Orientador: Neusa Maria Costa Alexandre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T16:13:26Z (GMT). No. of bitstreams: 1 Souza_AnaClaudiade_M.pdf: 7872303 bytes, checksum: f5e99f81b17d682fd9559b6c0d9e38f6 (MD5) Previous issue date: 2011 / Resumo: Os distúrbios osteomusculares são a principal causa de incapacidade e perda de produtividade no trabalho, merecendo destaque no cenário de adoecimento das mais diversas profissões. A literatura destaca os trabalhadores da enfermagem como grupo de risco para o desenvolvimento de sintomas osteomusculares. As afecções osteomusculares podem resultar em dor persistente e incapacidade para o trabalho. Dessa forma, os objetivos desse estudo foram investigar a ocorrência de sintomas osteomusculares em trabalhadores da enfermagem e sua associação com desempenho no trabalho e verificar, entre os indivíduos sintomáticos, a relação entre intensidade da dor e incapacidade. Participaram do estudo 301 sujeitos, com média de idade de 36 anos (DP±9,8), de ambos os sexos e de todos os turnos de trabalho, que compunham o quadro de técnicos e auxiliares de enfermagem de uma Instituição de Saúde, localizada no interior do estado de São Paulo. Inicialmente, os trabalhadores responderam uma ficha de caracterização sociodemográfica, ao Questionário Nórdico e ao Questionário de Avaliação do Desempenho no Trabalho. Aqueles que relataram sintomas ostemusculares em qualquer região corporal, nos últimos seis meses, responderam à Escala Numérica de Dor e ao Questionário de avaliação da incapacidade causada pela dor. Os dados foram submetidos à análise descritiva, de comparação e de correlação. Para comparar o desempenho no trabalho de indivíduos com e sem sintomas osteomusculares foi utilizado o Teste de Mann-Whitney e para correlacionar intensidade da dor e incapacidade, o Coeficiente de Correlação de Spearman. Verificou-se que dos 301 trabalhadores da enfermagem, 80,7% apresentaram sintomas osteomusculares em pelo menos uma região do corpo. Nos últimos seis meses houve maior ocorrência de dor ou desconforto nas regiões lombar (48,5%), torácica (47,5%), ombros (37,2%) e, nos últimos sete dias, a queixa mais freqüente foi dor lombar (27,3%). Quanto ao desempenho no trabalho de indivíduos sintomáticos, a pontuação média obtida foi menor para as demanda física, de plano de trabalho e de produção do que para as demandas social e mental. Quando os escores de sujeitos com sintomas osteomusculares foram comparados com os de assintomáticos, uma diferença significativa entre os dois grupos foi obtida para cada demanda do instrumento de Desempenho no Trabalho (p<0,05), exceto para a demanda social. Ao avaliar a intensidade da dor em indivíduos sintomáticos, verificou-se pontuação média de 4,5, considerada de média intensidade. Foram encontradas correlações significativas moderadas entre os escores de intensidade da dor e os domínios do Questionário de avaliação da incapacidade causada pela dor - Condição Funcional e Psicossocial (r=0,47) e escore total (r=0,50). Os resultados sugerem que os sintomas osteomusculares já estão interferindo na vida laboral desses trabalhadores / Abstract: Musculoskeletal disorders are the leading cause of disability and lost productivity at work, with emphasis on the setting of disease from various professions. The literature highlights the nursing workers as a group at risk for developing musculoskeletal symptoms. The musculoskeletal disorders can result in persistent pain and inability to work. Thus, the objectives were to investigate the occurrence of musculoskeletal symptoms in nursing workers and their association with work role functionning and verify, among symptomatic individuals, the relationship between pain intensity and disability. The study included 301 subjects, mean age was 36 years (SD±9.8), of both gender and all work shifts, which formed the framework of aides and technical nursing from a Health Institution, located in the state of Sao Paulo. Initially, the workers answered a sociodemographic form, the Nordic Questionnaire and the Work Role Functionning Questionnaire. Those who reported musculoskeletal disorders in any body region over the past six months, answered the Pain Numerical Scale and the Pain Disability Questionnaire. The data were submitted to descriptive analysis, comparison and correlation. To compare the work role of individuals with and without musculoskeletal disorders, was used the Mann-Whitney Test and to correlate the intensity of pain and disability of symptomatic individuals, the Spearman Correlation Coefficient. It was found that the 301 nursing workers, 80.7% had musculoskeletal symptoms in at least one body region. Over the past six months there was a higher occurrence of pain or discomfort in the low back (48.5%), upper back (47.5%), shoulder (37.2%) and for the past seven days, the most frequent complaint was low back pain (27.3%). In relation a work role of symptomatic subjects, the mean score obtained was lower for the physical demands, output demands and work scheduling demands than for social and mental demands. When the scores of the subjects with musculoskelestal disorders were compared to the scores of the asymptomatics, a significant difference between the two groups was obtained for each scale of the Work Role Functioning Questionnaire (p<0,05), except for the social scale. When assessing pain severity in symptomatic individuals, there was an average score of 4.5, considered a medium intensity. Significant correlations were moderate between the scores of pain intensity and demands of the Pain Disability Questionnaire - Functional and Psychosocial Status (r = 0.47) and total score (r = 0.50). The results suggest that the musculoskeletal symptoms are already interfering with the working life of these workers / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

The Department of Basic Education introduced the Integrated Quality Management system in 2003. This was an integration of the three systems, Developmental Appraisal System, Whole School Evaluation System and Performance Measurement System. The system was seen as to be the one that would allow teachers to play a vital role in assessing their own progress, and would integrate this with the necessary evaluation strategy for the professional development of teachers and monitoring of the quality of teaching and learning in schools. The purpose of this study was to research an evaluation of the Integrated Quality Management System impact in schools of the Mdantsane Area. The objective of the study was to establish whether the IQMS has addressed the concerns and needs of the educators and also establish their views on IQMS. The literature was reviewed to get more information on the key concepts of the IQMS and get to understand how the system should be implemented. Both quantitative and qualitative research methods have been used to get to probe the views of the educators and how the system impacts in schools. The data collected was analyzed by means of frequency tables and charts using statistical methods. It was concluded that educators still do not understand the policy document of IQMS and more training on the implementation of IQMS was recommended. The support and monitoring from the District Office needs to be strengthened.

Orientador: Sergio Roberto de Lucca / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T16:48:57Z (GMT). No. of bitstreams: 1 Alves_LuciaHelenaNeves_M.pdf: 1047857 bytes, checksum: b7e66e5a6d52cf2b14c0db2abeefad18 (MD5) Previous issue date: 2006 / Resumo: A Lei 8213/91, artigo 20 define a doença do trabalho como a doença adquirida ou desencadeada em função de condições especiais em que o trabalho é realizado e que com ele se relacione diretamente. Confirmado o nexo causal com o trabalho, o beneficiário (segurado da Previdência Social) recebe o benefício por incapacidade laborativa, denominado auxílio-doença acidentário. Entretanto, o nexo técnico que estabelece a relação de causalidade entre a doença e o trabalho é de competência legal da perícia médica do INSS. Para que o segurado tenha o reconhecimento do nexo causal, garantindo-lhe alguns direitos, é necessário requerer administrativamente a alteração no tipo de benefício (auxílio-doença previdenciário para auxílio-doença acidentário). Este estudo tem por objetivo identificar os entraves institucionais para concessão do auxílio-doença na Previdência Social. O estudo foi realizado na Agência da Previdência Social na cidade de Indaiatuba. É um estudo descritivo, com uma população de 148 casos atendidos para esse fim, no período de 1995 a 2004, em listagem feita em 08/11/2004. A fonte de dados empregada na pesquisa foi extraída das Comunicações de Acidente de Trabalho (CATs) constantes nos processos de transformação de auxílio doença previdenciário para auxílio-doença acidentário e, posteriormente, de entrevistas com os segurados, funcionários e representantes sindicais de cinco entidades com sede na cidade. O estudo concluiu que a maior freqüência nesses processos se deu entre os operadores de máquinas, com idade média de 37 anos e com doenças osteomusculares. A proporção entre os sexos, todavia, mostrou-se homogênea. Em relação às dificuldades para caracterização de nexo causal entre o trabalho e a doença, foram apontadas pelos servidores problemas de ordem técnica e político-administrativo. Os representantes sindicais e os segurados apontaram que a maior dificuldade foi a avaliação e conclusão médico-pericial para estes casos, ocorrendo inclusive pareceres antagônicos entre a assistência médica do SUS ou de convênios e a perícia médica / Abstract: Law nº 8213/91, in article 20, defines occupational disease as the disease acquired or unleashed by the special conditions in which work is done and has a direct relation to it. Once the causal relationship is confirmed, the worker receives compensation from the Brazilian National Social Security System for working disability, which is called accident-compensation. The technical nexus that establishes work-relatedness for compensation lies in the legal sphere of the expert medical board of the National Insurance and Social Security Institute 1(INSS). In order to obtain the recognition of the causal relationship, which assures some rights to the insured worker, it is necessary to file a claim at the INSS to change the type of compensation (from social security illness-compensation to accident-compensation). The aim of this study is to identify the institutional hindrances (medicolegal roadblocks) in the path to obtain the concession of illness compensation from the Social Security System. The investigation was carried out at the Social Security Agency in the town of Indaiatuba, state of São Paulo, Brazil. It is a descriptive study with 148 cases analyzed for this purpose in the period between 1995 and 2004, in a listing dated November 8th, 2004. The source of data used in this study was derived from CATs2 pertaining to claims filed to change benefits from illness-compensation to accident-compensation and subsequent interviews with the claimants, with employees at the Social Security Agency and union representatives of five entities with headquarters in town. The study reached the conclusion that machine operators, mean age 37, with musculoskeletal disorders, were the most frequent claimants. The proportion between genders, however, was homogeneous. Establishing the relation between work and illnesses was difficult due to technical and policy-administrative problems, as pointed out by the employees at the Agency. Union representatives and claimants referred that the greatest difficulty lied in the evaluations and conclusions of the expert medical board at the INSS for these claims.There were even opposing reports between clinicians working for SUS(the public medical care system)or for private health-insurers and the medical experts at the INSS / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-10-06T20:39:00Z No. of bitstreams: 1 DISSERTA??O_T?CIA_CORDEIRO_2014.pdf: 3475768 bytes, checksum: 413c3f0ef8fd6218184872cd9d992f8e (MD5) / Made available in DSpace on 2016-10-06T20:39:00Z (GMT). No. of bitstreams: 1 DISSERTA??O_T?CIA_CORDEIRO_2014.pdf: 3475768 bytes, checksum: 413c3f0ef8fd6218184872cd9d992f8e (MD5) Previous issue date: 2014-12-16 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Considering the context about the health of the worker and the work ability, this dissertation has as objectives: to describe the prevalence and factors associated with work ability among workers from Brazil; evaluate factors associated with work ability among nursing workers of the primary health care in Bahia, Brazil; and to evaluate validity of indicators of the work ability index among health workers in Bahia, Brazil. For that, constitutes three scientific articles: 1 ? Work ability among workers in Brazil: a systematic research; 2 ? Work ability among nursing workers of the primary health care; 3 ?Validation of the Work Ability Index - WAI among health workers. It is considered that the work ability is a broad construct, complex and multidimensional that involves individual aspects, physical and mental, organizational and of the work environment. The inadequate work ability of the nursing workers was associated with the bond of effective work, the work done in just one turn, have developed occupational disease, being dissatisfied with the work ability and live in high strain job. The work ability index showed itself as an instrument capable of measuring the work ability of health workers in primary health care and medium complexity through three dimensional factors related to mental resources, work ability physical and mental, and work ability in the presence of diseases and restrictions on health status. It is expected that this study will stimulate further research in the context of occupational health and that the work ability index can be used in studies with similar populations. So long, becomes necessary intervention in the organizational aspects of work environments to promote, maintain and restore the work ability, as well as the implementation of health work programs for quality and accessible to promote active aging. / En vista del contexto de la salud del trabajador y de la capacidad para el trabajo, esta disertaci?n tiene como objetivos: describir la prevalencia y los factores asociados con la capacidad para el trabajo de los trabajadores en el Brasil; evaluar los factores asociados con la capacidad para el trabajo entre los trabajadores de enfermer?a de la atenci?n primaria de la salud en Bah?a, Brasil; y evaluar los indicadores de validez del ?ndice de capacidad para el trabajo entre los trabajadores de la salud en Bah?a, Brasil. Por tanto, constituye tres art?culos: 1 - Capacidad para el trabajo entre los trabajadores en Brasil: una investigaci?n sistem?tica; 2 - Capacidad para el trabajo entre los trabajadores de enfermer?a de la atenci?n primaria de la salud; 3 ? Validaci?n del ?ndice de Capacidad para el Trabajo - ICT entre los trabajadores de la salud. Se considera que la capacidad para el trabajo es un constructo amplio, complejo y multidimensional que se refiere a aspectos individuales, f?sicos y mentales, organizacionales y del ambiente de trabajo. La capacidad para el trabajo inadecuada de los trabajadores de enfermer?a se asoci? con el v?nculo de trabajo efectivo, el trabajo realizado en un turno, han desarrollado una enfermedad profesional, estar insatisfecho con la capacidad para el trabajo y vivir en el trabajo de alto requisito. El ?ndice de capacidad para el trabajo se mostr? como un instrumento capaz de medir la capacidad para el trabajo de los trabajadores de salud en la atenci?n primaria de la salud y la complejidad media a trav?s de tres factores dimensionales relacionados con los recursos mentales, la capacidad para el trabajo f?sico y mental y la capacidad para el trabajo en la presencia de enfermedades y restricciones en el estado de salud. Se espera que este estudio estimule una mayor investigaci?n en el contexto de la salud laboral y que lo ?ndice de capacidad para el trabajo pueda ser utilizado en estudios con poblaciones similares. Contacto, se hace necesaria la intervenci?n en los aspectos de organizaci?n de los ambientes de trabajo para promover, mantener y restaurar la capacidad para el trabajo, as? como la implementaci?n de los programas de salud do trabajador de calidad y asequible para promover el envejecimiento activo. / Considerando o contexto acerca da sa?de do trabalhador e a capacidade para o trabalho, esta disserta??o teve como objetivos: descrever a preval?ncia e os fatores associados ? capacidade para o trabalho entre trabalhadores do Brasil; avaliar fatores associados ? capacidade para o trabalho em trabalhadores de enfermagem da aten??o b?sica ? sa?de na Bahia, Brasil; e avaliar indicadores de validade do ?ndice de capacidade para o trabalho entre trabalhadores da sa?de na Bahia, Brasil. Para tanto, se constitui de tr?s artigos cient?ficos: 1 ? Capacidade para o trabalho entre trabalhadores do Brasil: uma pesquisa sistem?tica; 2 ? Capacidade para o trabalho entre trabalhadores de enfermagem da aten??o b?sica ? sa?de; 3 ? Valida??o do ?ndice de Capacidade para o Trabalho - ICT entre trabalhadores da sa?de. Considera-se que a capacidade para o trabalho ? um construto amplo, complexo e multidimensional que envolve aspectos individuais, f?sicos e mentais, organizacionais e do ambiente de trabalho. A capacidade para o trabalho inadequada dos trabalhadores de enfermagem esteve associada ao v?nculo de trabalho efetivo, trabalho realizado em apenas um turno, ter desenvolvido doen?a ocupacional, estar insatisfeito com a capacidade para o trabalho e vivenciar alta exig?ncia no trabalho. O ?ndice de capacidade para o trabalho mostrou-se como um instrumento capaz de mensurar a capacidade para o trabalho dos trabalhadores da sa?de da aten??o b?sica ? sa?de e m?dia complexidade por meio de tr?s fatores dimensionais referentes aos recursos mentais, capacidade para o trabalho f?sica e mental e a capacidade para o trabalho na presen?a de doen?as e restri??es diante do estado de sa?de. Espera-se que este estudo estimule novas pesquisas no ?mbito da sa?de do trabalhador e que o ?ndice de capacidade para o trabalho possa ser utilizado em estudos com popula??es semelhantes. Contanto, se faz necess?rias interven??es nos aspectos organizacionais dos ambientes laborais para promover, manter e restaurar a capacidade para o trabalho, assim como a implementa??o de programas de sa?de do trabalhador de qualidade e acess?vel para promover um envelhecimento ativo.

No description available.

<p>Povratak na posao nakon operacije lumbalne diskus hernije determinisan je funkcionalnim stanjem, prisustvom i stepenom tegoba od strane lumbosakralne kičme, zahtevima na radnom mestu bolesnika ali i psihosocijalnim faktorima, koji pri oceni radne sposobnosti zaposlnih zahtevaju individualni pristup. Grupa pacijenata koja se neće vratiti na posao može biti identifikovana putem prognostičkog modela. Cilj ove studije je definisanje prognostičkog modela za povratak na posao bolesnika operisanih zbog lumbalne diskus hernije kao i identifikacija najznačajnijih faktora rizika odgovornih za lo&scaron; ishod operativnog lečenja, posmatrano kroz prizmu povratka na posao. Istraživanje je prospektivna studija koja je obuhvatila ukupno 200 ispitanika, koji su operisani zbog lumbalne diskus hernije na jednom nivou i praćeni su u vremenskom period do 12 meseci nakon operativnog lečenja. U statističku ananlizu je u&scaron;lo 153 bolesnika, koji su ispunili kriterijume selekcije ispitanika studije. Nakon određivanja značaja posmatranih biolo&scaron;kih, profesionalnih i psihosocijalnih faktora rizika za povratak na posao, kreirani su i evaluirani prognostički modeli bazirani na svim i na odabranim atributima desetostrukom kros-validacijom: stablo odlučivanja (DT), model vi&scaron;eslojnih perceptrona (MLP) i model potpornih vektora (SVM). Za predviđanje povratka na posao najveću tačnost, specifičnost i senzitivnost za odabrane atribute postiže model potpornih - podržavajućih vektora (SVM). Najbolju intuitivnu i praktičnu vrednost za predviđanje povratka na posao pruža model stabla odluka (DT). Identifikacijom najznačajnijih faktora rizika za nepovoljan ishod povratka na posao omogućeno je preventivno delovanje na iste, u cilju smanjenja broja pacijenata sa umanjenjem radne sposobnosti i invaliditeta.</p> / <p>Return to work after lumbar discectomy is determinated by functional status, presence and degree of discomfort in the lumbosacral spine, the requirements in the workplace of patients and psychosocial factors that in the assessment of working capabilities require an individual approach. Groups of patients which don&rsquo;t return to work after surgery could be identified by predictive model. The aim of this study is to define prognostic model to return to work patients after lumbar discectomy, as well as the identification major risk factors responsible for the poor outcome of operative treatment viewed through the prism of returning to work. This prospective study included a total of 200 patients, who underwent surgery for lumbar disc herniation on one level and were followed up in period of 12 months following surgery. The statistical analysis included 153 patients who fulfilled all selection criteria of the study subjects. After determining significance of the observed biological, professional and psychosocial risk factors for return to work, prognostic models were designed and evaluated based on all and selected attributes by tenfold cross-validation: decision tree (DT) model of multilayer perception (MLP) model and support vector (SVM). For the prediction of return to work best accuracy, specificity and sensitivity for selected attributes, is achieved by supporting vector model (SVM). The decision tree model (DT) provides the best intuitive and practical value for predicting return to work. By identifying the most important risk factors for adverse outcome for return to work it is made possible for preventive actions, to reduce the number of patients with reduced work ability and disability.</p>

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 6 uppsatser.

Due to physical, cognitive and emotional impairments, many individuals are unemployed or under-employed following a traumatic brain injury. The research evidence links the rigour of a vocational evaluation to future employment outcomes. Despite this link, no specific guidelines exist for vocational evaluations. Using the research evidence and a diverse panel of clinical and academic experts, the primary objective of this doctoral research was to develop an inter-professional clinical practice guideline for vocational evaluation following traumatic brain injury. The objective of the guideline is to make explicit the processes and factors relevant to vocational evaluation, to assist evaluators (i.e. clients, health and vocational professionals, and employers) in collaboratively determining clients’ work abilities and developing recommendations for work entry, re-entry or vocational planning. The steps outlined in the Canadian Medical Association's Handbook on Clinical Practice Guidelines were utilized to develop the guideline and include the following: 1) identifying the guideline’s objective/questions; 2) performing a systematic literature review; 3) gathering a panel; 4) developing recommendations; 4) guideline writing; 5) pilot testing. The resulting guideline includes 17 key recommendations within the following seven domains: 1) evaluation purpose and rationale; 2) initial intake process; 3) assessment of the personal domain; 4) assessment of the environment; 5) assessment of occupational/job requirements; 6) analysis and synthesis of assessment results; and 7) development of evaluation recommendations. Results from an exploratory study of the guideline’s implementation by occupational therapists in their daily practices revealed that clinicians used the guideline to identify practice gaps, systematize their evaluation processes, enhance inter-professional and inter-stakeholder communication, and re-conceptualize their vocational evaluations across disability groups. Statistically significant improvements were also noted in clients’ participation scores on the Mayo-Portland Adaptability Inventory–4 following guideline use. This guideline may be applicable to individuals with TBI, clinicians, health and vocational professionals, employers, professional organizations, administrators, policy makers and insurers.

Due to physical, cognitive and emotional impairments, many individuals are unemployed or under-employed following a traumatic brain injury. The research evidence links the rigour of a vocational evaluation to future employment outcomes. Despite this link, no specific guidelines exist for vocational evaluations. Using the research evidence and a diverse panel of clinical and academic experts, the primary objective of this doctoral research was to develop an inter-professional clinical practice guideline for vocational evaluation following traumatic brain injury. The objective of the guideline is to make explicit the processes and factors relevant to vocational evaluation, to assist evaluators (i.e. clients, health and vocational professionals, and employers) in collaboratively determining clients’ work abilities and developing recommendations for work entry, re-entry or vocational planning. The steps outlined in the Canadian Medical Association's Handbook on Clinical Practice Guidelines were utilized to develop the guideline and include the following: 1) identifying the guideline’s objective/questions; 2) performing a systematic literature review; 3) gathering a panel; 4) developing recommendations; 4) guideline writing; 5) pilot testing. The resulting guideline includes 17 key recommendations within the following seven domains: 1) evaluation purpose and rationale; 2) initial intake process; 3) assessment of the personal domain; 4) assessment of the environment; 5) assessment of occupational/job requirements; 6) analysis and synthesis of assessment results; and 7) development of evaluation recommendations. Results from an exploratory study of the guideline’s implementation by occupational therapists in their daily practices revealed that clinicians used the guideline to identify practice gaps, systematize their evaluation processes, enhance inter-professional and inter-stakeholder communication, and re-conceptualize their vocational evaluations across disability groups. Statistically significant improvements were also noted in clients’ participation scores on the Mayo-Portland Adaptability Inventory–4 following guideline use. This guideline may be applicable to individuals with TBI, clinicians, health and vocational professionals, employers, professional organizations, administrators, policy makers and insurers.