<p>Istraživanje prikazano ovim radom imalo je za cilj da opi&scaron;e mentalno zdravlje<br />dece na hraniteljstvu ranog &scaron;kolskog uzrasta i da sagleda kakvu ulogu u aktuelnom<br />stepenu njihovog psihosocijalnog funkcionisanja ima kvalitet brige koji im je pružen u<br />hraniteljskoj porodici. Kvaliteta staranja o detetu je konceptualizovan iz okvira teorije<br />afektivne vezanosti kao posvećenost hranitelja detetu na sme&scaron;taju i podrazumeva nivo<br />emocionalne investiranosti i motivisanosti hranitelja da sa detetom uspostavi emotivno<br />blizak, stabilan i trajan odnos.<br />U uzorak istraživanja je uključeno 82 dece na sme&scaron;taju u hraniteljskim<br />porodicama, uzrasta od 5 do 11 godina, koji su &scaron;tićenici Centra za socijalni rad Grada<br />Novog Sada i vi&scaron;e op&scaron;tinskih centara na teritoriji Vojvodine (Novi Bečej, Bačka<br />Topola, Mali Iđo&scaron; i Vrbas), bez ozbiljnijih smetnji u psihomotornom razvoju i koja u<br />aktuelnoj hraniteljskoj porodici borave najmanje dva meseca. U uzorku je podjednak<br />broj dečaka i devojčica, pri čemu dominiraju deca koja su na sme&scaron;taju u standardnim<br />(nesrodničkim) hraniteljskim porodicama (90.2 %), u odnosu na srodničke.<br />Podaci o mentalnom zdravlju dece su prikupljani uz pomoć dve skale za procenu<br />dečije psihopatologije koje su popunjavale hraniteljice: Liste provere dečijeg pona&scaron;anja<br />za decu od 6-18 godina (Child Behavior Checklist for ages 6-18, CBCL/6-18,<br />Achenbah &amp; Reskorla, 2001) i Liste za procenu dece u socijalnoj za&scaron;titi uzrasta od 4-11<br />godina (Assessment Checklist for Children for ages 4-11, ACC, Tarren-Sweeney,<br />2007). Podaci o mentalnom zdravlju su prikupljani i za kontrolni uzorak dece koja<br />odrastaju u biolo&scaron;kim porodicama, ujednačenom po broju, polnoj i uzrasnoj strukturi sa<br />uzorkom dece na hraniteljstvu, kao i u odnosu na pol roditelja koji pruža podatke<br />(majke). Za operacionalizovanje i procenjivanje kvaliteta staranja o detetu od strane<br />hranitelja je kori&scaron;ćen polustrukturirani intervju &ldquo;To je moje čedo&rdquo; (&ldquo;This Is My Baby&rdquo;<br />interview&rdquo;, TIMB, Bates &amp; Dozier, 1998) koji se sastoji od standardizovanih pitanja u<br />vezi hraniteljicinih osećanja prema detetu i njihovog međusobnog odnosa i daje uvid u<br />tri dimenzije: prihvatanja deteta na sme&scaron;taju kao svog (eng. acceptance), posvećenosti u<br />podsticanju njegovog rasta i razvoja bez emotivne &ldquo;zadr&scaron;ke&rdquo; (eng. commitment) i<br />svesnosti o uticaju uspostavljenog odnosa sa detetom na detetov emocionalni i socijalni<br />razvoj, aktuelno i u budućnosti (eng. awareness of influence).<br />Rezultati istraživanja ukazuju da deca na hraniteljstvu u poređenju sa svojim<br />vr&scaron;njacima koji odrastaju u biolo&scaron;kim porodicama, ispoljavaju značajno vi&scaron;e problema<br />mentalnog zdravlja, pri čemu prednjače problemi sa pažnjom, smetnje afektivne<br />vezanosti u vidu nediskriminativnog, pseudozrelog i nesigurnog pona&scaron;anja u<br />5<br />interpersonalnim relacijama, eksternalizujući problemi (agresivno pona&scaron;anje, kr&scaron;enje<br />pravila), abnormalni obrasci ishrane (čuvanje, skladi&scaron;tenje i krađa hrane) i<br />samopovređivanje. Mentalno zdravlje dece je determinisano nepovoljnim razvojnim<br />okolnostima koje prethode sme&scaron;taju ali i kvalitetom brige koja im je pružena u<br />hraniteljskoj porodici, pa se kod dece o kojima brinu hraniteljice visokog nivoa<br />prihvatanja i posvećenosti beleži manje emocionalnih problema, problema u pona&scaron;anju i<br />odnosu sa drugima. Rezultati ukazuju i na moderirajuće efekte kvaliteta staranja, u<br />smislu da je stepen prihvatanja i posvećenosti od strane hraniteljica posebno značajan za<br />decu koja su pre sme&scaron;taja u hraniteljsku porodicu imala visoko rizično iskustvo, čineći<br />ih znatno vulnerabilnijim u okolnostima niskog kvaliteta brige, kao &scaron;to i okolnosti<br />visokog kvaliteta staranja u ovoj grupi dece ostvaruju najintenzivniji protektivni i<br />kompenzatorni efekat.<br />Rezultati su diskutovani u svetlu teorije afektivne vezanosti, u smislu potvrde<br />kvaliteta staranja kao protektivnog činioca koji podstiče rezilijentnost dece i implikacija<br />relevantnih za praksu socijalnog rada u oblasti hraniteljstva.</p> / <p>The purpose of the research presented in this paper is to describe the mental<br />health of children in foster care at early school-age and to analyse the role that the<br />quality of care they receive in foster family plays in the current level of their<br />psychosocial functioning. The quality of child care has been conceptualized from the<br />framework of the attachment theory as the commitment of foster carers to the foster<br />children and it implies a level of emotional investment and motivation of the foster<br />carers to establish an emotionally close, stable and permanent relationship with the<br />child.<br />The research sample involved 82 foster children, aged 5 to 11, who are in the<br />care of the Centre for Social Work of the City of Novi Sad and several municipal<br />centres in the territory of Vojvodina (Novi Bečej, Bačka Topola, Mali Iđo&scaron; and Vrbas),<br />who are without serious difficulties in psychomotor development and who have been<br />with the current foster family for at least two months. The sample included the same<br />number of boys and girls, and the majority were children in standard (non-kinship)<br />foster families (90.2 %), as opposed to kinship foster families.<br />Information about the mental health of the children was collected using two<br />scales for the assessment of psychopathology in children, which were filled out by<br />foster mothers: Child Behaviour Checklist for ages 6-18 (CBCL/6-18, Achenbah &amp;<br />Reskorla, 2001) and Assessment Checklist for Children for ages 4-11 (ACC, Tarren-<br />Sweeney, 2007). Information about the mental health was also collected for the control<br />sample of children who live with biological families, identical in number, gender and<br />age structure with the sample of children in foster care, as well as in relation to the<br />gender of the parent providing the information (mother). In order to operationalize and<br />assess the quality of child care, the research used the semi structured interview &ldquo;This Is<br />My Baby&rdquo; (TIMB, Bates &amp; Dozier, 1998) which contains standardized questions in<br />relation to the foster mother&rsquo;s feelings towards the child and their mutual relationship<br />and it also provides insight into three dimensions: acceptance of foster child as her own,<br />commitment in encouraging their growth and development without emotional<br />&ldquo;reservations&rdquo; and the awareness of influence of the established relationship with the<br />child on the child&#39;s emotional and social development, now and in the future.<br />The results of the research indicate that the children in foster care, as compared<br />to their peers growing up with biological families, display significantly more mental<br />health problems, and the most frequent ones are attention problems, attachment related<br />difficulties in the form of indiscriminate, pseudo mature and insecure interpersonal<br />8<br />behaviours, externalising problems, aggressive and rule-breaking behaviour, eating<br />problems, food maintenance behaviour and self-injury. The mental health of the<br />children is determined by the unfavourable development circumstances prior to<br />placement in foster care, but also by the quality of care that they receive in foster<br />family, and so the children in the care of foster mothers with a high level of acceptance<br />and commitment display fewer emotional, behavioural and interpersonal problems. The<br />results also indicate the moderation effects of the quality of care, in the sense that the<br />level of acceptance and commitment by the foster mothers is of particular significance<br />for the children who had high-risk experience before they were placed in foster family,<br />which made them significantly more vulnerable in the circumstances of low-quality<br />care, just like the circumstances of high-quality care with this group of children<br />produced a more intensive protective and compensatory effect.<br />Results are discussed in the light of the attachment theory, in terms of<br />confirmation of the quality of care as a protective factor which encourages the resilience<br />of children, as well as the implications relevant to the social work practice in the field of<br />foster care.</p>

INTRODUÇÂO: A conformação do sistema de prestação de serviços sociais e de saúde no Brasil contou desde o período colonial com a presença de instituições singulares de origem portuguesa, cuja pioneira foi a Santa Casa de Lisboa, fundada em 1498. Hoje essas instituições são responsáveis por 40% das internações realizadas pelo SUS no Brasil e cerca de 55% das realizadas em São Paulo. A despeito da enorme importância, já apresentada acima, na constituição da rede prestadora de serviços do SUS, as instituições filantrópicas sofrem de enormes dificuldades gerenciais, que são o resultado da dificuldade em se obter recursos humanos qualificados e da falta de recursos financeiros, particularmente aqueles originários de fontes públicas. Essa realidade proporcionou condições para que outros atores sociais, na atual evolução da estrutura sócioeconômica do país e especialmente no estado de São Paulo, se mobilizassem para criar novas formas de apoio a essas instituições filantrópicas. Nesse contexto a Companhia Paulista de Força e Luz, empresa responsável pela distribuição de energia em cerca de metade dos municípios do interior do estado de São Paulo desencadeasse um processo de apoio à melhoria da gestão dos hospitais filantrópicos atuantes na sua área de concessão de energia. Este trabalho buscou avaliar a formulação e desenvolvimento da implantação do Programa de Revitalização dos Hospitais Filantrópicos desenvolvido pela CPFL em duas regiões do estado e seus resultados. METODOLOGIA: tratase de um estudo de caso, no qual se destacam a descrição e o relacionamento entre os fatores em cada situação, sendo que aos dados numéricos é dado um papel coadjuvante. Para a elaboração deste trabalho, no entanto, foi dada especial importância aos dados numéricos da assessoria prestada aos hospitais filantrópicos, pelo fato de servirem de base para a construção de um banco de dados municiador de informações sobre a evolução do programa. Portanto a analise a ser desenvolvida será também voltada à avaliação feita externamente aos hospitais filantrópicos incluídos nesta primeira fase do programa. RESULTADOS. Na descrição do processo de elaboração do programa de Revitalização, houve uma definição de acordos e parcerias entre diferentes agentes sociais que propiciaram a elaboração do Programa de Revitalização voltado à excelência da gestão. O programa se constituiu ao final com 4 componentes: criação de redes de apoio aos hospitais, assessoria direta, cursos e voluntariado. No que se refere à assessoria direta, a estratégia que se estabeleceu foi a de disponibilizar consultores em duplas com 16 hs semanais de trabalho presencial em 6 hospitais definidos como referencias nos sistemas regionais e locais das regiões de Franca e Piracicaba. Essas regiões foram escolhidas por só terem hospitais filantrópicos em sua área de atuação.. Na avaliação quantitativa realizada pelo CQH em 4 visitas feitas aos hospitais mencionados, a evolução da pontuação obtida pelos hospitais foi bastante significativa, pois dada média inicial de 112,70, a média final foi de 379,50 para um total possível de 500 pontos. Na avaliação feita da relação entre a evolução da pontuação e as pautas de assuntos tratados nos Comitês de Revitalização dos hospitais e classificados por critérios de excelência, observouse uma menor freqüência de discussões sobre os critérios de excelência relacionados ao perfil do hospital, à sociedade e sobre informações e conhecimento institucionais. Nos demais critérios a frequencia de pauta foi maior, porem se observa um melhor desempenho em termos de avaliação em liderança, em estratégias e planos e em clientes. O não tão bom desempenho em gestão de pessoas e gestão de processos pode ser atribuída a maior dificuldade em implementar determinadas ações que redundem em efeitos constatáveis a curto prazo. CONCLUSÔES: houve uma política eficaz de construção e implementação de um programa de responsabilidade social da empresa que congregou diferentes atores sociais. A estratégia de assessoria direta se mostrou adequada para promover impactos mensuráveis e significativos na gestão dos hospitais. A criação dos comitês de interlocução nos hospitais com representação de seus diversos setores se mostrou adequada, porém ainda necessita ser melhorada para que se possa alcançar melhores resultados. / INTRODUCTION: Distinctive Portuguese institutions, as pioneer Santa Casa de Lisboa founded in 1498, have contributed to the structure of the social and health care service system in Brazil since the colonial period. Currently these institutions account for 40% of SUS (Unified Health System) hospitalizations in Brazil, and approximately 55% of hospitalizations in São Paulo. Despite the major importance mentioned above, philanthropic institutions have immense managerial difficulties in order to take part in the SUS services network, resulting in drawbacks to attain qualified human resources and lack of financial resources, mainly those of public source origin. This scenario enables other social players, in the current stage of the socioeconomic structure of the country and especially in the state of São Paulo, to mobilize in order to create new ways to support these philanthropic institutions. In the present context, Companhia Paulista de Força e Luz, the company responsible for distributing electricity to roughly half of the cities in the interior of São Paulo triggered a process to support improvement in the management of philanthropic hospitals operating in its area of power concession. This study aimed to evaluate the preparation and development of the implementation of the Philanthropic Hospital Revitalization Program developed by CPFL in two regions of the state, and its results. METHOD: case study in which the description and relationship among factors in each situation stand out, with figures playing a supporting role. In order to prepare the study, however, special attention was given to the figures of the consulting services provided to philanthropic hospitals, given they were the foundation to build the information database on the development of the program. Therefore the analysis developed was also oriented toward the assessment carried out externally to the philanthropic hospitals included in the first stage of the program. RESULTS. In the description of the process to prepare the Revitalization Program, agreements and partnerships among the different social agents that enabled the preparation of the Revitalization Program oriented toward management excellence were defined. The program comprised 4 components: development of hospital support networks, direct consulting, courses and volunteer work. In relation to direct consulting, the strategy established was to make a pair of consultants available 16 hours per week with onsite work in 6 hospitals defined as references in the regional and local systems of the Franca and Piracicaba regions. The regions were chosen because they only had philanthropic hospitals in their area of action. The quantitative assessment performed through CQH in 4 visits to the hospitals mentioned, and the development and score reached by hospitals was very significant, given there was a progression from an initial mean of 112.70, to a final mean of 379.50 within a total possible 500point score. Regarding the assessment of the relationship between the development of the score and agenda of the issues discussed at Hospitals Revitalization Committees and classified per excellence criteria, there were less frequent discussions on excellence criteria related to hospital profile, society and on information and institutional knowledge. Remaining criteria were more frequent in the agenda, but better performance in terms of leadership assessment, strategies and plans and clients was observed. Performance in people and process management was not as good maybe due to more drawbacks to implement certain actions that result in long term observable effects. CONCLUSIONS: there was an effective policy to build and implement a company social responsibility program that joined different social players. The direct consulting strategy was shown to be appropriate to promote measurable and significant impact on hospital management. The creation of interface committees at hospitals, with representatives from its several sectors proved appropriate, but still has to be enhanced in order to reach better results.

Thesis (D.P.H.)--University of Michigan, 1993.

Thesis--University of Michigan, 1996.

Thesis (D.P.H.)--University of Michigan, 1993.

Thesis--University of Michigan, 1996.

Thesis (M.S.)--Miami University, Dept. of Physical Education, Health, and Sport Studies, 2007. / Title from first page of PDF document. Includes bibliographical references (p. 64-67).

Background: For human beings´ sexuality is a core characteristic and in the Occupational Therapy Practice Framework sexuality is listed as an activity of daily living (ADL). Still, sexuality related issues are rarely investigated in occupational therapy and nursing. Aim: The aim was to investigate the relevance of the Quality of Sexual Function Scale (QSFS) for occupational therapists and nurses in Sweden. Methodology: Two Qualitative Focus Group Discussions (FGDs) with occupational therapists and nurses with 8 participants was done online (March 2021), recorded, transcribed and analysed with a deductive content analysis.Results: The analyses revealed five main categories that described the relevance of the QSFS; outdated wordings, heteronormative per default and definition of sex, an educational tool, needed to refine laws and break taboos and a facilitator to work with sexual health. Overall, an instrument measuring sexual health was desired and well received by the participants, however the QSFS need to be revised to adapt to accurate vocabular and embrace diversity. A revised tool may facilitate to address questions about sexuality, intimacy and expressions that are fundamental aspects of a person’s wellbeing. However, questions about sexuality should be raised by staff as a natural part of their work, without a tool. Conclusion: The QSFS is not an optimized tool to assess the quality of sexual function and needs among patients. The tool requires further development. Greater emphasis needs to be placed on policies and praxis in work-places and health care educations to address patients’ sexual expressions and needs.

Das Ziel dieser Studie war es, die mundgesundheitsbezogene Lebensqualität (MLQ) bei Patienten mit rheumatoider Arthritis (RA) unter Berücksichtigung krank- heitsspezifischer Parameter zu bewerten. Dabei sollte eine Analyse der verschiedenen Dimensionen der MLQ, wie Funktionseinschränkungen des Kausystems, psychosozialer Einfluss, orofaziale Schmerzen sowie dentofaziale Ästhetik, durchgeführt werden.

IN ENGLISH The diploma thesis presents physical activity and quality of life. Thesis characterizes these two areas, discusses the influences that affect these two areas and then compares the influence of themselves - or the influence of one of them on the other, the impact of physical activity on the quality of life. The theoretical part presents physical activity as a tool of benefit, a determinant of health, part of an active lifestyle. The quality of life is discussed in a similar way. The practical part examines the influence of physical activity on the quality of life in individual age categories. In addition to the influence of physical activity on the quality of life in general, practical part is also testing the influence of this activity on individual dimensions of quality of life. Two questionnaires - WHO QOL-BREF and GPAQ - are used to determine the values needed for the research.