Contribution of EQA to improve Preanalytical practices by systematic verification of Laboratory Services

International literature describes the preanalytical phase as the most susceptible to errors due to the numerous non automated activities it involves Most EQA organizers offer preanalytical schemes to participants. There are basically three types of surveys procedures registration, samples circulation and errors registration The Portuguese EQA Programme ( provides these type of schemes for 13 years, using as a guide the ISO 15189 2012 In order to improve the evaluation of the preanalytical phase, PNAEQ recently launched two other preanalytical EQA schemes, mystery client and presential audits in 2015 and 2016 respectively. The aim of the mystery client survey is to verify whether the information provided to the patient is constant regardless the day and time or if it is dependent on the collaborator. The aim of the presential audit survey is to give the participants a tool to verify if the procedures performed daily are in accordance with laboratorial good practices recommendations. Conclusions: Results from Mystery Client surveys demonstrate the need for written procedures and harmonization of practices for all collaborators, as more than a third of the responses differed in date/time and operator in a global view. In the Presential Audit surveys we highlight as critical points the results regarding questions 3 5 and 6 as they point to specific problems that occurred during the blood collection procedure, such as operator and patient safety, as well as the quality of the sample collected, suggesting the need to review legal and normative issues and to train collaborators. Participants who use systematically these two methodologies are monitoring some of the requirements of ISO 15189:2012, namely 4. 1.2.6, 4.3, 4.4.1, 4.14, 5.4.2 (both), 5.4.4.2 (mystery client) and 5.1.2, 5.2.2, 5.2.5, 5.3.2.5, 5.3.2.7, 5.4.4 (presential audit), contributing to release reliable results for medical decisions. For the future, we will extend the questions and items in evaluation in these two surveys to Microbiology area and continuing to offer training in Preanalytical matters.N/

Asset price distributions and risk aversion : what can we learn from options market?

This dissertation infers descriptive statistical measures from the estimated risk-neutral probability density functions derived from short-term out-of-the money monthly S&P 500 option prices in respective precrisis and crisis periods. The generalized beta distribution of the second kind, the mixture of lognormal distribution and the lognormal polynomial distribution comprise the three parametric methods used to estimate such density functions. The three estimated risk-neutral probability density functions tend to be negatively skewed, leptokurtic and exhibit roughly equal distribution mean values. The constant relative risk aversion coefficient is computed through the method used by Liu et al. (2007) for quarterly risk-neutral densities. The pre-crisis constant relative risk aversion value is approximately 2.672 with a MLN distribution and 2.666 with a GB2 distribution, compared to constant relative risk aversion of 2.507 and 2.477, respectively, during the crisis period. The real-world densities became less skewed, less kurtic and contain a higher first-moment value than the risk-neutral densities. Results are fairly consistent with available academic literature

Performance of PNAEQ participant’s results for HIV and HCV infection in the First EQA round 2019

The Portuguese National External Quality Assessment Program (PNAEQ) has been collaborating with Labquality since 2002. One of the first schemes distributed to PNAEQ participants was for HIV laboratory tests, followed by HCV laboratory tests scheme in 2003. A suitable scheme for Point of Care Testing (POCT) is available for HIV since 2012 and for HCV since 2018. Given the burden of HIV and HCV diseases, the Portuguese legislation allows, since 2018, that other locations than laboratories, such as pharmacies and Non-Governmental-Organizations (NGOs), perform tests for detect HIV and HCV infection. For this purpose, and in order to assure reliable results that leads to an early correct diagnostic and a timely treatment, leading to a decrease in the person-to-person transmission of HIV and HCV infection, a specific training to perform POCT for HIV and HCV is mandatory for these entities, as well as the participation in such EQA schemes, namely the PNAEQ-Labquality. The performance of PNAEQ participants for HIV and HCV tests in the First EQA round 2019 was considered in general good. For HIV POCT, the user that reported an undetermined result proceeded correctly requesting a second sample for confirmation. Regarding the two incorrect results reported by laboratories, it is necessary to review the internal validation procedure and revalidation of the laboratory test, and implement corrective and preventive actions. The training of participants that used POCT for the first time proved to be effective in acquiring skills to perform the tests properly. PNAEQ will continue to provide education and training in quality control and motivate all the participants to continuously evaluate the results from the internal quality control and the reports from the external quality assessment.N/

The Role of the Ombudsman in the Defense of Fundamental Rights

En Portugal, al Proveedor de justicia es el equivalente al Ombudsman y se caracteriza por ser un órgano independiente de control de la actividad de la Administración pública. Fue instituido en la década de 1970 y su objetivo es también la defensa de los derechos fundamentales de los ciudadanos. En el presente artículo, la autora subraya esta función defensora de protección y promoción de ios derechos fundamentales, resaltando los derechos más reclamados al Defensor del Pueblo portugués y reflejando las competencias constitucionales y estatutarias de la Institución y su específica adecuación para el reconocimiento del Proveedor de Justicia, como un defensor de los derechos humanos.The Proveedor de Justicia, although corresponding to the classic Ombudsman model as an independent body to control the activities of the public administration, has been established, in the 1970s, also with a mandate of defence of fundamental rights. In the present article, the author emphasises this Ombudsman's function of protection and promotion of fundamental rights, exposing, on one hand, the rights which are more frequently complained about to the Portuguese Ombudsman and, on the other hand, reflecting on certain constitutional and statutory powers granted to the institution and respective adequacy for the recogmtion ofthe Proveedor de Justicia as an human rights defender

Doença Coronária e Disfunção Erétil

Introdução: A doença coronária é uma das principais causas de morbilidade e mortalidade em todo mundo. (1) A aterosclerose é uma doença inflamatória crónica multifatorial que ocorre como resposta à lesão endotelial. Assim sendo, a disfunção erétil apresenta processos patofisiológicos e fatores de risco semelhantes aos da doença coronária, uma vez que a lesão endotelial é um denominador comum. (2) Desta forma, fatores de risco cardiovascular, como a hipertensão arterial, dislipidemia, diabetes mellitus, obesidade e tabagismo são comuns a estas duas patologias. (3) Assim sendo, vários estudos demonstram a íntima relação entre estas duas condições, evidenciando que uma proporção significativa (42-89%) dos indivíduos diagnosticados com doença coronária apresentam disfunção erétil. (4,5) Objetivos: Verificar a existência de relação entre a doença coronária e a disfunção erétil. Bem como avaliar a relevância estatística de variáveis como a idade, fatores de risco cardiovascular e fármacos anti-hipertensores. Metodologia: Este estudo foi realizado entre janeiro e março de 2020 na Consulta externa de Cardiologia do Centro Hospitalar Universitário Cova da Beira. A recolha de dados baseou-se na aplicação de um questionário que avaliava a função erétil dos doentes coronários, bem como informações clínicas e sociodemográficas. Resultados: Foram estudados 50 indivíduos do sexo masculino com idades entre os 48 e 81 anos. Verificou-se que nesta amostra, 62% dos indivíduos praticavam atividade sexual, dos quais 71% apresentavam algum grau de disfunção erétil. Demonstrou-se haver uma relação estatisticamente significativa entre a variável índice de massa corporal e a presença de disfunção (p-value = 0,007), bem como entre o uso de bloqueadores dos canais de cálcio e a função erétil (p-value = 0,03). Para além disso, verificou-se que indivíduos com índice de massa corporal superior ou igual a 25 apresentavam um risco relativo de ter DE de 6,8 (intervalo de confiança de 95% entre 1,233 – 37,497). Por outro lado, no que diz respeito à caracterização da doença coronária não se verificaram diferenças estatisticamente significativas. Conclusões: Tendo em conta os resultados obtidos, demonstrou-se que nesta amostra existe uma elevada prevalência de disfunção erétil, concordante com a literatura. Da mesma forma, outros estudos comprovaram a relação entre o índice de massa corporal e a disfunção erétil. Por outro lado, foram obtidos resultados discordantes no que diz respeito aos bloqueadores dos canais de cálcio, sendo por isso necessário um estudo com uma dimensão superior para avaliar o seu verdadeiro impacto. De facto, uma das principais causas para que não se verificassem mais relações entre as diferentes variáveis é sem dúvida a pequena amostra em estudo. Assim, importa destacar que este estudo pretende em primeira instância alertar para a relação entre estas duas patologias, de forma a que melhores estratégias preventivas possam ser alcançadas.Introduction: Coronary artery disease is a major cause of morbidity and mortality worldwide. (1) Atherosclerosis is a multifactorial chronic inflammatory disease that occurs in response to endothelial injury. Therefore, erectile dysfunction has pathophysiological mechanisms and risk factors similar to those of coronary disease, since endothelial injury is a common denominator. (2) Thus, cardiovascular risk factors such as hypertension, dyslipidemia, diabetes mellitus, obesity and smoking are common to these two pathologies. (3) Accordingly, several studies demonstrate the close relationship between these two conditions, showing that a significant proportion (42-89%) of individuals diagnosed with coronary disease have erectile dysfunction. (4,5) Objective: To verify the existence of a relationship between coronary artery disease and erectile dysfunction. As well as assessing the statistical relevance of variables such as age, cardiovascular risk factors and antihypertensive drugs. Methodology: This study was carried out between January and March 2020 at the Cardiology Outpatient Clinic of Cova da Beira University Hospital Center. Data collection was based on the application of a questionnaire that assessed the erectile function of coronary patients, as well as clinical and sociodemographic information. Results: Fifty male individuals aged between 48 and 81 years old were studied. In this sample it was found that 62% of the participants had regular sexual activity, of which 71% had some degree of erectile dysfunction. There was a statistically significant relationship between the variable body mass index and the presence of dysfunction (p-value = 0.007), as well as between the use of calcium channel blockers and erectile function (p-value = 0,03). In addition, it was found that individuals with a body mass index greater than or equal to 25 had a relative risk of having erectile dysfunction of 6.8 (95% confidence interval between 1.233 - 37.497). On the other hand, with regard to the characterization of coronary disease, there were no statistically significant differences. Conclusions: Taking into account the results obtained, it was demonstrated that in this sample there is a high prevalence of erectile dysfunction, in agreement with the literature. Likewise, other studies have proven the relationship between body mass index and erectile dysfunction. On the other hand, conflicting results were obtained with regard to calcium channel blockers, which is why a larger study is needed to assess its true impact. In fact, one of the main reasons for not having more relationships between the different variables is undoubtedly the small sample under study. Thus, it is important to highlight that this study intends to alert to the relationship between these two diseases, so that better preventive strategies can be achieved

Celebridades nas propagandas de medicamentos: um estudo acerca das dimensões da credibilidade do endossante e seus impactos na atitude e intenção de compra do consumidor

TCC (graduação) - Universidade Federal de Santa Catarina, Centro Sócio Econômico, Curso de Administração.A indústria farmacêutica encontra-se no ranking dos setores econômicos que mais investem em publicidade no Brasil. Em 2014 ocupava o décimo lugar com investimento anual de R$6.040.390. No ano passado, os investimentos em publicidade passaram de oito milhões de reais, fazendo o setor saltar para o sexto lugar do ranking. Sabe-se que uma das estratégias publicitárias frequentemente utilizada por essa indústria, além de bastante onerosa, é a contratação de celebridades para endossarem a compra ou o uso de determinado medicamento. A propaganda de medicamentos direta ao consumidor pode ser uma prática causadora de riscos. A automedicação, uso inadequado, dosagem incorreta, risco de intoxicação, diagnósticos feitos por leigos e a crença de que um medicamento é totalmente seguro são apenas alguns dos problemas que permeiam as discussões acerca da legalidade da propaganda de medicamentos. Por serem potencialmente nocivos à saúde, diferente dos bens de consumo comuns, os medicamentos não podem ser regulados unicamente pela lei da oferta e da demanda, uma vez que, se consumidos de forma indiscriminada podem causar sérios prejuízos à saúde ou até a morte, em casos mais extremos. No Brasil, a propaganda direta ao consumidor só é permitida para os medicamentos isentos de prescrição médica, também chamados de medicamentos de venda livre. São nessas propagandas que as celebridades aparecem sozinhas, como personagens, com suas famílias ou com crianças, muitas vezes utilizando-se também do humor e de figuras de linguagem. Estudos sobre endosso de celebridades realizados com produtos comuns, como tênis, roupa, perfume e celular, mostraram que a eficácia do endosso nas propagandas está relacionada à credibilidade da celebridade endossante. Entretanto, não foram encontrados estudos que tenham testado se esse efeito também se observa nas propagandas de medicamentos, uma vez que estes não são bens de consumo comuns. Buscando preencher essa lacuna, o presente estudo investigou se a credibilidade dos endossantes influencia a intenção de compra e as atitudes dos consumidores em relação à propaganda e à marca a partir das três dimensões da credibilidade propostas por Ohanian (1990), a confiabilidade, a atratividade e a expertise. Para tanto, foi realizado um experimento em 12 turmas do curso de Administração da UFSC. As turmas foram expostas a anúncios de medicamentos com endosso de celebridades com diferentes níveis de credibilidade. A partir da análise dos dados foi constatada a existência de correlação linear positiva entre a credibilidade e a atitude frente à marca, à propaganda e à intenção de compra, sendo mais forte nestas duas últimas. Quanto às dimensões, a expertise mostrou uma associação forte com a atitude frente ao anúncio (r = 0,7). Já a intenção de compra e a atitude frente à marca foram mais influenciadas pela confiabilidade do endossante. Observou-se que a atratividade foi a dimensão que menos impactou as variáveis estudadas.The pharmaceutical industry is ranked one of biggest investors in advertising in Brazil, among the economic sectors. In 2014, it was ranked 10th, with an annual investment of R$ 6.040.390. Last year, the investments in advertising went over the figure of eight million reais, making the sector to occupy the sixth spot on the ranking. It is well known that one of the most frequently used advertising strategies by this industry, even if really costly, is to hire celebrities to endorse the purchase or the use of a determined medicine. The advertising of medicines directly to the consumer can be a risk inducing practice. The self-medication, inadequate use, inaccurate dosages, intoxication risks, layman’s diagnosis and the belief that some medicine is completely safe, are just some of the problems that appear among the debate on the legitimacy of medicine advertising. As they are potentially dangerous to the health, unlikely more common consumer goods, the medicines can’t be regulated only by the law of supply and demand, once that, if consumed incorrectly can cause serious injuries to health and even death, in the most extreme cases. In Brazil, the advertising directly oriented to the consumer is only allowed if the medicine does not need medical prescription, also known as free sale medicines. Those are the ads that celebrities appear sole, as characters, with their family or children, and many times, being humorous and using figure of speech. Studies about the endorse of celebrities made on common goods, like sneakers, clothes, perfume and cell phones, show that the efficiency of the endorse in the ads are directly connected to the credibility of the endorsing celebrity. However, it was not found any study that tested if that effect is also observed in ads of medicines, once that they are not common consumer goods. Trying to fill this gap, this study inquired if the credibility of the endorser influences the buying intent and attitudes of the consumer regarding the ad and the brand from the viewpoint of the three dimensions of credibility suggested by Ohanian (1990), trustworthiness, attractiveness and expertise. For this end, an experiment was conducted in 12 classes of students enrolled in administration at UFSC. The classes were exposed to ads of medicines with endorse of celebrities with different levels of credibility. From the analyses of the data, it was found that there is a linear positive correlation between the credibility and the attitude towards the brand, the ad and the buying intent, it being stronger in the two last. As for the dimensions, the expertise displayed a strong association with the attitude towards the ad (r=0,7). But, the buying intent and attitude towards the brand were more influenced by the trustworthiness of the endorser. It was observed that the attractiveness was the least impactful dimension between the studied variables

Tradução e validação para a população portuguesa da Individual Workload Perception Scale - Revised

As condições de trabalho dos enfermeiros têm vindo a ser alvo de preocupação e interesse crescentes por parte dos investigadores e gestores, por serem impulsionadoras da qualidade dos cuidados e dos níveis de satisfação dos profissionais e dos clientes. Neste sentido, o ambiente da prática de enfermagem é fortemente influenciado pelos comportamentos, produtividade, motivação e satisfação dos profissionais. Para a existência de um ambiente favorável é necessário que todos estes aspetos se desenvolvam e prosperem. A área da enfermagem é reconhecida pelos elevados níveis de stress associados ao ambiente de trabalho. Os enfermeiros estão constantemente sujeitos a riscos psicossociais com impacto a nível físico, psicológico e social, decorrentes de fatores de sobrecarga de trabalho, interação e conflitos com os pares ou outros profissionais, horários por turnos, carência de recursos materiais/técnicos/humanos e exigências emocionais inerentes ao contacto direto com os clientes. As tentativas de descrever esta questão complexa da carga de trabalho em enfermagem têm-se concentrado em medidas objetivas, tais como: horas por dia de cuidados de enfermagem ao cliente, e níveis de dependência do cliente determinados pela quantidade de cuidados realizados durante um certo período. Estes métodos não têm em conta a experiência e as competências dos profissionais de saúde, nem os problemas com o suporte do enfermeiro gestor/pares e as limitações dos recursos. A escala Individual Workload Perception Scale – Revised (IWPS-R) foi desenvolvida para ser um instrumento que avalia a satisfação dos enfermeiros relativamente à sua carga de trabalho. Deste modo, o objetivo do presente estudo é adaptar culturalmente/ linguisticamente e validar a escala IWPS-R, dando origem à versão portuguesa da mesma. Para tal, recorreu-se a um estudo do tipo quantitativo, observacional e descritivo transversal, sendo o instrumento validado numa amostra de 323 enfermeiros pertencentes a um centro hospitalar. A sua aplicação decorreu desde 10 a 26 de fevereiro, sendo a maioria da amostra pertencente ao sexo feminino (87,3%) e a média de idades a situar-se no intervalo de idades dos 30 aos 39 anos. Para validação do questionário foi solicitada autorização à autora da escala IWPS-R original, bem como ao Conselho de Administração e Comissão de Ética da instituição envolvida. A fiabilidade foi garantida através da determinação da consistência interna, tendo sido testada através do Alfa de Cronbach onde se obteve 0,9, com exclusão de 8 itens. A validade de conteúdo foi garantida pela realização do teste de compreensão e a validade de construto através da análise fatorial, cuja análise de componentes principais deu origem a uma matriz constituída por cinco fatores: Suporte do Enfermeiro Gestor, Suporte da Equipa, Carga de Trabalho, Recursos da Organização, Intenção de Permanecer. A IWPS-R revelou ser um instrumento adequado para ser aplicado no contexto cultural português, através das suas características psicométricas.Nurses´ working conditions have been the subject of growing concern and interest for researchers and managers, as these conditions drive the quality of care and the levels of satisfaction of professionals and clients. In this sense, the nursing practice environment is strongly influenced by the behaviors, productivity, motivation and satisfaction of professionals. For a favorable environment, all these aspects must develop and prosper. The nursing job is recognized for the high levels of stress associated with the work environment. There are psychosocial risks inherent to the nursing practice, with a physical, psychological and social impact on the professionals, due to work overload factors, conflicts with peers or other professionals, shift schedules, lack of material/technical/human resources, and emotional demands associated to the direct contact with customers. Attempts to describe the complex issue of nursing workload have focused on objective measures, such as: hours per day of nursing client care, and client dependency levels determined by the amount of care performed over a given period. However, these methods don´t consider relevant aspects, like the experience and skills of the professionals, limited support from nurse manager/peers, and resource limitations. The Individual Workload Perception Scale – Revised (IWPS-R) was developed to be an instrument that assesses nurses' satisfaction with their workload. Thus, the objective of the present study is to culturally/linguistically adapt and validate the IWPS-R scale, so it can be developed the Portuguese version of it. In order to achieve this, the instrument was validated in a sample of 323 nurses from a hospital center, through a quantitative, observational and descriptive/cross-sectional study. Its application took place from the 10th to the 26th of February, with the majority of the sample belonging to the female sex (87.3%) and the average age between 30 to 39 years. For validation of the questionnaire, it was requested authorization from the original IWPS-R scale´s author, as well as from the Directors´ Board and the Ethics Committee of the institution involved. Reliability was guaranteed by the determination of internal consistency, through the measure of Cronbach's Alpha, where 0.9 was obtained and 8 items were excluded. Content validity was guaranteed by carrying out the comprehension test. Construct validity, in turn, it was assured through factor analysis, whose main components analysis gave rise to a five factors matrix: Support from the Nurse Manager, Team Support, Workload, Organization Resources, and Intent to Stay. It was proved that the IWPS-R is a suitable instrument for application in the Portuguese cultural context, through its psychometric characteristics

External Quality Assessment in Laboratory Safety Area (PNAEQ-1S Segurança Laboratorial 2023)

Introduction: The National External Quality Assessment Program (PNAEQ) provides tools for carrying out external quality assessment in Laboratory Safety area. These tools allow the identification of occurrences and/or critical points in the operation, installations or equipment, that could have impact on the safety of patients and workers, beyond prioritize the necessary improvement actions. Objective: Presentation of the methodology implemented in PNAEQ in 2023, for the External Quality Assessment (EQA) in Laboratory Safety area.info:eu-repo/semantics/publishedVersio

External Quality Assessment in Laboratory Safety Area (PNAEQ-1S Segurança Laboratorial)

Introduction: The National External Quality Assessment Program (PNAEQ) provides tools for carrying out external quality assessment in Laboratory Safety area, since 2010. These tools have changed over the years, but all of them allow the identification of occurrences and/or critical points in the operation, installations or equipment, that could have impact on the safety of patients and workers, beyond prioritize the necessary improvement actions. Aims: Presentation of data and methodology implemented in PNAEQ since 2010, for the External Quality Assessment (EQA) in Laboratory Safety area.info:eu-repo/semantics/publishedVersio

Avaliação da componente sensorial da casta loureiro na região dos Vinhos Verdes

RESUMO Neste trabalho pretendeu-se comparar as diferenças sensoriais em vinhos, produzidos na região dos vinhos verdes da casta Loureiro, com leveduras Sachacomyces e não Saccharomyces associadas. O ensaio decorreu no ano de 2013 numa vinha situada em Grandra, freguesia de Sobrado, pertencente à empresa Quinta das arcas. Para avaliação dos efeitos sensoriais da aplicação de diferentes leveduras foram utilizadas três amostras distintas, em que duas foram inoculadas diferentes leveduras não Saccharomyces associadas a uma Saccharomyces e na terceira apenas uma levedura Saccharomyces. No fim do decorrer da fermentação foram feitas três análises sensoriais e retiradas conclusões. Palavras-passe: Loureiro, leveduras, Saccharomyces e não Saccharomyces, análise sensorial.ABSTRACT This work is intended to compare the sensory differences in wines produced in the Vinho Verde region of Loureiro, with Sachacomyces yeast Saccharomyces and not associated. The test took place in 2013 in a vineyard situated in Grandra, parish Sobrado, belonging to the Quinta das Arcas company. For sensory evaluation of the effects of applying different yeasts were used three different samples were inoculated on two different non-Saccharomyces yeast Saccharomyces associated with the third and only Saccharomyces yeast. At the end of the course of the fermentation were made three sensory analysis and conclusions reached. Keywords: Loureiro, yeast, Saccharomyces and non-Saccharomyces, sensory analysi