京都大学 / 新制・課程博士 / 博士(医学) / 甲第25163号 / 医博第5049号 / 京都大学大学院医学研究科医学専攻 / (主査)教授 近藤 尚己, 教授 古川 壽亮, 教授 阪上 優 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

Systemic lupus erythematous (SLE) is an autoimmune and inflammatory disease that can affect all organs of the body. The purpose of this quantitative cross-sectional study was to examine SLE-related issues associated with depression and work-productivity impairment, and to assess if depression mediated the relationship between SLE disease activity and damage and work-productivity impairment. Participants were 257 residents of the state of Georgia in the United States with SLE and were recruited from the Georgians Organized Against Lupus study. Bandura'€™s social cognitive theory was the guiding theoretical framework of the study. Findings showed that the majority of participants worked full time (78.2%), identified as Black (72.8%), female (94.2%), above poverty level (77.4%), and had private health insurance (70.0%). Mean and median score results indicated that participants missed, on average, slightly less than half a day of work every 7 days, and had mild-to-moderate levels of work productivity impairment. Mean and median scores showed that participants reported mild-to-moderate levels of SLE disease activity and damage and depression. Linear regression results revealed significant relationships between SLE activity and damage and work productivity impairment. Hierarchical linear regression for mediation findings indicated that depression partially mediated the relationship between SLE disease activity and damage and work productivity impairment. The findings from this study might help to increase stakeholder awareness of SLE disease activity and damage and SLE effects on depression and work functioning.

Managed Mental Health Care (MMHC) began blanketing the United States when cost of care rose exponentially. MMHC is one avenue many employers and insurance companies have chosen to provide employees with mental health treatment at controlled costs. However, not all employers view supplying their employees with mental health treatment beneficial, as they do not know mental health problems can significantly decrease work productivity. Brown and Jones (2005) used the Social Role Scale (SR) of the Severe Outcome Questionnaire (SOQ) to estimate work productivity in employees under the assumption that the scale measures work productivity. The purpose of this study was to move closer to an estimation of the relationship between improved mental health and improved workplace functioning by examining the relationships among a self-report measure of mental health (i.e., the SR), a self-report measure of work productivity (i.e., the Work Productivity and Activity Impairment Scale [WPAI]), and objective measures of work productivity (i.e., the quality and timeliness of institutional records, supervisor ratings, and sick hours used). It was thought that understanding the relationships among these measures might assist in estimating the cost/benefit of investing in psychotherapy. Participants in this study were employees and inpatients at the Utah State Hospital. Statistical analyses indicated the SR did predict two WPAI scales (i.e., Presenteeism and Activity Impairment) for employees. Specific relationships among measures, and suggestions for future research, are discussed.

Produktivitetsutvecklingen i byggbranschen är låg jämfört med många andra branscher. Stigande produktivitet är en förutsättning för en fortgående ökning av en organisations tillväxt. Arbetsproduktiviteten i byggproduktionen kan ses som en grov uppskattning av den totala produktiviteten, där byggnadsarbetarens arbetstid blir en spegling av hur väl projektorganisationen, produktionsledningen och produktionsplaneringen fungerar i verksamheten. Syftet med detta examensarbete är att ta reda på de mest bidragande faktorerna som påverkar arbetsproduktiviteten i byggproduktionen samt att kartlägga hur de olika faktorerna upplevs hos det undersökta byggföretaget. Vidare undersöks vilka samband det finns mellan de olika faktorerna och dess bakomliggande orsaker med fokus på den dagliga verksamheten. Målet är att ta reda på förbättringsåtgärder gällande arbetsmetodik för ett produktivt arbete. Frågorna som besvarades i detta examensarbete var vilka faktorer som är mest bidragande till arbetsproduktiviteten i byggproduktionen, hur byggnadsarbetare och tjänstemän på företaget upplever de undersökta faktorerna samt vilka förbättringsåtgärder företaget ska arbeta med som leder till en ökad arbetsproduktivitet. De metoder som använts i forskningsrapporten är dels en litteraturstudie som tagit reda på vilka faktorer som bidrar mest till arbetsproduktiviteten i byggfasen. Efter detta gjordes en ytterligare undersökning på varje faktor med syftet att ta reda på vilka delfaktorer som påverkar den undersökta faktorn. Därefter utfördes en enkätstudie som var uppbyggd utefter de olika faktorerna. 51 byggnadsarbetare och 17 tjänstemän medverkade i studien. Därpå gjordes en sammanställning av enkätsvaren som sedan analyserades. Resultatet visar att de mest bidragande faktorerna som påverkar arbetsproduktiviteten är arbetsmiljö, produktionsplanering, kommunikation, motivation och engagemang. Den generella bilden över hur byggnadsarbetare och tjänstemän på företaget upplever de olika faktorerna är positiv. De mest prioriterade förbättringsåtgärderna som företaget bör prioritera att förbättra för att optimera arbetsproduktiviteten är följande: genomtänkt tidsplanering, resursplanering efter bästa lag, materialbeställning i rätt tid, involvera byggnadsarbetare i arbetsberedningar, att byggnadsarbetare får utbildningar som ökar deras kompetens, att platsledningen är ute oftare på byggarbetsplatsen och styr bygget, att informera om nästa arbetsuppgift i god tid, att byggnadsarbetare får en högre lön samt att få beröm från chefen. / Productivity development in the construction industry is low compared to many other industries. Rising productivity is a prerequisite for an ongoing increase in the growth of an organization. Work productivity in construction work can be seen as a rough estimate of total productivity, where the construction worker's working time becomes a reflection of how well the project organization, production management and production planning work in the business. The purpose of this thesis is to find out the most contributing factors that affect work productivity in construction production and to map how the various factors are experienced at the company that being examined. Furthermore, the connections between the various factors and their underlying causes with a focus on daily activities are examined. The goal is to find out improvement measures regarding work methodology for productive work. The questions that were answered in this thesis were which factors contributed most to work productivity in construction work, how construction workers and officials at the company perceive the factors examined and what improvement measures the construction company should work with that leads to increased work productivity. The methods used in the research report are partly a literature study that has identified which factors contribute most to work productivity in the construction phase. After this, a further study was done on each factor with the aim of finding out which sub-factors affect the examined factor. Then, a questionnaire study was carried out that was structured according to the various factors. 51 construction workers and 17 officials participated in the study. Then a survey of the questionnaire responses was made, which was then analyzed. The result shows that the most contributing factors that affect work productivity are work environment, production planning, communication, motivation and commitment. The general picture of how construction workers and officials at the company experience the different factors is positive. The most prioritized improvement measures that the company should prioritize in order to optimize work productivity are the following: well thought-out time planning, resource planning according to team best team, ordering material at the right time, involving construction workers in work preparations, that construction workers receive education that increases their competence, that the site management is out more often at the construction site and controls the work, to inform about the next task in good time, that construction workers receive a higher salary and to receive praise from the boss.

The major goal of this study is to test the direction and strength of the relations of low-income single mothers’ depressive symptoms to their employment and income experiences over a time period following major welfare policy changes in the U.S. (2001 to 2003). The Panel Study of Income Dynamics provided data on 623 low-income, single mothers. The economic characteristics studied were: employment status, hours of work, wages, earnings, a job’s provision of personal control, family income, and welfare receipt. The mental health measure was the K-6 Non-Specific Psychological Distress Scale. The study adds to our understanding of the temporal relations between employment experiences and mental health by testing the social causation, social selection, and interactionist (bidirectional) perspectives. Specifically, this study tested the different perspectives with a wide range of economic indicators, tested mechanisms that may link mental and economic well-being, and combined multiple employment factors to see if patterns emerged that related uniquely to psychological distress. The findings supported social selection as earlier psychological distress predicted future employment, hours, wages, earnings, household income, and welfare receipt. The tested mediator of days of lost work affected by psychological distress indicated an indirect effect of poor mental health predicting diminished job productivity that, in turn, predicted reduced employment, hours, wages, and earnings. Results were similar for subgroups of mothers based on the age of their youngest child or prior welfare history. The single significant finding was that a longer span of welfare receipt predicted worse mental health as compared to mothers who reported a shorter period of welfare receipt. Latent class analysis identified three patterns of employment and welfare receipt across time: a) exchanged earnings for welfare, b) high employment and earnings growth with reduced welfare, and c) moderate employment growth. The groups that exchanged earnings for welfare (about 10% of the sample) evidenced increased psychological distress compared to mothers with high or moderate employment growth. Support for the social selection hypothesis suggests that policies and interventions that help low-income mothers improve their psychological well-being could also enhance their economic well-being. Implications for future research could explore the effects of such policies. / text

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-02-01T14:05:05Z No. of bitstreams: 1 julianamenezesmendesmauricio.pdf: 954533 bytes, checksum: ae7a46de702fa257145b7f6e9ee4f303 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-02-01T15:49:54Z (GMT) No. of bitstreams: 1 julianamenezesmendesmauricio.pdf: 954533 bytes, checksum: ae7a46de702fa257145b7f6e9ee4f303 (MD5) / Made available in DSpace on 2016-02-01T15:49:54Z (GMT). No. of bitstreams: 1 julianamenezesmendesmauricio.pdf: 954533 bytes, checksum: ae7a46de702fa257145b7f6e9ee4f303 (MD5) Previous issue date: 2014-02-27 / A presente dissertação objetiva aprofundar a compreensão teórica das categorias analíticas de trabalho produtivo e improdutivo a fim de apreendê-las na relação com o trabalho do assistente social imerso no assalariamento na cena contemporânea. Visa também aprofundar o desvelamento das determinações da dimensão abstrata do trabalho, buscando traçar reflexões que caminhem no sentido de uma maior compreensão dos fundamentos do trabalho do assistente social posteriormente a uma maior compreensão das categorias supracitadas no pensamento marxiano e marxista. O caminho seguido para efetivação da proposta de estudo acima explicitada, que será desenvolvida através de uma pesquisa de natureza teórica, é composto por dois capítulos. O primeiro é constituído pela apreensão teórica e pela exposição de algumas das determinações da sociabilidade capitalista sob o ângulo analítico do trabalho e a produtividade do trabalho: trabalho produtivo e improdutivo. Também são analisadas suas dimensões constitutivas, sua inserção nas relações sociais e suas configurações contemporâneas. Já o segundo capítulo é constituído da apreensão e explicitação da inserção do assistente social nos marcos da divisão social e técnica do trabalho; e sua condição assalariada. Por fim, serão traçadas considerações finais acerca da compreensão do trabalho dos assistentes sociais nos marcos da produtividade, da necessidade no trato e apreensão da condição assalariada destes profissionais, bem como, acerca das condições contemporâneas de efetivação da atividade profissional destes trabalhadores especializados. / The present thesis aims to probe the theoretical comprehension on the analitical categories of the productive and unproductive work in order to understand them in the relation to the social worker job. It also intends to probe the disclosure of the abstract dimension of the job, trying to draw reflections which will lead towards a higher knowledge of the social worker job principles and later to a greater comprehension of the forementioned categories in the marxist and marxian thought. The pathway followed to implement the study proposal aforesaid, which will be developed through a theoretical research, is composed by two chapters. The first one is constituted by the theoretical understanding and exposition of some determinations of the capitalist socialibility from the work perspective and productivity: productive and unproductive work. Some other parameters will be analysed: its constitutive dimensions, its insertion in the social relationships and its contemporary settings; whereas the second chapter is constituted by the understanding and explicitness on how the social assistant falls within the social and technical work division; and its salaried condition. Ultimately, some final comments will be drawn on the apprehension of the social workers on the productivity, necessity of a better treatment and understanding of the salaried situation of these professionals, as well as, on the contemporary conditions on which these specialized works are being hired.

El correcto establecimiento de un Sistema de Control Interno se torna apremiante en todas las empresas, tanto públicas como privadas, para mejorar sus resultados, reducir riesgos y aprovechar correctamente los recursos que manejan. En este contexto, se ha detectado que el sector de turismo es uno de los que más se ha desarrollado en el Perú en los últimos años, contribuyendo en el PBI del país de manera significativa, lo que ha permitido que el mercado permanezca en continua expansión; pero en el que hay mucha informalidad y desorden, que aún no puede controlarse. Es por ello, que la presente investigación tiene como objetivo principal identificar el impacto que tiene la falta de un Sistema de Control Interno basado en el modelo Coso 2013 en la gestión financiera de los operadores de turismo receptivo en el distrito de Miraflores. Se tomó como objeto de estudio a los operadores turísticos porque se observó que están desarrollandose, en la mayoría de los casos, de forma empírica, sin una correcta planificación o estudio, y teniendo una visión a corto plazo. La investigación es de tipo explicativa, no experimental. Para la recolección de datos se revisaron antecedentes, se profundizó en temas del sector, se observó a una empresa Modelo representativa, y se realizaron cuestionarios y entrevistas a profundidad. / The correct establishment of an Internal Control System becomes urgent in all companies, both public and private, to improve their results, reduce risks and properly utilize their resources. In this context, it has been detected that the tourism sector is one of the most developed in Peru in recent years, contributing significantly to the country's GDP, which has allowed the market to remain in continuous expansion; but there is still too much informality and disorder, which cannot be controlled yet. For this reason, this research has as main objective to identify the impact that the lack of an Internal Control System has, based on the Coso 2013 model, in the financial management of receptive tourism operators in the district of Miraflores. Tour operators were taken as an object of study because it was observed that they are developing in the majority of cases empirically, without proper planning or study, and having a short-term vision. The research is explanatory, not experimental. For the collection of information, background checks were reviewed, sector topics were studied, a representative Model company was observed, and in-depth questionnaires and interviews were conducted. / Tesis

The practical part of the diploma thesis deals with the impartial presentation of the rewarding system and evaluation in the joint-stock company of Měšťanský pivovar Strakonice. The stress is put on considering whether the applied rewarding system, which includes the individual hourly wage, extra components and the system of employment bonuses in the chosen company is an appropriate model ? mostly to conform with the macroeconomic situation.

The aim of thesis is a proposal how to improve a work-life balance at the city council and identify the most common problems the company and people are dealing with. The main highlighted benefit are factual results of research – data from real respondents – employees working hours and the analysis of the real benefits for the company which are used as a base for the real proposal of the implementation.