Policy Effects on the Quality of Public Health Care: Evaluating Portuguese Public Hospitals’ Quality through Customers’ Views

In this paper, public health care administration issues are reviewed and public hospital patients’ views on quality of health care are empirically tested. The purpose is to support the recommendation of new public policies that lead to better performance, if necessary. Hospital patients’ views on service quality were assessed through a questionnaire to estimate a global customer satisfaction measure. We argue that customer satisfaction should be measured through multiple indicators, as a latent variable. Thus, we considered the latent segment models (LSM) approach to assess customer service satisfaction. We found a two segment latent structure: segment 1, the satisfied, with 48 percent of patients, mostly male and middle-aged patients; and segment 2, the unsatisfied, with 52 percent of patients, mostly female and youngest/oldest patients.info:eu-repo/semantics/publishedVersio

Avaliação das aprendizagens: Representações sociais elaboradas por estudantes de enfermagem

A avaliação envolve variáveis de contexto como dinâmicas de sala de aula e estudantes, em particular na forma como influencia os processos de aprendizagem. Estas variáveis emergem como fatores menos estudados (Fernandes, 2009). Com o objetivo de analisar as representações sociais (RS), sobre avaliação das aprendizagens, elaboradas pelos estudantes de enfermagem realizou-se estudo exploratório com 40 participantes. Recolheram-se dados por questionário elaborado para a técnica da evocação livre de palavras. Os dados foram processados nos softwares Evoc e SIMI que forneceram a estrutura e o campo das RS. Os participantes são maioritariamente do sexo feminino, com idade média de 21 anos. A estrutura das RS obtida é: Núcleo central – conhecimentos, estudar e frequências 2ª Periferia – aulas, importante, praticar e professores. Comprovou-se a centralidade do elemento conhecimentos e uma relação forte entre os elementos conhecimentos e avaliações, trabalhos e frequência. A avaliação é entendida como fazendo parte da aprendizagem (Boggino, 2009; Fernandes,2009; Pinto e Santos, 2006). O teste escrito individual é o instrumento de avaliação por excelência quando o foco é categorizar as respostas dadas (Pinto e Santos, 2006). Qualquer avaliação conduz o aluno ao processo de reflexão orientado para o que estudar e como estudar (Carmona e Flores, 2008). A avaliação deve fazer parte duma abordagem coerente que promova o desenvolvimento profissional, a aprendizagem e a qualificação dos estudantes (Boggino, 2009;Looney, 2011). Conclui-se que no universo estudado a avaliação das aprendizagens significa para os estudantes estudar, realizarem provas e adquirirem conhecimentos. A avaliação significa a relação entre o processo de aprendizagem e os resultados do mesmo o que indicia a existência da dualidade que o conceito encerra. Os elementos da representação social com menor consistência referem-se aos processos que fazem parte da formação reforçando o indício da avaliação ser entendida estratégia para a aprendizagem. Há necessidade de desenvolver a investigação e a investigação-ação em projetos relacionados com as técnicas, as estratégias de avaliação e os resultados na aprendizagem

Análise do impacto do relevo na ocupação do solo urbano em zonas de montanha – Aplicação à cidade da Guarda, Portugal

O relevo é um dos fatores que influenciam o crescimento urbano e a sua morfologia. Este elemento natural, dependendo da sua intensidade, pode condicionar o desenvolvimento urbano sustentável. A existência de barreiras topográficas obriga à fragmentação do tecido urbano e consequente dispersão. Apresenta-se ao longo deste artigo a metodologia desenvolvida com o objetivo de analisar a integração das classes de uso e ocupação do solo urbano na topografia urbana. A análise espacial desenvolveu-se com recurso a Sistemas de Informação Geográfica. Os resultados obtidos permitiram concluir acerca da integração dos vários tipos de uso e ocupação do solo urbano no declive local; avaliar a existência de barreiras topográficas naturais no interior de espaços urbanos construídos, constituindo elementos fraturantes do crescimento urbano; analisar a inclusão de usos e ocupações de solo artificializado em zonas de risco. Esta análise constitui uma ferramenta de apoio ao planeamento urbano, na identificação de zonas de risco

Urban sprawl assessment model in the context of sustainable development

The disordered urban growth may prove catastrophic for the future of cities if preventive measures are not taken. The increase of built-up areas, the growing need for implementation of urban infrastructures, the resulting increase in soil sealing, the excessive consumption of natural resources, the elevated need for car use on daily travels, the increase in travel distances, etc., are examples of the negative effects caused by urban sprawl. In order to implement measures to halt or avoid the damage caused by urban sprawl on the environment, society and economy, it is necessary to know which areas to intervene. In this sense, a multicriteria analysis model is presented that combines sustainable development indicators, with the main objective of calculating an index of sustainable urban expansion. This model, developed according to the Analytical Hierarchy Process, comprises three levels of analysis. At the first level, the indicators of urban sustainable development are aggregated and associated withsix criteria. The weighted aggregate of composite indicators, which constitute the second level of analysis, allows evaluating different scenarios and studying the level of influence of urban sprawl on the diverse dimensions. In the last level of analysis, an index is calculated,resulting from the aggregation of all indicatorsconsidered along the hierarchical structure. Thus, the proposed model allows quantifying the level of sustainability of urban sprawl, according to the lines of sustainable development defined for this work, serving as a tool to support urban planning interventions

Surface functionalization of cuttlefish bone-derived biphasic calcium phosphate scaffolds with polymeric coatings

Cuttlefish bone (CB) has been explored as biomaterial in the bone tissue-engineering field due to its unique porous structure and capacity of the aragonite mineral to be hydrothermally converted into calcium phosphates (CaPs). In the present study, undoped and ion (Sr2+, Mg2+ and/or Zn2+) doped biphasic calcium phosphate (BCP) scaffolds were prepared by hydrothermal transformation (HT, 200 °C, 24 h) of CB. The obtained scaffolds were sintered and then coated with two commercial polymers, poly(ε-caprolactone) (PCL) or poly(DL-lactide) (PDLA), and with two synthesized ones, a poly(ester amide) (PEA) or a poly(ester urea) (PEU) in order to improve their compressive strength. The scaffolds were characterized by X-ray diffraction (XRD) coupled with structural Rietveld refinement, Fourier transform infrared (FTIR) spectroscopy, and scanning electron microscopy (SEM). The results demonstrate that CB could be entirely transformed into BCPs in the presence or absence of doping elements. The initial CB structure was preserved and the polymeric coatings did not jeopardize the interconnected porous structure. Furthermore, the polymeric coatings enhanced the compressive strength of the scaffolds. The in vitro bio-mineralization upon immersing the scaffolds into simulated body fluid (SBF) demonstrated the formation of bone-like apatite surface layers in both uncoated and coated scaffolds. Overall, the produced scaffolds exhibit promising properties for bone tissue engineering applications.publishe

Evaluation of the antitumour and antiproliferative effect of Xanthohumol-Loaded PLGA nanoparticles on melanoma

Cutaneous melanoma is the deadliest type of skin cancer and current treatment is still inadequate, with low patient survival rates. The polyphenol xanthohumol has been shown to inhibit tumourigenesis and metastasization, however its physicochemical properties restrict its application. In this work, we developed PLGA nanoparticles encapsulating xanthohumol and tested its antiproliferative, antitumour, and migration effect on B16F10, malignant cutaneous melanoma, and RAW 264.7, macrophagic, mouse cell lines. PLGA nanoparticles had a size of 312 ± 41 nm and a PdI of 0.259, while achieving a xanthohumol loading of about 90%. The viability study showed similar cytoxicity between the xanthohumol and xanthohumol-loaded PLGA nanoparticles at 48 h with the IC50 established at 10 µM. Similar antimigration effects were observed for free and the encapsulated xanthohumol. It was also observed that the M1 antitumor phenotype was stimulated on macrophages. The ultimate anti-melanoma effect emerges from an association between the viability, migration and macrophagic phenotype modulation. These results display the remarkable antitumour effect of the xanthohumol-loaded PLGA nanoparticles and are the first advance towards the application of a nanoformulation to deliver xanthohumol to reduce adverse effects by currently employed chemotherapeutics.info:eu-repo/semantics/publishedVersio

Life cycle assessment of advanced bioethanol production from pulp and paper sludge

This work evaluates the environmental performance of using pulp and paper sludge as feedstock for the production of second generation ethanol. An ethanol plant for converting 5400 tons of dry sludge/year was modelled and evaluated using a cradle-to-gate life cycle assessment approach. The sludge is a burden for pulp and paper mills that is mainly disposed in landfilling. The studied system allows for the valorisation of the waste, which due to its high polysaccharide content is a valuable feedstock for bioethanol production. Eleven impact categories were analysed and the results showed that enzymatic hydrolysis and neutralisation of the CaCO3 are the environmental hotspots of the system contributing up to 85% to the overall impacts. Two optimisation scenarios were evaluated: (1) using a reduced HCl amount in the neutralisation stage and (2) co-fermentation of xylose and glucose, for maximal ethanol yield. Both scenarios displayed significant environmental impact improvements

Stigmatizing attitudes toward patients with psychiatric disorders among medical students and professionals

Introduction: Stigma attached to mental health encompasses discrimination and exclusion of psychiatric patients and hinders their opportunities to have more productive and fulfilling lives. Moreover, stigma also exists among health professionals, and therefore, it hampers the provision of treatment and care and the promotion of mental well-being. This manuscript intends to assess and compare the levels of stigmatization toward patients with mental illness between medical students and doctors from different specialties. Methods: The Portuguese version of Attribution Questionnaire (AQ-27) was used to assess the attitudes of medical students (n = 203), non-psychiatry doctors (n = 121), and psychiatry specialists (n = 29) from the University of Minho and three hospitals in the region of Braga, Portugal (Hospital de Braga, Hospital Senhora da Oliveira, and Hospital de Fafe). Results: Psychiatrists were the group that displayed lower levels of stigmatizing attitudes in all the items of the AQ-27, followed by the students. The regression analyses revealed that professional group and presence of a relative with mental illness were the factors that have a significant impact on the levels of stigmatization. Conclusions: Mental illness stigma is widely spread in community and reaches not only general population but also health professionals. Psychiatrists presented lower levels of stigma compared with non-psychiatry physicians and medical students. We found that stigma is related with age and the presence of relatives with psychiatric disorders. These findings highlight the critical relevance of raising awareness on this topic and, therefore, break stereotypes to reduce the negative consequences of stigma.info:eu-repo/semantics/publishedVersio