Fatores de risco em saúde mental : contributos para o bem-estar biopsicossocial dos profissionais da saúde

CONTEXTO: A nossa investigação estuda o stress no trabalho e a sua relação com a saúde mental. Descrevemos fatores específicos e de risco psicossocial no trabalho, particularmente no trabalho dos enfermeiros, e as suas implicações para a saúde mental e para o bem-estar biopsicossocial, tais como: Tipo de trabalho; Conteúdo do trabalho; Desempenho de papel; Relações interpessoais e grupais; Desenvolvimento da carreira; Novas tecnologias e Aspetos organizacionais. OBJETIVO(S): O objetivo fundamental foi estudar a influência de algumas variáveis pessoais e situacionais de risco biopsicossocial na saúde mental e no bem-estar dos profissionais de saúde, em contexto hospitalar METODOLOGIA: Trata-se de um estudo quantitativo, transversal e descritivo, do tipo correlacional. A recolha de informação obedeceu a um protocolo constituído por dados pessoais e as escalas: Satisfação geral do trabalho, Questionário geral de saúde, Questionário de saúde, Escala de fadiga crónica, Escala de ansiedade cognitiva-somática, Inventário de personalidade de Eysenck, Inventário clínico de autoconceito, Inventário de resolução de problemas, Questionário de vulnerabilidade ao stress e Questionário de stress ao trabalho. A amostra foi não probabilística intencional, constituída por 570 enfermeiros, a laborarem por turnos e em regime normal, no contexto hospitalar, perfazendo, no final, 360 enfermeiros. RESULTADOS: Os principais resultados apontam o seguinte: Os enfermeiros manifestam algum descontentamento com o ambiente de trabalho; A globalidade da amostra demonstra índices de saúde baixos; Regra geral, todos os enfermeiros estão vulneráveis ao stress; Em relação ao stress produzido pelas circunstâncias organizacionais, a totalidade da amostra revela elevados índices de stress e o seu bem-estar biopsicossocial, manifestamente afetado. CONCLUSÕES: Destes resultados fomos levados a concluir que quanto maior for a fadiga crónica, o neuroticíssimo e a ansiedade cognitiva, maior será a tendência dos enfermeiros para diminuírem a autorresponsabilização e o medo. Esta relação pode tornar-se circular e levar a comportamentos desajustados como, por exemplo, indiferença, desinteresse, relações interpessoais conflituosas, entre outros aspetos. As consequências de tais comportamentos poderão traduzir-se em absentismo, erros de desempenho ou vontade de abandonar a instituição.

Life cycle program management & evaluation : an heuristic approach /

"Prepared for use by the Cooperative Extension System"--Cover.

Travel time models for forest roads : a verification of the Forest Service Logging road handbook /

"9677 1202--SDTDC"--Cover.

Approaches and Strategy for Cancer Research and Surveillance Data: Integration, Information Pipeline, Data Models, and Informatics Opportunities

Thesis (Ph.D.)--University of Washington, 2016-04

Questions in Narratives from Oral Tradition to Literature

Thesis (Ph.D.)--University of Washington, 2016-06

Self-reported difficulty in conceiving as a measure of infertility

BACKGROUND: This study aimed to explore the meaning and potential use of women's self-reported difficulties in conceiving as a measure of infertility in epidemiological studies, and to compare women's stated reasons for infertility with information in their medical records. METHODS: Data were available from a population-based case-control study of ovarian cancer involving 1638 women. The sensitivity and specificity of women's self-reported infertility were calculated against their estimated fertility status based on detailed reproductive histories. Self-reported reasons for infertility were compared with diagnoses documented in women's medical records. RESULTS: The sensitivity of women's self-reported difficulty in conceiving was 66 and 69% respectively when compared with calendar-derived and self-reported times taken trying to conceive; its specificity was 95%. Forty-one (23%) of the 179 women for whom medical records were available had their self-reported fertility problem confirmed. Self-reported infertility causes could be compared with diagnoses in medical records for only 22 of these women. CONCLUSIONS: Self-reported difficulty conceiving is a useful measure of infertility for quantifying the burden of fertility problems experienced in the community. Validation of reasons for infertility is unlikely to be feasible through examination of medical records. Improved education of the public regarding the availability and success rates of infertility treatments is proposed.

Enhancing student performance through cooperative learning in physical sciences

Students in a physical sciences course were introduced to cooperative learning at the University of Queensland, Gatton Campus. Groups of four to five students worked together in tutorial and practical sessions. Mid-term and practical examinations were abolished and 40% of total marks were allocated to the cooperative learning activities. A peer- and self-assessment system was successfully adapted to account for individual performance in cooperative learning group assignments. The results suggest that cooperative learning was very well received by students, and they expressed willingness to join cooperative learning groups in other courses. In addition, cooperative learning offered many benefits to students in terms of graduate attributes such as teamwork, communication, lifelong learning and problem-solving.

Cognitive fit between conceptual schemas and internal problem representations: The case of geospatio-temporal conceptual schema comprehension

Geospatio-temporal conceptual models provide a mechanism to explicitly represent geospatial and temporal aspects of applications. Such models, which focus on both what and when/where, need to be more expressive than conventional conceptual models (e.g., the ER model), which primarily focus on what is important for a given application. In this study, we view conceptual schema comprehension of geospatio-temporal data semantics in terms of matching the external problem representation (that is, the conceptual schema) to the problem-solving task (that is, syntactic and semantic comprehension tasks), an argument based on the theory of cognitive fit. Our theory suggests that an external problem representation that matches the problem solver's internal task representation will enhance performance, for example, in comprehending such schemas. To assess performance on geospatio-temporal schema comprehension tasks, we conducted a laboratory experiment using two semantically identical conceptual schemas, one of which mapped closely to the internal task representation while the other did not. As expected, we found that the geospatio-temporal conceptual schema that corresponded to the internal representation of the task enhanced the accuracy of schema comprehension; comprehension time was equivalent for both. Cognitive fit between the internal representation of the task and conceptual schemas with geospatio-temporal annotations was, therefore, manifested in accuracy of schema comprehension and not in time for problem solution. Our findings suggest that the annotated schemas facilitate understanding of data semantics represented on the schema.

Improvement in measures of psychological distress amongst amphetamine misusers treated with brief cognitive-behavioural therapy (CBT)

This trial of cognitive-behavioural therapy (CBT) based amphetamine abstinence program (n = 507) focused on refusal self-efficacy, improved coping, improved problem solving and planning for relapse prevention. Measures included the Severity of Dependence Scale (SDS), the General Health Questionnaire-28 (GHQ-28) and Amphetamine Refusal Self-Efficacy. Psychiatric case identification (caseness) across the four GHQ-28 sub-scales was compared with Australian normative data. Almost 90% were amphetamine-dependent (SDS 8.15 +/- 3.17). Pretreatment, all GHQ-28 sub-scale measures were below reported Australian population values. Caseness was substantially higher than Australian normative values {Somatic Symptoms (52.3%), Anxiety (68%), Social Dysfunction (46.5%) and Depression (33.7%). One hundred and sixty-eight subjects (33%) completed and reported program abstinence. Program completers reported improvement across all GHQ-28 sub-scales Somatic Symptoms (p < 0.001), Anxiety (p < 0.001), Social Dysfunction (p < 0.001) and Depression (p < 0.001)}. They also reported improvement in amphetamine refusal self-efficacy (p < 0.001). Improvement remained significant following intention-to-treat analyses, imputing baseline data for subjects that withdrew from the program. The GHQ-28 sub-scales, Amphetamine Refusal Self-Efficacy Questionnaire and the SDS successfully predicted treatment compliance through a discriminant analysis function (p

Virtual training environments to improve train driver's crisis decision making

This paper reports on a current research project in which virtual reality simulators are being investigated as a means of simulating hazardous Rail work conditions in order to allow train drivers to practice decision-making under stress. When working under high stress conditions train drivers need to move beyond procedural responses into a response activated through their own problem-solving and decision-making skills. This study focuses on the use of stress inoculation training which aims to build driver’s confidence in the use of new decision-making skills by being repeatedly required to respond to hazardous driving conditions. In particular, the study makes use of a train cab driving simulator to reproduce potentially stress inducing real-world scenarios. Initial pilot research has been undertaken in which drivers have experienced the training simulation and subsequently completed surveys on the level of immersion experienced. Concurrently drivers have also participated in a velocity perception experiment designed to objectively measure the fidelity of the virtual training environment. Baseline data, against which decision-making skills post training will be measured, is being gathered via cognitive task analysis designed to identify primary decision requirements for specific rail events. While considerable efforts have been invested in improving Virtual Reality technology, little is known about how to best use this technology for training personnel to respond to workplace conditions in the Rail Industry. To enable the best use of simulators for training in the Rail context the project aims to identify those factors within virtual reality that support required learning outcomes and use this information to design training simulations that reliably and safely train staff in required workplace accident response skills.

QUALIDADE DE VIDA E ESTRATÉGIAS DE ENFRENTAMENTO DE MULHERES COM E SEM LINFEDEMA APÓS CÂNCER DE MAMA

O linfedema no membro superior é uma complicação inerente ao tratamento de câncer de mama. Caracterizado pelo aumento do volume do membro, leva às limitações físicas e funcionais, e impacto negativo no âmbito psicológico e social. O objetivo deste estudo foi investigar a qualidade de vida e seus domínios, as estratégias de enfrentamento frente ao câncer de mama, e a correlação entre essas variáveis. Este estudo foi realizado em um centro de saúde dedicado às mulheres, por quatro meses. Os instrumentos de avaliação foram: questionário de caracterização geral e específico do câncer de mama, perimetria dos membros superiores; questionários de qualidade de vida da Organização Européia de Pesquisa e Tratamento do Câncer, EORTC QLQ-30 e BR-23; e Inventário de Estratégias de Coping. Foram entrevistadas 82 mulheres, idade média de 57,4 anos (DV12,3), submetidas a tratamento cirúrgico de mama unilateral e esvaziamento axilar, sem metástase. O linfedema apresentou-se em 39,03% (32) e parece não interferir muito na qualidade de vida das mulheres pós-câncer de mama, sendo a função social a mais prejudicada. Sintomas relacionados à quimioterapia e a mama incomodam as mulheres de ambos grupos, porém os sintomas relacionados aos braços foram estatisticamente maiores nas portadoras de linfedema. As estratégias mais utilizadas pelas entrevistadas para enfrentar o câncer foram a reavaliação, resolução de problemas, fuga, suporte social e autocontrole, somente o autocontrole foi estatisticamente maior nas mulheres com linfedema. As estratégias de resolução de problemas, autocontrole e baixo suporte social podem ter colaborado para o desencadeamento do linfedema. Conclui-se que o uso de estratégias ativas e positivas para enfrentar o câncer de mama parece resultar na boa adaptação psicossocial

Uso do protocolo no serviço de psicologia e avaliação psicodinâmica em candidatos à cirurgia bariátrica

A clínica da Obesidade Mórbida e a Cirurgia Bariátrica exige estudos e acompanhamentos do paciente. Os benefícios e riscos do emagrecimento por tratamento cirúrgico devem servir como ponto de alerta aos profissionais da saúde. O uso do questionário no serviço de psicologia é norteado pela escuta psicológica. Objetivos: 1) Descrever o perfil sócio-demográfico candidatos à cirurgia bariátrica. 2) Analisar a percepção dos pacientes sobre características de personalidade associadas à obesidade e transtornos alimentares. 3) Descrever os conteúdos psicodinâmicos da narrativa do sujeito e avaliar o sistema tensional inconsciente de dois pacientes por meio do Teste das Relações Objetais de Phillipson (TRO). Método: O delineamento metodológico com análise de dados pelo método epidemiológico e estudo de caso clínico, orientação psicanalítica. Na primeira etapa foram consultados 300 questionários do serviço de psicologia e na segunda dois pacientes com ganho de peso após 24 meses. São pacientes que procuraram tratamento em clínica especializada, em uma metrópole do sudeste brasileiro, sob consentimento pós-informado. Os questionários foram preenchidos por 227 mulheres e 73 homens; com média de idade igual a 36 anos; escolaridade ensino médio e superior, 53%; maioria casados; IMC entre grave e super mórbido (94,3%). Técnicas cirúrgicas indicadas Capella Bypass e Fobi-Capella (67%). Resultados: características psicológicas referidas pelos pacientes, a ansiedade apontou em 93,7% das respostas, seguidas por impulsividade, depressão, tolerância à frustração, baixa auto-estima, resolvedor de problemas dos outros (mais de 50%). No histórico familiar da obesidade está em mais de 70% depressão e uso do álcool em 30%; realização de psicoterapia (30%) e medicamentos para depressão e ansiedade (10%). Na segunda etapa, foi realizado o diagnóstico psicodinâmico, por meio do Teste das Relações Objetais de Phillipson com duas pacientes, cuja análise indicou necessidade de psicoterapia psicanalítica, pois tinham fixações na posição esquizoparanóide e apresentavam dificuldade em lidar com perdas e baixa motivação para mudança e insigth. Conclusões: Com a aplicação do questionário e o registro das observações empíricas, este questionário de entrevista semidirigida preenche condições de melhor acessar e avaliar os conteúdos revelados pelos pacientes. As contradições entre as respostas e o discurso, no contato individual com o psicólogo, apontam a necessidade de investimento no preparo do paciente para a cirurgia e mais acentuadamente o acompanhamento psicológico no primeiro ano do pós-operatório. Há um pensamento mágico a ser trabalhado durante a aplicação do questionário sobre as crenças frente à cirurgia e o emagrecimento e assim convocar o paciente a ocupar o lugar do sujeito implicado em seu processo pré e pós-operatório. O TRO contribuiu na compreensão do diagnóstico psicodinâmico de pacientes com ganho de peso após cirurgia e reforçou a necessidade de maior investimento no pré-operatório.(AU)

Transnational environmental policy:reconstructing ozone

Transnational Environmental Policy analyses a surprising success story in the field of international environmental policy making: the threat to the ozone layer posed by industrial chemicals, and how it has been averted. The book also raises the more general question about the problem-solving capacities of industrialised countries and the world society as a whole. Reiner Grundmann investigates the regulations which have been put in place at an international level, and how the process evolved over twenty years in the US and Germany.

Expert systems for fault analysis

The initial aim of this research was to investigate the application of expert Systems, or Knowledge Base Systems technology to the automated synthesis of Hazard and Operability Studies. Due to the generic nature of Fault Analysis problems and the way in which Knowledge Base Systems work, this goal has evolved into a consideration of automated support for Fault Analysis in general, covering HAZOP, Fault Tree Analysis, FMEA and Fault Diagnosis in the Process Industries. This thesis described a proposed architecture for such an Expert System. The purpose of the System is to produce a descriptive model of faults and fault propagation from a description of the physical structure of the plant. From these descriptive models, the desired Fault Analysis may be produced. The way in which this is done reflects the complexity of the problem which, in principle, encompasses the whole of the discipline of Process Engineering. An attempt is made to incorporate the perceived method that an expert uses to solve the problem; keywords, heuristics and guidelines from techniques such as HAZOP and Fault Tree Synthesis are used. In a truly Expert System, the performance of the system is strongly dependent on the high quality of the knowledge that is incorporated. This expert knowledge takes the form of heuristics or rules of thumb which are used in problem solving. This research has shown that, for the application of fault analysis heuristics, it is necessary to have a representation of the details of fault propagation within a process. This helps to ensure the robustness of the system - a gradual rather than abrupt degradation at the boundaries of the domain knowledge.

Testing incremental politics : the case of North Sea oil

In the quest to secure the much vaunted benefits of North Sea oil, highly non-incremental technologies have been adopted. Nowhere is this more the case than with the early fields of the central and northern North Sea. By focusing on the inflexible nature of North Sea hardware, in such fields, this thesis examines the problems that this sort of technology might pose for policy making. More particularly, the following issues are raised. First, the implications of non-incremental technical change for the successful conduct of oil policy is raised. Here, the focus is on the micro-economic performance of the first generation of North Sea oil fields and the manner in which this relates to government policy. Secondly, the question is posed as to whether there were more flexible, perhaps more incremental policy alternatives open to the decision makers. Conclusions drawn relate to the degree to which non-incremental shifts in policy permit decision makers to achieve their objectives at relatively low cost. To discover cases where non-incremental policy making has led to success in this way, would be to falsify the thesis that decision makers are best served by employing incremental politics as an approach to complex problem solving.