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- O impacto da perceção das práticas de responsabilidade social corporativa na resposta dos consumidores a uma crise organizacional : estudo de caso do NovobancoPublication . Lopes, Ana Laura Guerreiro Ferreira; Simão, João Duarte Borges Martins de VasconcelosAs organizações coexistem em mercados cada vez mais competitivos e voláteis e respondem a exigências e necessidades de clientes mais exigentes. Apesar das crises, sejam de saúde publica ou económicas, serem uma realidade cada vez mais presente nas organizações, existem setores mais expostos. Nesta dissertação foi estudado um setor que é muito intrínseco à vida de cada pessoa e que é essencial para o equilíbrio e manutenção das economias dos países, o setor bancário. Sendo um setor que permanece presente no dia a dia das pessoas durante um longo espaço de tempo e que assume um papel fulcral, as organizações do setor devem procurar alinhar-se com as necessidades dos stakeholder e da sociedade. Ligando estes dois elementos: uma atuação responsável e crise organizacional, esta dissertação pretende entender de que forma a Responsabilidade Social e Corporativa e a comunicação da mesma pode impactar o resultado de uma crise organizacional, mais precisamente a fase de avaliação de uma crise. A fase de avaliação é essencial para o desfecho da crise, uma vez que é o período em que são atribuídos o grau de responsabilidade e gravidade. Estes elementos tem o potencial de maximizar ou minimizar as reações afetivas e posteriormente, o desfecho da crise organizacional. Para entender esta relação a dissertação partiu da questão de partida “Qual o impacto da comunicação das estratégias de RSC, percebida pelos clientes do novobanco, na sua resposta a uma crise organizacional?” e foi realizado um estudo de caso do novobanco com elementos metodológicos qualitativos, para obter a perspetiva da organização em estudo, e quantitativos, para obter a perspetiva do cliente. O banco escolhido para o estudo foi o novobanco. Os resultados desta dissertação demonstraram que os clientes do novobanco identificam as práticas de RSC do banco e sentem que são informados das mesmas, mas poucos se sentem envolvidos no estabelecimento das mesmas. No que diz respeito à relação em estudo, foi possível concluir que os clientes do novobanco que não se sentem envolvidos no estabelecimento das estratégias de RSC e não reconhecem que estas estão alinhadas com os seus valores, atribuem níveis de responsabilidade e gravidade superiores. O estudo apresentado mostra a importância que o envolvimento dos clientes no estabelecimento das estratégias RSC pode ter num período de crise.
- How to improve ethical decision-making in clinical practice? Practical models and guidelinesPublication . Pereira, S. Martins; Hernández-Marrero, P.Background: Clinical practice in palliative care is characterized by the need of making ethico-clinical decisions, particularly at the end-of-life. End-of-life situations are situations in which a severe deterioration in health, due to the evolution of a disease or another cause, threatens the life of a person irreversibly in the near future, posing the need to make ethico-clinical decisions. Often, these decisions are difficult and challenging; the so-called “ethical challenges” emerge. Despite its ubiquity, there is no consensualized definition of this expression. Various terms are used interchangeably, e.g., “ethical challenges”, “ethical problems”, “ethical issues”, “ethical dilemmas”. Moreover, even though there is a wide range of ethical decisions that need to be made in palliative and end-of-life care, there is no unique model or guideline to help professionals and teams in making difficult and complex decisions. Aim: To explore practical models and guidelines that can be used in clinical contexts to improve ethical decision-making in palliative and end-of-life situations. Methods: This presentation is based on the work developed within project DELiCare: Decisions, Decision-making, and End-of-Life Care: Ethical Framework and Reasoning. The overall project, its objectives, methods, results, and implications will be presented in an integrated fashion, including the application of ethical decision-making models and guidelines to specific clinical cases. Results: End-of-life decisions are rooted in clinical, sociocultural, political, legal, economic, and ethical concerns. Several models and guidelines for ethical decision-making at the end-of-life coexist but are rarely used in clinical practice. These models and guidelines can be a relevant aid for healthcare professionals and teams. They can stimulate the debate around disputed and controversial issues, helping professionals to follow a well-informed and shared decision-making model in order to meet patients’ values, wishes and preferences. Conclusions: Decision-making processes underlying end-of-life decisions are influenced by and foster clinical, ethical, sociocultural, religious, political, legal, and economic concerns and debates. Healthcare professionals working in palliative and end-of-life care often perceive these decision-making processes as complex and challenging. The use of practical models and guidelines can enhance professionals and teams’ competencies and effectiveness in making ethico-clinical decisions at the end-of-life.
- Estudo microbiológico na produção de cerveja artesanal para melhoria da sua qualidadePublication . Chaves, Inês Costa; Teixeira, Paula Cristina MaiaA cerveja é considerada uma das bebidas alcoólicas mais antigas produzidas e consumidas no mundo. Atualmente, dependendo do modo de produção, existem dois estilos de indústria, a de cerveja artesanal, e a de cerveja industrial, sendo que, ao longo dos últimos anos, a cerveja industrial tem vindo a perder cota de mercado para a cerveja artesanal. O processo de produção de cerveja artesanal na Fábrica de Cervejas Portuense engloba as etapas de Moagem do Malte – Brassagem – Filtração – Ebulição – “Whirlpool” – Arrefecimento – Fermentação – Maturação – Centrifugação – Enchimento. A ausência de uma etapa de filtração esterilizante e/ou pasteurização antes do enchimento, torna este modo de produção mais suscetível a contaminações microbiológicas e consequente deterioração. Na fase quente da produção (desde a moagem do malte até ao “Whirlpool”), onde são aplicadas temperaturas elevadas, considera-se que o controlo é assegurado, mas o mesmo não acontece na fase fria (desde o arrefecimento até ao enchimento). No estágio realizado, além do acompanhamento da produção cervejeira, foram realizadas análises microbiológicas a amostras colhidas de equipamentos e materiais utilizados na fase fria do processo, assim como à cerveja em tanque e à cerveja final, de modo a avaliar a qualidade da cerveja e a identificar potenciais pontos de contaminação. Para tal, foi analisada a presença de Lactobacillus e de Acetobacter, como bactérias indicadoras de qualidade, e a presença de bactérias pertencentes à família Enterobacteriaceae, como indicadoras de higiene. Os resultados mostraram que, apesar de existirem cervejas com elevada qualidade microbiológica, algumas apresentavam níveis de contaminação acima do esperado e, que esta contaminação poderia ocorrer em vários pontos do processo.
- How to enhance the informed consent process in persons unable to consent? Experiences from different contexts and settingsPublication . Hernández-Marrero, P.; Pereira, S. MartinsBackground: Informed consent is the most scrutinized and controversial aspect of clinical research ethics. In palliative and end-of-life care, assessing decision-making capacity may be challenging. Patients, particularly those with cognitive impairment, deserve special attention when developing, implementing, and evaluating the informed consent process. Respecting patients’ autonomy in research includes obtaining informed consent; facilitating and supporting patients’ choices about research options; allowing patients to refuse participating in research; disclosing comprehensive and truthful information; and maintaining privacy and confidentiality. An autonomous decision requires that participants/patients have the capacity to provide informed consent. Aim: To explore how to enhance the informed consent process in persons unable to consent (e.g., persons with cognitive impairment, dementia, severe and persistent mental illness, and/or at the end-of-life) to increase equity and fair participant selection. Methods: This presentation is based on a series of systematic reviews and international research projects. It combines theoretical frameworks and ethical principles with empirical research conducted in different contexts and settings. Results: The informed consent process involves both consent and assent, which should be monitored throughout the research process. Informed consent must be an ongoing process of communication, understanding and decision-making that involves a wide range of key stakeholders (the patient and potential participant, possible surrogates, clinicians, and researchers) throughout the course of the study. Cognitive impairment, and other disorders affecting cognition, may have a negative impact on patients’ capacity to provide consent to research participation. Also, stereotypes among researchers can contribute to failures in the informed consent process. This might prevent patients with limited decision-making capacity from participating in relevant research. Conclusions: This presentation provides an overview of ethical frameworks and principles linked to the informed consent process and decision-making capacity in palliative care research, particularly in patients with cognitive impairment and/or limited decision-making capacity. A core set of ethical questions and recommendations is drawn to aid researchers, institutional review boards and potential research participants in the process of obtaining informed consent for palliative and end-of-life care research.
- Experiencing total pain in burn intensive care units: a meta-ethnographic reviewPublication . Pereira, S. Martins; Ribeiro, A. F.; Hernández-Marrero, P.Background: Critically burned patients and their families experience unbearable pain and suffering. Working in burn intensive care units (Burn ICUs) is also a major cause of emotional distress for healthcare professionals. Although burn-related pain is part of the acute care provided to burned patients, little is known on how to optimally provide suffering relief. Aim: To understand patients, families, and healthcare professionals’ experiences with total pain and its relief in Burn ICUs. Methods: Meta-ethnography of qualitative evidence following PRISMA. Studies were retrieved from 3 databases (PubMed, ISI and EBSCO host searching CINAHL Complete, MEDLINE Complete, and MedicLatina), combining 3 sets of terms (suffering AND burns AND qualitative). Original qualitative studies exploring experiences of critically burned patients, their families and healthcare teams in BurnICUs were included from inception to October 2022. Results: 305 articles retrieved; 10 selected for analysis and synthesis, with 263 participants. 11 themes emerged from the analysis: Patients’ suffering (changed self, mental anguish, physical pain and its management from onset until discharge when it happened, and divergent opinions about sedation); Families’ suffering (navigating through the experience, managing uncertainty about survival, vicarious suffering, and isolation in their “bubble of trauma”); and Nurses’ suffering (stress, compassion fatigue, and burnout). Discussion/Conclusions: This meta-ethnographic review shows that critically burned patients and their families experience total pain. Nurses caring for these patients and their families express signs of physical and emotional suffering. Timely and targeted palliative care could have a positive impact on these patients, families, and professionals, improving care outcomes. Further research is needed to determine how healthcare systems can best optimise palliative care provision to critically burned patients and their families to address their experience of total pain.
- Words of welcomePublication . Pereira, Sandra MartinsDear Colleagues, dear Friends; It is a pleasure to welcome you to the 18th World Congress of the European Association for Palliative Care in Rotterdam. This 2023 congress is the first face-to-face congress organized by the EAPC since 2019. Like other EAPC congresses, this congress is the result of two years of planning, organisation, meetings, reflection, and decision-making. Finally, here we are! It has been my honour to co-chair the Scientific Committee of this congress together with my colleague Agnes Csikos. For the first time, as far as I remember, the Scientific Committee, composed of a dedicated group of colleagues (thank you Alberto Alonso, Augusto Caraceni, Fin Craig, Jeroen Hasselaar, Martin Loucka, Wendy Oldenmenger, Christoph Ostgathe, Danai Papadatou, Nancy Preston, Audrey Roulston, and Rainer Simader), was co-chaired by two women who have the particularity of living in the South and Eastern parts of Europe. Under the theme “Equity and Diversity in Palliative Care”, the EAPC 2023 congress focuses on understanding health inequities and diversity in palliative care. Through a rich and diversified program, this congress draws attention to the utmost need and goal of creating equity of fair access, opportunity, and advancement in palliative care for all people in need of this care, within a context of diversity. We will have the opportunity to reflect on ways to better understand why and how inequities in palliative care occur, develop strategies aimed at reducing those inequities, and identify which challenges and policies could help to improve equity in palliative care. That is why, determining the prominent factors in the production of inequities in palliative care and deciding which ones are most amenable to change is paramount. As an operational definition of equity in palliative care, we adapted the definition proposed by the International Society for Equity in Health. Equity in palliative care is the absence of systematic and potentially remediable differences in one or more aspects of palliative care outcomes across socially, demographically, or geographically defined population groups. There is no basis for expecting a single characteristic or set of characteristics to be most influential in causing inequities in palliative care. Evidence suggests otherwise. To complement the understanding of health inequities in palliative care, we need to take diversity in palliative care into account. The definition of diversity encompasses variety and the condition of being different or having differences. Rarely are diverse influences simultaneously explored in the literature to better understand and tackle plausible explanations for inequities in palliative care. Sometimes, diversity is used as a euphemism for “outside the majority” or “different from the dominant group”. Yet, as human beings, diversity is part of who we are. We are inherently diverse, and evidence shows that when reflecting on and discussing palliative care, there is no “one size fits all”. Are we promoting equity in palliative care? If not, why are we failing on equity in palliative care? Do we spend inadequately or inappropriately on palliative care provision? Why in a world now much more aware of the impact of the social determinants of health are the world’s most vulnerable persons still missing out? Why are we still failing in providing increased or augmented palliative care services for socially, demographically, or geographically defined population groups with greater palliative care needs? How can diversity help to understand and tackle inequities in palliative care? These are just a few examples of questions that will certainly become “food for thought” during our days together in Rotterdam. And, we are so grateful to all and each one of you for your contributions to the scientific programme. The 18th World Congress of the European Association for Palliative Care gives us the opportunity to reconnect and share all the exiting work that is being developed within our worldwide palliative care community. These days together offer us the amazing chance to meet colleagues and friends, to be inspired and inspire others, and to re-energise ourselves to face the future challenges for palliative care.Promoting equity and taking diversity into account is not only the theme of the 18th World Congress of the EAPC. They should also be at the heart of palliative care practice, organisation, research, education, advocacy, and policy. I wish you a wonderful and exciting congress and look forward to meeting you in Rotterdam.
- An analysis of the EU-China relationship : the role and implications of the EU’s Fundamental valuesPublication . Pereira, João Filipe Simões; Ribeiro, SóniaIn the EU’s current Strategic Outlook to China, the country is officially characterised as a “systemic rival”. It is an unavoidable actor on the global scale, due to its status as the largest trading partner of the EU – and vice-versa – which illustrates the necessity for the two entities to work with one another. As European Council’s President Charles Michel stated in the G20 Conference in Indonesia, in November 2022, it is imperative to “rebalance the relationship, listen to each other, develop a better understanding” (Reuters, 2022a). The Union’s positioning regarding China is often clear in criticism in some fields, while concomitantly being vague or uncompromising in others – a clear summation of this complex relationship, where a constantly shifting balance between pragmatism and idealism takes place, in search of the ideal compromise. The differences between the two entities are profoundly rooted in their contrasting core values, a vital assessment when trying to reach a deeper understanding of their relationship. As such, this research addresses the EU’s fundamental values as a starting point, counterposing them with those which deemed to be the pillars of the Chinese Communist Party’s ideology, in order to paint a clear picture of how the guidelines of these two entities compare to one another. Fundamental divergencies are then identified, with a particular focus on opposite and antagonistic ideals. In order to understand how the EU’s stance on China has evolved until the present day, a selection of official EU documents related to China were submitted to discourse analysis. This, in turn, revealed underlying patterns or behavioural tendencies related to particular periods of time and particular subjects. The research has focused on the time period between 2012, when the agreement to negotiate the Comprehensive Agreement on Investment (CAI) between the EU and China was reached, and 2022. For each of the facets of the bilateral relationship, represented by categories of documents, the objective will be to understand the extent to which the EU’s fundamental values are referred to, defended, used as justification or upheld in countering opposing views from China, in order to infer if different types of issues display a different behaviour. The method of Critical Discourse Analysis, as developed and characterised by Norman Fairclough (Fairclough, 2013), will provide the theoretical basis for discourse analysis. The resulting analysis helps uncover tendential patterns, related to subjects, contexts or time periods, which were then applied in characterising the current state of the bilatera relationship.
- A importância da realização de eventos e da presença de influencers para a notoriedade das marcas de belezaPublication . Simões, Andreia Marques; Simão, João Duarte Borges Martins de VasconcelosO presente Relatório de Estágio debruça-se sobre a importância da realização de eventos e a presença de influencers nos mesmos para a notoriedade das marcas de beleza da Agência de Comunicação Companhia das Soluções. Assim sendo, para o enquadramento teórico são analisados alguns temas de interesse para a investigação, como o mercado das Agências de Comunicação, a Internet e a Web 2.0, as Redes Sociais, o Instagram, os Influencers e os seus seguidores, o conceito de Evento e a sua evolução, assim como os vários tipos de eventos e a importância dos mesmos para as marcas. Face ao aumento da popularidade da presença de influencers em eventos de marcas de beleza, e apesar de várias investigações explorarem o papel dos influencers na criação de valor para as marcas, é escassa a pesquisa que se debruce sobre o papel dos influencers na presença de eventos e na notoriedade que estes podem trazer para as marcas de beleza. Para dar resposta à pergunta de partida “Qual a importância dos eventos e da presença de influencers nos mesmos para a notoriedade das marcas de beleza da Companhia das Soluções?”, procurou-se a perspetiva de colaboradores da agência de comunicação onde foi desenvolvido o estágio curricular, a companhia das Soluções, assim como a perspetiva de influencers que já tenham ido a eventos de marcas de beleza organizados pela respetiva agência de comunicação. Deste modo, foi aplicada uma metodologia etnográfica, composta por Observação Participante, por Entrevistas estruturadas e por uma Revisão de Literatura, uma vez que se adequa melhor à experiência de estágio e ao contacto com a realidade da agência de comunicação. A partir desta investigação foi possível compreender melhor o que são os influencers, de que maneira se movem e atuam no ambiente digital e a influência que exercem sobre o seu público, na medida em que resultam numa grande importância para as marcas, trazendolhes assim uma maior notoriedade no seio do seu público-alvo. Fica assim clara a importância que a realização de eventos e a presença de influencers nos mesmos tem para a notoriedade das marcas de beleza da Companhia das Soluções.
- O debriefing no serviço de urgência, utilizando o modelo stop: estratégia de melhoria dos cuidados e segurança da pessoa em situação críticaPublication . Marques, Benjamim Cavaco Fernandes Silva; Deodato, Sérgio
- Enhancing ethical decision-making at the end-of-life: empowering conditions or team empowerment?Publication . Hernández-Marrero, Pablo; Pereira, Sandra MartinsBackground: Healthcare professionals are increasingly making end-of-life decisions (ELDs), which have become an integrated dimension of contemporary palliative and end-of-life care. ELDs are medical decisions made at the end of life that may have a potentially life-shortening effect. These situations are very often moments of high vulnerability with a profound impact on patients' ability to exercise their autonomy. Healthcare professionals perceive end-of-life decision-making as complex, difficult, and stressful. Evidence shows that making ELDs is frequently associated with burnout and moral distress. Strategies need to be implemented to enhance ethical decision-making at the end-of-life. Aim: To explore and discuss strategies on how to promote team empowerment within interdisciplinary teams to support and enhance ethical decision-making processes surrounded by uncertainty, risk, and asymmetry of information. Methods: This presentation is based on the work developed within project DELiCare: Decisions, Decision-making, and End-of-Life Care: Ethical Framework and Reasoning. The knowledge, experiences, and evidence from different fields will be mobilized and integrated to build theoretical and empirical frameworks. The structure and processes that can enhance ethico-clinical decision-making processes and their effectiveness in palliative and end-of-life care will be explored. Results: The need to make ELDs requires healthcare professionals and teams, as well as patients and family members, to embrace ethico-clinical decision-making processes under uncertainty, risk, and asymmetry of information. Shared decision-making is a cooperative process among healthcare professionals, patients, and families that enables a way of decision-making combining both the professionals’ expertise and the patient’s values, preferences, and goals. Shared decision-making processes should integrate information exchange, a deliberation period and making a decision. Communication among all stakeholders is paramount. Conclusions: Shared decision-making processes helps teams to bring together information and views, anticipate scenarios, and prepare a joint and common approach to the decision that needs to be made. This team empowering strategy fosters the sense of both individual and teamwork meaning, a core dimension of empowerment. By fostering shared decision-making processes, professionals and teams feel more empowered and are more effective in meeting patients’ values, wishes and preferences.