Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Dissertation (D.P.H.)--University of Michigan.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Trata-se de uma pesquisa documental, retrospectiva de fonte secundária,que adota uma abordagem quantitativa descritiva-exploratória. A partir da constatação de altos índices de absenteísmo nas unidades hospitalares, despertou-se o interesse em estudar os custos diretos das doenças ocupacionais que levam aos afastamentos e seu impacto econômico para o orçamento de recursos humanos de um hospital universitário do Rio de Janeiro. Neste contexto, definiu-se como objeto de estudo, o impacto econômico do absenteísmo por doença na equipe de enfermagem e, como objetivos: identificar as causas prevalentes de afastamentos no hospital universitário, de acordo com Classificação Internacional de Doenças e Problemas Relacionados a Saúde (CID-10); estimar os custos diretos mínimos das doenças que afastaram o trabalhador de enfermagem; estimar o custo real aproximado do absenteísmo relacionado a 1 (um) dia de trabalho prestado pelos trabalhadores de enfermagem, com projeção de 1 (um) mês e 1(um) ano numa visão operacional do Sistema Único de Saúde (SUS). Foi utilizada uma amostra estratificada de prontuários dos profissionais de saúde da equipe de enfermagem (enfermeiros e técnicos de enfermagem), a partir do seguinte critério de inclusão: profissionais de enfermagem concursados com afastamento no ano de 2010 e com diagnóstico médico determinante do afastamento, definido claramente. Para a coleta das informações foi feita a apreciação dos documentos arquivados no Serviço de Saúde do Trabalhador do hospital estudado e contou com a apreciação de especialistas médicos relativos aos grupos de diagnósticos estudados, orientados por roteiros criados pela pesquisadora. Os dados foram analisados e armazenados no programa Statistical Package for the Social Sciences (SPSS) versão 15 e no editor Microsoft excel 2003. Dentre os resultados obtidos tiveram destaque para as seguintes causas de afastamento, respectivamente, às doenças do sistema osteomuscular, os fatores que influenciam o estado de saúde e o contato com serviços de saúde, os transtornos mentais e comportamentais, as lesões, envenenamento e outras consequencias de causas externas e, as doenças do sistema circulatório, que representam um custo estimado aproximado de R$ 2,6 milhões. Pôde-se constatar que o impacto econômico do absenteísmo decorrentes dos agravos à saúde para o orçamento de recursos humanos do hospital universitário foi de aproximadamente 2,7%. O custo real aproximado do absenteísmo de enfermagem por dia, foi avaliado em R$ 92,50, tendo projeção mensal de R$ 2.775,00 e anual de R$ 33.300,00. Recomenda-se avaliar o absenteísmo dos profissionais regularmente para identificar as causas reais do absenteísmo por doença, a fim de definir metas para os programas de intervenção à saúde dos trabalhadores e promover uma Gestão participativa que favoreça uma análise do processo de trabalho no que concerne o atendimento das necessidades de saúde e operacionais da força de trabalho, determinantes do absenteísmo. / It is a documentary research, retrospective from secondary source , which adopts a quantitative descriptive- exploratory aprouch. From the observation of high rates of absenteeism in hospital the interest in studying the direct costs of occupational diseases that lead cleareances and their economic impact to the human resources budget of a university hospital in Rio de Janeiro. In this context, it was defined as an object of study the economic impact of sickness absenteeism among nursing and the following objectives: to identify the prevalent causes of absenteeism at the university hospital studied, according to the Internacional Classification of Diseases and Related Health Problems (ICD-10), to estimate the minimum directs costs of the diseases conditions that lead absenteeism to the nursing worker, to estimate the real cost of absenteeism related to one day of work provided by the nursing staff, with projection for one month and one year in operational vision of the Unified Health System (SUS). We used a stratified sample of health professionals records representing nursing staff (nurses and nursing technicians) according to the following inclusion criteria: gazetted professional nursing, with absences in 2010 with medical diagnosis, clearly defined. For data go thing, we used the files the university hospital worker health service and had the appraisal of medical experts for the diagnostic groups studied, according to scripts created by the researcher. Data were analyzed and stored in the program Statistical Package for Social Sciences (SPSS) version 15 and Microsoft excel 2003 in the editor. Among the results obstained, emphasis respectively for diseases of the musculoskeletal system, the factors influencing health status and contact with health services; disorders mental and behavioral disorders, injuries, poisoning and other consequences of external causes, and diseases of the circulatory system, representing an estimated approximate total cost of the R$ 2,6 million. Perceives that the economic impact absenteeism due to the health problems in the studied university hospital humam resources budget was approximately 2,7%. The approximate daily real cost of absenteeism in nursing was valued at R$ 92,50, and monthly forecast of R$2.775,00 and R$ 33.300,00 annually . It is recommended to usually evaluate the absenteeism of professionals to identify the real causes of sickness absenteeism in order to set intervention programs for the health workers and promote participatory management that encourages the evaluation of work process with respect to the health needs and operational workforce, determinants of absenteeism.

abstract: Current economic conditions necessitate the extension of service lives for a variety of aerospace systems. As a result, there is an increased need for structural health management (SHM) systems to increase safety, extend life, reduce maintenance costs, and minimize downtime, lowering life cycle costs for these aging systems. The implementation of such a system requires a collaborative research effort in a variety of areas such as novel sensing techniques, robust algorithms for damage interrogation, high fidelity probabilistic progressive damage models, and hybrid residual life estimation models. This dissertation focuses on the sensing and damage estimation aspects of this multidisciplinary topic for application in metallic and composite material systems. The primary means of interrogating a structure in this work is through the use of Lamb wave propagation which works well for the thin structures used in aerospace applications. Piezoelectric transducers (PZTs) were selected for this application since they can be used as both sensors and actuators of guided waves. Placement of these transducers is an important issue in wave based approaches as Lamb waves are sensitive to changes in material properties, geometry, and boundary conditions which may obscure the presence of damage if they are not taken into account during sensor placement. The placement scheme proposed in this dissertation arranges piezoelectric transducers in a pitch-catch mode so the entire structure can be covered using a minimum number of sensors. The stress distribution of the structure is also considered so PZTs are placed in regions where they do not fail before the host structure. In order to process the data from these transducers, advanced signal processing techniques are employed to detect the presence of damage in complex structures. To provide a better estimate of the damage for accurate life estimation, machine learning techniques are used to classify the type of damage in the structure. A data structure analysis approach is used to reduce the amount of data collected and increase computational efficiency. In the case of low velocity impact damage, fiber Bragg grating (FBG) sensors were used with a nonlinear regression tool to reconstruct the loading at the impact site. / Dissertation/Thesis / Ph.D. Aerospace Engineering 2011

Orientador: Wilza Carla Spiri / Resumo: Introdução: a Liderança Transformacional (LT) é um processo em que o líder é capaz de compreender a importância do seu papel como agente de mudanças e transformação nas organizações. Conduz a equipe na realização de mudanças positivas e na forma como desempenham suas atividades. Assume responsabilidades, oferece aos liderados conhecimento e fortalecimento, conduzindo-os na motivação, empoderamento, busca de desafios, visibilidade e desenvolvimento de forma a modificar comportamentos, formando profissionais e pessoas focados para melhores resultados por meio de seus próprios exemplos e atitudes. Objetivo: compreender o significado de LT e propor um ambiente de aprendizagem por meio de uma intervenção educativa com discussão de temas sobre liderança. Método: Realizado em duas etapas. Na primeira etapa adotou-se a análise de conteúdo como estratégia metodológica, segundo o referencial de Graneheim e Ludman. A segunda etapa utilizou a pesquisa-ação como estratégia de construção coletiva de uma intervenção educativa para a reflexão sobre a prática gerencial e sua interface com a liderança transformacional. O cenário da pesquisa foi a rede de urgência e emergência de um município paulista. Os participantes foram os nove enfermeiros que ocupavam a posição de gerentes, três desses eram enfermeiros assistenciais que substituem os gerentes das unidades de Pronto Atendimento e do Pronto Socorro Municipal. Todos os participantes eram do sexo feminino, com tempo na função variando de três... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

This study used a quantitative approach to evaluate the application of the performance management and development system in the Eastern Cape Department of Health, from the perspective of employees. The evaluation report has three sections that are designed as interrelated but stand-alone documents. Section One is written as a report directed to the Eastern Cape Department of Health. Section Two is a review of the relevant literature that was conducted to review the existing literature related to the application of performance management and development systems, and underpinned the construction of the questionnaire. Section Three provides a description and justification of the design of the research, as well as describing the research procedure followed. Pertinent components of Sections Two and Three are extracted from these sections and included in the report in Section One. The literature review focused on the following areas: the purpose of performance management, components of the performance management process, challenges/ criticism of performance management systems, integration of performance management with other systems and the effectiveness of performance management system. The results revealed that about 74% of employees disagree that management is committed towards the successful application of the performance management system. This finding concurs with the literature. For example, De Waal and Counet (2009:367) argue that one of the problems in the application of performance management system is that the management lacks commitment to the implementation of a performance management system. Systematic sampling (Leedy and Ormrod, 2010) was used to select 120 participants in three Departmental programmes or clusters from grade levels six to 15. The researcher distributed the questionnaires to every fifth person of the population electronically using SurveyBob, which is an on line survey tool. The collected data was then analyzed using Excel software. The findings indicated that although overall employees are not satisfied with the application of the PMDS system in the Eastern Cape Department of Health, there were some successes. Nevertheless, the challenges outweighed successes of the system. The challenges that resulted in the failure of the system include poor communication, a lack of understanding of the system by the employees and a lack of knowledge with regards to the integration of PMDS with other initiatives and plans already in place. Page 4 There were positive views with enabling factors and these were work plans that are mutually agreed upon between the employee and their supervisors and are aligned to departmental strategic priorities. Constraining factors included the low levels of commitment of the management to the application of the PMDS processes, review meetings not being undertaken on a quarterly basis, and a lack of written outcome reviews. The majority of the study participants believe that the PMDS lacks fairness in its implementation. Recommendations were made on the basis of the gaps that were identified so as to improve the application of the performance management system in the Eastern Cape Department of Health. It is therefore recommended that the Department should ensure that training and development of employees on the PMDS takes place to enhance manager’s understanding of the policy. This will enable managers to understand the important role played by performance management in their day to day activities. A performance management and development system needs to be integrated with all other processes to be effective. On-going communication of the PMDS policy should be considered. Accountability of managers to the Accounting Officer and submission of quarterly reports are imperative to ensure their compliance. In conclusion, dissatisfaction outweighs satisfaction of the employees with regards to the implementation of the PMDS system.