Although school counselors strive to address the needs of all students, children with learning disabilities are often overlooked (Bergin & Bergin, 2005; Dahir, 2004). Under federal requirements, all federally funded schools are required to provide services to students with disabilities. Further, the American School Counselor Association's (ASCA) model for school counseling programs stipulates that school counselors should ensure appropriate services are provided to all students (Milsom, 2002). Research has been completed regarding teachers' attitudes toward complying with the federal mandates (Bateman & Bateman, 2002; Rea & Davis-Dorsey, 2004). There is, however, considerably less information regarding school counselors' roles, and only minimal information on their attitudes and background experience regarding learning disabilities (Frye, 2005; Greene & Valesky, 1998; Milsom, 2002). School counselors from ASCA's southern region were asked to respond to the Attitudes Toward Learning Disabilities Instrument online survey. The findings of this study demonstrated that although school counselors overwhelmingly support ASCA's guidelines, few have the full credentials outlined by the ASCA model. A majority of the counselors in this study had little or no educational training and reported feeling unprepared to address educationally-based tasks such as developing classroom accommodations, or acting as a consultant to the school staff on learning disability issues. In contrast, one third of the participants in this study were certified teachers who reported feeling prepared and confident about all areas of academic and disability services. These results support the conclusions of previous research which indicated that counselor preparation and years of experience were found to be related to more positive attitudes toward inclusion (Greene & Valesky, 1998; Greer & Greer, 1995; Milsom, 2002; Milsom & Akos, 2003) Availability Unrestricted: Release the

Cette recherche tente de répondre à la problématique suivante : dans quelle mesure la mise en place d’un manager-hybride et d’une équipe pluridisciplinaire, peut- elle permettre la gestion de la concurrence entre des logiques institutionnelles au sein d’une organisation hybride ? Nous avons alors établi un cadre théorique développant d’abord la notion d’organisation hybride. Ensuite, nous investiguons la notion de manager-hybride en la rapprochant de celle de l’acteur-frontière. Enfin, nous nous intéressons à l’équipe pluridisciplinaire qui apparaît alors comme un espace favorable à la collaboration interprofessionnelle. Concernant notre démarche empirique, celle-ci, dans le cadre d’une étude de cas unique, s’est déroulée au sein du pôle Femme-Enfant d’un centre hospitalier intercommunal de grande taille que nous considérons comme un cas extrême et révélateur. Plus particulièrement nous avons endossé une méthodologie qualitative (entretiens semi-directifs avec analyse de contenu). Quant à nos résultats, nous avons constaté que les contextes institutionnel et organisationnel apparaissent comme empreints de tensions entre les différents groupes d'acteurs. Pour autant, le chef du pôle Femme-Enfant et le trio gestionnaire parviennent, via différents mécanismes, à agir en faveur d’une compréhension mutuelle des différents groupes et d’une hybridité équilibrée. Nous émettons alors deux principaux axes de discussion : l’un traitant des différentes habiletés du manager-hybride à soutenir la conciliation entre des logiques institutionnelles concurrentes ; et l’autre, de l’équipe pluridisciplinaire comme espace favorable à la diffusion d’une hybridité équilibrée et durable / The particular purpose of the research is to answer the following question : to what extent is the implementation of a hybrid-manager and a multidisciplinary team enables the management of competing institutional logics within a hybrid organization ? To this end, we propose a theoretical framework that develops, firstly, the concepts of hybrid organization. Next, we focus on the concept of hybrid-manager to put it closer to the boundary-actor one. Lastly, we focus on the concept of multidisciplinary team. Multidisciplinary team that appears as a favorable space for interprofessional collaboration. Our empirical approach is based on a single case study, which references a particular department in a hospital located in southern France (i.e. the « child-woman pole ») that we consider as an extreme and revelatory case. More specifically, we applied a qualitative methodology (i.e. semi-structured interviews with content analysis). Concerning our results, the data analysis shows an institutional and organizational context marked by tensions between individuals. But, the the head of the child-woman pole and the trio foster a mutual understanding between groups, and in so doing, balances competing logics. Finally, these results lead us to put foward two main themes for discussion : one centred on the skills and competencies of the hybrid-manager to support reconciliation and to balance coexistence of competing logics ; and the second one, centred on the multidisciplinary team as favorable space for the emergence of a hybrid institutional logic and for the dissemination of balanced and sustainable hybridity

Made available in DSpace on 2017-07-21T14:42:33Z (GMT). No. of bitstreams: 1 MARCELO WISNIEWSKI.pdf: 2182472 bytes, checksum: 6feb7e047dc964aaf318165e6ae31cb5 (MD5) Previous issue date: 2015-09-10 / Since the advent of AIDS in the 1980’s, much has been discussed about this syndrome. Either by strands designated as 'scientific' or not, the matter raised polemics, controversies, but also caused to science to put on demand urgent studies on the treatment of this disease. In Brazil, the arrival of innovative antiretroviral therapies from the second half of the 1990’s as well as the requirement for free distribution by the public health system, contributed undoubtedly to increase longevity and quality of life of people with HIV. Overcome this phase, the epidemic maintains its trajectory and other demands, among them, adherence to drug therapies, were outlined as mandatory elements for the successful treatment of this syndrome. In this study, it was intended to historically rescue the deployment of public services care for HIV / AIDS in Ponta Grossa - PR, from the point of view of multidisciplinary teams involved. Moreover, it was emphasized the historical trajectory of the management of these patients during the arrival of the National Humanization Policy (PNH). And how these professionals involved have assimilated this police of the Unified Health System to develop promotion strategies for adherence to antiretroviral therapies. The methodology proposed in this research was conducted through a qualitative analysis of the subject throught exploratory research. Using elements such as: a literature review, documentary research through newspapers, magazines and movies on the HIV/AIDS issues; and interviews with professionals who acted and act in the treatment of patients with HIV for further analysis of content. The results obtained from this research demonstrated the underspending of PNH as supportive tool to adherence of antiretroviral therapies in the researched county. / Desde o advento da AIDS nos anos 1980, muito se discutiu a respeito desta síndrome. Seja por vertentes designadas como ‘científicas’ ou não, o assunto suscitou polêmicas, controvérsias, mas também, provocou a Ciência a colocar em demanda de urgência estudos sobre o tratamento dessa enfermidade. No Brasil, a chegada de terapias antirretrovirais inovadoras a partir da segunda metade dos anos 1990, bem como a obrigatoriedade de sua distribuição gratuita pelo sistema público de saúde, contribuiu, indiscutivelmente, para o incremento na longevidade e qualidade de vida dos portadores de HIV. Superada essa fase, a epidemia mantém sua trajetória e outras demandas, dentre elas, a adesão às terapias medicamentosas, delinearam-se como elementos imperativos para o sucesso terapêutico sobre esta síndrome. Nesta pesquisa, pretendeu-se resgatar historicamente a implantação dos serviços públicos de atendimento para portadores de HIV/AIDS em Ponta Grossa – PR, sob o ponto de vista das equipes multidisciplinares envolvidas. Destacou-se a trajetória histórica da gestão desses pacientes à luz da chegada da Política Nacional de Humanização (PNH). Buscou-se, também, verificar como os profissionais envolvidos assimilaram essa política no Sistema Único de Saúde para desenvolver estratégias de promoção à adesão às terapias antirretrovirais. A metodologia proposta nessa pesquisa foi realizada através da análise qualitativa do tema por meio de pesquisa exploratória. Utilizando-se de elementos como: a revisão teórica, a pesquisa documental através de jornais, revistas e filmes sobre o tema HIV/AIDS; e entrevistas com profissionais que atuaram e atuam no tratamento de pacientes portadores de HIV, para posterior análise de conteúdo. O resultado obtido com essa pesquisa demonstrou a subutilização da PNH como ferramenta incentivadora da adesão as terapias antirretrovirais no município de estudo.

Erros de medicação e eventos adversos relacionados a medicamentos são comuns em pacientes hospitalizados. O risco de ocorrer problemas com a população pediátrica é cerca de três vezes maior do que com a população adulta, especialmente em unidades de terapia intensiva, onde os pacientes são submetidos a grande número de prescrições de medicamentos intravenosos, com baixo índice terapêutico e formas farmacêuticas adaptadas. A farmácia clínica tem como objetivo introduzir o farmacêutico clínico junto à equipe multidisciplinar de saúde no sentido de intervir, prevenindo problemas relacionados a medicamentos à farmacoterapia (PRF), otimizando-a e contribuindo para a segurança do paciente. O presente estudo teve como objetivo avaliar a implantação e o impacto das intervenções da farmácia clínica no Centro de Terapia Intensiva-Pediátrico (CTIP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP). Trata-se de estudo prospectivo, observacional e descritivo que incluiu crianças de zero a dezoito anos, no período de um ano. Foi aplicada a ferramenta Failure Mode and Effects Analysis (FMEA - Análise dos Modos de Falha e seus Efeitos) no início do estudo para avaliar os riscos relacionados aos medicamentos no CTIP e orientar a atuação da farmácia clínica, em que o farmacêutico avaliou as prescrições diárias e realizou intervenções junto à equipe multidisciplinar. Foram acompanhadas 162 crianças e avaliadas 1586 prescrições com uma taxa de PRF de 12,42% (IC95% 10,50-14,04). Foram realizadas 197 intervenções com custo salvo de R$15.118,73. Os principais tipos de intervenções foram relacionados à indicação e necessidade do medicamento. A partir destas, os grupos foram divididos em pacientes com PRF e sem PRF. Foram detectadas diferenças significativas nas seguintes variáveis: peso, idade, tempo de internação, tempo de acompanhamento, custo total, custo salvo pelas intervenções, gravidade dos pacientes avaliada pelo escore PRISM e PELOD, quantidade total de medicamentos utilizados e quantidade de medicamentos potencialmente perigosos e endovenosos contínuos. Além disso, houve diferenças significativas na taxa de óbito e nas categorias diagnósticas entre os grupos. A implantação do serviço de farmácia clínica no CTIP mostrou impacto positivo na redução de riscos relacionados a todo o processo de utilização de medicamentos. As intervenções do farmacêutico clínico identificaram e preveniram PRF, promovendo o uso racional de medicamentos e contribuindo para a redução de custos associados à prescrição médica. / Medication errors and adverse events related to drugs are common in hospitalized patients. The potential risk for medication errors in pediatric patients is about three times higher than in adults, especially in intensive care units, where patients are subjected to a large number of intravenous drug prescriptions, with low therapeutic index and adapted pharmaceutical forms. Clinical pharmacy aims to introduce the clinical pharmacist in a multidisciplinary health team in order to intervene, preventing drug-related problems (DRPs) and optimize pharmacotherapy, contributing to patient safety. This study aimed to assess the implementation and the impact of clinical pharmacy interventions in the Pediatric Intensive Care Unit (PICU) of Hospital das Clinicas of Ribeirao Preto Medical School, University of São Paulo (HCFMRP-USP). This was a prospective, observational and descriptive study which included children from zero to eighteen years of age, over a one year period. Failure Mode and Effects Analysis Tool (FMEA) was applied at the beginning of the study to assess the risks related to medicines in the PICU and to guide clinical pharmacy work, where the pharmacist evaluated daily prescriptions and made interventions along with a multidisciplinary team. One thousand five hundred and eighty-six prescriptions of 162 children were assessed, and a DRPs rate of 12.42% (95% CI - 10.50 to 14.04) was found. One hundred ninety-seven interventions were performed, with a cost saving of R$ 15,118.73. The main types of interventions were related to indication and necessity of the drug. From these, the groups were divided in patients with DRPs and without DRPs. Significant differences were found in weight, age, time of hospitalization, time of follow-up, total cost, costs saved by interventions, severity of patients assessed by PRISM and PELOD scores, total amount of medications used, and number of potentially dangerous and continuous intravenous medications. In addition, there were significant differences in mortality rate and diagnostic categories between groups. The implementation of clinical pharmacy service in the PICU showed a positive impact on patients\' treatment. The clinical pharmacist interventions identified and prevented DRPs, promoting the rational use of medications and contributing to the reduction of costs associated with medical prescription.

Made available in DSpace on 2016-04-27T13:10:24Z (GMT). No. of bitstreams: 1 Walter Anibal Filho.pdf: 2121512 bytes, checksum: 703a7c09d1732c473fd21d82591e73c3 (MD5) Previous issue date: 2014-03-17 / Diabetes mellitus (DM) is a chronic disease characterized by impaired glucose metabolism, whose inadequate glycemic control can reduce life expectancy and impair quality of life. Due to high government investment, poor adherence by the user and little rapport of the multidisciplinary team in the program self-monitoring blood glucose (AMG), appeared motivated this study with the objectives of evaluating the performance of the team; develop and evaluate educational strategies for effective performance monitoring in type 2 diabetic patients in the AMG. We conducted a qualitative and quantitative research, the principles of action research. A total of ten professionals Basic Health Unit and Health Reference Elderly (UBS/URSI) Carandiru, SP. Eight meetings were held with educational interventions, participatory and reflexive strategies. To evaluate the performance of the team an instrument of perception and was used to assess knowledge was applied pre-and post - tests. The AMG was worse with dimension Review: little appreciation, absence of permanent education and actions that strengthen and/or value the work of professionals and systematic review. It was found best results pos test. The collective construction actions established itself as: update, add knowledge, interdisciplinary rapport, case discussion, self-assessment, focus on promotion and prevention, strengthening the program, set goals for membership, user awareness, joint consultations with multidisciplinary care and inclusion in the annual work plan. Interventions contributed to identify factors affecting the routine work, enhance the knowledge/skills, encourage participation and create a favorable environment for teamwork. Therefore efforts should be targeted to interactive strategies that are incorporated into the practice of professionals for greater integration of the team, for the benefit of the user / O diabetes mellitus (DM) é uma doença crônica, caracterizada pelo comprometimento do metabolismo da glicose, cujo controle glicêmico inadequado pode reduzir a expectativa de vida e comprometer a qualidade de vida. Devido ao alto investimento governamental, a baixa adesão por parte do usuário e o pouco entrosamento da equipe multiprofissional no programa automonitoramento glicêmico (AMG), surgiu a motivação deste estudo com os objetivos de avaliar a atuação da equipe; desenvolver e avaliar estratégias de educação para a efetiva atuação no acompanhamento de pacientes diabéticos tipo 2 no AMG. Realizou-se uma pesquisa quali-quanti, nos princípios da pesquisa-ação. Participaram dez profissionais da Unidade Básica de Saúde e de Referência Saúde do Idoso (UBS/URSI) Carandiru, SP. Foram realizados oito encontros, com intervenções educativas, com estratégias participativas e reflexivas. Para avaliar a atuação da equipe foi utilizado um instrumento de percepção e para avaliar o conhecimento foi aplicado um pré e pós-testes. O AMG foi dimensão com pior avaliação: pouca valorização, ausência de educação permanente e de ações que fortalecem e/ou valorizam a atuação dos profissionais e avaliação sistemática. Constataram-se melhores resultados no pos teste. Na construção coletiva estabeleceu-se como ações: atualização, agregar conhecimentos, entrosamento interdisciplinar, discussão de casos, auto avaliação, focar na promoção e prevenção, aprofundamento no programa, estabelecer metas de adesão, conscientização do usuário, articulação das consultas com o atendimento multiprofissional e inclusão no plano de trabalho anual. As intervenções contribuíram para identificar fatores que interferem na rotina de trabalho, aprimorar os conhecimentos/competências, estimular a participação e criar um ambiente favorável para o trabalho em equipe. Desta forma esforços devem ser direcionados para que estratégias interativas sejam incorporadas na pratica dos profissionais, para uma maior integração da equipe, em benefício do usuário

Erros de medicação e eventos adversos relacionados a medicamentos são comuns em pacientes hospitalizados. O risco de ocorrer problemas com a população pediátrica é cerca de três vezes maior do que com a população adulta, especialmente em unidades de terapia intensiva, onde os pacientes são submetidos a grande número de prescrições de medicamentos intravenosos, com baixo índice terapêutico e formas farmacêuticas adaptadas. A farmácia clínica tem como objetivo introduzir o farmacêutico clínico junto à equipe multidisciplinar de saúde no sentido de intervir, prevenindo problemas relacionados a medicamentos à farmacoterapia (PRF), otimizando-a e contribuindo para a segurança do paciente. O presente estudo teve como objetivo avaliar a implantação e o impacto das intervenções da farmácia clínica no Centro de Terapia Intensiva-Pediátrico (CTIP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP). Trata-se de estudo prospectivo, observacional e descritivo que incluiu crianças de zero a dezoito anos, no período de um ano. Foi aplicada a ferramenta Failure Mode and Effects Analysis (FMEA - Análise dos Modos de Falha e seus Efeitos) no início do estudo para avaliar os riscos relacionados aos medicamentos no CTIP e orientar a atuação da farmácia clínica, em que o farmacêutico avaliou as prescrições diárias e realizou intervenções junto à equipe multidisciplinar. Foram acompanhadas 162 crianças e avaliadas 1586 prescrições com uma taxa de PRF de 12,42% (IC95% 10,50-14,04). Foram realizadas 197 intervenções com custo salvo de R$15.118,73. Os principais tipos de intervenções foram relacionados à indicação e necessidade do medicamento. A partir destas, os grupos foram divididos em pacientes com PRF e sem PRF. Foram detectadas diferenças significativas nas seguintes variáveis: peso, idade, tempo de internação, tempo de acompanhamento, custo total, custo salvo pelas intervenções, gravidade dos pacientes avaliada pelo escore PRISM e PELOD, quantidade total de medicamentos utilizados e quantidade de medicamentos potencialmente perigosos e endovenosos contínuos. Além disso, houve diferenças significativas na taxa de óbito e nas categorias diagnósticas entre os grupos. A implantação do serviço de farmácia clínica no CTIP mostrou impacto positivo na redução de riscos relacionados a todo o processo de utilização de medicamentos. As intervenções do farmacêutico clínico identificaram e preveniram PRF, promovendo o uso racional de medicamentos e contribuindo para a redução de custos associados à prescrição médica. / Medication errors and adverse events related to drugs are common in hospitalized patients. The potential risk for medication errors in pediatric patients is about three times higher than in adults, especially in intensive care units, where patients are subjected to a large number of intravenous drug prescriptions, with low therapeutic index and adapted pharmaceutical forms. Clinical pharmacy aims to introduce the clinical pharmacist in a multidisciplinary health team in order to intervene, preventing drug-related problems (DRPs) and optimize pharmacotherapy, contributing to patient safety. This study aimed to assess the implementation and the impact of clinical pharmacy interventions in the Pediatric Intensive Care Unit (PICU) of Hospital das Clinicas of Ribeirao Preto Medical School, University of São Paulo (HCFMRP-USP). This was a prospective, observational and descriptive study which included children from zero to eighteen years of age, over a one year period. Failure Mode and Effects Analysis Tool (FMEA) was applied at the beginning of the study to assess the risks related to medicines in the PICU and to guide clinical pharmacy work, where the pharmacist evaluated daily prescriptions and made interventions along with a multidisciplinary team. One thousand five hundred and eighty-six prescriptions of 162 children were assessed, and a DRPs rate of 12.42% (95% CI - 10.50 to 14.04) was found. One hundred ninety-seven interventions were performed, with a cost saving of R$ 15,118.73. The main types of interventions were related to indication and necessity of the drug. From these, the groups were divided in patients with DRPs and without DRPs. Significant differences were found in weight, age, time of hospitalization, time of follow-up, total cost, costs saved by interventions, severity of patients assessed by PRISM and PELOD scores, total amount of medications used, and number of potentially dangerous and continuous intravenous medications. In addition, there were significant differences in mortality rate and diagnostic categories between groups. The implementation of clinical pharmacy service in the PICU showed a positive impact on patients\' treatment. The clinical pharmacist interventions identified and prevented DRPs, promoting the rational use of medications and contributing to the reduction of costs associated with medical prescription.

1 online resource (vii, 138 leaves : ill.) / Following an awareness of an increased turn over of staff in the eating disorder unit as compared with other specialised units, in a psychiatric hospital in Johannesburg, South Africa, Tara Hospital, the researcher was motivated to investigate the issue. An exploratory, descriptive based research was chosen to explore and gain information about the topic and its implications. A qualitative research approach was used to gain insight into the perceptions and needs of the team working on the unit. The case study method was used. A pilot study was undertaken to test the validity of the interview schedules. The sampling category was a non- probability one. Individuals were selected from the population of staff working on the unit. Participants were selected from two groups, those who were presently working on the unit and those who had previously worked on the unit and now working in other units. Interview procedure involved personal semi-structured interviews conducted by the researcher and analysed qualitatively and a structured interview questionnaire analysed quantitatively. The researchers assumption that many staff members move from working in an eating disorders unit was confirmed and is due to the following: Staff turnover is due to constant exposure to occupational stress and burnout. Feelings of helplessness, a sense of being unappreciated and excessive exposure to conflict from the patients. In addition, staff experience minimum rewards leading to lowered job satisfaction due to the patients slow recovery rates and a poor prognosis of the illness. Staff also experience a change in their eating patterns and an increased awareness around food and food issues. Recommendations to the staff include: * Psycho-education on eating disorders. * Implementation of strategies to provide supportive care for all staff members. * Education on stress management and strategies to prevent staff burnout and lowered job satisfaction. * A multidisciplinary teamwork approach by the staff, when working in the unit. / Social Work / M. A. (Social Science in Mental Health)

The thesis attempts to outline the extent to which the decision-making role of nurses is utilized, and the main factors that affect decision-making of nurses within the scope of provision of nursing care. The research has found out that nurses utilize their decision-making role to an insufficient extent hence the sense and purpose of decision-making must be emphasised again. This task may be assumed by managing nurses. Managing nurses may also contribute by more effective defending of competences of nurses. From the factors needed by nurses for effective decision-making, attention should be paid particularly to education. It is necessary to make possible for nurses to extend their knowledge and thus to obtain theoretical insight (e.g. in respect of decision-making) to be used by them while providing care to a patient/client.

This thesis deals with a multidisciplinary approach to clients suffering from schizophrenia. The main aim is to reflex the multidisciplinary approach to schizophrenic clients, appealing to social work and having respect to ethical principles of participating branches. The work includes chapters that are necessarily coherent to this topic. These are mainly the social work in the context of schizophrenia, specifics of schizophrenia, the structure of the multidisciplinary team, team work and all ethical aspects arising out of team work and individual experts' work. This thesis tries to link up theoretical and practical knowledge, mainly by means of casuistry and practical observations.

This diploma thesis deals with the psychosocial problems of patients treated for chronic hepatitis C. The aim of the thesis was to map the problems arising during this treatment and to divide them into biological, psychological, and social problems and problems leading to a change in the patient's quality of life. The disease is also assessed in relation to risky behaviour - a history of substance dependence. The work should also show how the individual components of the multidisciplinary team are involved in intervention during treatment. In the first part of the thesis, I describe the theoretical issues of hepatitis C as a consequence of intravenous drug dependence, and I deal with quality of life, the multidisciplinary team and psychosocial care with the help of professional literature. In the empirical part, I chose qualitative research through the interviewing method using the semi-structured interview technique. The research sample consisted of eight clients of the infectious disease ward treated for or shortly after chronic hepatitis C. The data analysis was evaluated by the data categorization method. The results showed a very demanding, mainly physically, course of treatment with a significant impact on the mental and social function of the patient. The reason why the clients had turned to addictive substances was varied, from a curiosity in youth, through addiction as a consequence of trauma from sexual abuse in childhood, to addiction as a consequence of leaving a children's home without the adequate social preparedness and assistance. The components of the multidisciplinary team that intervened the most were healthcare, psychiatry, psychology - psychotherapy, the District Social Security Administration, and the Labour Office. This work identifies the issues that are not widely spoken of. It has shown us that not only addiction to addictive substances is dangerous for the individuals, but that the health problems do not end even after the treatment of their addiction, and the clients have to undergo a rather demanding treatment in order to eliminate these problems. However, on a society-wide level, it is desirable that as many of these clients as possible be treated with a positive result, even if they are drawing large amounts from the general health insurance. The results could serve as materials for the prevention of socio-pathological phenomena, for educational activities in schools or for institutions in, for example, K-centres, which provide help to addictive substance users.