Uma Aplicação Shiny

Nos dias de hoje vivemos num mundo visual no qual a representação do conhecimento e a sua disseminação são quase impossíveis de se realizar sem recorrer a imagens. Com o avanço da tecnologia, a utilização de visualizações para promover a aprendizagem pode ser aprimorada através de simulações com as quais se podem criar representações simples e mais adequadas para ilustrar ideias complexas e abstratas contidas nos textos. De um modo particular, a realização de simulações em Probabilidades e Estatística é fundamental pois facilita a compreensão de conceitos de aleatoriedade e variação de amostras, permite observar em alguns minutos a evolução temporal de um fenómeno que levaria horas, dias ou anos em tempo real, além de permitir a repetição de experiências aleatórias nas mesmas condições e tantas vezes quantas se queira. Este facto incentivou-nos a desenvolver no presente trabalho, com o auxílio do software R, uma aplicação Shiny para simular e ilustrar alguns conceitos e resultados de probabilidades e estatística a um nível introdutório. O Shiny é um pacote do RStudio que é uma interface do R que permite a criação de ferramentas, nomeadamente aplicações interativas, para tratamento de dados de forma flexível e acessível para usuários do R. A gratuidade do software R, e o aspeto apelativo e fácil utilização das aplicações Shiny, são uma vantagem para a utilização da aplicação que desenvolvemos por professores e alunos no processo de ensino e aprendizagem de probabilidades e estatística.In our days, we live in a visual world in which the representation of knowledge and its dissemination are almost impossible to perform without resorting to images. With the development of technology, the use of visualizations to promote learning can be improved through simulations with which simple and more adequate representations can be created to to illustrate abstract and complex ideas contained in texts. In particular, simulations are fundamental in Probability and Statistics because they facilitate the undertanding of the concepts of randomness and variation of samples, allow the observation, in few minutes, of the temporal evolution of a phenomenon that would take hours, days or years in real time. Be- sides this, they allow the repetition of random experiences in the same conditions and as many times as we want. This fact encouraged us to develop in the present work, with the support of software R, a Shiny application to simulate and illustrate some concepts and results of probabilities and statistics at an introductory level. Shiny is a package of RStudio, a R interface, that allows the development of tools, namely interactive applications, for data processing in a flexible and accessible way for the users of R. Being software R free of charge and the appealing aspect and easy use of Shiny applications, make the application that we developed advantageous for teachers and students to use in the teaching and learning process of probabilities and statistics

Major surgery delegation to mid-level health practitioners in Mozambique: health professionals' perceptions

Background: This study examines the opinions of health professionals about the capacity and performance of the 'técnico de cirurgia', a surgically trained assistant medical officer in the Mozambican health system. Particular attention is paid to the views of medical doctors and maternal and child health nurses. Methods: The results are derived from a qualitative study using both semi-structured interviews and group discussions. Health professionals (n = 71) were interviewed at both facility and system level. Eight group discussion sessions of about two hours each were run in eight rural hospitals with a total of 48 participants. Medical doctors and district officers were excluded from group discussion sessions due to their hierarchical position which could have prevented other workers from expressing opinions freely. Results: Health workers at all levels voiced satisfaction with the work of the "técnicos de cirurgia". They stressed the life-saving skills of these cadres, the advantages resulting from a reduction in the need for patient referrals and the considerable cost reduction for patients and their families. Important problems in the professional status and remuneration of "técnicos de cirurgia" were identified. Conclusion: This study, the first one to scrutinize the judgements and attitudes of health workers towards the "técnico de cirurgia", showed that, despite some shortcomings, this cadre is highly appreciated and that the health delivery system does not recognize and motivate them enough. The findings of this study can be used to direct efforts to improve motivation of health workers in general and of técnicos de cirurgia in particular

Hypertension, Diabetes Mellitus and Task Shifting in Their Management in Sub-Saharan Africa

Chronic diseases are becoming increasingly important in sub-Saharan Africa (SSA). The current density and distribution of health workforce suggest that SSA cannot respond to the growing demand for chronic disease care, together with the frequent infectious diseases. Innovative approaches are therefore needed to rapidly expand the health workforce. In this article, we discuss the evidences in support of nurse-led strategies for chronic disease management in SSA, with a focus on hypertension and diabetes mellitus

Retention of health workers in Malawi: perspectives of health workers and district management

<p>Abstract</p> <p>Background</p> <p>Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance.</p> <p>Methods</p> <p>A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.</p> <p>Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate.</p> <p>Results</p> <p>The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation.</p> <p>Conclusion</p> <p>A strong human resource management function operating at the district level is likely to improve worker motivation and performance.</p

Task shifting: the answer to the human resources crisis in Africa?

Ever since the 2006 World Health Report advocated increased community participation and the systematic delegation of tasks to less-specialized cadres, there has been a great deal of debate about the expediency, efficacy and modalities of task shifting

Key Aspects of Health Policy Development to Improve Surgical Services in Uganda

Recently, surgical services have been gaining greater attention as an integral part of public health in low-income countries due to the significant volume and burden of surgical conditions, growing evidence of the cost-effectiveness of surgical intervention, and global disparities in surgical care. Nonetheless, there has been limited discussion of the key aspects of health policy related to surgical services in low-income countries. Uganda, like other low-income sub-Saharan African countries, bears a heavy burden of surgical conditions with low surgical output in health facilities and significant unmet need for surgical care. To address this lack of adequate surgical services in Uganda, a diverse group of local stakeholders met in Kampala, Uganda, in May 2008 to develop a roadmap of key policy actions that would improve surgical services at the national level. The group identified a list of health policy priorities to improve surgical services in Uganda. The priorities were classified into three areas: (1) human resources, (2) health systems, and (3) research and advocacy. This article is a critical discussion of these health policy priorities with references to recent literature. This was the first such multidisciplinary meeting in Uganda with a focus on surgical services and its output may have relevance to health policy development in other low-income countries planning to improve delivery of surgical services

Human Resource and Funding Constraints for Essential Surgery in District Hospitals in Africa: A Retrospective Cross-Sectional Survey

In the second of two papers investigating surgical provision in eight district hospitals in Saharan African countries, Margaret Kruk and colleagues describe the range of providers of surgical care and anesthesia and estimate the related costs

Mozambican Government Portal Case Study : Visitor Analysis

The e-Government initiative in Mozambique is an ambitious and far-reaching movement with immense potential for positive impact on the Mozambican government and economy. Central to this initiative is the Government Portal—a portal dedicated to intuitively and helpfully disseminating government news, services, and information to citizens, the public sector, and the private sector. Such an important project of the e-Government initiative requires frequent evaluation of the project performance and ways in which it can improve. This document attempts to measure the performance of the Government Portal through visitor analysis. It discusses the limitations of analysis through this approach, what can be deduced from the visitor analysis, and possible ideas to improve the project in an attempt to help it reach its objectives