Digital technology access among patients with chronic respiratory diseases

Pulmonary rehabilitation (PR) is an evidence-based intervention to manage chronic respiratory diseases (CRD), but its benefits diminish over time. Web-based approaches may have a key-role in supporting patients to comply with their maintenance action plan, if familiarity with this technology exist. This study explored if patients with CRD have access to digital technology and if they feel confident in using it. This was a cross-sectional study with patients referred to community-based PR programs. Patients were surveyed regarding the use of the internet, computers, smartphones/tablets and cell phones. Their confidence in using these technologies was assessed using a scale from 0 (not at all confident) to 10 (completely confident). Patients were considered confident when a score >5 was selected. A multivariate logistic regression to predict use of internet was performed using the Enter method. 141 patients (61% male; 67±11y) were included. Chronic obstructive pulmonary disease (60%) and asthma (18%) were the most common diagnoses. Most patients (n=115; 81.6%) used digital technology, namely smartphone/tablets (44%), computers (38%) and cell phones (37%). 114 (81%) patients reported to be confident in using these devices (Median-M 7, Interquartile-IQR 5-9.5). More than half (n=75; 53%) used the internet and 85% of them felt confident in using it (M 8, IQR 5.75-10). Lower age (odds ratio-OR=.935; 95%CI .889-.982) and higher level of education (OR=3.633; 95%CI 2.093-6.307) explained 46% of the variance in internet use. Patients with CRD have access to and feel confident in using digital technologies. Digital technologies may be promising for self-management/maintenance strategies in this population.publishe

Improving access to community-based pulmonary rehabilitation: 3R protocol for real-world settings with cost-benefit analysis

Background: Pulmonary rehabilitation (PR) has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. Methods: A 12-week community-based PR will be implemented in primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers (dyads patientcaregivers) will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea (modified Medical Research Council Questionnaire), fatigue (Checklist of individual strength and Functional assessment of chronic illness therapy – fatigue), cough and sputum (Leicester cough questionnaire and Cough and sputum assessment questionnaire), impact of the disease (COPD Assessment Test), emotional state (The Hospital Anxiety and Depression Scale), number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion (Family Adaptation and Cohesion Scale). Other clinical outcomes will be peripheral (biceps and quadriceps-hand held dynamometer, 1 or 10 repetition-maximum) and respiratory (maximal inspiratory and expiratory pressures) muscle strength, muscle thickness and cross sectional area (biceps brachialis, rectus femoris and diaphragm-ultrasound imaging), exercise capacity (six-minute walk test and one-minute sit to stand test), balance (brief-balance evaluation systems test) and physical activity (accelerometer). Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted.Discussion: This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. Trial registration: The trial was registered in the ClinicalTrials.gov U.S. National Library of Medicine, on 10th January, 2019 (registration number: NCT03799666). Keywords: Exercise training, Education and psychosocial support, Chronic respiratory diseases, Primary healthcare, Cost-benefit.This work, was funded by Fundo Europeu de Desenvolvimento Regional (FEDER) - Comissão Diretiva do Programa Operacional Regional do Centro and by Fundação para a Ciência e Tecnologia - FCT (SAICT-POL/23926/2016), and partially funded by Programa Operacional Competitividade e Internacionalização (COMPETE), through COMPETE 2020 (POCI-01-0145- FEDER-016701 and POCI-01-0145-FEDER-007628) and FCT (UID/BIM/04501/ 2013 and UID/BIM/04501/2019). CJ has a post-doctoral grant (SFRH/BPD/ 115169/2016) funded by FCT, co-financed by the European Social Fund (POCH) and Portuguese national funds from MCTES (Ministério da Ciência, Tecnologia e Ensino Superior).publishe

Does the market recognise the value of firms'real options? : evidence from Euronext

Dissertação de mestrado em Contabilidade e Finanças pela Faculdade de Economia da Universidade de Coimbra, 2009

Proceedings of the 3rd International Conference in Accounting and Finance Innovation: Sustainability Business and Innovation

No abstract available.publishe

Auditoria a Processos e Sistemas: Um Mapa do Percurso do Cliente

Comunicação em Conferência InternacionalComo parte integrante do modelo das três linhas das organizações, a função de auditoria interna necessita não só de ter um papel ativo na identificação e monitorização dos riscos emergentes e respetivas oportunidades, mas também um papel proativo como apoio à estratégia das organizações, reforçando o trabalho de equipa sendo igualmente relevante para a mesma. Para tal, é necessário um investimento no talento das equipas e no Future Enterprise, apoiado na inovação e respetivos modelos de negócio, porém, é igualmente necessário percorrer os modelos digitais, a inovação no pensamento (mindset) das equipas para uma abordagem mais centrada no Cliente. Assim, o presente artigo tem como objetivo abordar o gap de expectativas associado ao desempenho da auditoria interna através da metodologia Design Thinking, nomeadamente através do mapeamento do percurso do Cliente da auditoria, nos vários pontos de interação com a mesma. A presente contribuição visa identificar os pontos de melhoria da experiência da auditoria, otimização orientada a processos, sistemas e identificação de oportunidades de negócio através da obtenção da perceção de auditores internos. Para o efeito, foi realizada uma análise ao normativo internacional de auditoria interna e literatura existente relacionada com os temas de inovação, Design Thinking e mapeamento de percurso do Cliente. A nível prático foram efetuadas entrevistas e distribuído um questionário, disponível online entre 06/11/2019 e 31/05/2020, de forma a obter conhecimento dos pontos chave necessários para efetuar o mapeamento, tendo sido obtida uma amostra representativa e validada de 32 membros do IPAI. Os resultados obtidos revelam imaturidade a nível da utilização da transformação digital, certificação da atividade de auditoria interna e dos respetivos auditores, assim como, no âmbito do programa de avaliação de qualidade e de melhoria contínua, como ferramentas de captação de novas oportunidades e de melhoria do desempenho da função.info:eu-repo/semantics/publishedVersio

Análise financeira: teoria e prática - aplicação no âmbito do SNC

A capacidade de interpretar a informação disponível e de caracterizar a situação económico-financeira das empresas é essencial para a tomada de decisão futura. Contudo, apesar dos procedimentos de recolha e tratamento dos elementos informativos relevantes poderem ser algo sistematizados, as especificidades de cada negócio fazem de cada análise um processo diferente e único. Esta obra, de cariz essencialmente didático, destina-se a profissionais da área financeira e a estudantes de ensino superior nas áreas de gestão e finanças, e visa a integração dos principais conceitos, métodos e técnicas de análise financeira nas suas diversas vertentes. Para além da utilização de linguagem acessível, procura facilitar o entendimento da teoria com aplicações práticas a empresas reais de diferentes setores de atividade, evidenciando os cuidados necessários na interpretação dos resultados obtidos

Proceedings of the 2nd International Conference in Accounting and Finance Innovation: accounting, finance and technologies in learning organizations

Sem resumo disponível.publishe