Made available in DSpace on 2016-04-04T18:27:43Z (GMT). No. of bitstreams: 1 Cybele Carolina Moretto.pdf: 285699 bytes, checksum: cad86eda2105bb74fc5d0f04fb11e393 (MD5) Previous issue date: 2008-12-02 / The development of this paper was based on a natural group and activities performed simultaneously by the author at a child mental health institution, as psychologist. This study aimed to investigate some emotional experiences of a multidisciplinary team, focusing on understanding of ties formed. The specific aims were describing and understanding of some emotional phenomenon produced spontaneously on group. Considering it a natural group, when this research began, there were some directions already defined on team meetings, which were similar to forming group of Anzieu and Ka?s (1989). Participants were the professionals and interns of the team, altogether fifteen people. Records were done as following: each meeting, a member written all content and, at the end, it was read in a loud voice for everybody. According needs, some changes could be done by the speaker. This procedure aimed objectivity on study, trust on records and subjectivity free from speaker. The experience of study took six meetings, with two hours long. But only four of them were used to the analysis. It was used the technique content analyzing of qualitative proof, proposed by Mathieu (1967) and Ka?s (1977). The target was going beyond the description of messages content, applying inferences that allowed a deep understanding. Concluding, the group made possible the sensitization to the phenomenon s group and to understanding some psychic formulations of it, it worked as an easy way for members to express stress and feelings and provided a reflection about practices of work. / O presente estudo foi realizado a partir de um grupo natural e, concomitantemente com as atividades que a autora desenvolve numa institui??o de sa?de mental infantil, como psic?loga. Teve como objetivo geral investigar algumas experi?ncias emocionais de uma equipe interdisciplinar, com o intuito de compreend?-las a partir dos v?nculos que se formam. Os objetivos espec?ficos foram descrever e compreender alguns fen?menos emocionais produzidos no aqui-agora do grupo. Por se tratar de um grupo natural, quando a pesquisa foi iniciada j? havia um enquadre determinado nas reuni?es da equipe, o qual se assemelhava ao grupo de forma??o (Anzieu & Ka?s, 1989). Os participantes foram os profissionais e estagi?rios da equipe, totalizando 15 pessoas. Os registros foram realizados da seguinte maneira: em cada reuni?o, um membro do grupo escrevia todo o conte?do que, ao final, era lido em voz alta para todos os integrantes. Conforme havia a necessidade de altera??es, essas eram feitas pelo redator. O procedimento adotado visou ? objetividade no estudo, fidedignidade do registro e isen??o da subjetividade do redator. A experi?ncia do estudo permaneceu durante seis reuni?es, com dura??o de duas horas cada, sendo que, dessas, apenas quatro fizeram parte da an?lise. Utilizamos o modelo qualitativo de pesquisa de an?lise do conte?do proposto por Mathieu (1967) e Ka?s (1977). Tal an?lise visou ultrapassar a mera descri??o do conte?do das mensagens, com aplica??o de infer?ncias que possibilitam uma interpreta??o aprofundada. Conclu?mos que o espa?o grupal possibilitou a sensibiliza??o aos fen?menos de grupo e a compreens?o de certas formula??es ps?quicas deste, funcionou como um facilitador para que os integrantes expressassem tens?es e sentimentos e proporcionou a reflex?o sobre as pr?ticas de trabalho.

Esta pesquisa abordou o tema da Política de Ações Afirmativas, nos processos de in/exclusão dos alunos com renda inferior, a partir da análise das práticas institucionais mobilizadas pela equipe multidisciplinar da Divisão de Seleção e Acompanhamento Pedagógico, Psicológico e Social (DSS), que pertence a Pró-Reitoria de Assuntos Estudantis (PRAE), da Universidade Federal do Rio Grande do Sul (UFRGS). Por meio desta pesquisa foi possível: a) discutir os processos de in/exclusão, especialmente no que diz respeito à renda inferior e à inclusão como um imperativo de Estado; b) relatar brevemente como ocorreu o processo de democratização do Ensino Superior no Brasil, buscando identificar pontos relevantes do processo de implantação das ações afirmativas; c) construir um breve histórico do processo de implantação das Ações Afirmativas na UFRGS e algumas mudanças que ocorreram no decorrer deste percurso; d) compreender as práticas desenvolvidas pela DSS a partir do conjunto de políticas que a mobiliza, nos processos de in/exclusão dos estudantes com renda inferior; e) buscar alternativas para o seu melhor funcionamento através do levantamento de questões e f) propor reflexões que digam respeito às práticas postas em funcionamento por esta equipe no contexto institucional. Foram utilizados como procedimentos metodológicos entrevistas semiestruturadas com os servidores da DSS e ex-gestores da PRAE. As categorias de análise foram construídas a partir das recorrências dos excertos analisados. Nas análises, foi possível evidenciar a necessidade de uma gestão mais qualificada e engajada para buscar atender a esses novos compromissos assumidos pela Universidade, fortalecendo o importante trabalho realizado pela equipe multidisciplinar da DSS. Assim, esta dissertação traz pistas que podem nortear a (re) construção do setor a partir dos seguintes pressupostos: 1) retomada do histórico do setor no contexto institucional, reconstituída na dissertação; 2) reorganização da gestão do setor a partir: a) da visão da DSS como um espaço de estudo e de elaboração de propostas de trabalho conjuntas: b) da elaboração de um cronograma de trabalho que mescle momentos de estudo e de planejamento do trabalho da equipe; c) da discussão e da organização do trabalho de acompanhamento dos alunos (ingresso, permanência e sucesso acadêmico), tendo em vista as atribuições de cada uma das áreas dos profissionais que atuam no setor; d) da necessidade de avançar na discussão com outros setores da UFRGS – no caso das ações de acompanhamento, o diálogo com as COMGRAD’s e a elaboração de ações conjuntas será essencial; e) da avaliação do tipo de acompanhamento que será realizado; e) da criação de mecanismos que possibilitem a avaliação processual do trabalho desenvolvido, bem como a sistematização e o registro permanente dos dados coletados. / This research addressed the topic of Affirmative Action Policy in the processes of in / exclusion of lower income students, based on the analysis of the institutional practices mobilized by the Multidisciplinary Team of the Pedagogical, Psychological and Social Selection and Monitoring Division (DSS), which Belongs to Pro-Rectory of Student Affairs (PRAE), Federal University of Rio Grande do Sul (UFRGS).Through this research it was possible to: a) discuss the processes of in / exclusion, especially with regard to lower income and inclusion as a state imperative; B) to report briefly how the process of democratization of Higher Education in Brazil occurred, seeking to identify relevant points of the process of implementation of affirmative actions; C) construct a brief history of the implementation process of Affirmative Actions in UFRGS and some changes that occurred during this course; D) understand the practices developed by the DSS from the set of policies that mobilize it, in the processes of in / exclusion of students with lower incomes; E) seek alternatives for its better functioning through the survey of issues and f) propose reflections regarding the practices put in place by this team in the institutional context. Semi-structured interviews were used as methodological procedures with the DSS servers and former PRAE managers. The categories of analysis were constructed from the recurrences of the excerpts analyzed. In the analyzes, it was possible to highlight the need for a more qualified and engaged management to seek to meet these new commitments assumed by the University, strengthening the important work carried out by the DSS multidisciplinary team. This dissertation presents clues that can guide the (re) construction of the sector from the following assumptions: 1) resumption of the history of the sector in the institutional context, reconstituted in the dissertation; 2) reorganization of the management of the sector from: a) the vision of the DSS as a space for study and preparation of joint work proposals; b) the preparation of a work schedule that combines moments of study and planning of the work of the team; C) discussion and organization of student follow-up work (admission, permanence and academic success), considering the responsibilities of each of the areas of professionals working in the sector; D) the need to advance the discussion with other sectors of UFRGS - in the case of follow-up actions, dialogue with COMGRAD's and the elaboration of joint actions will be essential; E) the evaluation of the type of follow-up to be carried out; F) the creation of mechanisms that allow the process evaluation of the work developed, as well as the systematization and permanent recording of the data collected.

Diversos serviços de saúde no Brasil vem apresentado episódios de superlotação, em um contexto onde os recursos são limitados. A redução do tempo de permanência em internações hospitalares tem como consequência direta a disponibilização de mais leitos-dia. O gerenciamento e melhoria do fluxo de pacientes ao longo das internações hospitalares é importante, sendo que o uso eficiente dos leitos pode acontecer devido a uma série de fatores. Estudos demonstram que equipes multidisciplinares podem realizar uma assistência de qualidade, reduzindo custos e o tempo em que os pacientes permanecem internados, sem impacto na reinternação ou mortalidade. Também há trabalhos que apontam a eficácia de unidades dedicadas ao atendimento de doenças específicas. A admissão de pacientes dentro de critérios bem definidos aumenta o giro de leitos. Com o objetivo de analisar se a equipe multidisciplinar Medicina Interna – Emergência (MIE) poderia contribuir para a redução do tempo de permanência hospitalar dos pacientes portadores de doenças prevalentes, sem alterar os indicadores de reinternação e mortalidade, o presente estudo experimental, controlado, não-randomizado, comparou o período pré e pós-intervenção, ou seja, a criação de uma Unidade de Curta Permanência no Serviço de Medicina Interna, do Hospital de Clínicas de Porto Alegre (HCPA). Foram analisadas internações ocorridas através da Emergência do HCPA, de pacientes com 14 anos ou mais, com as doenças prevalentes classificadas conforme grupos do CID-10 (J09-J018; J40-J47; N30-N39; I30-I52; I60-I69; B20-B24; C15-C26; A30-A49; e E10-E14), no período compreendido entre 01 de dezembro de 2008 a 30 de novembro de 2010 (n = 11040). Os resultados do estudo demonstram que após a criação da equipe E-MEI e a sua unidade de curta permanência, houve uma redução do tempo de permanência dos pacientes internados pelas causas selecionadas (antes: 10,89 ± 13,17 dias, após: 9,47 ± 11,24 dias, p = 0,006), e uma diminuição mais acentuada nas internações do Serviço de Medicina Interna [antes (n = 680): 14,33 ± 14,57 dias, após (n = 1243): 9,77 ± 10,62 dias, p = 0,000]. Não ocorreu alteração na taxa de mortalidade de todos os pacientes admitidos para as causas selecionadas [antes (n = 3800): 11,3%, após (n = 3958): 11,8% p = 0,123]. Também não houve alteração na taxa de reinternação de 7 dias na amostra estudada [antes (n = 3369): 7,2%, depois de (n = 3491): 6,7%, p = 0,407]. / Several health services in Brazil has shown episodes of overcrowding, in a context where resources are limited. Reducing the length of stay in hospital has as a direct consequence the provision of more beds-day. Managing and improving the flow of patients throughout the hospital is important, and the efficient use of beds can happen due to a number of factors. Studies have shown that multidisciplinary teams can perform quality care, reducing costs and the time patients remain hospitalized, with no impact on mortality or rehospitalization. There are also studies that show the effectiveness of units dedicated to the treatment of specific diseases. The admission of patients into well-defined criteria increases the turnover of beds. With the objective of analyzing the multidisciplinary team Internal Medicine – Emergency, could help to reduce the length of hospital stay of patients with diseases prevalent, without changing the indicators of rehospitalization and mortality, the present study experimental, controlled, not -randomized study compared the pre-and post-intervention, ie the creation of a Short Stay Unit in the Department of Internal Medicine, Hospital de Clinicas de Porto Alegre (HCPA). We analyzed hospital admissions through the Emergency HCPA, for patients aged 14 years or older with prevalent disease groups classified according to the ICD-10 (J09-J018, J40-J47, N30-N39, I30-I52, I60-I69; B20-B24, C15-C26, A30-A49, and E10-E14), during the period from December 1, 2008 to November 30, 2010 (n = 11,040). The study results show that after the creation of the multidisciplinary team, and its Short Stay Unit, there was a reduction in the length of stay of inpatients by selected causes (before: 10.89 ± 13.17 days after: 9 47 ± 11.24 days, p = 0.006) and a greater reduction in hospitalizations Service of Internal Medicine [before (n = 680): 14.33 ± 14.57 days after (n = 1243): 9, 77 ± 10.62 days, p = 0.000]. No change in the mortality rate of all patients admitted to selected causes [before (n = 3800): 11.3% after (n = 3958): 11.8% p = 0.123]. There was also no change in the rate of readmission than 7 days in our sample [before (n = 3369): 7.2% after (n = 3491): 6.7%, p = 0.407].

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Trauma-provoked tinnitus challenges patients and clinicians. Effects of trauma may exacerbate tinnitus, and patients with both tinnitus and posttraumatic stress disorder rate distress levels as higher than patients who experience only one or the other. This presentation will highlight links between tinnitus and trauma histories relevant to clinical audiologists.

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Controlled substance stewardship, much in the same vein as antimicrobial stewardship, is a professional obligation for prescribers and pharmacists alike in today’s practice environment. This presentation will introduce this concept and present a model for pharmacist-led controlled substance prescribing interventions in a primary care clinic. The Controlled Substances Initiative (CSI) at Penobscot Community Health Care in Bangor, Maine, was implemented in 2013. The interprofessional CSI Committee meets weekly to review patient cases involving controlled substances and communicate best practice recommendations to prescribers. All committee operations are sustained by pharmacists participating in a postgraduate residency training program. To assess the organization-wide impact of the initiative, presenters will share data on controlled substance dose reductions and mortality trends. They will offer pearls for application of this model to other practice settings, including community pharmacies.

Response to Intervention (RTI) is a multi-tiered framework that focuses on the early identification and support of students who are struggling to learn. In the problem-solving model of RTI, where a multidisciplinary team uses data to drive decision making, much remains unknown about how RTI should be implemented when struggling English language learners (ELLs) are the focus of team deliberations. The development of the multidisciplinary problem-solving team (PST) is grounded in the assumption that professionals from different disciplines such as school psychology, special education, and counseling would make less biased decisions than a single individual. However, a group of professionals may still make biased decisions based on stereotypes of ethnicity (Orosco, 2010), social class (Knotek, 2003), and inadequate knowledge of second language acquisition and bilingualism (Orosco, 2010). Not much is known about the process of team decision-making; in fact, no research to-date has examined how a PST deliberates about struggling ELLs. A qualitative case study approach was utilized to investigate how one school’s multidisciplinary problem-solving team used data in their deliberations about struggling ELLs in early primary grades. Ten members of a PST at an elementary school in an urban area of Texas participated in this study; seven ELLs were the focus of the observed team meetings. Data were generated from the discourse of the team meetings, interviews, and school documents, including students’ cumulative folders and language proficiency assessment records. Data were analyzed using discourse analysis, content analysis, and pattern-matching logic. Findings revealed that the Tier 3 problem-solving process was not aligned with the district’s expressed intent. In addition, a hierarchy of control constrained the problem-solving process and restricted the PST’s ability to freely discuss the cases of struggling ELLs. Implications for implementing RTI with ELLs and suggestions for future research are presented. / text

The work concerns the peculiarity of multidisciplinary team work, providing community mental health services. Theory defines the main principles of arranging the services, overview the tendency of reforms in field of psychiatry in Lithuania, propose brief development review, overlook legislation, highlighting various professional work components in the care system. The main purpose of research is to make an evaluation of Karoliniskiu mental health center’s staff and team work peculiarities parasitizing multidisciplinary team work method. Research was made using qualitative analysis, which identifies muldisciplinary team work, measures links between various professional groups. Conclusions: it is clear, that the institution has top-down (hierarchical) interactions, uneven information sharing between professional groups: psychiatrists, psychologists, nurses, social workers. Those are the main obstacles in building multidisciplinary team work in practice and equal interaction in between professionals; in case to make the treatment of patient’s problems more effective, it is necessary to enforce team work and change the information sharing system in institution – hierarchical collaboration should be changed to equal collaborating, while every professional’s competence has equal wage in general work process.

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