Formação e supervisão das práticas clínicas : uma abordagem ecológica

Nos últimos anos, um conjunto de mudanças de natureza tecnológica institucional, legal e cultural alteraram as funções, a responsabilidade social e a estrutura das organizações de saúde. Estas transformações estão na base do debate actual sobre supervisão clínica em enfermagem enquanto estratégia de promoção da satisfação profissional, segurança e qualidade dos cuidados. A emergência da supervisão clínica em enfermagem permitiu interrogar e dar visibilidade a novas modalidades de formação no contexto de trabalho. A supervisão clínica é um processo multidimensional que inclui encontros regulares entre supervisores e supervisados, com o objectivo de analisar experiências de trabalho e de formação. Dedica-se especial atenção às dimensões emocionais, qualidade de cuidados, relação terapêutica e desenvolvimento pessoal e profissional. A presente pesquisa assume a forma de um estudo de caso realizado num hospital psiquiátrico (Hospital Magalhães Lemos). O objectivo principal do estudo consistiu em compreender o processo amplo e complexo de aprendizagens desenvolvidas em contexto clínico e a forma como estas condicionam as estratégias supervisivas. Recorrendo ao modelo bioecológico de Bronfenbrenner, o estudo interroga de forma sistemática a origem e as relações entre formação e supervisão. Os participantes do estudo foram 18 enfermeiros do referido hospital. Contamos, igualmente, com a colaboração de três peritos com profundo conhecimento da cultura e realidade hospitalar. A informação foi colhida com base em questionários e entrevistas semiestruturadas. O questionário (Clinical Supervision Nursing Inventory – CSNI - V1) inclui três partes. A parte I e II foram relevantes para caracterizar os participantes e o contexto clínico. A parte III do instrumento inclui um inventário com 24 itens. O Alfa de Cronbach calculado pelo autor foi de 0,93 para os 24 itens da escala, indicando excelentes resultados psicométricos. A entrevista semi-estruturada foi usada para a recolha de dados junto dos três peritos. Os enfermeiros possuem uma atitude positiva perante a supervisão clínica. O desenvolvimento pessoal e profissional dos enfermeiros estava relacionado com as oportunidades de formação emergentes no contexto das práticas. Embora a expressão “supervisão clínica” seja por vezes utilizada de forma incorrecta nas organizações, concluímos que existiam no hospital boas práticas a nível da supervisão dos cuidados, relacionando desenvolvimento pessoal, qualidade de cuidados e competências profissionais. Tentámos problematizar as experiências supervisivas partindo de teorias sócio-culturais e bio-ecológicas. Os participantes do estudo referiram que há necessidade de formalizar o sistema de supervisão clínica em enfermagem, evitando relacionálo com o sistema de supervisão de gestão. São apresentados e discutidos diversos subsídios para o desenvolvimento do sistema de supervisão clínica em enfermagem, no hospital.

O trabalho dos executivos: A mudança que não ocorreu

A preocupação com o trabalho dos executivos tem chamado cada vez menos a atenção dos pesquisadores. Tal fato nos parece um contra-senso quando relembramos que eles desempenham papel fundamental nas organizações atuais e que o discurso que é difundido sobre mudanças organizacionais parece alterar substancialmente o seu trabalho. O objetivo deste artigo foi comparar o trabalho dos executivos na atualidade brasileira com estudos sobre o tema. Percebemos em nossas análises, que o trabalho dos executivos de nossa amostra se assemelha muito com os descritos pela literatura consagrada. Parece que nada mudou em relação aos estudos de Fayol (1976 [1916]), Barnard (1938); Carlson (1951) e Mintzberg (1973). Eles continuam organizando, controlando e promovendo a cooperação nas organizações. Suas atividades são fragmentadas, intensas, superficiais. Além disso, notamos que há vários caminhos para desenvolvimento de pesquisas, principalmente investigar a diferença entre o trabalho desempenhado pelos executivos em empresas brasileiras e estrangeiras no país, questões relativas ao impacto de sua profissão na vida das suas famílias, aspectos relativos a controle e ideologia e influência do ensino de administração nas tarefas que desempenham no dia a dia.

O processo de criação do programa Universidade para Todos - PROUNI

From the end of the 80s, the Brazilian higher education experience strong growth, coming from the private sector, which would intensify further in the late 90th Higher education has become a lucrative business. With a drop in the number of students entering and strong competition, the number of idle places in private institutions of higher education reached 49.5% in 2004. That same year, by Measure, was the University for All Program (PROUNI) program, to include high school students from public higher education, offering scholarships to those students in private HEIs. In exchange, the IES gain tax exemption. The objective of this research is to investigate the game of interest occurred in the formulation of this program and identify the model and the political game and has led to the creation of PROUNI, analyzing the process occurred since the wording of a bill, the issue of Measure Law and that the legitimacy PROUNI, with the most important changes made initial model. Since the first draft of the Law to the final Act, the PROUNI was disfigured in its main points, as the percentage of stock for paying students, the process of selection of stock and bond of the IES program. Throughout the process of creating the program, it is quite clear the performance of the institutions representing the private higher education. As reference for the analysis was based on Rational Choice Theory of Political Science. The basic argument of the methods based on rational choice is the maximization of the benefit will be the main motivation of individuals, but they can give that your goals can be achieved more effectively through institutional action and thereby discover that their conduct is shaped by institutions. Thus, individuals rationally choose to get to a certain extent constrained to join in certain institutions, whether voluntarily or not. The PROUNI was submitted by government and public policy covered by the mystical aura of the discourse of social justice and economic development, as in higher education includes a stratum of people who would not have access to the university, due to restrictions in the supply network public higher education. However, the greatest benefit from the program are the private HEIs, which through a difficult time in a scenario marked by high competition and idleness of nearly half of the vacancies offered. The PROUNI became a program that prioritizes access and not the residence of the student to higher education. More serious than a supporting program for students Fellows is a program supporting the institutions of private education

A intemporalidade traumática: Contribuições psicanalíticas sobre a perturbação de stress pós traumático

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

Être médecin diplômé à l’étranger au Québec : des parcours contrastés d’intégration professionnelle

En 2015, il y aurait au Québec plus de 5 000 médecins diplômés à l’étranger, dont près de 2 500 travaillent comme médecins et possiblement autant qui ont emprunté d’autres voies professionnelles, momentanément ou durablement. Les migrants très qualifiés sont réputés faire face à de multiples barrières sur le marché du travail, particulièrement ceux membres de professions réglementées. Le cas des médecins est exemplaire compte tenu de sa complexité et de la multiplicité des acteurs impliqués au cours du processus de reconnaissance professionnelle. Ayant comme principal objectif de documenter les trajectoires d’intégration professionnelle de diplômés internationaux en médecine (DIM) et leurs expériences sur le marché du travail québécois, cette thèse s’attache à comprendre ce qui pourrait distinguer les trajectoires d’intégration en emploi pour un même groupe professionnel. En observant notamment les stratégies d’intégration et les ressources mobilisées, nous cherchons à mieux saisir les parcours des DIM qui se requalifient et qui exercent au Québec et ceux qui se réorientent vers d’autres secteurs d’activités. La démarche méthodologique est qualitative (terrain 2009 à 2012), le cœur des analyses étant basé sur 31 récits de vie professionnelle de DIM ayant migré au Québec principalement dans les années 2000. Les données secondaires incluent 22 entretiens non dirigés auprès d’acteurs clés de milieux institutionnels, communautaires ou associatifs ainsi qu’auprès de DIM très récemment immigrés ou ayant le projet d’immigrer. S’y ajoute l’observation ethnographique ponctuelle, telle que des activités associatives. La forme retenue pour cette thèse en est une par articles. Le fil directeur est l’exploration de l’interface entre les politiques, les pratiques et les individus au cœur des trajectoires d’intégration professionnelle. Les trois articles (chapitres 4 à 6) visent des focales complémentaires avec le même objectif : l’exploration de la complexité des trajectoires d’intégration professionnelle et la dialectique entre les niveaux micro, méso et macrosociaux. Ces derniers renvoient respectivement à la puissance d’agir des individus et leurs contraintes d’action, les relations sociales, les institutions et les pratiques organisationnelles et plus largement les structures sociopolitiques. Les résultats de cette thèse mettent en lumière des aspects complémentaires de l’intégration professionnelle et en interaction dynamique : 1) dimension macrosociale et politique; 2) dimensions institutionnelles et relations sociales; 3) identité professionnelle. Suite à l’introduction, la problématique (chap. 1) et la méthodologie (chap.2), le chapitre 3 expose les types des trajectoires d’intégration des DIM, leur hétérogénéité, et met en relief leurs récits de vie professionnelle. Le chapitre 4 soulève le paradoxe entre les politiques d’attraction de l’immigration déployés par les gouvernements canadien et québécois et les mécanismes de régulation opérant sur le marché du travail. Le chapitre 5 explore les stratégies et ressources mobilisées par les DIM et met en lumière l’effet positif des ressources symboliques. Les ressources institutionnelles de soutien, quoique élémentaires dans le processus de reconnaissance professionnelle, ne sont subjectivement pas considérées comme un élément central. Ce sont plutôt les ressources informelles qui jouent ce rôle d’appui significatif, en particulier les pairs DIM. Le chapitre 6 adopte une perspective microsociale et explore le caractère dynamique et relationnel de l’identité professionnelle, mais surtout, la puissance des conditions d’appartenance qui obligent à une flexibilité professionnelle et parfois au retrait de la profession ou du pays. Le chapitre 7 discute au plan théorique de l’intérêt d’une combinaison d’échelles analytiques et d’une ouverture disciplinaire afin de souligner les tensions et angles morts en ce qui concerne les mobilités de professionnels de la santé et leur intégration professionnelle. Cette thèse explore l’interrelation complexe entre les ressources économiques, sociales et symboliques, dans un contexte de fragmentation des ressources institutionnelles et de corporatisme.

Roślinność wodna, błotna i bagienna północnej części Dolnych Łużyc

Wydział Biologii

A NARRATIVE CASE STUDY EXAMINING THE EXPEREINCES OF MEN TEACHING SPECIAL EDUCATION IN THE ELEMENTARY GRADES

Over the past several decades, the landscape of the workplace has changed in many industrialized nations. In the United States this time period has seen the outright elimination or outsourcing of well-paying “blue collar” jobs. The workforce continues to evolve, change, and become more global, and men and women are making nontraditional occupational decisions, whether by choice or necessity. The traditional views of men and women have begun to shift. However, gender assumptions about masculinity have failed to keep pace with the shift. There are approximately 1.8 million elementary grade level teachers in United States public schools; of these, a mere 9% are male. The paucity of male teachers in the elementary grades has been a concern for many years. According to the Bureau of Labor Statistics, roughly 86% of all special education teachers are female. In 2012, 86.2% of all special education teachers were female, and by the following year, the number had dropped to 80.4%. The evidence indicates that more men are embarking on nontraditional career paths. Despite theses changes there is minimal research looking at the experiences of men working as special education teachers My goal in this study was to obtain a better understanding of the influences on and the process by which men make the decision to pursuing a career teaching special education in the elementary grades. The study utilized social role theory (Eagly, 1987), and Stead’s (2014) social constructionist theory as well as Williams’ (1992) glass escalator proposition The findings of this study confirm some of the factors related to career choice, experiences and barriers faced by men in nontraditional careers detailed in the literature. Three themes emerged for each research question: Experiences, advocacy, and benefits. Three themes emerged around the second research question exploring the experiences of men in a female-concentrated profession: The male body, communication, and perception. Three themes arose around the third research question: administration, My Masculinity, and pay. The findings run counter to Williams’ glass escalator proposition, which posits men working in female-concentrated professions are at an advantage. The findings advance support for Buschmeyer’s theory of (2013) alternative masculinity.

REDUCING TEACHER ATTRITION: THE ROLES AND RESPONSIBILITIES OF BUILDING PRINCIPALS IN A LARGE URBAN DISTRICT TO SUPPORT TEACHER RETENTION

The high rate of teacher attrition in urban schools is well documented. While this does not seem like a problem in Carter County, this equates to hundreds of teachers that need to be replaced annually. Since school year (SY) 2007-08, Carter County has lost over 7,100 teachers, approximately half of (50.1%) of whom resigned, often going to neighboring, higher-paying jurisdictions as suggested by exit survey data (SY2016-2020 Strategic Plan). Included in this study is a range of practices principals use to retain teachers. While the role of the principal is recognized as a critical element in teacher retention, few studies explore the specific practices principals implement to retain teachers and how they use their time to accomplish this task. Through interviews, observations, document analysis and reflective notes, the study identifies the practices four elementary school principals of high and relatively low attrition schools use to support teacher retention. In doing so, the study uses a qualitative cross-case analysis approach. The researcher examined the following leadership practices of the principal and their impact on teacher retention: (a) providing leadership, (b) supporting new teachers, (c) training and mentoring teaching staff, (d) creating opportunities for collaboration, (d) creating a positive school climate, and (e) promoting teacher autonomy. The following research questions served as a foundational guide for the development and implementation of this study: 1. How do principals prioritize addressing teacher attrition or retention relative to all of their other responsibilities? How do they allocate their time to this challenge? 2. What do principals in schools with low attrition rates do to promote retention that principals in high attrition schools do not? What specific practices or interventions are principals in these two types of schools utilizing to retain teachers? Is there evidence to support their use of the practices? The findings that emerge from the data revealed the various practices principals use to influence and support teachers do not differ between the four schools.

Crisis de la masculinidad hegemónica: (re)escrituras finiseculares de la batalla de los sexos en Estados Unidos

The present dissertation explores the concept of masculinity as power, paying special attention to the production and resistance of the rigid narratives of masculinity. Such configuration has prescribed the role of men in society—both at an individual and collective level—placing man at the centre of the patriarchal system and thus conferring upon men superiority over women. Such ideological construction is based on an essentialist view of the world, where biology determines destiny. As Men’s Studies have been advocating since their emergence, the victims of such an inegalitarian system are mainly women, but there are others, such as marginalized groups of men and hegemonic men themselves. Our focus is centered on the so-called crisis of masculinity that North American men went through in the last two decades of the twentieth century, the consequences of which have not yet been completely overcome. While from an essentialist point of view such a crisis is questionable, the political, economic and sociological reality of the Reagan’s Age made visible the downsides and pitfalls of toxic masculinity. In order to face the problems derived from the damaging nature of a construction that constrains men, three broad responses to the problem were taken: pro-feminist, anti-feminist and spiritual. Except for pro-feminists, the main reaction of these groupings consisted of victimizing themselves and of defending their essentialist supremacy—lulled by the fantasy world fostered by the “politics of symbolism” (Dallek, 1999 [1984]) of Reagan’s escapist policies. Opposing this reassuring image of the United States, the Blank Generation addressed the crisis of masculinity from a nihilist perspective. Through the analysis of American Psycho, this dissertation will illustrate the darkest side of the hegemonic model of masculinity...

Análise bioética do uso de artes expressivas no cuidado oncológico infantil em hospital público de Pernambuco

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Bioética, 2015.

EXISTENCE OF UNUSED MANAGED CAPACITY ON DEDICATED LANES AND AN ALTERNATIVE ON HOW TO SELL IT VIA AUCTIONS

This dissertation verifies whether the following two hypotheses are true: (1) High-occupancy/toll lanes (and therefore other dedicated lanes) have capacity that could still be used; (2) such unused capacity (or more precisely, “unused managed capacity”) can be sold successfully through a real-time auction. To show that the second statement is true, this dissertation proposes an auction-based metering (ABM) system, that is, a mechanism that regulates traffic that enters the dedicated lanes. Participation in the auction is voluntary and can be skipped by paying the toll or by not registering to the new system. This dissertation comprises the following four components: a measurement of unused managed capacity on an existing HOT facility, a game-theoretic model of an ABM system, an operational description of the ABM system, and a simulation-based evaluation of the system. Some other and more specific contributions of this dissertation include the following: (1) It provides a definition and a methodology for measuring unused managed capacity and another important variable referred as “potential volume increase”. (2) It proves that the game-theoretic model has a unique Bayesian Nash equilibrium. (3) And it provides a specific road design that can be applied or extended to other facilities. The results provide evidence that the hypotheses are true and suggest that the ABM system would benefit a public operator interested in reducing traffic congestion significantly, would benefit drivers when making low-reliability trips (such as work-to-home trips), and would potentially benefit a private operator interested in raising revenue.

Avian flu: the creation of expectations in the interplay between science and the media

This paper examines the emerging cultural patterns and interpretative repertoires in reports of an impending pandemic of avian flu in the UK mass media and scientific journals at the beginning of 2005, paying particular attention to metaphors, pragmatic markers ('risk signals'), symbolic dates and scare statistics used by scientists and the media to create expectations and elicit actions. This study complements other work on the metaphorical framing of infectious disease, such as foot and mouth disease and SARS, tries to link it to developments in the sociology of expectations and applies insights from pragmatics both to the sociology of metaphor and the sociology of expectations.

Sucesso e insucesso no licenciamento: uma perspectiva integrada.

Doutoramento em Gestão.

Carbon reduction activism in the UK: lexical creativity and lexical framing in the context of climate change

This article examines discourses associated with a new environmental movement, “Carbon Rationing Action Groups” (CRAGs). This case study is intended to contribute to a wider investigation of the emergence of a new type of language used to debate climate change mitigation. Advice on how to reduce one's “carbon footprint,” for example, is provided almost daily. Much of this advice is framed by the use of metaphors and “carbon compounds”—lexical combinations of at least two roots—such as “carbon finance” or “low carbon diet.” The study uses a combination of tools from frame analysis and lexical pragmatics within the general framework of ecolinguistics to compare and contrast language use on the CRAGs' website with press coverage reporting on them. The analysis shows how the use of such lexical carbon compounds enables and facilitates different types of metaphorical frames such as dieting, finance and tax paying, war time rationing, and religious imperatives in the two corpora.

Jujube fruit water relations during fruit maturation stage under different water deficit conditions

The fruit maturation stage is considered the optimal phenological stage for implementing water deficitin jujube (Zizyphus jujuba Mill.), since a low, moderate or severe water deficit at this time has no effect onyield, fruit volume or eating quality. However, no information exists at fruit water relations level on themechanisms developed by Z. jujuba to confront drought. The purpose of the present study was to increaseour understanding of the relationship between leaf and fruit water relations of jujube plants under dif-ferent irrigation conditions during fruit maturation, paying special attention to analysing whether fruitsize depends on fruit turgor. For this, adult jujube trees (cv. Grande de Albatera) were subjected to fiveirrigation treatments. Control plants (T0) were irrigated daily above their crop water requirements inorder to attain non-limiting soil water conditions in 2012 and 2013. T1 plants were subjected to deficitirrigation throughout the 2012 season, according to the criteria frequently used by the growers in thearea. T2 (2012), T3 and T4 (2013) were irrigated as T0 except during fruit maturation, in which irrigationwas withheld for 32, 17 and 24 days, respectively. The results indicated that the jujube fruit maturationperiod was clearly sensitive to water deficit. During most of this stage water could enter the fruits viathe phloem rather than via the xylem. From the beginning of water withholding to when maximumwater stress levels were achieved, fruit and leaf turgor were maintained in plants under water deficit.However, a direct relation between turgor and fruit size was not found in jujube fruits, which could bedue to an enhancement of a cell elasticity mechanism (elastic adjustment) which maintains fruit turgorby reducing fruit cells size or to the fact that jujube fruit growth depends on the fruit growth-effectiveturgor rather than just turgor pressure.