De senaste årens strukturella förändringar i svensk hälso- och sjukvård har påverkat vårdpersonalen i det sjukvårdande arbetet såväl fysiskt och psykiskt. Kontinuerlig återkoppling genom reflektion kan vara ett verktyg för avdelningschefen att leda utveckling, lärande och förnyelse i omvårdnadsarbetet. Studiens syfte var att genom fenomenografisk ansats beskriva avdelningschefers uppfattningar av reflektion i omvårdnadsarbete.Analysen av 15 intervjuer resulterade i fem beskrivningskategorier av reflektion: kunskapsintegrerande, bearbetande, utvecklande, arbetsledande och patientinriktad. Den kunskapsintegrerande reflektionen fångar studenternas utbildning som kan användas i omvårdnadsarbetet. Genom bearbetande reflektion skapas en fortlöpande tankeprocess av omvårdnadsarbetet. I utvecklande reflektion stärktes medarbetare genom att samtala med varandra. Arbetsledande reflektion beskrevs som ett eget forum för att bearbeta chefsrollen. Patientinriktad reflektion lyfte fram patientens delaktighet. Slutsatsen var att avdelningscheferna använde reflektion på olika nivåer och i olika sammanhang. Reflektionen visade sig betydelsefull för omvårdnadsarbetet. Studiens resultat kan bidra till ökad kunskap för att utveckla ledarskapet i riktning mot bättre arbetsmiljö och patientsäkerhet. Fortsatt forskning borde inriktas på interventionsstudier med reflektion i fokus. / Continuous feedback through reflection can be used as a tool by the department head for leading the development, learning and innovation in nursing work. The aim of the study was to describe the department heads´perceptions of reflection in nursing care by a phenomenographical approach. The analysis of 15 interviews resulted in five description categories of reflection. Knowledge integral reflection captures students´training that can be used in nursing work. Processing creates a continuous thought process in nursing work. Reflection development was reinforced among employees when talking to each orther. Managerial reflection was described as a separate forum in the process manager role. Patient-oriented reflection highlighted the patient´s participation. The conclusion was that department heads used reflection on different levels and in different contexts. Reflection proved important in nursing care. Study findings may help to increase knowledge in order to develop leadership whick leads to beter quality of care and patient safety. Continued research should focus on intervention studies with an emphasis on reflection.

Made available in DSpace on 2017-07-21T14:42:29Z (GMT). No. of bitstreams: 1 Jucelene Mendes V Pedroso.pdf: 1903087 bytes, checksum: 683d44d42127f638348307f8d4918ea8 (MD5) Previous issue date: 2015-03-02 / This research has as object of study "The daily work experienced by professionals in the Municipal Center for Specialized Support - CEMAE of Telêmaco Borba - PR, in the context of inclusive education policy, considering the relation between the multidisciplinarity and interdisciplinarity, its tensions and possibilities, bounded through the years 2005-2012. It has as the main objective to analyze how it was in the daily work the relationship between multidisciplinarity and interdisciplinarity, from CEMAE team experience in the context of inclusive education in the municipality of Telemaco Borba - PR. The research is based on a qualitative approach and developed using the following methodological instruments: literature, documentary research, individual interviews, and content analysis in the thematic-categorical format. The participants were team members of CEMAE (Social Worker, Psychologist, Educator, speech therapist), and the testimonials were collected from a semi-structured script with open and closed questions, characterized by eight questions that were about the work experience from each other. The process of investigation led it to raise six categories of analysis of empirical material, being: experience of the team; specificity of professional work on this team; challenges present in the experience of CEMAE professionals; tensions and dilemmas in overcoming multidisciplinary process for interdisciplinarity; social relevance of the team's experience in CEMAE; understanding of interdisciplinarity practice. Given the above, this paper was organized in four chapters: the first chapter entitled "State and public policies: education in the Brazilian context"; the second chapter called "Public Policy Brazilian Education and Special Education in the Perspective of Inclusive Education"; the third chapter "Daily work and interdisciplinarity: contextual elements for understanding the interdisciplinarity process"; Finally, the fourth chapter "The daily work of the interdisciplinarity team of Municipal Support Center Specializing in Telêmaco Borba - PR: experience in the years 2005-2012". Thus, it is concluded that the staff recognizes the interdisciplinarity work as a guideline focused on educational inclusion, while points to the need to overcome barriers in the daily work that generate fragmentation of their actions and their objectives. / Esta pesquisa tem como objeto de estudo “O cotidiano profissional vivenciado pelos profissionais do Centro Municipal de Apoio Especializado – CEMAE, de Telêmaco Borba - PR, no contexto da política educacional inclusiva, considerando a relação estabelecida entre a multidisciplinaridade e a interdisciplinaridade, suas tensões e possibilidades, delimitadas entre os anos de 2005 a 2012”. Tem se como objetivo geral analisar como se deu no cotidiano profissional a relação entre a multidisciplinaridade e interdisciplinaridade, a partir da experiência da equipe do CEMAE no contexto da educação inclusiva no município de Telêmaco Borba - PR. A pesquisa é de cunho qualitativo e se desenvolveu utilizando os seguintes procedimentos metodológicos: pesquisa bibliográfica, pesquisa documental, entrevista individual, análise de conteúdo no formato temático-categorial. Os sujeitos participantes foram profissionais da equipe do CEMAE (Assistente Social, Psicólogo, Pedagogo, Fonoaudiólogo), sendo que os depoimentos foram colhidos a partir de um roteiro semiestruturado, com questões abertas e fechadas, caracterizado por oito perguntas que giravam em torno da experiência profissional de cada um. O processo de investigação possibilitou levantar seis categorias de análise do material empírico, sendo: experiência da equipe; especificidade do trabalho do profissional nessa equipe; desafios presentes na experiência dos profissionais do CEMAE; tensões e impasses no processo de superação do multidisciplinar para o interdisciplinar; relevância social da experiência da equipe no CEMAE; compreensão da prática interdisciplinar. Diante do exposto, este trabalho ficou organizado em quatro capítulos: o primeiro capítulo intitulado “Estado e políticas públicas: a educação no contexto brasileiro”; o segundo capítulo denominado “Política Pública de Educação Brasileira e Educação Especial na Perspectiva de Educação Inclusiva”; o terceiro capítulo “Cotidiano e interdisciplinaridade: elementos contextuais para compreensão do processo interdisciplinar”; por fim, o quarto capítulo “O cotidiano da equipe interdisciplinar do Centro Municipal de Apoio Especializado de Telêmaco Borba –PR: a experiência nos anos de 2005 a 2012”. Assim, concluiu-se que a equipe reconhece a interdisciplinaridade como diretriz do trabalho voltado para a inclusão educacional, ao mesmo tempo em aponta para a necessidade de ultrapassar as barreiras cotidianas no trabalho que geram fragmentação das suas ações e dos seus objetivos.

Made available in DSpace on 2016-04-29T14:16:40Z (GMT). No. of bitstreams: 1 Valter Martins.pdf: 1244983 bytes, checksum: d0a8fe47290a3c57136e136deb21be7d (MD5) Previous issue date: 2015-04-09 / In the last three decades, the changes in the international scenery have resulted in severe changes to the state, to social policies and to the social workers labor market. The profession has undergone substantial changes with the reorganization of the State organizations and with the outlines that the new social policies have printed on the attention to social needs. The scope of neoliberal ideas prints a set of new determinations to the daily work of social workers, through new designs of social policies. Despite the expansion of the labor market, the profession has suffered a theoretical-operative redirection in related socio-occupational areas, especially with the implementation of the Bolsa Família Program (BFP) and the Social Welfare policy. The BFP introduces a set of instrumental determinations to work at the State level, the result of management's views that the state has taken in this neoliberal scenario. Thus, this thesis analyzes the roots of the changes that occur in the logic of work in today's society and its consequences for the work of social workers who work in the Social Assistance Reference Centers (SARC) and the BFP operational components. Furthermore, this thesis also considers the daily work, the professionalism, competencies, attributes and the daily answers formulated in these socio-occupational spaces. As objective, it aims to analyze the conception and the outlines of social workers work, unraveling the theoretical and methodological resources mobilized to meet the challenges of everyday life, the determinations of management technologies at work, and how these new ways of operating shape professional answers developing and imposing new powers, duties and / or restrictions to work. In this sense, the thesis presents a contribution to the debate about the work of social workers in the context of social policies, especially under the particularities assumed in the scope of the BFP / Nas últimas três décadas, as transformações no cenário internacional têm implicado em severas mudanças para o Estado, para as políticas sociais e também para o mercado de trabalho dos assistentes sociais. A profissão vem sofrendo alterações substanciais com a recomposição das organizações do Estado e com os contornos que as novas políticas sociais têm impresso na atenção às necessidades sociais. O escopo das ideias neoliberais imprime um conjunto de novas determinações ao trabalho cotidiano dos assistentes sociais, por meio dos novos desenhos das políticas sociais. Apesar da ampliação do mercado de trabalho, a profissão vem sofrendo um redirecionamento teórico-operativo nos espaços sociocupacionais ligados, especialmente, com a execução do Programa Bolsa Família (PBF) e com a política de Assistência Social. O PBF inaugura um conjunto de determinações instrumentais para o trabalho na esfera estatal, resultado das concepções de gestão que o Estado vem assumindo nesse cenário neoliberal. Assim, a presente tese analisa as raízes das transformações que ocorrem na lógica do trabalho na sociedade atual e suas consequências para o trabalho dos assistentes sociais que atuam nos Centros de Referência de Assistência Social (CRAS) e com os componentes operacionais do PBF. Pondera, ainda, o trabalho cotidiano, a profissionalidade, as competências e atribuições e, também, as respostas cotidianas formuladas nesses espaços sociocupacionais. Busca-se, como objetivo, analisar a concepção e os contornos do trabalho dos assistentes sociais, desvendando os recursos teórico-metodológicos mobilizados para enfrentar os desafios do cotidiano, as determinações das tecnologias de gestão no trabalho, e como essas novas formas de operar moldam as respostas profissionais desenvolvendo e impondo novas competências, atribuições e/ou restrições ao trabalho. Nesse sentido, a tese apresenta uma contribuição ao debate acerca do trabalho dos assistentes sociais no contexto das políticas sociais, especialmente sob as particularidades assumidas no âmbito do PBF e nos CRAS

As-built schedules prepared during and after construction are valuable tools for State Highway Agencies (SHAs) to monitor construction progress, evaluate contractor's schedule performance, and defend against any potential disputes. However, previous studies indicate that current as-built schedule development methods are manual and rely on information scattered in various field diaries and meeting minutes. SHAs have started to collect field activity data in digital databases that can be used to automatically generate as-built schedules if proper computational algorithms are developed. This study develops computational algorithms and a prototype system to automatically generate and visualize project level and activity level as-built schedules during and after construction. The algorithm is validated using a real highway project data. The study is expected to significantly aid SHAs in making better use of field data, facilitate as-built schedule development, monitor construction progress with higher granularity, and utilize as-built schedule for productivity analysis.

One vital task of a project's owner is to determine a reliable and reasonable construction time for the project. A U.S. highway agency typically uses the bar chart or critical path method for estimating project duration, which requires the determination of construction logic. The current practice of activity sequencing is challenging, time-consuming, and heavily dependent upon the agency schedulers' knowledge and experience. Several agencies have developed templates of repetitive projects based on expert inputs to save time and support schedulers in sequencing a new project. However, these templates are deterministic, dependent on expert judgments, and get outdated quickly. This study aims to enhance the current practice by proposing a data-driven approach that leverages the readily available daily work report data of past projects to develop a knowledge base of construction sequence patterns. With a novel application of sequential pattern mining, the proposed framework allows for the determination of common sequential patterns among work items and proposed domain measures such as the confidence level of applying a pattern for future projects under different project conditions. The framework also allows for the extraction of only relevant sequential patterns for future construction time estimation.

<p><strong>ABSTRACT</strong><strong></strong></p> <p><strong>Background</strong>: Healthcare-associated infections (HAIs) and HAI disease outbreaks present challenges for healthcare facilities. In 2008, a <em>Clostridium difficile</em> outbreak in Ontario resulted in the deaths of 91 patients and raised awareness of HAIs. Over the last 5 years, the outbreak rate has risen dramatically. Traditionally, HAI research has focused on epidemiology, healthcare systems, and the economic burden. Little is known about the impact HAI disease outbreaks have on the work of healthcare professionals.</p> <p><strong>Purpose</strong>: The purpose of this study was to examine the effects of HAI outbreaks on healthcare professionals in a large acute care hospital in Ontario.</p> <p><strong>Methods</strong>:<strong> </strong>A retrospective exploratory case study approach was used, including individual interviews, document analysis, and incidence analysis of HAIs hospital data. The sample was frontline nurses, clinical managers, infection control professionals, and environmental service staff. Document analysis included hospital policies and protocols related to infectious diseases and HAI disease outbreaks.</p> <p><strong>Findings</strong>: The incidence rates of Methicillin-resistant s<em>taphylococcus aureus</em>, <em>Clostridium difficile</em>, and Vancomycin-resistant<em> </em>enterococci<em> </em>have decreased but remained above the provincial benchmarks. The daily work of healthcare professionals was impacted by HAI outbreaks. Nurses experienced workload challenges, time pressures, and increased documentation. Infection control professionals' responsibilities have expanded. The environmental services staffs' cleaning processes have become more intensive. In response, several unique innovations were developed by hospital staff.</p> <p><strong>Conclusion</strong>: The daily work of healthcare professionals at the study site has been affected by HAI outbreaks. Implications for future research include the need to review healthcare professionals’ workloads and evaluate contributing factors to HAI outbreaks.</p> / Master of Science in Nursing (MSN)