adherence (verified by a second author) and systematically displayed with supporting illustrative quotes. Results Thirteen studies (14 study reports) were included; eight recruited only or predominantly women with urinary incontinence, three recruited postnatal women, and two included women with pelvic organ prolapse. The quality of methodological reporting varied. Six “modifiers” of adherence were described: knowledge; physical skill; feelings about PFMT; cognitive analysis, planning, and attention; prioritization; and service provision. Conclusions Individuals' experience substantial difficulties with capability (particularly knowledge and skills), motivation (especially associated with the considerable cognitive demands of PFMT), and opportunity (as external factors generate competing priorities) when adopting and maintaining a PFMT program. Expert consensus was that judicious selection and deliberate application of appropriate behavior change strategies directed to the “modifiers” of adherence identified in the review may improve PFMT outcomes. Future research is needed to explore whether the review findings are congruent with the PFMT experiences of antenatal women, men, and adults with fecal incontinence.

Pelvic-floor-muscle-training adherence “modifiers” : a review of primary qualitative studies : 2011 ICS State-of-the-Science Seminar research paper III of IV

Aims This review aims to locate and summarize the findings of qualitative studies exploring the experience of and adherence to pelvic floor muscle training (PFMT) to recommend future directions for practice and research. Methods Primary qualitative studies were identified through a conventional subject search of electronic databases, reference-list checking, and expert contact. A core eligibility criterion was the inclusion of verbatim quotes from participants about PFMT experiences. Details of study aims, methods, and participants were extracted and tabulated. Data were inductively grouped into categories describing “modifiers” of adherence (verified by a second author) and systematically displayed with supporting illustrative quotes. Results Thirteen studies (14 study reports) were included; eight recruited only or predominantly women with urinary incontinence, three recruited postnatal women, and two included women with pelvic organ prolapse. The quality of methodological reporting varied. Six “modifiers” of adherence were described: knowledge; physical skill; feelings about PFMT; cognitive analysis, planning, and attention; prioritization; and service provision. Conclusions Individuals' experience substantial difficulties with capability (particularly knowledge and skills), motivation (especially associated with the considerable cognitive demands of PFMT), and opportunity (as external factors generate competing priorities) when adopting and maintaining a PFMT program. Expert consensus was that judicious selection and deliberate application of appropriate behavior change strategies directed to the “modifiers” of adherence identified in the review may improve PFMT outcomes. Future research is needed to explore whether the review findings are congruent with the PFMT experiences of antenatal women, men, and adults with fecal incontinence.

Methods and tools to foster territorial approaches for the assessment of food supply chains

The challenges of the current global food systems are often framed around feeding the world's growing population while meeting sustainable development for future generations. Globalization has brought to a fragmentation of food spaces, leading to a flexible and mutable supply chain. This poses a major challenge to food and nutrition security, affecting also rural-urban dynamics in territories. Furthermore, the recent crises have highlighted the vulnerability to shocks and disruptions of the food systems and the eco-system due to the intensive management of natural, human and economic capital. Hence, a sustainable and resilient transition of the food systems is required through a multi-faceted approach that tackles the causes of unsustainability and promotes sustainable practices at all levels of the food system. In this respect, a territorial approach becomes a relevant entry point of analysis for the food system’s multifunctionality and can support the evaluation of sustainability by quantifying impacts associated with quantitative methods and understanding the territorial responsibility of different actors with qualitative ones. Against this background the present research aims to i) investigate the environmental, costing and social indicators suitable for a scoring system able to measure the integrated sustainability performance of food initiatives within the City/Region territorial context; ii) develop a territorial assessment framework to measure sustainability impacts of agricultural systems; and iii) define an integrated methodology to match production and consumption at a territorial level to foster a long-term vision of short food supply chains. From a methodological perspective, the research proposes a mixed quantitative and qualitative research method. The outcomes provide an in-depth view into the environmental and socio-economic impacts of food systems at the territorial level, investigating possible indicators, frameworks, and business strategies to foster their future sustainable development.

An ergonomic approach to reorganize parking inspection agents` work productivity, health and safety in Sao Paulo, Brazil

Objective: The Traffic Engineering Company of the City of Sao Paulo (Brazil) observed a decrease in productivity, and an increase in sick leave, accidents and psychological distress among their parking inspection agents. To document this situation, qualitative research was undertaken to obtain an in-depth comprehension of work activity. Participants: Workers, managers and health and safety professionals contributed to the documentation of the problem and to the proposal of possible solutions. Methods: Ergonomic work analysis focusing on real work activity, as well as interviews with individual or groups of stakeholders, were conducted. Results: This research revealed that political-economic factors gradually contributed to: 1) an increasing work load; 2) growing fatigue throughout the day, increasing the workers` vulnerability to incidents and accidents and their tendency to react inappropriately to violence experienced on the street; and 3) excessive individual responsibility to manage dangerous situations. Conclusions: Recommendations to ameliorate the situation are proposed. These suggestions are discussed in terms of feasibility given the impact of macro social factors upon micro work activity, and the associated potential expansion of the ergonomist`s role.

Conceitos de eletricidade e suas aplicações tecnológicas : uma unidade de ensino potencialmente significativa

O presente trabalho teve como objetivo central a elaboração de uma unidade de ensino sobre conceitos de eletricidade e validação desse material como uma Unidade de Ensino Potencialmente Significativa (UEPS). Assim, foi desenvolvida uma unidade de ensino sobre os temas diferença de potencial, corrente elétrica e suas aplicações sob a luz da Teoria da Aprendizagem Significativa de Ausubel e aplicada em seis turmas do terceiro ano do ensino médio de uma escola estadual do Espírito Santo. A fim de investigação das potencialidades desse método de ensino, utilizou-se metodologias de pesquisa qualitativa descritiva interpretativa e quantitativa préexperimental. Tendo em vista a importância dos conhecimentos prévios dos estudantes para promover aprendizagem significativa, no início do estudo foram aplicados questionários de opinião, realizados diálogos prévios e construções de mapas conceituais, sendo esses importantes instrumentos para a adequação do material apresentado ao aluno em relação ao seu perfil e à sua estrutura cognitiva. Para coleta de dados da pesquisa foram feitas gravações em áudio das principais etapas, diários de bordo, fotografias dos trabalhos, questionários e mapas conceituais prévios e finais e, finalmente, avaliação escrita. A análise dos mapas conceituais constituiu um dos principais instrumentos para avaliação sob o ponto de vista do desenvolvimento cognitivo dos estudantes, no sentido de classificar os mapas, associá-los às estruturas cognitivas de quem os construiu e identificar variações estatisticamente válidas em relação às construções de novos significados. A investigação revelou que, de modo geral, a unidade foi responsável por melhorias significativas na predisposição dos alunos em aprender e na promoção da aprendizagem significativa, possibilitando sua a validação como uma UEPS.

O e-portefólio como instrumento de avaliação de desempenho e veículo de partilha entre os professores do ensino básico

O tema da avaliação de desempenho dos professores continua a ser um tema muito presente no dia-a-dia de uma escola. O atual modelo de avaliação veio revolucionar o meio e acabou por trazer com ele o descontentamento dos professores. Face a este descontentamento, procurámos, investigar a exequibilidade de um novo instrumento de avaliação: o e-portefólio. Assim, o foco deste estudo de caso centra-se em estudar a praticabilidade da utilização de um instrumento de avaliação alternativo, o e-portfólio, enquanto instrumento de partilha entre os docentes e possível instrumento de avaliação de desempenho. Para o efeito desenvolvemos um estudo de natureza qualitativa, tendo realizado entrevistas semiestruturadas a um conjunto de professores do ensino básico, e posteriormente procedido à sua análise de conteúdo. Da análise e interpretação dos resultados concluímos que os docentes consideram que a partilha de materiais, através de e-portefólios, veio facilitar a vida dos professores e que estes assumem-se como um auxílio precioso e vantajoso no dia-a-dia dos docentes. Concluímos, também, que o e-portefólio poderá ser um possível instrumento de avaliação a adotar, desde que rigorosa e criteriosamente utilizado, uma vez que poderá estar bem visível parte do trabalho que os professores realizam. Os dados alertam, ainda, para a necessidade de uma reflexão, por parte da tutela, para a constante falta de tempo e excesso de burocracias mencionadas pelos professores.

Public school teachers’ perceptions about mental health

OBJECTIVE To examine public school teachers’ perceptions about general health and mental health, and the way in which they obtained this information. METHODS Qualitative research was conducted with 31 primary and secondary school teachers at a state school in the municipality of Sao Paulo, SP, Southeastern Brazil, in 2010. The teachers responded to a questionnaire containing open-ended questions about mental health and general health. The following aspects were evaluated: Teachers’ understanding of the terms “health and “mental health,” the relevance of the need for information on the subject, the method preferred for obtaining information, their experience with different media regarding such matters, and perceptions about the extent to which this available information is sufficient to support their practice. The data were processed using the Qualiquantisoft software and analyzed according to the Discourse of the Collective Subject technique. RESULTS From the teachers’ perspective, general health is defined as the proper physiological functioning of the body and mental health is related to the balance between mind and body, as a requirement for happiness. Most of the teachers (80.6%) showed great interest in acquiring knowledge about mental health and receiving educational materials on the subject. For these teachers, the lack of information creates insecurity and complicates the management of everyday situations involving mental disorders. For 61.3% of the teachers, television is the medium that provides the most information on the topic. CONCLUSIONS The data indicate that there is little information available on mental health for teachers, showing that strategies need to be developed to promote mental health in schools.

Plano de negócios: UpBiz

Trabalho de projeto apresentado à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Publicidade e Marketing.

Medição e gestão do desempenho e sistemas de controlo de gestão: um estudo de caso no sector público da saúde.

Dissertação de Mestrado apresentada ao Instituto Superior de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação do Mestre Paulino Silva

A Percepção dos Cuidadores Informais Relativamente ao Centro de Dia Para Pessoas com Doença de Alzheimer

A sobrecarga familiar provocada pela doença de Alzheimer é reconhecida como um problema de saúde pública: há cada vez menos cuidadores jovens para cada vez mais doentes idosos e as insuficientes respostas de suporte social são uma realidade. O acto de cuidar no domícilio afecta de forma significativa os padrões ocupacionais dos prestadores de cuidados, levando-os a situações de desiquilíbrio ocupacional e a grande desgaste fisico e emocional. Assim, este trabalho pretende compreender a percepção dos cuidadores informais relativamente à integração destas pessoas em centros de dia, como estratégia de melhoria da estabilidade emocional e equilíbrio ocupacional dos seus familiares. Em termos da recolha da informação empírica, recorremos a uma metodologia mista, constituída por procedimentos mais de natureza quantitativa e outros de carácter mais qualitativo. Nesse enquadramento foram administrados a cerca de 10 cuidadores informais, antes e depois do seu familiar ter sido integrado no centro de dia, os instrumentos “Entrevista de Zarit para a sobrecarga do cuidador” e o “Teste abreviado da qualidade de vida” (WHOQOL-Bref), no sentido de se avaliar o impacto desta medida no equilíbrio emocional e percepção subjectiva da qualidade de vida. Concomitantemente, foram realizadas entrevistas também antes e depois da integração no sentido de compreender de que forma a frequência no centro de dia potencia um equilíbrio ocupacional mais adaptado. Os resultados obtidos mostram que ocorreu uma diminuição da sobrecarga emocional e uma melhoria da percepção subjectiva de qualidade de vida por parte dos cuidadores, bem como, um padrão de equilíbrio ocupacional mais ajustado e equilibrado e potenciador de bem-estar, após a frequência de seis meses do familiar com doença de Alzheimer no centro de dia “Memória de Mim”. Ainda que tratando-se de um estudo exploratório, estas conclusões parecem apontar para a importância destas respostas sociais no suporte às pessoas com demências e aos seus familiares.

Elaboração e estruturação de um modelo de rating interno

Temos vindo a assistir nos últimos anos a uma evolução no que respeita à avaliação do risco de crédito. As constantes alterações de regulamentação bancária, que resultam dos Acordos de Basileia, têm vindo a impor novas normas que condicionam a quantidade e a qualidade do risco de crédito que as Instituições de Crédito podem assumir nos seus balanços. É de grande importância as Instituições de Crédito avaliarem o risco de crédito, as garantias e o custo de capital, pois têm um impacto direto na sua gestão nomeadamente quanto à afetação de recursos e proteção contra perdas. Desta forma, pretende-se com o presente trabalho elaborar e estruturar um modelo de rating interno através de técnicas estatísticas, assim como identificar as variáveis estatisticamente relevantes no modelo considerado. Foi delineada uma metodologia de investigação mista, considerando na primeira parte do trabalho uma pesquisa qualitativa e na segunda parte uma abordagem quantitativa. Através da análise documental, fez-se uma abordagem dos conceitos teóricos e da regulamentação que serve de base ao presente trabalho. No estudo de caso, o modelo de rating interno foi desenvolvido utilizando a técnica estatística designada de regressão linear múltipla. A amostra considerada foi obtida através da base de dados SABI e é constituída por cem empresas solventes, situadas na zona de Paredes, num horizonte temporal de 2011-2013. A nossa análise baseou-se em três cenários, correspondendo cada cenário aos dados de cada ano (2011, 2012 e 2013). Para validar os pressupostos do modelo foram efetuados testes estatísticos de Durbin Watson e o teste de significância - F (ANOVA). Por fim, para obtermos a classificação de rating de cada variável foi aplicada a técnica dos percentis. Pela análise dos três cenários considerados, verificou-se que o cenário dois foi o que obteve maior coeficiente de determinação. Verificou-se ainda que as variáveis independentes, rácio de liquidez geral, grau de cobertura do ativo total pelo fundo de maneio e rácio de endividamento global são estatisticamente relevantes.

Altmetrics in Institutional Repositories: New Perspectives for Assessing Research Impact

Poster (and extended abstract) presented at the 13th International Conference "Libraries in the Digital Age (LIDA 2014)" held on 16-20th June, University of Zadar, Zadar, Croatia

A consumer research project as the basis for the development of a marketing plan for a new spirit brand producing gin in Germany

This work project is about developing a marketing plan for a new gin brand in Germany. It is based on consumer and market research, including Portugal as a trend market for the qualitative research. For the undertaking it is seen as fundamental to understand the industry as well as the consumer needs, attitudes and preferences. Furthermore, it is important to consider the estimation of opinion leaders and trendsetters in the industry. In this context it turned out that barkeepers have a key-influencing role for the stimulation of demand. Based on the insights from this research as well as on the gained market knowledge, the marketing plan was developed. The goal is to convince other brand users to switch brands.