Managerial leadership for research use in nursing and allied health care professions : a narrative synthesis protocol

BACKGROUND: Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours.Methods/design: Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. DISCUSSION: With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use by health care practitioners, and how to develop leadership for the purpose of enhancing research use in clinical practice.

Integrating a sense of coherence into the neonatal environment

Background: Family centred care (FCC) is currently a valued philosophy within neonatal care; an approach that places the parents at the heart of all decision-making and engagement in the care of their infant. However, to date, there is a lack of clarity regarding the definition of FCC and limited evidence of FCCs effectiveness in relation to parental, infant or staff outcomes. Discussion: In this paper we present a new perspective to neonatal care based on Aaron Antonovksy's Sense of Coherence (SOC) theory of well-being and positive health. Whilst the SOC was originally conceptualised as a psychological-based construct, the SOCs three underpinning concepts of comprehensibility, manageability and meaningfulness provide a theoretical lens through which to consider and reflect upon meaningful care provision in this particular care environment. By drawing on available FCC research, we consider how the SOC concepts considered from both a parental and professional perspective need to be addressed. The debate offered in this paper is not presented to reduce the importance or significance of FCC within neonatal care, but, rather, how consideration of the SOC offers the basis through which meaningful and effective FCC may be delivered. Practice based implications contextualised within the SOC constructs are also detailed. Summary: Consideration of the SOC constructs from both a parental and professional perspective need to be addressed in FCC provision. Service delivery and care practices need to be comprehensible, meaningful and manageable in order to achieve and promote positive well-being and health for all concerned.

Redefining the Academic Library Managing the Migration to Digital Information Services

Academic libraries are faced with a daunting series of challenges brought on by the digital revolution. In an era when millions of books, articles, images, and videos available instantaneously via the web, libraries across all institutional types are experiencing declining demand for their traditional services, built around the storage and dissemination of physical resources. At the same time, new demand for digital information services and collaborative learning spaces promise new areas of opportunity and engagement with patrons. A rapid and orderly transition to “the library of the future” requires difficult trade-offs, however, as no institution can afford to continue expanding both its commitment to comprehensive, local print collections as well as new investments in staff, technology, and renovations. This report illustrates how progressive academic libraries are evolving in response to these challenges, providing case studies and best practices in managing library space, staff, and resources.

O SEBRAE/RJ e a implantação de micro e pequenas empresas no Estado do Rio de Janeiro

As pequenas empresas desempenham um papel fundamental no sistema produtivo brasileiro, principalmente no que diz respeito a geração de postos de trabalhos. Ciente desta importância, o governo brasileiro vem buscando há três décadas dinamizar este segmento através de políticas de incentivo, como acesso ao crédito e programas de capacitação. A prova mais tangível desta preocupação foi a formatação do SEBRAE - Serviço Brasileiro de Apoio às Micro e Pequenas Empresas e dos SEBRAEs regionais, em 1990, que concentrou, de certa forma, todas as decisões do poder público e da iniciativa privada para os pequenos empreendimentos. O objetivo deste trabalho é estudar a atuação do SEBRAE/RJ no Estado do Rio de Janeiro, na primeira metade da década de noventa, quando a instituição adotou uma estratégia que priorizou a capilaridade da rede de atendimento e a massificação de informações, que resultou numa atuação totalmente diferenciada do SEBRAE/RJ, se comparada com os demais SEBRAEs regionais. Não obstante as limitações identificadas, esta experiência pode ser discutida por seu caráter inovador e diferenciada, principalmente considerando a dimensão e importância dos pequenos empreendimentos para a economia do estado do Rio de Janeiro.

O impacto das práticas ITIL na flexibilidade organizacional - evidências empíricas em uma empresa multinacional de TI

The present work has as main objective the identification and impact analysis for the practice ITIL in the organizational flexibility of a multinational IT company, being this study of quali-quantitative and exploratory nature. To achieve this objective, some theoretical studies on bureaucracy, organization flexibility, control, IT governance and ITIL were done, as a form to better understand the research problem. For analysis effect a set of eleven ITIL process was considered in this research ¿ service desk, incident management, problem management, change management, configuration management, release management, service level management, availability management, capacity management, continuity management and finally IT financial services management ¿ grouped in its two core areas ¿ service support and service delivery. Then a scale was constructed and validated, on the basis of theoretical models developed by Volberda (1997), Tenório (2002) and Golden and Powell (1999), to measure the flexibility related to each process comprising the ITIL core. The dimensions adopted to measure flexibility were: organization design task, managerial task, IT impact on work force, HR management, efficiency impact, sensitivity, versatility and robustness. The instrument used in research was a semi-structured interview, which was divided in two parts. The data collection was performed with ten interviewed people from an IT multinational company, based on convenience, some were managers and there were users, some were ITIL certified and others not. The statistic tests of t student and Wilcoxon non-parametric were adopted. The result of the research indicated that the ITIL service support area, for possessing greater operational focus, presents flexibility trend. The opposite was found for the service delivery area, which has greater tactical focus. The results also suggest that the change management discipline was the one that contributed for the most flexibility inside the company, followed by incident management discipline and the service desk function.

Politicas publicas e telecomunicações no Brasil (1985-1992) : analise dos impactos sociais

Após 1985, o objetivo de privatização e desregulamentação substituiu a doutrina de desenvolvimento e segurança que orientava a formulação da política de telecomunicações no Brasil desde 1962. Utilizando referências da Escola de Análise de Políticas Públicas, Escolha Coletiva e da Teoria da Regulação, a pesquisa analisa os reflexos dessa mudança nas áreas sociais: Educação, Saúde e Previdência. O monitoramento da política de telecomunicações identificou programas visando a popularização do telefone, mas que não atingiram plenamente seus objetivos. Novas tecnologias foram introduzidas, como o satélite BRASILSAT, a telefonia celular e a TV a cabo, mas os benefícios principais de sua disseminação continuaram em favor de grupos preferenciais. A recente reformulação dos programas de TV educativos e a iniciativa de prover o acesso das escolas à rede INTERNET permitem prognosticar impactos positivos na Educação, entretanto, até 1992, a população continuava a ser mantida ausente da agenda da política pública e a tecnologia da informação ainda não tinha chegado nas escolas. Os impactos na Previdência decorreram da implantação de uma moderna rede de comunicações pela DATAPREV, reduzindo os prazos de atendimento aos segurados do INSS, e melhorando o controle fmanceiro sobre a arrecadação de contribuições e o pagamento dos benefícios. Os impactos na Saúde ainda não foram sentidos no atendimento ao cidadão, mas a disseminação de informações coletadas e processadas pelos sistemas do DATASUS provocaram efeitos positivos no planejamento e controle dos gastos com consultas médicas e internações hospitalares.

Convênios para implantação de obras públicas: accountability em risco

Convênios estão sendo cada vez mais usados na implementação de programas e na prestação de serviços públicos, como uma ferramenta de administração para compartilhar poder e autoridade com os parceiros do governo na tomada de decisões. O objetivo deste estudo foi avaliar se a estrutura (framework) de governança dos convênios firmados entre o Estado do Rio de Janeiro e diversos municípios para a implantação de obras públicas tem sido adequada. Em particular, verificar se essas ações públicas descentralizadas atendem aos princípios da liderança, do interesse público, da transparência e da accountability, oferecendo, aos stakeholders e aos cidadãos, meios apropriados para que também exerçam o controle social sobre a execução das ações governamentais. Nesta pesquisa, foram examinadas as principais questões referentes à efetiva participação em convênios, identificados os atributos desejáveis desses acordos de cooperação, assim como algumas boas práticas de implementação. Na avaliação, constata-se que a accountability ao legislativo é fraca e que a boa governança nem sempre está assegurada, dada a reduzida capacidade de celebrar, acompanhar e fiscalizar a execução, assim como de avaliar os resultados e as prestações de contas.

O enfoque comunitário: uma visão renovadora das abordagens tradicionais em psicologia e aconselhamento

Nos últimos anos, vem sendo desenvolvido um número significativo de abordagens dos problemas comportamentais e sociais. Todas elas fazem parte de um movimento mais amplo de mudança de funções, papéis, metodologias e programas tradicionais das profissões de ajuda. As novas direções vislumbradas em psicologia, ultrapassam os limites de uma postura profissional passiva e destacam que os modelos intrapessoais da psicologia nem sempre condizem com as realidades sociais. o objetivo deste estudo foi fornecer uma visão geral destas abordagens inovadoras, que refletem um posiconamento novo, não tradicional, nas profissões de ajuda, integrando-as em um conjunto coeso: a abordagem comunitária em psicologia e, mais especificamente, no aconselhamento psicológico. A abordagem comunitária enfatiza a necessidade de se desenvolver modelos preventivos e desenvolvimentistas de amplo alcance, em psicologia, bem como a necessidade de se reconhecer o contexto social no qual ela é praticada. Requer novas definições de muitas e papéis para as atividades de ajuda. Tratou-se, neste estudo, de apresentar definições e de estabelecer um fundamento histórico, ideológico e teórico para esta posição, bem como de ilustra-la através de programas de nível comunitário, que extrapolam a orientação tradicional de ajuda. Tratou-se também, dos muitos problemas enfrentados nestes programas e das perspectivas para o novo campo da psicologia e do aconselhamento comunitário. Concluiu-se que a descrição de tal posição poderá fornecer importantes subsídios para aqueles psicólogos interessados em desempenhar um papel profissional mais completo e em atualizar-se acerca das modalidades preventivas e desenvolvimentistas de prestação de serviços.

Adoção de governo eletrônico no Brasil: a perspectiva do usuário do Programa Nota Fiscal Paulista

A intensa utilização da tecnologia da informação (TI) por todos os setores disseminou-se também na Administração Pública. A utilização da TI aliada à internet como ferramenta de gestão pública é denominada governo eletrônico e tem como objetivos qualificar melhor a prestação dos serviços e possibilitar aos cidadãos uma participação mais efetiva no processo político. O presente estudo buscou investigar o contexto do governo eletrônico no Brasil e apresenta um modelo de adoção baseado numa iniciativa de informatização de mecanismos de controle fiscal do Estado de São Paulo. O objetivo geral da tese foi estudar quais são os elementos que influenciam a utilização do governo eletrônico no Brasil, por meio de um estudo no programa Nota Fiscal Paulista (NFP). A metodologia envolveu técnicas do método qualitativo, pelo uso de opiniões de especialistas, associadas a procedimentos do método quantitativo, por meio de um survey aplicado em 715 usuários da NFP. A análise utilizou modelagem por equações estruturais. Os resultados contribuem para as pesquisas em TI, apresentando um modelo que reforça e amplia os estudos anteriores sobre adoção tecnológica e os estudos de governo eletrônico, acrescentando um modelo em um novo contexto ainda pouco explorado. No caso da NFP, os fatores testados e que influenciam no processo de adoção são: Benefício Percebido, Facilidade de Uso Percebida, Influências Sociais, Segurança Percebida, Confiança e Hábito. Em termos práticos, a pesquisa auxilia na compreensão da participação e do envolvimento dos cidadãos na fase atual de desenvolvimento de governo eletrônico no Brasil. Com melhor esclarecimento da influência dessa tecnologia na vida pessoal e profissional dos usuários, é possível elevar a qualidade da prestação dos serviços para atender às demandas da sociedade. Isto posto, auxilia também na implantação mais rápida do programa em outros contextos administrativos para o governo eletrônico, gerando informações úteis para os principais pontos a se considerar para ampliar a adesão dos cidadãos e ter mais chance de sucesso na implantação.

Participação no processo orçamentário (PPA, LDO, LOA) por meio de aplicativos móveis: uma proposta para o governo do estado de São Paulo

Este trabalho tem como objetivo explorar como o governo do Estado de São Paulo pode utilizar a tecnologia para fortalecer a participação dos cidadãos no processo orçamentário público por meio de aplicativos móveis. Nos últimos anos, o advento e a difusão de novas tecnologias tem impactado significativamente o relacionamento do Estado com os cidadãos em todo o mundo. Uma destas mudanças é a difusão e popularização de smartphones e tablets, que impõe desafios e oportunidades em termos de prestação de serviços e participação do cidadão no processo de elaboração, implementação e avaliação de políticas públicas. Para o alcance dos objetivos deste trabalho, como método de pesquisa, foi realizada, inicialmente, uma revisão da literatura sobre m-government, e-democracia e sistema orçamentário brasileiro. Em um segundo momento foi realizada a observação de experiências internacionais e nacionais, posteriormente aplicada ao estudo do caso do governo do Estado de São Paulo, explorando as possibilidades de utilização do m-government no processo orçamentário paulista. A partir de 2010, as leis anuais de diretrizes orçamentárias do Estado de São Paulo, passaram a conter dispositivos com relação à realização de audiências públicas ao Orçamento Estadual, de forma regionalizada. O uso das TICs no processo orçamentário pode contribuir para facilitar o entendimento dos complexos conceitos de finanças públicas e orçamento público. A utilização do m-government para elaboração de um futuro aplicativo no Estado de São Paulo deve possuir uma área explicativa, com textos e vídeos educativos, possibilitando aos cidadãos uma participação mais qualificada e efetiva. Conclui-se que os temas de e-democracia e m-government ainda são incipientes no Brasil, porém representam uma oportunidade para que governos se aproximem dos cidadãos, tendo em vista que ainda não está sendo explorado o potencial de interação e comunicação através da internet e aplicativos móveis. Esta perspectiva ainda não está inserida na agenda governamental, mas a sociedade civil está cobrando participação efetiva no ciclo de políticas públicas. Sugere-se que seja ampliada a adoção do uso de ferramentas tecnológicas de m-government e e-government, porque tendem a contribuir na interação entre cidadãos e o governo na elaboração, implementação e avaliação de políticas públicas com o aperfeiçoamento da alocação dos escassos recursos orçamentários disponíveis.

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Utilização do Balanced Scorecard na gestão pública : um estudo de caso na Polícia Militar do Estado do Rio Grande do Norte

This dissertation deals with the use of the Balanced Scorecard (BSC) in the Military Police of Rio Grande do Norte (PMRN), an organization of service delivery in the area of public safety. For this purpose we sought refuge in the company's own documents, which presented the mission, vision and strategic objectives, which are items essential to the development of the instrument and its prospects. With the general objective of developing the BSC to PMRN, fitting into the methodology in a single case study, that from the desk study and according to their development, we established the classification of goals to the generic models and the BSC then adjusted according to public understanding of the corporation presented by professionals in the process of collection and in-depth interviews. Thus emerged the strategy map PMRN, based on the presentation of the causes and effects between the strategic objectives of each perspective, the value proposition to customers, internal processes needed to meet this value proposition and intangible assets, which are the basis to execute these processes

Egressos na avaliação da qualidade de um curso: o caso da Engenharia de Produção da UFRN

This thesis aims at analyzing the perspective of graduates perceived quality of an undergraduate course in order to contribute to continuous improvement. In order to achieve the proposed objectives, we performed a literature search, seeking together the work surrounding this issue, with the intent to update the concepts discussed today on the subject studied, they are: quality management, quality in higher education institutions and the system national assessment of higher education - Sinaes. The methodology is characterized as a case study, quantitative, and the object of study is composed of students who graduated from Production Engineering, Federal University of Rio Grande do Norte, which includes students who graduated from 2002 to 2010; data collection was done through the survey instrument, questionnaire, available online through SurveyMonkey interface, data analysis was done by means of descriptive statistics and multivariate analysis, including factor analysis. The proposed survey instrument consists of questions nineteen and twenty statements that address the central theme of this dissertation. The results show the identification of four latent factors (obtained by exploratory factor analysis), through two perspectives, the analysis of perception and importance, the results were similar in terms of the variable factors. The first factor was related to the support given to students, a factor known to support two extra class, the third factor related aspects of the library, and finalizing the evaluation and approached a factor of 4 facilities. Through research it was concluded that this study presents several points to be improved by the management team, and recommended to continue to evaluate the perceptions of graduates, seeking continuous improvement in service delivery by the university

O impacto dos custos não-gerenciáveis na determinação das tarifas de energia elétrica: um estudo nas companhias distribuidoras do nordeste que tiveram revisão tarifária nos exercícios de 2003 e 2004

This work presents results derived from a study related to impact on non-controllable costs in the determination of energy taxes. This is done analyzing tax review practiced by concessionaries responsible for the distribution of electrical energy located in the Northeastern Region of Brazil, between 2003 and 2004. This Region was chosen as a study area due to the researcher s expectation in congregating companies that deliver services to markets that have similar social-economical profiles. A brief explanation related to the restructuring of the electrical sector in Brazil is presented, pointing out that there was privatization of the great majority of these companies. The study also points out the definition of regulating rules in service delivery process. The components of taxes that are practiced by these companies aimed at final consumers, as well as the market as a whole and the revision process that is executed by Agência Nacional de Energia Elétrica ANEEL for the definition of these taxes are demonstrated in the research. A brief historical of the concessionaires that were focus of the research is presented, totaling five companies. Some data used by ANEEL in the tax review process was analyzed as well as data on components of approved taxes. It is concluded that as a media 47, 49% of the components of taxes in the researched companies correspond to the non-controllable costs. These is done considering previous classification by ANEEL in the tax review process. Although, if it is considered that these companies since 2006, by the means of participation in energy auctions are able to negotiate energy prices for their own needs, it is concluded that these concession contracts guarantee the delivery of the service to the costumer in the total tribute. The percentage of non-controllable costs is 16, 27% average of the tax. This means, amongst other information, that the government has a great deal of responsibility in the formation of price practiced by these companies and its target markets