INTERVENÇÕES DE PSICÓLOGOS NAS UNIDADES BÁSICAS DE SAÚDE DO GRANDE ABC

Este trabalho tem como objetivo fazer um levantamento das intervenções que são realizadas pelos psicólogos que atuam nas Unidades Básicas de Saúde (UBS) do Grande ABC, bem como traçar um perfil destes profissionais. Pretendeu-se fazer na Região do Grande ABC este levantamento, baseando-se na tradição que a Psicologia tem de pesquisar-se como profissão, nos últimos trinta anos. A análise dos dados da pesquisa se deu através de quatro categorias levantadas a partir das mudanças que o exercício da profissão nas UBS requer: 1) do âmbito do atendimento, do individual para o coletivo; 2) do atendimento em consultório para instituição pública; 3) do enfoque do trabalho, do curativo para o preventivo; 4) da área de atuação, da saúde mental para a psicologia da saúde. Os resultados apresentados são oriundos de trinta e oito entrevistas realizadas com psicólogos das UBS s da Região do Grande ABC, no decorrer do ano de 2002, que trazem as dificuldades para o desenvolvimento das atividades. Dentre elas, destaca-se as de ordem política, econômica e social, que independem do desejo dos profissionais. Além destas, constatou-se dificuldades frente à formação profissional e à compreensão do papel e da função do psicólogo nas UBS s.

INTERVENÇÕES DE PSICÓLOGOS NAS UNIDADES BÁSICAS DE SAÚDE DO GRANDE ABC

Este trabalho tem como objetivo fazer um levantamento das intervenções que são realizadas pelos psicólogos que atuam nas Unidades Básicas de Saúde (UBS) do Grande ABC, bem como traçar um perfil destes profissionais. Pretendeu-se fazer na Região do Grande ABC este levantamento, baseando-se na tradição que a Psicologia tem de pesquisar-se como profissão, nos últimos trinta anos. A análise dos dados da pesquisa se deu através de quatro categorias levantadas a partir das mudanças que o exercício da profissão nas UBS requer: 1) do âmbito do atendimento, do individual para o coletivo; 2) do atendimento em consultório para instituição pública; 3) do enfoque do trabalho, do curativo para o preventivo; 4) da área de atuação, da saúde mental para a psicologia da saúde. Os resultados apresentados são oriundos de trinta e oito entrevistas realizadas com psicólogos das UBS s da Região do Grande ABC, no decorrer do ano de 2002, que trazem as dificuldades para o desenvolvimento das atividades. Dentre elas, destaca-se as de ordem política, econômica e social, que independem do desejo dos profissionais. Além destas, constatou-se dificuldades frente à formação profissional e à compreensão do papel e da função do psicólogo nas UBS s.

QUALIDADE DE VIDA, SUPORTE SOCIAL E CONTROLE GLICÊMICO EM PORTADORES DE DIABETES MELLITUS TIPO2

Diabetes Mellitus é uma doença crônica degenerativa que impõe uma série de limitações em função da necessidade de tratamento constante. Por isso, considerou-se que o estudo da qualidade de vida e suporte social poderia trazer conhecimento para melhorar a qualidade das intervenções para estes pacientes. O objetivo deste trabalho foi avaliar a qualidade de vida, suporte social e controle glicêmico de portadores de Diabetes Mellitus tipo2. Trata-se de um estudo descritivo e transversal, desenvolvido com 120 pacientes de ambos os gêneros, atendidos no ambulatório de endocrinologia de um hospital situado na cidade de São Bernardo do Campo. Para coleta dos dados foram utilizados os seguintes instrumentos: questionário para caracterização da população, questionário de qualidade de vida (WHOQOL-BREF) e a Escala de Percepção de Suporte Social (EPSS). Os dados referentes ao controle glicêmico foram coletados nos prontuários dos pacientes. Para análise dos dados utilizou-se à estatística descritiva e provas estatísticas (Pearson, QuiQuadrado, Exato de Fisher, Anova e Pos-hoc). Os resultados indicaram que o domínio das relações sociais foi o que mais contribuiu a qualidade de vida. E as variáveis tempo de diagnóstico, insulinoterapia, número de dependentes, escolaridade, dieta e medicação interferiram na qualidade de vida e na qualidade do tratamento. Estes resultados chamam a atenção para que as avaliações médicas devam ser atreladas a avaliações da qualidade de vida, suporte social e também variáveis que interferem na qualidade do tratamento para que, desta forma possam redimensionar ou melhorar fazeres ligados às intervenções com estes pacientes.

Internet financial reporting in Saudi Arabia: users' perceptions and disclosures

This thesis investigates corporate financial disclosure practices on Web sites and their impact. This is done, first by examining the views of various Saudi user groups (institutional investors, financial analysts and private investors) on disclosure of financial reporting on the Internet and assessing differences, if any, in perceptions of the groups. Over 303 individuals from three groups responded to a questionnaire. Views were elicited regarding: users attitude to the Internet infrastructure in Saudi Arabia, users information sources about companies in Saudi Arabia, respondents perception about the advantages and disadvantages in Internet financial reporting (IFR), respondents attitude to the quality of IFR provided by Saudi public companies and the impact of IFR on users information needs. Overall, it was found professional groups (Institutional investors, financial analysts) hold similar views in relation to many issues, while the opinions of private investors differ considerably. Second, the thesis examines the use of the Internet for the disclosure of financial and investor-related information by Saudi public companies (113 companies) and look to identify reasons for the differences in the online disclosure practices of companies by testing the association between eight firm-specific factors and the level of online disclosure. The financial disclosure index (167 items) is used to measure public company disclosure in Saudi Arabia. The descriptive part of the study reveals that 95 (84%) of the Saudi public companies in the sample had a website and 51 (45%) had a financial information section of some description. Furthermore, none of the sample companies provided 100% of the 167 index items applicable to the company. Results of multivariate analysis show that firm size and stock market listing are significant explanatory variables for the amount of information disclosed on corporate Web sites. The thesis finds a significant and negative relationship between the proportion of institutional ownership of a companys shares and the level of IFR.

Medication reconciliation by a pharmacy technician in a mental health assessment unit

Background: Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies. Objective: To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust. Setting: In-patient mental health services. Methods: Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics; and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies. Main outcome measure: Mean number of discrepancies per admission corrected by the pharmacy technician. Results Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected. The most common discrepancy was omission (n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43 (37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age. Conclusions: Medication discrepancies are common within mental health services with potentially significant consequences for patients. Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety. © 2013 Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie.

Learning and change in interorganizational networks:the case for network learning and network change

The ALBA 2002 Call for Papers asks the question ‘How do organizational learning and knowledge management contribute to organizational innovation and change?’. Intuitively, we would argue, the answer should be relatively straightforward as links between learning and change, and knowledge management and innovation, have long been commonly assumed to exist. On the basis of this assumption, theories of learning tend to focus ‘within organizations’, and assume a transfer of learning from individual to organization which in turn leads to change. However, empirically, we find these links are more difficult to articulate. Organizations exist in complex embedded economic, political, social and institutional systems, hence organizational change (or innovation) may be influenced by learning in this wider context. Based on our research in this wider interorganizational setting, we first make the case for the notion of network learning that we then explore to develop our appreciation of change in interorganizational networks, and how it may be facilitated. The paper begins with a brief review of lite rature on learning in the organizational and interorganizational context which locates our stance on organizational learning versus the learning organization, and social, distributed versus technical, centred views of organizational learning and knowledge. Developing from the view that organizational learning is “a normal, if problematic, process in every organization” (Easterby-Smith, 1997: 1109), we introduce the notion of network learning: learning by a group of organizations as a group. We argue this is also a normal, if problematic, process in organizational relationships (as distinct from interorganizational learning), which has particular implications for network change. Part two of the paper develops our analysis, drawing on empirical data from two studies of learning. The first study addresses the issue of learning to collaborate between industrial customers and suppliers, leading to the case for network learning. The second, larger scale study goes on to develop this theme, examining learning around several major change issues in a healthcare service provider network. The learning processes and outcomes around the introduction of a particularly controversial and expensive technology are described, providing a rich and contrasting case with the first study. In part three, we then discuss the implications of this work for change, and for facilitating change. Conclusions from the first study identify potential interventions designed to facilitate individual and organizational learning within the customer organization to develop individual and organizational ‘capacity to collaborate’. Translated to the network example, we observe that network change entails learning at all levels – network, organization, group and individual. However, presenting findings in terms of interventions is less meaningful in an interorganizational network setting given: the differences in authority structures; the less formalised nature of the network setting; and the importance of evaluating performance at the network rather than organizational level. Academics challenge both the idea of managing change and of managing networks. Nevertheless practitioners are faced with the issue of understanding and in fluencing change in the network setting. Thus we conclude that a network learning perspective is an important development in our understanding of organizational learning, capability and change, locating this in the wider context in which organizations are embedded. This in turn helps to develop our appreciation of facilitating change in interorganizational networks, both in terms of change issues (such as introducing a new technology), and change orientation and capability.

Emotional responses to King-Kopetzky syndrome:a qualitative study

The objective of the study was to identify the effects of King-Kopetzky syndrome on emotional well-being and the effects of emotional well-being on the condition itself. The study was designed as a qualitative study using semi-structured interviews, using six patients with long-standing hearing problems and exposure to a range of interventions. Participants were recruited from Audiology and Hearing Therapy Services, Bath and the Welsh Hearing Institute, Cardiff. Interviews were conducted in participants' homes and work places. King-Kopetzky syndrome was perceived to result in a change in level of anxiety, distress and depression. The determining factor in whether the change was positive (e.g. reduction in anxiety, distress or depression) or negative (e.g. increase in anxiety, distress or depression) was the person's interpretation of the experience of not hearing. This process of interpretation was based on feeling different towards other people, the relationship with the communicant person, and the confidence to employ strategies and the types of strategies chosen. Participants associated an increase in distress, anxiety or depression with an increase in mishearing or not hearing, and a reduction in hearing difficulties with a reduction in anxiety, distress and depression. It is hypothesised that emotional response to King-Kopetzky syndrome affects the degree of hearing difficulty experienced. Interventions aimed at the process of interpretation may be a means of empowering individuals in managing their own hearing difficulties.

Using a mixed design study to develop a breast screening intervention among Chinese women in the UK

Breast cancer is the most common cancer among Chinese women living in the UK. However the literature suggests that Chinese women are less likely to attend breast screening than white British women. No studies have been conducted to explore reasons for low attendance among this specific population. The purpose of this thesis was to understand the psycho-social factors related to breast cancer prevention and screening among Chinese women in the UK, and then to inform a breast screening intervention design. Three studies were conducted. The first was a systematic review of interventions to increase breast screening among Chinese women living in Western countries. The second and third studies used focus groups to explore Chinese women’s beliefs about breast cancer prevention and screening practices among older and younger generations. Finally, Intervention Mapping was used to synthesise the findings of the focus groups with those of the systematic review to design an empirical and theoretical evidence based breast screening intervention directed at Chinese women who are non-adherent to the NHS Breast Screening Programme. The qualitative findings revealed that older participants held a more holistic view of health maintenance, and had less knowledge about breast cancer and its causes than younger participants. They showed positive attitudes to breast screening and most had responded to receiving a mammography invitation. Language was a key barrier to older participants using medical care and obtaining health-related information. Younger participants expressed high dissatisfaction with health care in UK and showed a strong ‘neo-fatalistic’ view of breast cancer prevention, believing the main cause of breast cancer to be genetic predisposition. The synthesis of findings suggest that healthcare providers need to take Chinese cultural and language concerns, but also the differences between generations, into account when designing and implementing breast screening services and educational programmes which target Chinese women.

Employment and the Social Economy. EU Funding Opportunities for Developing Human Resources

The paper examines the role of EU cohesion policy in the field of human resources development and improving conditions for employment. The main objective of the analysis is to present a comprehensive picture about funding opportunities in connection with financing the activities of organisations of the social economy. As a background, the study stresses that the success of the European integration process depends to a great extent on the strength of economic and social cohesion between EU member states and regions. In order to create conditions for sustainable and balanced growth with social inclusion, there is a need to enhance the competitiveness of less developed regions combating the difficulties of structural change, and to improve their development prospects. To achieve this aim, one of the most important fields is to improve human resources. The paper points out, that EU cohesion policy has a crucial role in reducing disparities. After a general introduction to the EU level regional policy funding, the study focuses on the activities supported by the European Social Fund (ESF). The next part of the study deals with the possible types of the social economy projects and problems of self-financing. The author emphasises that social innovation emerges where State and markets fail to deliver for society (theory of non-profit/third sector) but not just to fix or replace them. The author concludes that these projects require state subsidies (official grants) at the beginning, but at the same time they can generate income. In this respect they follow same economic goals as other market actors, however, the crucial difference is that their main goal is not to make high profits for the owners. In the last part, as a concrete case study, the paper concentrates on the priorities of the Hungarian development plan in relation to social renewal. The author explains the priorities and fields of interventions of the social renewal programme. Finally, the chapter deals with the recent changes in the Hungarian employment policy and related measures supported by the European Social Fund. The chapter concludes that several employment programmes, projects for the development of social economy and programmes assisting the spreading of voluntariness and the training of volunteers have been launched with the co-financing of ESF.

A systems model for community injury prevention

The purpose of this study was to develop, explicate, and validate a comprehensive model in order to more effectively assess community injury prevention needs, plan and target efforts, identify potential interventions, and provide a framework for an outcome-based evaluation of the effectiveness of interventions. A systems model approach was developed to conceptualize the major components of inputs, efforts, outcomes and feedback within a community setting. Profiling of multiple data sources demonstrated a community feedback mechanism that increased awareness of priority issues and elicited support from traditional as well as non-traditional injury prevention partners. Injury countermeasures including education, enforcement, engineering, and economic incentives were presented for their potential synergistic effect impacting on knowledge, attitudes, or behaviors of a targeted population. Levels of outcome data were classified into ultimate, intermediate and immediate indicators to assist with determining the effectiveness of intervention efforts. A collaboration between business and health care was successful in achieving data access and use of an emergency department level of injury data for monitoring of the impact of community interventions. Evaluation of injury events and preventive efforts within the context of a dynamic community systems environment was applied to a study community with examples detailing actual profiling and trending of injuries. The resulting model of community injury prevention was validated using a community focus group, community injury prevention coordinators, and injury prevention national experts. ^

Mentoring and minority student development

Positive student development is a complex and multidimensional process, and is therefore best understood through interdisciplinary approaches. Recently, researchers studying the optimization of student development have responded to the challenge by using and integrating concepts from both educational and human developmental theories (King & Magdola, 1999). This theoretical confluence holds significant promise for ethnic minority college students due to the particular challenges these students often encounter. This research assesses individuals involved in an undergraduate educational and professional development mentoring intervention designed to optimize student development for ethnic minority students. First, in order to explore how development is fostered for minority college students, three objectives were pursued. The first objective was to assess the goals that students set for themselves and the degree of personal expressiveness they have in relation to their chosen goals. The second objective was to identify the types of challenges and obstacles that minority students perceive during their college years. The third objective was to identify the need for and availability of resources and support in overcoming obstacles to college success. Specifically, it was assessed whether (and in what ways) students involved in the intervention perceive significantly fewer obstacles and limitations to their development and greater availability of support and resources as a result of their involvement with the mentoring intervention. Second, the relationship between intervention involvement and students' perceptions of institutional and mentor nurturance and support was assessed. ^ A survey was conducted with 77 undergraduate students at Florida International University. A comparison-control design was used to compare students who were involved in the intervention (n = 38) and students who were not involved (n = 39) on variables related to their goals, perceived obstacles and supports, and college experiences. Results indicate that students in the intervention and students in the control group differed in goal orientation and perceived obstacles and supports. The two groups did not differ in their perceptions of institutional nurturance and support. Implications for the development and refinement of interventions aimed at fostering professional development for minority students are discussed. ^

Essays on audit report lag

Audit reporting lag continues to remain an issue of significant interest to regulators, financial statement users, public companies, and auditors. The SEC has recently acted to reduce the deadline for filing annual and quarterly financial statements. Such focus on audit reporting lag arises because, as noted by the Financial Accounting Standards Board, relevance and reliability are the two primary qualities of accounting information; and, to be relevant, information has to be timely. In my dissertation, I examine three issues related to the audit report lag. The first essay focuses on the association between audit report lag and the meeting or beating of earnings benchmarks. I do not find any association between audit report lag and just meeting or beating earnings benchmarks. However, I find that longer audit report lag is negatively associated with the probability of using discretionary accruals to meet or beat earnings benchmarks. We can infer from these results that audit effort, for which audit report lag is a proxy, reduces earnings management. The second part of my dissertation examines the association between types of auditor changes and audit report lag. I find that the resignation of an auditor is associated longer audit report lag compared to the dismissal of an auditor. I also find a significant positive association between the disclosure of a reportable event and audit report lag. The third part of my dissertation investigates the association between senior executive changes and audit report lag. I find that audit report lag is longer when client firms have a new CEO or CFO. Further, I find that audit report lag is longer when the new executive is someone from outside the firm. These results provide empirical evidence about the importance of senior management in the financial reporting process.

Ethnic identification: Impact on HIV/AIDS risk among migrant and seasonal workers in South Florida

Migrant workers are one of the most rapidly growing populations in the United States (U.S.) and have been significantly affected by HIV/AIDS. More than 9 million people in the U.S., primarily concentrated in Texas, Florida, Washington, California, Oregon, and North Carolina, are migrant farm workers. High prevalence rates are also suspected among migrant worker communities where risky health behaviors appear to be common. Constant mobility, isolation, limited education, substandard housing, and poverty are some of the factors that migrant workers experience and in many cases increases their HIV risk. Recent studies have suggested that ethnic identity or the level of attachment with one's ethnic group may influence engagement in HIV risk behaviors, a fact that may be important in the development of interventions among ethnic minorities. This study assesses the relationship between ethnic identity and HIV risk behaviors in two different samples; one assesses this relationship at baseline with a total of 431 African American migrant and seasonal workers in Immokalee, Florida. The second analyzes changes in ethnic identity and HIV behaviors in a sample of 270 Hispanic and African American migrant and seasonal workers in Immokalee, Florida. Data from baseline and 6-month follow-up were used in the analyses presented. The results suggest that individuals with higher levels of ethnic identity report lower levels of engagement in some, but not all, of the risky behaviors examined. These findings point to a potentially protective role for ethnic identity among this sample.

O papel do centro histórico na cidade: um estudo comparativo entre João Pessoa e Tours

In the contemporary scene, it is conspicuous that the patrimony and the culture have assumed privileged positions in urban policies, presenting themselves as instruments for transforming and shaping the aspect of cities. In the plot line of such glowing trend, the competitiveness among cities has drawn more attention, for at present such urban centers garner an image that makes them suitable for economic purposes, thus more likely to attract investments and tourists. In the spotlight of such stage, the cities become notable actors, directed by policies of urban rehabilitation. In such plot line, the historical centers gain more visibility and are converted into venues for staging the spectacle of everyday life. Overlapped in this process of producing images, the phenomenon of gentrification recrudesces. Thus, the discussion threaded about the patrimony gains strength in urban studies, keeping a close relationship with the ways of perceiving the cities nowadays. This work is based on the principle that the historical centers are engendered and fond by urban policies, working as transforming instruments of city perceptions and living. In that sense, the way how the historic center and the valuation assessed to old buildings are comprehended by the inhabitants is largely guided by urban policies that outline a sellable image of the city. In the light of such elaborations, an ethnographic research was made with focus on two different contexts, namely: the historic centers of João Pessoa (Brazil) and Tours (France). It was done in a comparative perspective, for it allows us to trace the main specificities of each situation in order to highlight the similarities and distinctions about the two regions mentioned above. The research aimed at apprehending how the pair redevelopment-abandonment engendered by the urban policies influence on the process of revaluation of historical centers by dwellers and to what extent there are convergences regarding such kinds of interventions, as an object of policies of urban and touristic development in Brazil and France. In order to make this work – besides the abundant bibliographic review carried out in libraries of several universities and institutions in Brazil and France – dwellers, merchants, teachers, representative people of public agencies and former residents of the historic centers of both cities were interviewed. In Tours, immigrants/Portuguese descendants were interviewed, point that greatly contributed to the understanding of the historic center before Vieux Tours renewal and restoration. Moreover a rich research on Archives and Public Agencies was done, as well as investigations on newspaper and articles on the Internet. Thus, in the context of the ethnography in historic centers, it was possible to notice that both realities reveal similarities in a comparative analytical framework

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.