A utilização adequada de um sistema de códigos é fundamental para a qualidade das informações de saúde registradas com o propósito de subsidiar o planejamento, a programação e a avaliação das ações de saúde. O objetivo do trabalho foi descrever o padrão de uso da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID) em atestados odontológicos apresentados em um serviço público federal com a finalidade de concessão de licença para tratamento de saúde. Analisou-se a concordância entre a codificação apresentada nos atestados e a codificação atribuída por cirurgiões-dentistas peritos oficiais; o grau de especificidade das codificações e a perspectiva de uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Este estudo concluiu que é necessário um aperfeiçoamento na utilização da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde Décima Revisão (CID-10) e que o uso complementar da Classificação Internacional de Doenças em Odontologia e Estomatologia (CID-OE) e da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) pode favorecer o processo de tomada de decisão quanto à necessidade de afastamento do trabalho, fornecendo dados relevantes para o monitoramento do absenteísmo por motivo odontológico. / Appropriate use of a code system is fundamental to the quality of registered health information in order to support the planning, programming and assessment of health measures. The objective of this study was to describe the pattern of use of the International Statistical Classification of Diseases and Related Health Problems (ICD) in dental certificates presented in a federal public service for the purpose of granting permission for medical treatment. The degree of agreement between the coding presented in health certificates and the coding given by official dental experts was assessed, as the degree of specificity of coding and the prospect of using the International Classification of Functioning, Disability and Health (ICF).This study concluded that an improvement is needed in the use of the International Statistical Classification of Diseases and Related Health Problems - Tenth Revision (ICD-10) and that complementary use of the International Classification of Diseases in Dentistry and Stomatology (ICD-DA) and International Classification of Functioning, Disability and Health (ICF) can aid the decision-making process regarding the need to take time off work, providing relevant data for monitoring absenteeism for dental reasons.

This dissertation presents multiple facets of the assessment system reform of the School Leaving Certificate (SLC) exam in Nepal through grounded theory methodology. The main purpose of this study is to develop a substantive grounded theory of the reform that explicates a complete process of the assessment reform, i.e., how this reform was conceptualized, what was done as a foundational preparation, how it was implemented, and what were the preliminary responses to the reform implementation. In order to theorize the reform process, this study applied a constructivist grounded theory approach, specifically based on the work of Charmaz (1996, 2005, 2006, 2012), as the research methodology. The data were collected by conducting 10 focus group discussions and 24 one-on-one semi-structured interviews. The participants represented almost all the categories of stakeholders (e.g., policymakers, employers, teachers, students) as well as experts and educators. The emergent conceptual categories and sub-categories from the interviews and focus group discussions were categorized under three constructs: (1) Conceptualization of the reform, (2) implementation of the reform and (3) reform effects. The first construct covers those theme categories and sub-categories that state the origin and type of the reform, reform aims, and framework as well as preparation for the reform. Similarly, the second construct includes those theme categories and sub-categories that inform the mechanism underpinning reform related information dissemination, the strategic plan used to implement the reform and factors that could influence the reform process. Finally, the third construct comprises those categories that discuss reform associated quandaries and condemnation, factors contributing to magnifying the quandaries, resultant opportunities from the reform, reform impact, step forward, and other relevant categories. The findings have been explicated under three phases- the pre-implementation phase, the implementation phase and the post-implementation phase as the integrated grounded theory. The theoretical components presented under the pre-implementation phase include exhaustive analysis of need and feasibility; input from experts, educators and key stakeholders; clarity on reform aims and objectives; cooperative triangular relationships; comprehensive documentation; explicit roadmap and exhaustive planning; infrastructure and resource management, and capacity building. Similarly, three major theoretical components- teacher advocacy, stakeholder ownership, and timely and authentic information have been described under the implementation phase. Finally, eight major theoretical components, such as identification and analysis of resulting issues, immediate actions for the urgent/sensitive issues, special programs for the low-grade holders, bridge between academic and vocational programs, need for impact analysis, effective communication channel, need for institutional memory, need for an unconventional assessment system, and need for a resourceful unit of assessment and testing have been presented under the post-implementation phase. The combination of the theoretical components described under the three phases mentioned above is the integrated substantive grounded theory of the assessment system reform in Nepal. This study contributes by adding value for those involved in assessment reform as well as the academicians and researchers because it puts forward recommendations for foundational preparation and homework in the conceptual phase of assessment reform; action steps to minimize the possible resistance to reform; strategies to implement the reform successfully; and initiatives to institutionalize the reform or address the resulting issues and concerns.

O surgimento e a popularização de arquiteturas de software que fornecem suporte à programação distribuída orientada a objetos, como CORBA, .NET e Java EE, gerou uma demanda por infra-estruturas de segurança eficientes, capazes de proteger os recursos dos sistemas de ataques maliciosos. Essa proteção começa pela identificação dos usuários que interagem com os sistemas, processo conhecido como autenticação. Entretanto, a autenticação por si só não é suficiente para garantir a segurança dos recursos, uma vez que a autenticação não determina quais ações os usuários estão autorizados a executar depois de autenticados. Em outras palavras, um mecanismo de autorização, que faz valer as políticas de controle de acesso aos recursos definidas pelos administradores de sistemas, se faz necessário. Neste trabalho estudamos mecanismos de controle de acesso baseado em papéis e a aplicabilidade dos certificados de atributos X.509 como estrutura de armazenamento desses papéis em um ambiente Java EE. Em particular, estendemos a infra-estrutura de segurança do servidor de aplicações JBoss, de modo que ela passasse a comportar os certificados de atributos X.509. Além disso, analisamos as vantagens e desvantagens do uso de tais certificados e avaliamos o desempenho da extensão desenvolvida em relação a outras alternativas que são oferecidas pelo JBoss para o armazenamento de papéis dos usuários. / The popularization of software architectures that provide support for distributed object-oriented programming, like CORBA, .NET, and Java EE, revealed the need for efficient security infrastructures to protect the resources of enterprise systems from malicious attacks. This protection usually begins with the identification of the users that interact with the systems, a process known as authentication. However, authentication alone is not enough to guarantee the protection of the resources, as it cannot determine what actions a particular user is allowed to execute on a given resource. In other words, an authorization mechanism is needed in order to enforce the access control policies as defined by the system administrators. In this dissertation we studied role-based access control mechanisms and the use of X.509 attribute certificates as data structures that store the users roles in a Java EE environment. Particularly, we added X.509 attribute certificates support to the existing JBoss application server security infrastructure. Furthermore, we evaluated the pros and cons of using these certificates, and compared the performance of the developed extension to the performance of the existing solutions provided by JBoss to store the users roles.

No Brasil, é crescente o número de instituições de saúde que estão buscando a certificação da qualidade dos seus processos por meio da acreditação e está em aprovação um projeto de Lei que visa tornar obrigatória a obtenção de uma certificação para todas as instituições de saúde. Entretanto, as pesquisas sobre acreditação demostram a existência de lacunas sobre os seus reais benefícios e que não há uma abordagem única para a introdução do programa no mundo. O objetivo do estudo foi avaliar o impacto dos programas de acreditação nas instituições de saúde brasileiras, com foco em hospitais. O projeto de pesquisa foi desenvolvido em duas etapas: revisão da literatura e pesquisa empírica com a adoção de abordagem quantitativa, empregando o método pesquisa de avaliação (survey). O questionário foi elaborado a partir da revisão da literatura, outras pesquisas empíricas e opinião de especialistas. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade de São Paulo (Parecer 1.416.014). A pesquisa foi realizada pela internet utilizando o software SurveyMonkey®, no período de fevereiro a maio de 2016. Do total de 161 respostas recebidas, 141 foram consideradas válidas, sendo 74,47% (105/141) provenientes de hospitais e 23,53% (36/141) de outras instituições do setor de saúde, tais como ambulatórios, laboratórios, entre outros. A amostra foi não-probabilística, podendo ser classificada como por conveniência. Participaram da pesquisa instituições de 18 estados brasileiros e do Distrito Federal. Quanto ao perfil dos participantes, a idade média foi de 40 anos, 88% eram pós-graduados, 81% ocupavam posições gerenciais e 75% tinham mais de 10 anos de experiência profissional. Para avaliação dos resultados foram realizadas as análises de correlação de Spearman e de regressão logística. Os resultados demostraram que, na amostra analisada, há evidência de correlação significativa (? = 5%) e moderada entre o status da acreditação e as atividades de segurança do paciente (coeficiente de correlação = 0,537), de gestão da qualidade (coeficiente de correlação = 0,590), de planejamento - políticas e estratégias (coeficiente de correlação = 0,629) e envolvimento dos profissionais com os programas de qualidade (coeficiente de correlação = 0,430). A relação entre o status da acreditação e o envolvimento dos pacientes foi significativa (? = 5%), porém fraca (coeficiente de correlação = 0,252) o que sugere que o tema deveria ser tratado com uma política própria. Foram identificados 13 impactos organizacionais da acreditação relacionados, principalmente, aos processos internos, cultura, capacitação, imagem da instituição e diferencial competitivo. Na dimensão financeira, não foi confirmado como relevante o impacto da acreditação nos resultados, porém foi validada a necessidade de investimento em infraestrutura, inovação tecnológica e tecnologia da informação na etapa de preparação. Foi realizada a avaliação de confiabilidade e validade do instrumento de pesquisa, demonstrando que a estrutura do questionário estava adequada. Adicional à avaliação dos impactos da acreditação, a pesquisa identificou aspectos importantes que podem contribuir, na etapa de planejamento, com as instituições que pretendem adotar a acreditação. / There are an increasing number of health care organizations seeking quality certification of their processes through accreditation and a new law is under approval to make the quality certification compulsory for all institutions in Brazil. However, the research on accreditation demonstrate that there are still gaps on its actual benefits and that there is no general approach to the adoption of this program in the world. The aim of this study was to evaluate the impact of accreditation programs in Brazilian healthcare institutions, focusing on hospitals. The research project was developed in two stages: a literature review and an empirical research with the adoption of a quantitative approach, applying survey method. The questionnaire was developed from the literature review, other empirical researches and experts\' opinion. The project was approved by the Research Ethics Committee of the Faculty of Medicine from the University of São Paulo (Process number 1,416,014). The survey was conducted over the internet using the SurveyMonkey® software, from February to May 2016. From the 161 responses received, 141 were considered valid, 74.47% (105/141) were from hospitals and 23.53 % (36/141) came from other institutions in the healthcare sector, such as ambulatories, laboratories, among others. The sample was non-probabilistic and can be classified as a \"convenience sample\". The respondents are from 18 Brazilian states and the Federal District. Regarding the profile of the participants, the average age was 40 years old, 88% were postgraduates, 81% held managerial positions and 75% presented more than 10 years of professional experience. To evaluate the results, it was performed the Spearman correlation and logistic regression analysis. The results showed that, in the sample, there is evidence of a significant (? = 5%) and moderate correlation between the status of accreditation and patient safety activities (correlation coefficient = 0.537), quality management (correlation coefficient = 0.590), planning - policies and strategies (correlation coefficient = 0.629) and involvement of professionals in the quality programs (correlation coefficient = 0.430). The correlation between the status of accreditation and the patients\' involvement was significant (? = 5%), but weak (correlation coefficient = 0.252) suggesting that this issue should be treated with an exclusive policy. It was identified 13 organizational impacts of accreditation related mainly to internal processes, culture, training, reputation of the institution and competitive aspects. The accreditation impact on the results has not been confirmed as relevant in the financial dimension, however, related to financial issues, it has been validated the need for investment in infrastructure, technological innovation and information technology in the earlier stage. It was also analyzed the reliability and validity of the survey instrument, showing that the structure of the questionnaire was adequate. In addition to the assessment of accreditation impact, this research identified some issues that may support institutions that intend to implement accreditation, in the planning phase.

This collection of five papers explores the validity of exam accommodations in Ireland, in particular the spelling and grammar waiver, an accommodation unique to Ireland. A review of the literature relating to each accommodation is followed by two papers investigating the validity of the spelling and grammar waiver. A spelling and grammar waiver can be granted to a student with a specific learning disability who attains a standard score of 85 or below on a spelling test. Two groups of students were compared- those who had or had not been granted a waiver, Mock exam scripts of both groups were marked both with and without a spelling and grammar waiver by experienced markers. When a spelling and grammar waiver was applied, the scores of both groups significantly increased. The ‘boost’ received by students who had been granted a waiver was not significantly higher than the ‘boost’ received by the other students, suggesting that the spelling and grammar waiver gives an advantage to all who receive it. Examiner markings were re-examined in a follow up study to investigate possible examiner bias. Results found that elements of the marking scheme, which should not have been affected by a spelling and grammar waiver, were marked more leniently when the examiner marked students’ scripts which had a spelling and grammar waiver applied to it. These studies suggest that the spelling and grammar waiver is not a valid accommodation. In the following study, three spelling tests commonly used by teachers to apply for accommodations were compared. Significant differences were found among the scores. Students scoring below the cut off point for a spelling and grammar waiver ranged from 5.8% to 43.8% depending on the test used. These significant differences in scores across the three tests highlighted the need for an Irish normed spelling test. The final paper details the creation and standardisation of a spelling test in the Republic of Ireland. Limitations to each study and areas of further research are addressed. Suggestions to improve the validity of the spelling and grammar waiver by using an alternative marking scheme and teacher training are discussed.

No description available.

Abstract not available

The attainment of high grades on the Victorian Certificate of Education (VCE) is critical to the future study and employment prospects of many Australian adolescents. Thus it is important to understand the factors that contribute to performance in the VCE. The aims of this study were twofold: the main aim was to test competing models of academic performance, subsuming a range of situational and dispositional variables based on a) self-efficacy theory, b) target and purpose goals, c) cognitive skills and self-regulatory strategies, and d) positive psychology. These models were each tested in terms of English performance and mathematics performance as these units contribute proportionally the most to overall VCE scores. In order to study whether pressures peculiar to the VCE impact on performance, the competing models were tested in a sample of Victorian students prior to the VCE (year 10) and then during the VCE (year 11). A preliminary study was conducted in order to develop and test four scales required for use in the major study, using an independent sample of 302 year nine students. The results indicated that these new scales were psychometrically reliable and valid. Three-hundred and seven Australian students participated in the year 10 and 11 study. These students were successively asked to provide their final years 9, 10 and 11 English and mathematics grades at times one, three and five and to complete a series of questionnaires at times two and four. Results of the year 10 study indicated that models based on self-efficacy theory were the best predictors of both English and mathematics performance, with high past grades, high self-efficacy and low anxiety contributing most to performance. While the year 10 self-efficacy models, target goal models, positive psychology models, self-regulatory models and cognitive skill based models were each robust in the sample in year 11, a substantial increase in explained variance was observed from year 10 to year 11 in the purpose goal models. Results indicated that students’ mastery goals and their performance-approach goals became substantially more predictive in the VCE than they were prior to the VCE. This result can be taken to suggest that these students responded in very instrumental ways to the pressures, and importance, of their VCE. An integrated model based on a combination of the variables from the competing models was also tested in the VCE. Results showed that these models were comparable, both in English and mathematics, to the self-efficacy models, but explained less variance than the purpose goal models. Thus in terms of parsimony the integrated models were not preferred. The implications of these results in terms of teaching practices and school counseling practices are discussed. It is recommended that students be encouraged to maintain a positive outlook in relation to their schoolwork and that they be encouraged to set their VCE goals in terms of a combination of self-referenced (mastery) and other-referenced (performance-approach) goals.

This study examines whether recent changes to the mathematics courses offered in the final year of secondary school (Year 12) in the state of Victoria, Australia have affected the learning outcomes of students in terms of then: skill levels in algebra, calculus and problem solving; and in terms of their preparation for a tertiary mathematics unit. The impact of these changes on the transition from secondary to tertiary mathematics is also considered. A comparison is made between students who attempted a first year mathematics unit at the University of Melbourne (U. of M.) having completed the new V.C.E. (Victorian Certificate of Education) mathematics courses and mathematics courses from the previous H.S.C. (Higher School Certificate) system. The comparison involves the use of tests administered upon entrance to a tertiary mathematics unit at the U. of M., and questionnaires. In 1991, V.C.E, students and H.S.C. students attempted the same mathematics test at the U. of M. and their results were compared. In 1992, the tests were attempted by V.C.E. students only. To compare new V.C.E. students and H.S.C. students, questions on the 1991 test were matched with similar questions on the 1992 tests and a panel of experts determined what the H.S.C. students who attempted the 1991 test would have been expected to average on these matched questions on the 1992 tests had they attempted them. These expected average scores were then compared with the actual scores of the new V.C.E. students. The scores of the groups were scaled when necessary. Questionnaires were administered to 1991 U. of M, mathematics students who were part of the V.C.E. pilot group in 1990, secondary mathematics educators, tertiary mathematics educators, and 1991 V.C.E. (1992 U. of M.) students. The mathematical misconceptions exhibited by new V.C.E. students are discussed and their frequencies stated. The research indicates that the new V.C.E. mathematics courses have provided the V.C.E. mathematics students in this study with significantly lower skill levels and a significantly poorer preparation for a tertiary mathematics unit than those which were previously provided by the H.S.C. mathematics courses.

The Victorian Certificate of Applied Learning (VCAL) emerged to provide more relevant curriculum programs that would cater for increasing retention rates of post-compulsory students. It is also an example of the ‘new’ learning arising from contemporary debates and reforms that highlight inadequacies of the more traditional modes of learning. This thesis focuses on the pedagogical and sociological issues emerging from the VCAL being introduced as an ‘alternative’ learning pathways for ‘at-risk’ students within a traditional secondary school culture. Through the eyes of an insider-researcher, the thesis argues for a deeper understanding of applied learning as a ‘re-engaging’ pedagogy by studying the schooling experience of VCAL students and teachers. The thesis concludes that traditional academic modes of teaching contribute to the social construction of ‘at-risk’ students and argues that secondary school pedagogy needs to be redefined as a cultural phenomenon requiring teachers to be reflexively aware of their role in bridging the gap between students’ life experiences and the curriculum.