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Identificação de fatores prognósticos em pacientes com lombalgia mecânica comum crônica submetidos ao tratamento fisioterápico convencional / Identification of prognostic factors in patients with chronic mechanical back pain submitted to conventional physiotherapy treatmentFeitosa, Aloma da Silva Alvares 25 October 2012 (has links)
Introdução: A lombalgia gera altos custos, em todo o mundo, com tratamentos e perda de produtividade. Embora hoje existam vários tratamentos para lombalgia, não ocorrem estudos demonstrando a superioridade de um programa específico de reabilitação e o número de pacientes que recidiva da dor é alto, sobrecarregando os serviços públicos de saúde. Questionamos se uma lista de fatores prognósticos elaborada, em 2007, pelo Multinational Musculoskeletal Inception Cohort Study, poderiam servir também para identificar fatores prognósticos da resposta terapêutica à fisioterapia convencional, em pacientes com lombalgia crônica já estabelecida. Objetivos: Identificar fatores prognósticos para resposta ao tratamento fisioterápico em uma população de pacientes com lombalgia crônica. Materiais e métodos: Foram selecionados 130 pacientes com lombalgia mecânica comum crônica no Ambulatório de Doenças da Coluna da Reumatologia. Estes pacientes foram avaliados inicialmente, após realização de dez sessões de fisioterapia e três meses após a da última sessão. Os pacientes foram classificados como respondedores ao apresentarem melhora na escala numérica de dor (END) e redução no questionário de Roland Morris (QRM). Resultado: A ausência de dor extra- espinhal e medo evitação-trabalho aumentam a chance de melhora na END ao final do tratamento. Já a melhora pelo QRM, ao final de dez sessões, só é influenciada pela ausência de dor extra-espinhal. Após três meses do final do tratamento, a ausência de medo-evitação trabalho e dor extra-espinhal aumentam a chance de melhora na END. Conclusão: Identificamos que medo e evitação-trabalho, bem como a presença de dor extra-espinhal são características de subgrupos de pacientes que podem necessitar de programas de reabilitação especiais / Introduction: Low back pain causes high treatment expenses and productivity losses worldwide. Although several treatments are currently available for low back pain, no studies have demonstrated the superiority of any rehabilitation program, and the number of patients exhibiting relapse is notably high, which has the effect of overloading the public health services. We questioned whether the list of prognostic factors elaborated in 2007 by the Multinational Musculoskeletal Inception Cohort Study, could also serve to identify prognostic factors of therapeutic response to conventional therapy in patients with chronic LBP already established. Aim: To identify prognostic factors for the response to physiotherapy treatment in a population of patients with chronic low back pain. Materials and Methods: A total of 130 patients with chronic mechanical low back pain were selected at the spine disease outpatient clinic of the rheumatology unit of a hospital. These patients were assessed at recruitment, at the completion of 10 sessions of physiotherapy and three months later. Patients were classified as responders when they exhibited at least a two-point improvement on a numerical rating scale (NRS) and at least a four-point reduction on the Roland-Morris Disability Questionnaire (RMDQ). Results: According to the NRS, the absence of extra-spinal pain and fear avoidance work increased the odds of improvement at the end of treatment. Improvement in the RMDQ at the end of 10 sessions was only influenced by the lack of extra-spinal pain. Three months after the end of the treatment, as measured by the NRS, the absence of fear-avoidance with regard to work and the absence of extra-spinal pain increased the improvement odds. Conclusion: We identified fear-avoidance with regard to work and the presence of extra-spinal pain as characteristics of subgroups of patients who may require special rehabilitation programs
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Distinção entre obrigações de meios e obrigações de resultado / Distinction between best efforts duties and duties to achieve a specific resultCastilho, Taarik de Freitas 06 May 2011 (has links)
O objeto da dissertação é o estudo de uma classificação das obrigações entre aquelas de meios e as de resultado, as primeiras obrigando o devedor a uma prestação de diligência, as segundas, à realização de uma vantagem para o credor, sem o que não haveria o devedor de exonerar-se. Um estudo histórico abre o trabalho, pesquisando os antecedentes remotos da distinção, até a sua consagração, no Traité de René Demogue, o que tornou famosa a distinção que passou a gerar profundas discussões doutrinárias na França e no resto do mundo. São também tratados os antecedentes mais recentes, o contexto histórico do surgimento da classificação e sua evolução sucessiva, tanto na França quanto em outros países, para, enumeradas algumas das muitas dificuldades envolvidas no estudo do tema, ainda hoje severamente combatido, pesquisar-se, do ponto de vista da estrutura do vínculo obrigacional, como esta classificação se relaciona com a prestação devida. Assim, acredita-se, seria possível dizer se, uma vez que todo vínculo obrigacional surge tendo em vista um resultado, a prestação obrigacional admite uma distinção entre aquelas que implicam uma atividade do devedor limitada por sua diligência (obrigação de meios) e aquelas que somente conduzem a obrigação a seu termo mediante cumprimento uma vez realizado um resultado, ou seja, desde que produzido um benefício específico para o credor (obrigações de resultado). / The purpose of the dissertation is to study the classification of obligations in the ones so called best efforts duty and those referred to as duty to achieve a result, the first imposing to the debtor the duty to act diligently, the second attain a certain benefit to the creditor, without which the debtor would never be exonerated. A historical study initiates the dissertation with the research of the remote antecedents of such classification until its public recognition through the Traité written by René Demogue, which brought it great fame and created deep debates both in France and throughout the world. The recent antecedents of the classification are also pointed out, the historical context of its emergence and successive evolution in France and in other countries, to, after listing some of the many difficulties involved in the study of such subject, strongly criticized even nowadays, research through the scope of the legal relationship how the classification would relate with the duties imposed to the debtor. In doing so, it is believed to be possible to say, since every legal duty emerges to accomplish a certain objective, if would be possible to admit a distinction between duties that imply a conduct limited by diligence (best efforts duty) and those that would only be extinguished by the fulfillment of its purpose, in other words, since a specific result is produce and delivered to the creditor (duty to achieve a result).
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Výsledek hospodaření v účetnictví / Economic result in accountingJunger, Jiří January 2011 (has links)
The goal of this thesis is to show comprehensive information about economic result and its possible utilization. The first part deals with the definition of the term "economic result", its history and the possibilities of its determination. Another part deals with the comparison of profit and loss statement in the Czech legislation, IFRS and US GAAP. The third part includes different types of economic results, advantages and disadvantages and its utilization in practice as well. It is followed by a financial analysis focusing only on profitability which uses profit for its calculation. The separate chapter focuses on the indicator EVA.
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New Public Management i svenska förskolor : En kvalitativ studie om hur förskollärare arbetar och därmed ser på arbetssituationen på kommunala förskolor jämfört med privata förskolorBotrous, Delin January 2018 (has links)
The purpose of this study was to investigate if preschool teachers work and experience the work situation in the same way in private preschools compared to municipal preschools in Stockholm County. A qualitative method was used to accomplish the study, where semistructured interviews were used to gather data, in the form of semi-structured interviews. The previous theories and previous research this study is based on has shown that the public sector has started to imitate the private sector, and the reforms that the school has undergone in recent decades are called New Public Management (NPM). The results of the study indicate that when it comes to administrative work and documentation, the difference between the way private and municipal preschools work is different. Municipal preschools works with documentation more thank private preschools does. The study also showed that preschool teachers at both private and municipal preschools work quite similarly when it comes to how resources are used. However, the municipal pre-schools worked more in a goal-oriented and result-oriented manner than the private preschools. The conclusion in the study pointed out that, despite some differences in how they work, all preschool teachers who were interviewed in this study experienced that their work situation was good in broad terms as it is today. No major changes were desired. / Syftet med denna studie var att undersöka hur förskollärare arbetar och därmed upplever arbetssituationen på privata förskolor jämfört med kommunala förskolor i Stockholms län. En kvalitativ metod användes för att genomföra studien i form av semistrukturerade intervjuer. Teorier och tidigare forskning som denna studie bygger på har visat att den offentliga sektorn efterliknar näringslivet alltmer, och de reformer som skolan genomgått under de senaste decennierna går under benämningen New Public Management (NPM). Studiens slutsatser är att när det kommer till det administrativa arbetet och dokumentation skiljer det sig stort i hur privata och kommunala förskolor arbetar då kommunala förskolor jobbar mycket mer med dokumentation. Studien visade även att förskollärare på både privata och kommunala förskolor jobbar ganska likt när det kommer till hur resurser används. Däremot jobbade de kommunala förskolorna betydligt mer på ett mål- och resultatstyrt sätt än vad de privata förskolorna gör. Trots en del skillnader i hur de arbetar upplevde alla förskollärare som blev intervjuade i denna studie att arbetssituationen var bra i stora drag som det är idag. Inga större ändringar önskades.
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Towards efficient legacy test evaluations at Ericsson AB, LinköpingSterneberg, Karl Gustav January 2008 (has links)
<p>3Gsim is a load generator for traffic simulation in a WCDMA (WidebandCode Division Multiple Access) network. It is developed at Ericsson AB inLinköping. Tests are run daily and the results are evaluated by testers. Whenerrors or abnormalities are found, the testers write trouble reports and thedescribed problems are handed over to designers whose task is to fix them.In order to save time, Ericsson wished to improve the efficiency.This study has focused on a specific part of the process of the developmentof 3Gsim, namely the process of evaluating test results. The goal has beento investigate if and how the process of evaluating 3Gsim test results can bemade more efficient.The daily work of the testers has been studied at close hand by the author.The testers answered a questionnaire with questions about their work andtheir opinions about the tools being used. The answers were evaluated andfocus was laid on the main problems.It was found that a lot of time is wasted on searching for trouble reports.A big part of the test result evaluation process consists of going throughsummary logs with error print-outs. Unfortunately no mapping betweenerror print-outs and trouble reports is performed. When going through thesummary logs the testers have to determine which errors have already beenreported and which ones that haven’t. Another major problem is the factthat most tests fail. On the webpage where the test results are displayed,this is indicated by a coloured field showing red. This is believed to have anegative effect on the work attitude.A lot of time can be saved by mapping error print-outs to trouble reportsand automatically comparing new error print-outs with old ones. The mappingwill also help preventing the creation of duplicated trouble reports. Thissolution will have the greatest impact on the improvement of the efficiency.Another way to enhance the efficiency is to develop a more advanced colourcoding scheme than the one used today. This coding scheme will help thetesters making the right priorities when processing the test results. Furthermore,these two solutions will have a positive effect on the work attitude. Aprototype implementing the first solution has been created. This prototypegives Ericsson AB the possibility to test the solution idea in practice.</p>
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Heldygnsvård för missbrukare – en aktstudie av utfall och dokumentationGustavsson, Catrin, Karlsson, Sandra January 2008 (has links)
<p>Studiens syfte är att undersöka insatsers utfall för missbruksklienter efter avslutad vistelse på behandlingshem/ familjehem. Ett delsyfte är också att undersöka några variablers inverkan på utfallet samt hur dokumentationen ser ut. Utifrån detta har vi formulerat följande frågeställningar. (1) Hur har insatserna utfallit i stort? (2) Hur har sociala relationer beskrivits i anslutning till detta? (3) Hur har klientens delaktighet och motivation beskrivits? (4) Hur har den samlade dokumentationen av insatserna fungerat? För att besvara dessa har 14 akter studerats, metoden har varit såväl kvalitativ som kvantitativ. Resultatet visar att sex av klienterna har en förbättrad missbrukssituation sex månader efter avslutad behandling. Andelen kvinnor är ansenligt större än andelen män som har förbättrad missbrukssituation. Tidigare forskning gällande sociala relationer och motivation har visat att dessa variabler har betydelse för utfallet. Gällande sociala relationer tycks det i vår studie ha haft betydelse för missbrukssituationen. I det material vi har tagit del av har dokumentationen varit bristfällig varför vi har haft svårt att besvara frågeställningarna. Vår studie framhåller vikten av systematiska metoder för dokumentation då detta är en förutsättning för utvärdering och vidareutveckling av socialtjänstens verksamhet. Vidare framhålls betydelsen av att arbeta och dokumentera med klientens sociala relationer och behandlingsmotivation, detta för att påverka utfall i positiv riktning.</p> / <p>The purpose of this study is to examine the results of substance abusers after they have completed their visit in an institution/foster home. Parts of the purpose are to examine specific variables and their effects on the results as well as what the documentation looks like. From this we have formulated these following questions. (1) Generally, what have these efforts resulted in? (2) How have the social relationships been described in connection to this? (3) How has the client’s participation and motivation been described? (4) How has the collected documentation of these efforts been functioning? To answer these questions 14 files have been studied and the method has been both qualitative and quantitative. Our findings show that the result, regarding the abuse situation, has improved six months after completed treatment for six of the clients. The proportion women are considerably larger than the proportion of men with improved abuse situation. Previous research regarding social relationships and motivation has shown that these variables have significance for the result. Our findings regarding social relationships show that they were of importance for the abuse situation. The documentation in our research material has been insufficient and this has led to difficulties when trying to answer our questions. This study points out the importance of systematic methods of documenting because this is a prerequisite for the social services to be able to evaluate and to develop their activity. It seems like documenting and working with the client’s social relationships and motivation for treatment could influence the result to a more positive outcome.</p>
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Heldygnsvård för missbrukare – en aktstudie av utfall och dokumentationGustavsson, Catrin, Karlsson, Sandra January 2008 (has links)
Studiens syfte är att undersöka insatsers utfall för missbruksklienter efter avslutad vistelse på behandlingshem/ familjehem. Ett delsyfte är också att undersöka några variablers inverkan på utfallet samt hur dokumentationen ser ut. Utifrån detta har vi formulerat följande frågeställningar. (1) Hur har insatserna utfallit i stort? (2) Hur har sociala relationer beskrivits i anslutning till detta? (3) Hur har klientens delaktighet och motivation beskrivits? (4) Hur har den samlade dokumentationen av insatserna fungerat? För att besvara dessa har 14 akter studerats, metoden har varit såväl kvalitativ som kvantitativ. Resultatet visar att sex av klienterna har en förbättrad missbrukssituation sex månader efter avslutad behandling. Andelen kvinnor är ansenligt större än andelen män som har förbättrad missbrukssituation. Tidigare forskning gällande sociala relationer och motivation har visat att dessa variabler har betydelse för utfallet. Gällande sociala relationer tycks det i vår studie ha haft betydelse för missbrukssituationen. I det material vi har tagit del av har dokumentationen varit bristfällig varför vi har haft svårt att besvara frågeställningarna. Vår studie framhåller vikten av systematiska metoder för dokumentation då detta är en förutsättning för utvärdering och vidareutveckling av socialtjänstens verksamhet. Vidare framhålls betydelsen av att arbeta och dokumentera med klientens sociala relationer och behandlingsmotivation, detta för att påverka utfall i positiv riktning. / The purpose of this study is to examine the results of substance abusers after they have completed their visit in an institution/foster home. Parts of the purpose are to examine specific variables and their effects on the results as well as what the documentation looks like. From this we have formulated these following questions. (1) Generally, what have these efforts resulted in? (2) How have the social relationships been described in connection to this? (3) How has the client’s participation and motivation been described? (4) How has the collected documentation of these efforts been functioning? To answer these questions 14 files have been studied and the method has been both qualitative and quantitative. Our findings show that the result, regarding the abuse situation, has improved six months after completed treatment for six of the clients. The proportion women are considerably larger than the proportion of men with improved abuse situation. Previous research regarding social relationships and motivation has shown that these variables have significance for the result. Our findings regarding social relationships show that they were of importance for the abuse situation. The documentation in our research material has been insufficient and this has led to difficulties when trying to answer our questions. This study points out the importance of systematic methods of documenting because this is a prerequisite for the social services to be able to evaluate and to develop their activity. It seems like documenting and working with the client’s social relationships and motivation for treatment could influence the result to a more positive outcome.
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Guidelines for implementation of a performance management system in a level 2 public hospital / Sedumedi N.N.Sedumedi, Nolita Nancy January 2012 (has links)
INTRODUCTION
The intention of this study was to formulate guidelines for the implementation of
Performance Management System (PMS) regarding line managers (LM) and employees
(E) in a level 2 public hospital in the North–West Province. From a preliminary
evaluation it was evident that the implementation of performance management as
outlined in the NWPG policy No. 13, was not effective. The results of the research was
to provide baseline data of the current policy implementation by the line managers and
employees; an indication of the ability of the PMS to reach its goal of improved
performance between line managers and employees in the long term; and the barriers
to the policy implementation discovered over the course of the study.
RESEARCH QUESTIONS
Based on the statement of the problem, the following research questions were asked:
* How is PMS implemented from the perspective of line managers in a level 2 public
hospital?
* How is PMS implemented from the perspective of employees in a level 2 public
hospital?
* What guidelines can be formulated for line managers and employees regarding
PMS?
AIM AND OBJECTIVES OF THE STUDY
The principal aim of this study was to formulate guidelines for implementation of PMS
by line managers and employees. The objectives below of the research which are
derived from the principal aim were:
* To describe the implementation of the PMS from the perspective of line managers in
a level 2 public hospital.
* To describe the implementation of the PMS from the perspective of employees in a
level 2 public hospital.
* To formulate guidelines for line managers and employees regarding PMS?
RESEARCH DESIGN
A quantitative, explorative, descriptive, and contextual design was used in this study to
reach the overarching aim and respective objectives.
RESEARCH METHOD
The researcher firstly conducted a literature review to understand implementation of
PMS and related constructs. Thereafter the researcher used two similar structured
questionnaires for both LM and E to collect data. The questionnaires were developed to
measure the perceptions of both LM and E in the implementation of PMS in a level 2
public hospital. The questionnaires were based on the six steps (performance planning,
developing performance criteria, performance monitoring, performance review and
assessment, annual performance assessment and performance assessment outcomes)
of the current PMS policy used in a level 2 public hospital. The study is based on
transformational leadership whereby the line managers (LM) as nurse leaders with
transformational characteristics are assumed to be empowering the employees (E) and
creating enthusiasm for nursing practice. Minor adaptations were made to the
questionnaires prior to administration to the nursing personnel in a level 2 public
hospital in North West Province. An all inclusive sample was taken, representative of a
larger population and this amounted to twenty four line managers (n=24) and fifty five
employees (n=55) that participated in the study.
RESULTS
There were problems identified from both the line managers (LM) and employees (E) in
performance planning, developing performance criteria, and monitoring performance, organizing and the process of performance review and assessment and lastly the
annual performance assessment. The main two main findings are:
* The effect size of all the questions indicates a practically visible and thus
significant difference with regard to LM and E perceptions of the implementation
of PMS.
* There is statistical evidence of improper implementation of PMS from both
groups regarding some of the performance implementation items.
Based on the empirical evidence and the problems identified from the results, guidelines
for the implementation of PMS were formulated. It is suggested that these be used and
implemented to streamline the PMS in level 2 public hospitals.
Keywords: Key result areas (KRAs), Generic assessment factors (GAFs), reward, work
plan, Performance Agreement (PA), Performance Management System (PMS). / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.
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Guidelines for implementation of a performance management system in a level 2 public hospital / Sedumedi N.N.Sedumedi, Nolita Nancy January 2012 (has links)
INTRODUCTION
The intention of this study was to formulate guidelines for the implementation of
Performance Management System (PMS) regarding line managers (LM) and employees
(E) in a level 2 public hospital in the North–West Province. From a preliminary
evaluation it was evident that the implementation of performance management as
outlined in the NWPG policy No. 13, was not effective. The results of the research was
to provide baseline data of the current policy implementation by the line managers and
employees; an indication of the ability of the PMS to reach its goal of improved
performance between line managers and employees in the long term; and the barriers
to the policy implementation discovered over the course of the study.
RESEARCH QUESTIONS
Based on the statement of the problem, the following research questions were asked:
* How is PMS implemented from the perspective of line managers in a level 2 public
hospital?
* How is PMS implemented from the perspective of employees in a level 2 public
hospital?
* What guidelines can be formulated for line managers and employees regarding
PMS?
AIM AND OBJECTIVES OF THE STUDY
The principal aim of this study was to formulate guidelines for implementation of PMS
by line managers and employees. The objectives below of the research which are
derived from the principal aim were:
* To describe the implementation of the PMS from the perspective of line managers in
a level 2 public hospital.
* To describe the implementation of the PMS from the perspective of employees in a
level 2 public hospital.
* To formulate guidelines for line managers and employees regarding PMS?
RESEARCH DESIGN
A quantitative, explorative, descriptive, and contextual design was used in this study to
reach the overarching aim and respective objectives.
RESEARCH METHOD
The researcher firstly conducted a literature review to understand implementation of
PMS and related constructs. Thereafter the researcher used two similar structured
questionnaires for both LM and E to collect data. The questionnaires were developed to
measure the perceptions of both LM and E in the implementation of PMS in a level 2
public hospital. The questionnaires were based on the six steps (performance planning,
developing performance criteria, performance monitoring, performance review and
assessment, annual performance assessment and performance assessment outcomes)
of the current PMS policy used in a level 2 public hospital. The study is based on
transformational leadership whereby the line managers (LM) as nurse leaders with
transformational characteristics are assumed to be empowering the employees (E) and
creating enthusiasm for nursing practice. Minor adaptations were made to the
questionnaires prior to administration to the nursing personnel in a level 2 public
hospital in North West Province. An all inclusive sample was taken, representative of a
larger population and this amounted to twenty four line managers (n=24) and fifty five
employees (n=55) that participated in the study.
RESULTS
There were problems identified from both the line managers (LM) and employees (E) in
performance planning, developing performance criteria, and monitoring performance, organizing and the process of performance review and assessment and lastly the
annual performance assessment. The main two main findings are:
* The effect size of all the questions indicates a practically visible and thus
significant difference with regard to LM and E perceptions of the implementation
of PMS.
* There is statistical evidence of improper implementation of PMS from both
groups regarding some of the performance implementation items.
Based on the empirical evidence and the problems identified from the results, guidelines
for the implementation of PMS were formulated. It is suggested that these be used and
implemented to streamline the PMS in level 2 public hospitals.
Keywords: Key result areas (KRAs), Generic assessment factors (GAFs), reward, work
plan, Performance Agreement (PA), Performance Management System (PMS). / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.
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Modelagem de um sistema de controle interno para municípios com até cinqüenta mil habitantes do Estado do Rio Grande do SulFontoura, Tarcísio Neves da January 2006 (has links)
Cada vez mais o legislador brasileiro cria instrumentos legais na esfera pública para controlar e monitorar a aplicação dos recursos públicos. No entanto, tais regramentos legais têm-se demonstrado ineficazes no que diz respeito ao resultado que a sociedade brasileira espera, considerando os princípios constitucionais da eficiência e isonomia. A partir desta constatação de deficiência neste controle, sugere-se nova modelagem de Sistema de Controle Interno, na figura de uma Unidade Central de Controle Interno para pequenos municípios gaúchos, a qual deverá ser composta por vários profissionais técnicos especializados e de carreira, buscando-se assim atingir o ótimo na aplicação dos recursos públicos, através de uma integração dos setores administrativos municipais. Na busca da consecução do objetivo proposto, foram analisados os conceitos, organização e princípios de estado, governo e administração pública; estudados os conceitos, tipos e princípios de controle, controle interno, auditoria interna e controladoria; investigados os dois grupos de controles: formais e legais e os administrativos e operacionais, bem como os regramentos jurídicos e legais pertinentes ao tema. / The Brazilian legislator creates more and more legal instruments in the public sphere in order to control and monitor the application of the public resources. However, those legal rules have been shown to be inefficient in regards to the results expected by the Brazil ian society, if consider the constitutional principles of efficiency and isonomy. From this observation of the imperfection of that control, suggest a new modeling of the Internal Control System, into a new representation of a Central Unit of Internal Control for small municipalities from the state of Rio Grande do Sul. The representation must include many specialized technical professionals who are contractually committed, aspiring a great result in the application of the public resources through the integration of the managerial municipal sectors. While seeking to accomplish the proposed goal, many concepts, the organization and principles of the State, Government ad public administration were analysed; the concepts, types and principles of control , the internal control, auditor's internal tribunal and controllership were studied; the two groups of control: the formal and legal and the administrative and operational, as well as the juridical and legal rules concerning the subject were investigated.
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