Cultura organizacional e o bem-estar dos terapeutas ocupacionais Portugueses

Mestrado em Gestão e Avaliação de Tecnologias em SaúdeO comportamento individual e organizacional são influenciados pela cultura organizacional que configura as formas distintas de expressão e de interação social, que explicam hábitos, costumes e crenças, partilhados pelos membros do mesmo grupo. O presente estudo tem como objetivo principal verificar se a cultura organizacional influencia o bem-estar no trabalho percecionado pelos terapeutas ocupacionais. Pretende-se ainda perceber se as características pessoais e profissionais destes profissionais de saúde, influenciam o seu Bem-Estar no Trabalho. Por último, pretende-se identificar a dimensão que mais contribui para o Bem-Estar no Trabalho. Para a recolha de dados foi realizada por meio de um questionário online constituído por duas secções: a primeira incluiu o Organizacional Culture Assessment Instrument (OCAI) e a segunda, o questionário Bem-Estar no Trabalho para Profissionais de Saúde (BET-Prof.Saúde). A análise dos dados obtidos foi realizada através de análise estatística descritiva de tendência central, por meio do cálculo de frequências, percentagens, médias e desvio padrão, de modo a poder-se caracterizar a amostra e de testes paramétricos (T-Student, Correlação de Spearman, Oneway A-Nova). Foi ainda utilizada a Regressão Linear para análise do modelo de Bem-Estar no Trabalho. Obteve-se uma amostra de 147 participantes, dos quais 88% eram do sexo feminino e 22% do sexo masculino, com idade compreendida entre os 22 e os 63 anos (m=35,20; ± dp=9,648). Tendo em conta os resultados obtidos, concluiu-se que a cultura organizacional, mais precisamente as culturas de Clã e Adocrática, estão associadas positivamente a melhores níveis de Bem-Estar no Trabalho e que o inverso acontece quando predominam as culturas Hierárquica e de Mercado. As dimensões Engagement, Suporte Social e Clima de Equipa, podem ser influenciadas pelas características profissionais dos indivíduos (local de trabalho, tipo de contrato e função de chefia) e são as que mais se relacionam de forma positiva e significativa com o Bem-Estar no Trabalho.ABSTRACT - Individual and organizational behavior are influenced by the organizational culture that shapes the different forms of expression and social interaction that explain habits, customs, and beliefs shared by members of the same group. The main objective of this study is to verify if the organizational culture influences the well-being of work perceived by the occupational therapists. It is also intended to understand if the personal and professional characteristics of these health professionals influence their well-being at work. Finally, it is intended to identify the dimension that contributes most to Well-being at Work. Data collection was done through an online questionnaire consisting of two sections: the first included the Organizational Culture Assessment Instrument (OCAI) and the second, the questionnaire Bem-Estar no Trabalho para Profissionais de Saúde (BET-Prof.saúde). The analysis of the data obtained was performed through a descriptive statistical analysis of central tendency, by means of the calculation of frequencies, percentages, means and standard deviation, in order to be able to characterize the sample and of parametric tests (T-Student, Spearman Correlation, Oneway A-Nova). Linear Regression was also used to analyze the well-being model at work. A sample of 147 participants was obtained, of which 88% were female and 22% male, aged between 22 and 63 years (m = 35,20; ± DP = 9,648). Considering the results obtained, it was concluded that the organizational culture, more precisely the cultures of Clã and Adhocratic, is positively associated with better levels of well-being at work and that the opposite occurs when Hierarchical and Market cultures predominate. The Engagement, Social Support, and Team Climate dimensions can be influenced by the individual’s professional characteristics (workplace, type of contract, and leadership role) and are the ones that are most positively and significantly related to Well-being at work.N/

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Solving patients with rare diseases through programmatic reanalysis of genome-phenome data.

Funder: EC | EC Seventh Framework Programm | FP7 Health (FP7-HEALTH - Specific Programme "Cooperation": Health); doi: https://doi.org/10.13039/100011272; Grant(s): 305444, 305444Funder: Ministerio de Economía y Competitividad (Ministry of Economy and Competitiveness); doi: https://doi.org/10.13039/501100003329Funder: Generalitat de Catalunya (Government of Catalonia); doi: https://doi.org/10.13039/501100002809Funder: EC | European Regional Development Fund (Europski Fond za Regionalni Razvoj); doi: https://doi.org/10.13039/501100008530Funder: Instituto Nacional de Bioinformática ELIXIR Implementation Studies Centro de Excelencia Severo OchoaFunder: EC | EC Seventh Framework Programm | FP7 Health (FP7-HEALTH - Specific Programme "Cooperation": Health)Reanalysis of inconclusive exome/genome sequencing data increases the diagnosis yield of patients with rare diseases. However, the cost and efforts required for reanalysis prevent its routine implementation in research and clinical environments. The Solve-RD project aims to reveal the molecular causes underlying undiagnosed rare diseases. One of the goals is to implement innovative approaches to reanalyse the exomes and genomes from thousands of well-studied undiagnosed cases. The raw genomic data is submitted to Solve-RD through the RD-Connect Genome-Phenome Analysis Platform (GPAP) together with standardised phenotypic and pedigree data. We have developed a programmatic workflow to reanalyse genome-phenome data. It uses the RD-Connect GPAP's Application Programming Interface (API) and relies on the big-data technologies upon which the system is built. We have applied the workflow to prioritise rare known pathogenic variants from 4411 undiagnosed cases. The queries returned an average of 1.45 variants per case, which first were evaluated in bulk by a panel of disease experts and afterwards specifically by the submitter of each case. A total of 120 index cases (21.2% of prioritised cases, 2.7% of all exome/genome-negative samples) have already been solved, with others being under investigation. The implementation of solutions as the one described here provide the technical framework to enable periodic case-level data re-evaluation in clinical settings, as recommended by the American College of Medical Genetics

Insights into the swelling process and drug release mechanisms from cross-linked pectin/high amylose starch matrices

Cross-linked pectin/high amylose mixtures were evaluated as a new excipient for matrix tablets formulations, since the mixing of polymers and cross-linking reaction represent rational tools to reach materials with modulated and specific properties that meet specific therapeutic needs. Objective: In this work the influence of polymer ratio and cross-linking process on the swelling and the mechanism driving the drug release from swellable matrix tablets prepared with this excipient was investigated. Methods: Cross-linked samples were characterized by their micromeritic properties (size and shape, density, angle of repose and flow rate) and liquid uptake ability. Matrix tablets were evaluated according their physical properties and the drug release rates and mechanisms were also investigated. Results: Cross-linked samples demonstrated size homogeneity and irregular shape, with liquid uptake ability insensible to pH. Cross-linking process of samples allowed the control of drug release rates and the drug release mechanism was influenced by both polymer ratio and cross-linking process. The drug release of samples with minor proportion of pectin was driven by an anomalous transport and the increase of the pectin proportion contributed to the erosion of the matrix. Conclusion: The cross-linked mixtures of high amylose and pectin showed a suitable excipient for slowing the drug release rates

Chitosan-pectin multiparticulate systems associated with enteric polymers for colonic drug delivery

The great challenge in using native degradable polysaccharides for the development of drug delivery systems is their high aqueous solubility, which may contribute to the undesirable premature and localized release of the drug. Multiparticulate systems showing simultaneously specific biodegradability and pH-dependent drug release were prepared based on chitosan (CS), amidated pectin (PC), and calcium ions, using triamcinolone (TC) as model drug. Hidroxypropylmethyl cellulose phthalate (HPMCP) and cellulose acetate phthalate (CAP) were successfully incorporated into the system and aided the target action of the carbohydrates. Particles were characterized for size distribution, morphology, swelling behavior and dissolution tests in media simulating the gastrointestinal tract. The addition of CAP and HPMCP resulted in the highest control over the drug release in all media. CAP:TC formulation presented the slowest drug release rate, of only 1.33%, in acidic medium after 2 h, while the control formulation released 45.52% after the same time. (C) 2010 Elsevier Ltd. All rights reserved.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

In vitro characterization of coevaporates containing chitosan for colonic drug delivery

A relative simple drug delivery system in the form of coevaporates were prepared and analyzed. They were based on chitosan (CS), a polysaccharide that undergoes specific degradation by colonic enzymes. Enteric polymers, namely cellulose acetate phtalate (CAP) and hydroxypropylmethylcellulose phtalate (HPMCP), were incorporated, due to their insolubility in environments presenting low pH values. The systems were physically characterized, demonstrating that CS affects the swelling properties of the samples. The ability of these systems to reach the colonic region was assessed in vitro in simulated gastric, enteric and colonic fluids. Korsmeyer-Peppas and Weibull models were applied to analyze the drug release kinetics and the results suggested that the drug release from the coevaporates follows a complex release mechanism, in which several processes, including diffusion, swelling, and erosion. are involved and may occur simultaneously. The results demonstrated that it is possible to prepare relative simple drug carrier systems able to reach the colonic environment, since their swelling capacity can be controlled by varying the composition. (c) 2009 Elsevier Ltd. All rights reserved.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

AC Biosusceptometry as a Tool for Monitoring the Gastrointestinal Transit of Multiparticulate Drug Delivery System

Drug delivery systems based on natural polysaccharides, such as chitosan (CS) and pectin (PC), rather than on synthetic polymers, have been widely studied. Some reasons for that are low toxicity and costs and high biodegradability of the formers. A multiparticulate system based on CS and PC was developed in our laboratories, including the addition of an enteric polymer, cellulose acetate phtalate (CAP). Such improvement promoted stronger gastric and enteric resistances, as assessed in vitro, making the systems more selective to enzymatic degradation in the colon. Although in vitro dissolution tests can simulate some properties concerning the gastrointestinal transit (GT), collaborating to characterize the systems behavior in the biological fluids, frequently they do not result in satisfactory in vitro/in vivo correlations. The objective of this work was to follow in vivo the GT of the particles developed by means of AC biosusceptometry (ACB), a non-invasive and of low cost methodology. The particles containing ferrite in powder form were prepared by complex coacervation using an ideal 3:1:1 mass ratio for PC:CS:CAP. The magnetic particles were administered to healthy volunteers by oral route. The GT was monitored by using multi-sensor ACB system and the signal acquisition was performed every IS min until the colonic region was reached. By means of ACB technique, it was possible to acquiring images generated by the magnetic particles within the whole gastrointestinal tract including the colonic region. Variable particles transit times were observed among the volunteers, but without interference on the mapping of the particles until the colonic region. The particles were able to produce magnetic field strong enough to generate signals adequate for mapping the particles. The results suggest that integral particles reached the colon, after they resisted against gastric and enteric media. Studies associating transit time and in vivo drug release are in development in order to confirm the efficiency of the systems

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