Per pastaruosius 5-10 metų Lietuvos kultūrinė rinka susiduria su kaip niekad daug probleminio pobūdžio uždavinių. Tai kultūrinės veiklos ir verslo jungčių bei kultūrinių mainų su kitomis Europos ir pasaulio šalimis pasekmė, kuri smarkiai įtakoja Lietuvos muzikinį gyvenimą. Šiame tiriamajame darbe pristatoma asmeninės vadybos tema, atskleidžiant jos vaidmenį profesionalių muzikos atlikėjų veikloje. Iškeliama dviejų profesijų – muzikos atlikėjo ir vadybininko - jungties, vaidmenų pasiskirstymo problematika. Analizuojami giluminių interviu, anketinės apklausos duomenys, Lietuvos muzikos atlikėjų bei kūrėjų praktikos Lietuvoje ir Europos šalyse, apžvelgiami literatūros šaltiniai šia tema, pristatomos vadybininko pareigybės, agentų darbo savitumai. Darbo tikslas – atskleisti asmeninės vadybos vaidmens profesionalių muzikos atlikėjų veikloje reikšmingumą. Šiam tikslui pasiekti išsikelti uždaviniai: 1. pristatyti asmeninę vadybą teoriniu aspektu – apžvelgti literatūrą asmeninės vadybos tema, išskirti pagrindinius asmeninės vadybos dėsnius; 2. apžvelgti vadybos ir muzikinių įgūdžių derinimo aktualumo apraiškas Lietuvos muzikinėje rinkoje; 3. išaiškinti vadybininko pareigybes, agento darbo savitumą; 4. pristatyti Lietuvos menininkų praktikas, taikant asmeninės vadybos žinias profesionalaus muzikos atlikėjo, kūrėjo veikloje Lietuvoje ir Europos šalyse; 5. pateikti prielaidas, optimalaus santykio tarp vadybos ir meno įgūdžių modelio sukūrimui. Remiantis atliktų tyrimų medžiaga... [toliau žr. visą tekstą] / The Lithuanian cultural market, as never before, has faced many various problematic tasks over last five to ten years. This is a result of ties between cultural activities and businesses as well as cultural exchange with countries in Europe and elsewhere in the world, which is considerably influencing the musical life in Lithuania. This research presents the subject of self-management demonstrating its role in the activities of professional music performers. The issues of the link and the role division between two professions – music performer and manager – are raised. The data obtained from in-depth interviews and questionnaires are analysed, as well as the experience Lithuanian music performers and creators gained inside the country and in European countries; literature about the subject is surveyed; the job of the manager and the peculiarities of the agents’ work are presented. The goal of the study is to demonstrate the importance of the role of self-management in the activities of professional music performers. To achieve this goal the following tasks were undertaken: 1. To present self-management from the theoretical aspect – to survey literature about the subject, and to formulate the main laws of self-management; 2. To survey the importance of the conformity between the expression of management and musical skills in the Lithuanian musical market; 3. To explain the job of management and the peculiarities of the agents work; 4. To present the experience applying... [to full text]

Background: Traditional psychosocial treatments have been adapted for use with individuals with bipolar affective disorders due to the limited prophylactic nature of pharmacotherapy and the recognition of the role of psychosocial factors in the course of this disorder. Psychosocial interventions that include a prodromal monitoring and management component have been empirically shown to be an effective adjunct to medication for the treatment of bipolar disorder. Aims: There is a deficit of quantitative research that examines the impact of individualrelated (e.g. age, self-efficacy), disorder-related (e.g. time since diagnosis, experience of prodromal symptoms) and treatment-related (e.g. level of psychosocial input) factors on individuals’ ability to manage this disorder via the use of prodromal monitoring. The current research aimed to investigate factors that are associated with the identification and management of prodromal symptoms. Method: Participants completed five self-report measures in order to provide information on their experience of prodromal symptoms, current mood state, general self-efficacy, view of social support from significant others, and demographic and clinical-related variables. The data were collected from 101 participants, 58 of whom were female. The sample consisted of individuals with a diagnosis of bipolar disorder type I and II. Results: Univariate and bivariate analyses were used to explore the relationship between individual, disorder, and treatment-related variables associated with participants’ experience of bipolar disorder. Variables that were significantly associated with participants’ perception of their ability to identify and manage prodromes were further investigated using ordinal logistic regression analyses. The results indicated that general self-efficacy and prodromal-specific help from significant others were associated with an increase in participants’ perception of their ability to identify manic and depressive prodromal symptoms. General self-efficacy was also associated with participants’ view of their ability to manage cognitive and behavioural prodromes. Experience of prodromal symptoms (e.g. consistency of symptoms experienced, type of prodrome experienced) was associated the participants’ perception of their ability to identify and manage prodromes. In general, disorder-related variables (e.g. time since diagnosis, mood state, diagnosis type, and number of episodes experienced) were not significantly associated with the participants’ view of their ability to identify and manage prodromal symptoms. Individual-related variables such as gender and age, however, were associated with prodromal identification. Conclusion: The results indicated the need to consider constructs such as general selfefficacy and experience of prodromal symptoms (e.g. consistency of symptoms, types of prodromes experienced, and ability to recognise prodromes when they first present) when helping patients to learn how to identify and manage prodromal symptoms. In addition gender differences and the role of help from significant others were highlighted as variables that should be considered when using prodromal monitoring approaches with patients with bipolar disorder. Limitations of the research are reviewed in relation to the methodology used. Clinical implications and directions for future research are considered.

Bakgrund: Diabetes mellitus typ 2 är ett globalt problem som blir allt vanligare. Den nödvändiga egenvården kräver mycket av diabetes typ 2-patienten, och vårdpersonalen behöver adekvat kompetens för att kunna stötta dessa individer på bästa sätt. Syfte: Att undersöka patienters upplevelse av egenvård vid diabetes mellitus typ 2. Metod: En litteraturöversikt har gjorts baserat på elva originalartiklar tillgängliga på databaserna CINAHL Complete och PubMed. Artiklarna analyserades enligt Friberg, och teman och subteman skapades. Resultat: Resultatet presenteras i fyra teman. Det första temat är Patienters upplevelse av kostförändringar och har tre subteman: Kunskap och motivation, Kostförändringars inverkan på livskvalitet samt Egenvårdskontroll. Två andra teman som presenteras är Upplevelsen av läkemedelsbehandling och Upplevelsen av egenvård genom motion. Det fjärde och sista temat är Sjukvårdens roll i egenvården och presenteras genom tre subteman: Upplevelsen av gruppbaserad utbildning, Behov av stöd i egenvården samt Upplevelsen av mötet med sjukvården. Diskussion: Huvudfynden i resultatet analyserades för att se likheter och olikheter i de upplevelser som patienterna beskrivit. Dessa upplevelser diskuteras under två rubriker; Stödjande faktorer för egenvård och Försvårande faktorer för egenvård. Resultatet diskuterades utifrån Dorothea Orems egenvårdsteori samt konsensusbegreppet hälsa. / Background: Type 2 diabetes mellitus is a global problem that is increasing worldwide. The necessary self-management is demanding a lot of the type 2 diabetes-patient, and the health professionals needs adequate competence to be able to support these individuals in the best way. Aim: To examine patients' experience of self-management in type 2 diabetes mellitus. Method: A literature review has been made based on eleven original articles available on the databases CINAHL Complete and PubMed. The articles were analysed according to Friberg, and themes and subthemes were created. Results: The result is presented in four themes. The first theme is Patients´ experience of dietary changes and has three subthemes: Knowledge and motivation, Dietary changes and its impact on the quality of life and Self-management control. Two other themes are presented as The experience of drug treatment and The experience of self-management through physical activity. The fourth and last theme is The role of healthcare in self-management and is presented through three subthemes: The experience of group based education, The need of support in self-management and The experience of the meeting with the healthcare. Discussion: The main findings in the result were analysed to discover similarities and differences within the experiences as described by patients. These experiences were then discussed under two subtitles; Supporting factors for self-management and Aggravating factors for self-management. The result was discussed from the theory of self-care by Dorothea Orem and the consensus concept of health.

Traditionally, nurse anesthesia educators have utilized prior academic achievement to predict student success. However, research has indicated that prior academic achievement offers an inadequate assessment of student success in graduate healthcare programs with extensive clinical residencies. The educational literature has identified many non-cognitive factors, such as self-efficacy and locus of control, that may provide a more holistic prediction model of student success. An experimental study with pretest-posttest design and stratified random assignment was conducted to evaluate the effectiveness of an educational intervention to promote self-management, professional socialization, and academic achievement among first semester graduate nurse anesthesia students. Participants (N = 66) were demographically similar to the national graduate nurse anesthesia student body, though Hispanics and younger students were a little over-represented in the sample (56% female, 75.8% White, 15.2% Hispanic, 6% Other, 59% ≤ 30-years-old, 67% ≤ 3 years of ICU). The results showed that most graduate anesthesia students had strong self-management and professional socialization characteristics on admission. The results did not support the effectiveness of this educational intervention. Thus, ceiling effect may have accounted in part for statistically non-significant results regarding self-efficacy (p = .190, ω2 = .03), locus of control (p = .137, ω2 = .04), professional socialization (p = .819, ω2 = .001), and academic achievement (p = .689, ω2 = .003). Future researchers may need to expand the scope of the intervention, use a more powerful and sensitive instrument, and utilize a larger sample.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Although it is well known that self-care reduces the frequency of hospital admissions and exacerbations and enhances quality of life (QOL) in heart failure (HF) patients, little is known about self-care in this population. Therefore, the study purpose was to examine relationships among selected individual characteristics (demographics, severity of illness, comorbidities, and social support), self-care strategies, and QOL using Reigel's Model of Self Care in Patients with Heart Failure as the guiding framework. In this descriptive correlational study, self-care was measured using the Self-Care of Heart Failure Index (SCHFI), which measures self-care maintenance (SC-Mt), self-care management (SC-Mn), and self-care self-confidence (SC-Sc). QOL was measured using a disease-specific instrument, the Minnesota Living with Heart Failure Questionnaire (LHFQ), and a generic instrument, the Short-Form Health Survey (SF-12) characterizing physical and mental-emotional functioning. Multiple regression analysis was used to identify predictors of QOL.Data were collected using Dillman's tailored design method for surveys. One hundred and sixty-five patients with HF were invited through a mailed letter and a survey packet to participate in this study. Five potential participants requested not to take part in the study, seven were reported as being deceased, and 23 letters were returned as undeliverable. After the initial mailing, we discontinued mailings to them. Thus, out of a possible sample of 130 subjects, 98 participants completed and returned questionnaires for a response rate of 75.38%.The sample (mean age = 56.33 years, SD = 13.65) included 56.1% males and 43.9% females and consisted of 48% Caucasians and 52% non-Caucasians. Approximately 55.1% were married and 60.2% had an annual income less than $30,000. The majority of the sample (72.5%) had at least a high school education. Half of the sample were somewhat functionally impaired (NYHA Class 11) and had an ejection fraction less than 30%. Ninety-three percent of the sample had been diagnosed with HF less than 10 years (mean = 5.05, SD = 3.34). Seventy percent of the sample had 0 to 4 comorbidities, and 17.7% reported that they only had HF and no other diagnoses. In addition, the sample reported mean score of social support at 71.72 (SD = 17.30) indicating good social support. On average, participants reported that they frequently performed self-care in order to maintain a healthy lifestyle: SC-Mt (mean = 69.59, SD = 15.56). They responded quickly and were likely to manage signs and symptoms that occurred: SC-Mn (mean = 61.69, SD = 19.91). Sixty-two percent reported that they recognized signs and symptoms of HF that occurred in the last month. They were very confident they could perform self-care: SC-Sc (mean = 66.11, SD = 17.02). The results showed that the participants' perceived their QOL as good (mean = 49.44, SD = 27.82). On average, participants perceived their physical functioning as fair (mean = 45.38, SD = 22.47), as was their mental-emotional functioning (mean = 53.32, SD = 22.36).Multiple regression analyses demonstrated that better disease-specific QOL was predicted by being less likely to use SC-Mn strategies (β = .325; p = 0.003), better SC-Sc (β = -.251; p = 0.012), better NYHA functional class (β = .246; p = 0.008), and less comorbidity (β = .236; p = 0.014) (R 2 = .334; F = 7.269, p = 0.000). Better generic QOL (physical functioning) was predicted by better NYHA functional class (β = -.309; p = 0.001), better SC-Mt (β = .205; p = 0.037), better SC-Se (β = .296; p = 0.003), and being less likely to try SC-Mn strategies (β = -.165; p = 0.000) (R 2 = .361; F = 9.602, p = 0.000). Better generic QOL (mental-emotional functioning) was predicted by better NYHA functional class (β = -.229; p = 0.024) and being male (β = -.204; p = .047) (R 2 = .277; F = 4.548, p = 0.000).Findings suggest that better QOL is associated with being male displaying better NYHA functional class, less co-morbidity, and better performance of self-care activities in order to maintain health (SC-Mt), being less likely to identify and respond quickly to signs and symptoms of HF (SC-Mn), having and confidence in performing of self-care strategies (SC-Se). The findings add to the scientific body of knowledge in self-care.

Hypertension is a preventable and yet major risk factor for early death and morbidity among African Americans. Compared to other women in the US, African American women continue to die earlier and more frequently from preventable and controllable chronic health conditions that are notably due to hypertension and hypertension-related illnesses. While there are multiple factors contributing to the high death rates of African American women, hypertension is one of the most common and modifiable risk factors associated with fatal health outcomes among African American women. The rate of death resulting from hypertension is more than double for African American females compared to white females. Even armed with increased knowledge and awareness, African American women are encountering barriers to controlling their hypertension, which places them at higher risk of becoming sicker and dying earlier than their white counterparts. The purpose of this mixed-methods study was to examine the effects of psychosocial stress on the hypertension self-management behaviors. The rationale for the study is supported by findings from a systematic literature review identifying gaps and contributions in the health literature on African American women and hypertension management. Findings underscore a need to continue to examine psychosocial factors as barriers to African American women’s hypertension self-management. Specifically, the study found statistically significant associations between psychosocial stress and depression as it relates to the hypertension self-management of African American women. Further investigation is warranted to better understand the significance of the relationships between psychosocial stress, depression and African American women’s hypertension self-management.

This thesis offers a rethinking of the role for education as critical workplace pedagogy in complex problems of health care. Taking the case of paediatric diabetes, the study explored how health-care professionals learn the work of supporting children, and their parents, to self-manage the condition. By reconceptualising work problems as sociomaterial learning struggles, this research contributes new understandings of informal professional learning in everyday health-care provision. Data were generated through fieldwork in an outpatient clinic. Particular challenges of supporting self-management in this case were the difficulties of balancing policy aspirations for empowerment with biomedical knowledge about risks to immediate and long-term health. Tracing the materialisation of learning as it unfolded in moments of health-care practice showed professionals handling multiple and contradictory flows of information. Particular challenges were posed by insulin-pump technologies, which have specific implications for professional roles and responsibilities, and introduce new risks. A key insight is that professionals were concerned primarily with the highly complicated perpetual discernment of safe parameters within which children and their parents might reasonably be allowed to contribute to self-management. Such discernment does not readily correspond to the notion of empowerment circulating in the policies and guidelines intended to enable professionals to accomplish this work. As a result, this thesis argues that the work of discernment is obscured. Learning strategies evolve, but could be supported and extended by explicit recognition of the important work of learning as it unfolds in everyday practices of supporting self-management in paediatric diabetes. Most importantly, workplace pedagogies could be developed in ways that attune to the profound challenges and uncertainties that are at stake in these practices.

Esta dissertação trata da produção autogestionária do habitat na cidade de Buenos Aires, como parte de um processo mais amplo de debates e práticas autogestionárias na América Latina. Partindo do contexto histórico, estuda as consequências políticas e sociais das reformas neoliberais na Argentina no campo habitacional, e analisa a ação dos movimentos sociais a partir da crise de 2001. Esse contexto recente foi favorável ao crescimento das práticas autogestionárias na produção habitacional e na luta pelo direito à cidade, iniciando no combate ao neoliberalismo extremo Menemista até a queda do presidente De La Rua, quando os trabalhadores passaram a ocupar fábricas, edifícios, ruas e praças em um processo de autogestão urbana sem precedentes na América Latina pós-ditaduras militares. Como estudo de caso, esta pesquisa recupera as experiências desenvolvidas pelas cooperativas habitacionais a partir da Lei 341/00, que permitiu a produção habitacional por autogestão através de organizações sociais, impulsionada principalmente pelo Movimento de Ocupantes e Inquilinos (MOI), aprofundando questões relativas a este movimento. Há muitos estudos sobre a influência da Fucvam (Fed. Uruguaia de Cooperativas de Habitação e Ajuda Mútua) nos movimentos de moradia brasileiros, demonstrando como os princípios autogestionários importados do Uruguai desencadearam no Brasil uma nova forma organizativa, diferente inclusive da matriz original. A análise da importação de um modelo para outra realidade permite que o próprio modelo original seja analisado sob nova perspectiva. A experiência argentina recente do MOI - Movimento de Ocupantes e Inquilinos, que, assim como a experiência brasileira, se alimentou das ideias da Fucvam, se destaca entre as experiências de autogestão do habitat como proposta inovadora em termos arquitetônicos, urbanos e organizativos, com importantes novidades em relação às experiências uruguaias e brasileiras. / This essay is regarding the self-managed production of the habitat in Buenos Aires, as part of a wide process of debates and self-management practices in Latin America. Starting from the historical context, it focus on political and social consequences of neoliberal reforms in Argentina on housing field, and analyses the action of the social movements since the crisis of 2001. The growth of the self-management practices in housing production and the fight for the right to the city were favored by this recent context, starting during the battle against the extreme neoliberalism \"Menemista\" until the fall of President De La Rua, when workers began to occupy factories, buildings, streets and squares in a process of urban selfmanagement with no precedents in Latin America after military dictatorships. As a case study, this research brings back the experiences developed by housing cooperatives initiated with the Code 341/00, which allowed housing production for selfmanagement through social organizations, mainly driven by the Occupiers and Tenants Movement (MOI), expanding the issues related to this movement. There are many studies about the influence of FUCVAM (Fed. Uruguaia of Housing Cooperatives and Mutual Aid) in Brazilian housing movements, demonstrating how self-management principles, which were imported from Uruguay, have set off a new organizational form in Brazil, even different from the original former. The application of imported model to a different reality brings a new perspective to the original model situation. The recent Argentine experience MOI - Movement Occupants and Tenants, who, like the Brazilian experience, fed the ideas of FUCVAM, stands out between the experiences of the habitat self-management as innovative proposal in terms of architecture, urban and organization, with important news related to the Uruguayan and Brazilian experiences.

Introdução. O automanejo em saúde pode ser entendido como a habilidade da pessoa em conseguir resolver problemas e ser a protagonista, nas tomadas de decisão relacionadas à sua vida e à sua saúde. Este conceito tem sido associado com resultados positivos, tanto para o indivíduo como para as instituições de saúde. A escala Partners in Health (PIH) avalia o automanejo em saúde por meio do engajamento da pessoa com doença crônica na execução de ações que protegem e promovem a saúde. Objetivos. Este estudo metodológico teve como objetivos adaptar culturalmente a PIH e avaliar as propriedades psicométricas da versão adaptada em uma amostra de indivíduos adultos com doenças crônicas. Método. O estudo foi aprovado pelos Comitês de Ética das instituições envolvidas. O processo de adaptação cultural ocorreu como segue: tradução do instrumento original, avaliação e síntese das traduções pelo Comitê de Juízes, retrotradução, avaliação semântica dos itens, avaliação pelo autor do instrumento original, pré-teste e avaliação psicométrica. Os dados foram coletados entre janeiro e maio de 2016, em seis ambulatórios (nefrologia, gastroenterologia, cardiologia, imunologia, endocrinologia e oncologia) do Hospital de Clínicas de Ribeirão Preto. Participaram do estudo 176 indivíduos adultos de ambos os sexos, com diagnóstico de doenças crônicas há, pelo menos, seis meses e que estavam em acompanhamento clínico regular em um dos ambulatórios referidos. A PIH é respondida em uma escala ordinal com nove pontos, na qual menores valores indicam melhor automanejo, em um intervalo possível de zero a 96 pontos. A validade de constructo da PIH foi avaliada pelas correlações entre a medida de automanejo com as medidas de autoestima (Escala de Auto-Estima de Rosenberg), ansiedade e depressão (Escala Hospitalar de Ansiedade e Depressão- HADS). A confiabilidade foi avaliada pela consistência interna (alfa de Cronbach). O nível de significância adotado foi de 0,05. Resultados. A média de idade dos participantes foi 54,1 anos (DP=15,1, variação 21-87) e 51,6% eram do sexo feminino. O tempo médio de ensino formal relatado foi de 7 (DP=4,80, variação 0-21) anos. Eles apresentaram diversificadas doenças crônicas, e 80,3% tinham mais de dois anos de diagnóstico. O escore médio da PIH foi de 24,5 (DP=15,1). Em 75% dos itens, foi verificada a presença de efeito chão (itens 3, 5, 6, 7, 8, 9, 10, 11 e 12). O alfa de Cronbach foi de 0,78. A correlação entre as medidas de automanejo e autoestima apresentou valor negativo e de moderada intensidade (r = - 0,344; p < 0,001). As correlações entre as medidas de automanejo e sintomas de ansiedade (r = 0,360; p<0,001) e sintomas de depressão (r = 0,363; p < 0,001) apresentaram valores positivos e de moderadas intensidades. As propriedades psicométricas da versão adaptada da PIH foram consideradas adequadas. Conclusão. A versão brasileira da PIH apresentou propriedades psicométricas aceitáveis para medir o automanejo da saúde, entre os participantes do estudo. A versão adaptada da PIH deverá ser testada em outros grupos de indivíduos com doenças crônicas, com diferentes características sociodemográficas / Introduction. Self-management in healthcare can be understood as people\'s skill to manage to solve problems and play the leading role in making decisions related to their life and health. This concept has been associated with positive results both to the individual and to healthcare institutions. The Partners in Health (PIH) scale assesses self-management in health by means of the engagement of a person with a chronic disease in the execution of actions that protect and promote health. Aim. The objectives of this methodological study were to culturally adapt the PIH and to assess the psychometric properties of the adapted version in a sample of adult individuals with chronic diseases. Method. The study was approved by the ethics committees of the institutions involved. The process of cultural adaptation took place as follows: translation of the original instrument, evaluation and synthesis of the translations by a board of experts, back-translation, semantic evaluation of the items, evaluation by the author of the original instrument, pre-test, and psychometric evaluation. Data were collected between January and May 2016, in six outpatient clinics (nephrology, gastroenterology, cardiology, immunology, endocrinology and oncology) of the Clinics Hospital at the University of São Paulo - Ribeirão Preto/SP. Study participants were 176 adults, both male and female, with a diagnosis of chronic disease for at least six months, and who were undergoing regular follow-up at one of the aforementioned clinics. The PIH is answered in an ordinal scale with nine points, in which lower values indicate better self-management, in a possible range from 0 to 96 points. The construct validity of the PIH was assessed by correlations between the measures of self management and self-esteem (Rosenberg\'s Self-Esteem Scale), and anxiety and depression (Hospital Anxiety and Depression Scale - HADS). Reliability was assessed by internal consistency (Cronbach\'s alpha). Significance was set at 0.05. Results. Mean age of the participants was 54.1 years (SD=15.1, variation 21-87) and 51.6% were women. The mean length of formal education reported was 7.08 years (SD=4.80, variation 0-21). Participants presented varied chronic diseases and 80.3% had been diagnosed for more than two years. The mean self-management score of the PIH was 24.5 (SD=15.1). Floor effect was found in 75% of the items (items 3, 5, 6, 7, 8, 9, 10, 11 and 12). Internal consistency was ?= 0.78. The correlation between the measures of self-management and self-esteem presented a negative value and moderate intensity (r = - 0.344; p < 0.001). The correlation between the measures of self management and anxiety (r = 0.360; p<0.001) and depression symptoms (r = 0.363; p < 0.001) presented positive values and moderate intensity. The psychometric properties of the adapted version of the PIH were considered adequate. Conclusion. The Brazilian version of the PIH was considered adequate and its psychometric properties acceptable to measure the self management of the study participants. The adapted version of the PIH must be tested in other groups of individuals with chronic diseases, with different sociodemographic characteristics