M.Cur. / It is explicit that the change in the South African government since 1994 accompanied by the transformation of nursing services with its new policies and practices is inevitable, and poses challenges for the nursing service managers in Gauteng hospitals. The transformation of nursing services can be a difficult process creating a period of fear, uncertainty, stress and role ambiguity for the nursing service managers. The transformation has been so extensive that the nursing service manager's role responsibilities have changed to such an extent that they are now required to manage grossly reduced levels of resources, multicultural societies with different values, beliefs and attitudes and increased numbers of patients, resulting in overcrowded hospitals. The transformation of nursing services demands the demonstration of appropriate nursing service management. The abilities of the nursing service managers are critical to the effectiveness of the future. Most nursing service managers are unprepared for their new roles and the present concern is for the quality of the management of the transformation process. No written standards for transformation management in a nursing service are available in Gauteng public hospitals. Consequently, nursing service managers find themselves making major decisions about nursing service transformation with little information about the effectiveness of alternative approaches. The experiences and perceptions of the nursing service managers regarding transformation of nursing services in selected Gauteng hospitals are also not known. Understanding the nursing service managers' experiences and perceptions will provide a basis for the formulation of standards for transformation management in a nursing service.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-07-21T17:19:10Z No. of bitstreams: 1 Maria Aparecida Jesus Menezes.pdf: 1483074 bytes, checksum: ff695fb13b84a4536d95cb7b499b1047 (MD5) / Made available in DSpace on 2015-07-21T17:19:10Z (GMT). No. of bitstreams: 1 Maria Aparecida Jesus Menezes.pdf: 1483074 bytes, checksum: ff695fb13b84a4536d95cb7b499b1047 (MD5) Previous issue date: 2015-02-24 / To understand the relationship between falls and environmental hazards is necessary to identify the hazards of the environment that may influence the occurrence of these events. The aim of this work is to identify risks associated with the physical structure in patient units of medical and surgical clinics of a public hospital in the city of São Paulo. To evaluate the influence in the fall of hospitalized patients, identifying existing security measures, providing support for the design and construction phases of actions aimed at improving the management of the risk of falling. This is a descriptive study / exploratory case study. The technique of data collection used was a survey, through script's characteristic being listed spaces for the accommodation of patients and plant units. We were selected 06 units in the period January-June 2014.The notifications was 205 falls during this period. The results, the average age of individuals fall victims was 57 years and there was no difference between men and women. The mean time from admission until the occurrence was 14 days. A predominance of falls among men (59%) and at night (50%). 43% occurred in the fourth and 24% in the bathroom, totaling 67% of occurrences. The 6 units assessed, 100% meet the requirements that are minimum dimensions per room / bed, exclusive bathroom for each room, grab bars near the toilet, nurse call system and dry conditions in all rooms at the time of observation. Grab bars in the box in all bathrooms, wake lighting in all rooms, fluorescent general lighting in all rooms and nursing signaling items are served in most units (84%). The criteria light switch accessible and furniture with trundle and locks in all rooms are not seen in 100% of the units, which may be related to the occurrence of falls at night (50% of reported incidents). In 67% of the units had not caged beds in all beds, beds with locks on all beds, electric beds on all beds and stair steps in this 2 all beds and rubber tip. It follows that the physical structure can be evaluated as influential in determining the occurrence of falls from other environmental factors are considered. The scales should not be composed only with information about dimensions, but assess how hospital organizations use available space. The descriptives and technical specifications for equipment and furnishings should be updated and health services should ensure the proper performance of devices and availability to users. / Para entender a relação entre quedas e perigos ambientais é necessário identificar como o meio ambiente pode oferecer riscos para a ocorrência destes eventos. Portanto, o objetivo desta dissertação, é avaliar a estrutura física da unidade de internação de clínica médica e cirúrgica de um hospital público de grande porte do município de São Paulo e sua influência na gestão do risco de queda dos pacientes internados, identificando quais medidas de segurança existentes se relacionam à prevenção de quedas. Trata-se de um estudo descritivo/exploratório do tipo estudo de caso. A técnica de coleta de dados utilizada foi o levantamento por meio de roteiro, de modo que fossem listadas as características dos espaços destinados à acomodação dos pacientes e das plantas das unidades. Foram selecionadas seis unidades de internação onde as quedas foram mais frequentes no período de janeiro a junho de 2014. Neste período, foram analisadas 215 quedas, cuja caracterização da população revelou que estes indivíduos apresentam em média 56,63 anos (ambos os sexos). O tempo médio decorrido da admissão até a ocorrência foi de 14 dias. A frequência de quedas entre os homens foi discretamente maior (59%) e foi mais recorrente no período noturno (50%) do que nos turnos da manhã e tarde (26% e 21%, respectivamente). Quanto ao local, 43% ocorreram no quarto e 24% no banheiro, totalizando 67% no ambiente de internação. Das seis unidades avaliadas, observou-se que todas atendem aos quesitos dimensões mínimas por quarto/leito, banheiro exclusivo para cada quarto, barras de apoio próximas ao vaso sanitário, sistemas de chamada de enfermagem e piso seco em todos os quartos no momento da observação. Barras de apoio no box em todos os banheiros, iluminação de vigília em todos os quartos, iluminação geral fluorescente em todos os quartos e sinalização de enfermagem são itens atendidos na maioria das unidades (84%). Os quesitos interruptor de luz acessível e mobiliário com rodízio e travas em todos os quartos não são presentes em todas as unidades, o que, de certo modo, pode o maior número de ocorrência de quedas no período noturno (50% dos incidentes notificados). Em 67% das unidades não havia, em todos os leitos, camas com grades, camas elétricas e escada de dois degraus e com ponteira de borracha. Conclui-se assim que a estrutura física pode ser avaliada como de influência na determinação da ocorrência de quedas desde que outros fatores ambientais sejam considerados. Dessa maneira, os instrumentos de avaliação não devem ser compostos apenas com informações relativas a dimensões, mas também precisam considerar como as organizações hospitalares utilizam os espaços disponíveis. Os descritivos e especificações técnicas de equipamentos e mobiliários devem ser atualizados e os serviços de saúde devem garantir o adequado funcionamento dos dispositivos e disponibilidade aos usuários.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-09-15T13:32:10Z No. of bitstreams: 1 Thaissa de Souza Mendes.pdf: 865677 bytes, checksum: 5806518d0b19935585fe53efbcd63458 (MD5) / Made available in DSpace on 2015-09-15T13:32:10Z (GMT). No. of bitstreams: 1 Thaissa de Souza Mendes.pdf: 865677 bytes, checksum: 5806518d0b19935585fe53efbcd63458 (MD5) Previous issue date: 2014-11-28 / Health care services are provided in an environment that is currently changing. For instance, health care providers must address changes in customer profile, technological advances and increased competition. As a consequence, health care providers must seek to enhance their organizational and operational output by adapting their organizational structure to fit current client and market demands. These organizational changes, therefore, can be seen as natural changes, which are influenced by the specific environment in which organizations operate. The hospital, which is a health care provider with an extremely complex organizational structure, also had to increase its capacity to create and implement strategies to overcome current market challenges in order to reach organizational goals and thrive in its respective sector. The increased competition and the changes in the relationship between clients and organizations have created the need to standout from the competition; that is, clients expect increasingly higher quality products and services. As a consequence, it is essential to the survival of any service organization to achieve a high level of client satisfaction by employing a marketing campaign that not only strengthens the relationship between clients and organizations but also generates a positive word of mouth communication process. Therefore, the real objective of this paper is to assess the market impact that such operational and marketing strategies have on a hospital that is currently adapting its organizational structure in order to compete in its respective sector. To clarify, this assessment analyzes the interactions between the determinants of positive word of mouth communication, client loyalty, the intention to recommend the services to others and the actual consumer recommendation behaviour proposed by Brown et al. (2005). / Os serviços de saúde estão inseridos em um ambiente que encontra-se em processo de transformação, observando-se mudanças no perfil dos clientes, com evolução tecnológica, aumento da concorrência e consequente busca pela melhoria do desempenho operacional e organizacional, tornando-se necessário a realização de alterações na estrutura das organizações a fim de tornarem-se mais adaptativas, flexíveis e voltadas aos clientes e às necessidades do mercado. Sendo assim, o processo de mudança organizacional é visto como um processo natural da existência das organizações e decorrente das ações destas à ação de forças exercidas pelo meio em que estão inseridas. O hospital, sendo um serviço de saúde com uma estrutura organizacional complexa, também necessitou aumentar a capacidade de formular e implementar estratégias para vencer os desafios de mercado e atingir seus objetivos organizacionais, a fim de garantir sua sobrevivência no segmento que operam. O aumento da competitividade e as mudanças de relacionamento entre organizações e clientes resultaram na necessidade da existência de um diferencial de mercado, onde busca-se cada vez mais qualidade nos produtos e serviços oferecidos, sendo essencial para a organização buscar o maior nível de satisfação dos clientes, utilizando-se do marketing de serviços como ferramenta para o fortalecimento desse relacionamento, resultando na satisfação das expectativas e necessidades dos clientes e gerando o aparecimento de uma comunicação boca a boca positiva, com consequente fortalecimento da imagem da instituição e aumento da vantagem competitiva. Sendo assim, o objetivo geral deste trabalho é estimar o impacto mercadológico das estratégias de operações de serviços de um hospital em processo de mudança organizacional em sua disputa pelo mercado de assistência à saúde, através da análise das interações entre os antecedentes de comunicação boca a boca com o comprometimento, a intenção de recomendação e o comportamento de recomendação boca a boca, propostos no modelo de (T. J. Brown, Barry, Dacin, & Gunst, 2005).

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-03-30T17:50:19Z No. of bitstreams: 1 Regina Celia Barbosa Moreno.pdf: 1172142 bytes, checksum: 4eb4cda668d6b316af71bed0941a8baa (MD5) / Made available in DSpace on 2016-03-30T17:50:19Z (GMT). No. of bitstreams: 1 Regina Celia Barbosa Moreno.pdf: 1172142 bytes, checksum: 4eb4cda668d6b316af71bed0941a8baa (MD5) Previous issue date: 2015-12-09 / Nowadays, there is a tendency for the Health Services to demand changes both in the professional practices and in the management in order to improve the organizational performance. In a hospital organization, the Social Service doesn`t remain free from this demand, and this scenario took us to the following question: How to adapt the Evidence-Based Practice Attitude Scale (EBPAS) to the Brazilian Health Social Service, and how to validate it? Thus, this research aims to adapt e validate the Evidence-Based Practice Attitude Scale (EBPAS) to the Brazilian Health Social Service, and it offers a version for EBPAS which can measure the social worker`s attitude related to the systematization of the professional practices; such version can be useful for future studies related to the elaboration of social protocols. The present research works based on the methodology proposed by Beaton, Bombardier, Guillemin & Ferraz (2000); Beaton, Bombardier, Guillemin & Ferraz (2007). The translation and adaptation process contains five steps: (i) translation, (ii) back translation, (iii) synthesis of the translations, (iiii) evaluation by an expert commitee and (iiiii) pretest. For the psychometric validation, the results presented suggests that the instrument presents a convergent validation, and it can be considered a useful instrument to measure the social workers` attitude related to the adoption of the Evidence Based Practice, making possible its use in the health services when the professionals` readiness related to the implementation of innovative practices has to be measured. The instrument presented easy comprehension and showed also semantic, idiomatic, experimental and conceptual validation. It is evident the need to broaden the fields of the psychometric validation, as well as to diversify the sampling plan. / Há uma tendência, nos dias atuais, dos Serviços de Saúde exigirem mudanças nas práticas profissionais e de gestão com objetivo de melhorar o desempenho organizacional. O Serviço Social, dentro de uma organização hospitalar, não fica isento dessa exigência. Este panorama levou ao questionamento: Como adaptar e validar, para o Serviço Social da saúde no Brasil, o Evidence-Based Practice Attitude Scale (EBPAS)? Sendo assim, o estudo tem como objetivo adaptar e validar o instrumento Evidence-Based Practice Attitude Scale (EBPAS) para o Serviço Social da Saúde no Brasil, propondo uma versão do EBPAS que consiga mensurar a atitude do assistente social frente à sistematização das práticas para futuros estudos na criação de protocolos sociais. O estudo assumiu a metodologia proposta por Beaton, Bombardier, Guillemin & Ferraz (2000); Beaton, Bombardier, Guillemin & Ferraz (2007), o processo de tradução e adaptação foi composto de cinco etapas, (i) tradução, (ii) retrotradução, (iii) síntese das traduções, (iiii) avaliação por um comitê de juízes e (iiiii) pré-teste. Para a validação psicométrica os resultados apresentados sugerem que o instrumento apresenta uma validação convergente, podendo ser considerado como instrumento para mensurar a atitude dos assistentes sociais na adoção de Prática Baseada em Evidências - PBE, possibilitando sua aplicação nos serviços de saúde com vista à prontidão para a implementação de práticas inovadoras. O instrumento mostrou-se de fácil compreensão, apresentando validação semântica, idiomática, experimental e conceitual. Fica claro a necessidade de ampliação de domínios na validação de psicometria, bem como diversificação do plano amostral.

No description available.

Bone is a plastic tissue, changing in density and size with different levels of stress. Furthermore, it appears that BMD is altered in a site specific manner. However, BMD has not been studied extensively in all types of athletes, particularly well trained strengthpower athletes, such as throwers. The pwpose of this study was to examine the BMD of USA Division I collegiate throwers (shot put, discus, etc.). BMD was compared to normative data and to different athletes. Measures of whole body maximum strength and throwing performance were correlated with BMDs. Potential right/left side and sex differences were examined. Athletes were 4 males, 3 females age 19.9 ± 0.9 years. BMD was measured with a DEXA Maximum isometric strength was measured using a midthigh pull standing on a force plate. Force time-curves were generated during the strength tests. Peale force (PF) and normalized pealc force (PFa) were correlated with BMDs. Comparison indicates throwers have denser bones compared to normative data and compared to other types of athletes. Male throwers tend to have greater total body BMD than female throwers (p < 0.05). Dominant arm showed slightly greater BMD compared to non-dominant (p < 0.05). Furthermore, BMD is related to PF (r = 0.68) and PFa (r = 0.56). Throwers have greater BMD's than non-athletes or most other types of athletes. However, throwers showed only a small indication of sidedness. These observations likely stem from their training program (whole body heavy loading).

Certain variables: peak aerobic power (PAP), running economy, and lactate threshold, act as limiting factors for endurance running. However, all of the mechanisms underlying high-level endurance running are not completely clear. Alterations in maximum and explosive strength P27 have been shown to effect positive changes in endurance performance, likely by altering P28 running economy. If strength related factors affect running economy, then this should be evident in the running performance of long-distance runners and perhaps PAP. The purpose of this study was to examine the relationships between peak isometric strength (IPF), explosive strength (rate of force development, RFD), PAP and 3 k performance (3KT) among 5 female and 7 male (n = 12) X-country runners. Force-time curve analysis was conducted for each (2 trials) isometric pull and averaged for analyses. IPF and RFD from 0 - 200 ms were determined from appropriate curves. IPFs were normalized using an allometric (IPFa) scaling equation: absolute force/ (body mass (kg)0.67). ICCs were previously shown to be > 0.9. Relationships were established with Pearson's r; statistical differences with at-Test (p < 0.05). !PF, IPFa and RFD were not different between sexes. PAP was statistically greater in males. Correlations were: PAP vs 3KT (r = -0.92); !PF vs PAP (r = 0.58), 3KT (r = -0.66); IPFa vs PAP (r = 0.45), 3KT (r = 0.45). RFD vs PAP (r = 0.58), 3KT (r = -0.65). Results indicate that strength characteristics correlate moderately to strongly with PAP and 3KT. Data suggests that strong.

Explosive strength, a function of rate of force development (RFD), is a primary determinant for the amount of peak force that can be produced in critical sport performance time periods ( e.g. foot contact time). Evidence indicates that maximum strength and RFD are correlated. However, the characteristics of this relationship are not well established among athletes. This study examined the relationship of peak isometric force (IPF) and RFD from a mid-thigh pull, among male and female track and field athletes. Athletes were 12 sprinters (S), 10 jumpers (JP) and 12 cross-country runners (XC). Force-time curve analysis was conducted for each (2 trials) isometric pull and averaged for analyses. IPF and RFD from 0 - 200 ms were determined from appropriate curves. IPFs were normalized using an allometric (IPFa) scaling equation: absolute force/ (body mass (kg)0.67). ICCs were previously shown to be > 0.9. Relationships were established with Pearson's r; statistical differences with a Bonferroni adjusted t-Test. IPF, IPFa and RFD were greater in males than females for S and JP but not for XC. IPF, IPFa and RFD were greater for S and JP compared to XC. Similar relationships of IPF to RFD were noted among groups S(r = 0.85), JP (r = 0.87), XC (r = 0.88). Among males, n = 19, the relationship ofIPF to RFD was r = 0.89 and was somewhat higher compared to females, n = 15, (r = 0.78). Overall (n = 34) relationship between IPF and RFD was r = 0.90. These data indicate a strong relationship between maximum strength and "explosiveness" that is independent.

Abstract available in the Medicine & Science in Sports & Exercise

Objective: The relationship between alcohol use and suicidal behaviors is well-accepted, but less is known about the contribution of its early initiation. This study was designed to test the association of early alcohol initiation versus later initiation with suicidal ideation and attempt in an ethnically diverse sample. Methods: The Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003 (n = 20,013), database was used. A total of 13,867 participants were selected included 56.9% females and 43.1% males. Race and ethnicity were reported as 28.8% non-Hispanic White, 39.1% Black, 20.3% Latino, and 11.9% Asian. Logistic regression analyses tested the associations between early (< =14 years) and later (> =15) age alcohol initiation with suicide ideation and attempts. Alcohol initiation was indexed by self-report of the first time that any alcohol product was consumed. Potential confounders were controlled. Results: Early alcohol initiation was associated with higher odds (AOR = 3.64, 95% CI [2.51, 5.28]) of suicide ideation as compared with adults who had initiated > = age 15 (AOR = 2.11, 95% CI [1.46, 3.04]). Early age initiation was also associated with higher odds (AOR = 3.81, 95% CI [2.02, 7.18]) of lifetime suicide attempt versus later age initiators (AOR = 2.03, 95% CI [1.08, 3.79]). Significant differences were found between early and later age of initiation. Conclusion: Early age of alcohol initiation has profoundly increased odds of suicide ideation or attempt. It is critical that effective prevention programs for children and their caregivers be implemented to prevent or delay alcohol initiation and lessen the risk for future suicidal behaviors.