Representações estudantis da avaliação das instituições de ensino superior público

Doutoramento em Ciências SociaisDe entre as profundas mudanças que têm marcado a vida das instituições de ensino superior (IES), em especial, nas últimas três décadas, a adaptação à ‘filosofia’ e práticas da avaliação constitui, talvez, uma das mais preponderantes. Induzida, regra geral, pelo Estado, e organizada em componentes, de certo modo, comuns à maioria dos países da Europa ocidental, a avaliação orienta-se para a aferição do desempenho das instituições e, sobretudo, da sua qualidade. Tal como implementado em Portugal (1995-2005), este processo particular de regulação e controlo institucional, direccionado para os cursos de graduação, conta com a participação de vários actores, diferentemente posicionados em relação à definição política e desenvolvimento da avaliação. Entre estes actores, embora constituam uma das principais razões pelas quais a avaliação é realizada, os estudantes são os que menor poder detêm face à sua implementação. Sustentado no quadro teórico-conceptual proporcionado pela teoria das representações sociais, este estudo pretende, mediante a análise do conteúdo das representações que os estudantes elaboram sobre a avaliação, indagar sobre os contornos que emolduram a sua relação com este processo. Para tal, foram eleitos como objecto de análise, os estudantes de duas IES portuguesas. Com base em estratégias qualitativas de recolha de informação, foram realizadas cento e duas entrevistas semi-estruturadas. O tratamento do conteúdo dos dados recolhidos, realizado com base na análise de conteúdo temático-categorial, permitiram extrair as seguintes conclusões principais: 1. Os estudantes assumem atitudes tendencialmente positivas face à noção e implementação da avaliação das IES, como resultado da legitimidade que lhe reconhecem, conectada, essencialmente, com razões instrumentais (incremento da qualidade das instituições, cursos e docência e, em última instância, promoção da sua futura integração no mercado de trabalho); 2. Estes actores surgem, contudo, tanto em termos sócio-cognitivos como de experiência ‘prática’ do processo, numa posição de distância máxima em relação à avaliação; 3. Esta distância emerge como resultado da ausência de estratégias institucionais que visem integrar os estudantes na avaliação, da experiência que estes actores acumulam em relação a este processo, e da posição que ocupam no campo institucional (moldada pela sua relação face aos principais loci de poder e tomada de decisão institucional e académica); 4. Talvez como resultado desta distância, os estudantes tendem a elaborar as suas representações com base em quadros referenciais sustentados no conhecimento e experiência de outros formatos avaliativos que não a avaliação de cursos, reproduzindo, em grande medida o discurso político que legitima a avaliação, com base na retórica managerialista.Amongst the deep changes which have been affecting higher education institutions (HEIs), especially over the last thirty years, the adaptation to evaluation ‘philosophy’ and practices constitutes, perhaps, one of the most prevailing ones. Generally induced by State and organized in components somehow familiar to the majority of Western European countries, evaluation is directed at institutions performance assessment and particularly at their quality. As it has been implemented in Portugal (1995-2005), this particular process of institutional regulation and control, focused on undergraduate degrees, relies on the participation of several actors, differently positioned in relation to its definition and development. Although they compose one of the major reasons why evaluation is carried out, students are, amidst these actors, those who have less power regarding its implementation. Based on the theoretical and conceptual framework offered by social representations theory, this study intents on examining the configurations of students’ relation to this particular process by analysing the content of the representations they elaborate on evaluation. In order to accomplish this goal, we have defined, as our research object, students from two Portuguese HEIs. Based on qualitative strategies of data gathering, we have performed one hundred and two semi-structured interviews. The content analysis of this data led to the following major conclusions: 1. Students tend to assume positive attitudes towards the notion and implementation of HEIs’ evaluation, because of the legitimacy they ascribe to it, resulting, essentially, from instrumental reasons (institutions, undergraduate degrees and teaching quality increase and, ultimately, their future integration in the labour market); 2. Nevertheless, these actors appear in a position of maximum distance in relation to evaluation, both in socio-cognitive terms, and in terms of their ‘practical’ experience in the process; 3. This distance emerges as a result of the absence of institutional strategies aiming at students’ integration in evaluation, of the experience these actors accumulate within this process, and finally of the position they occupy in the institutional field (shaped by their relation to the major institutional and academic decision-making and power loci); 4. Probably resulting from this distance, students tend to elaborate their representations on the basis of reference frameworks of knowledge and experience of other evaluation formats, rather than undergraduate degrees evaluation, hence reproducing, to a great extent, the political discourse which legitimizes evaluation based on the managerialist rhetoric

Representações sociais dos distúrbios alimentares: Resultados de estudo empírico junto a ex-pacientes, familiares e técnicos de saúde

Partindo dos resultados da investigação que serviu de suporte à elaboração da sua Dissertação de Mestrado em Sociologia, a autora pretende apresentar sucintamente as principais conclusões retiradas quanto à forma como os distúrbios alimentares e a sua etiologia são socialmente representados. A referida investigação centrou-se, concretamente, na análise da forma como perturbações alimentares como a anorexia e a bulímia nervosas e as suas causas são representadas tanto por diferentes grupos de indivíduos, caracterizados por relações de maior ou menor proximidade relativamente a estas doenças, como na opinião pública (portuguesa), considerada como sendo representada pelo discurso que os meios de comunicação social produzem neste domínio. Os dados empíricos recolhidos a partir da observação indirecta (entrevistas) de ex-pacientes, familiares de pacientes e ex-pacientes destas patologias e de técnicos de saúde, especializados e não especializados na área, e ainda pela constituição de um observatório dos meios de comunicação social, sugerem que, embora os diferentes grupos e a opinião pública apresentem ligeiras diferenças no modo como representam a anorexia e a bulímia nervosas e a sua etiologia, parece existir uma representação comum, global, que se fundamenta no discurso que a ciência médica produz sobre o assunto

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research