Neonatal septicaemia and nosocomial infection are major causes of morbidity in neonatal intensive care units (NICU) in both developed and developing countries. This study documents infective episodes at two resource disparate NICUs; the Grantley Stable Neonatal Unit (GSNU), Royal Brisbane and Women’s Hospital (RBWH), Australia 1997-2006 and Danang NICU, Vietnam. The specific aims are: 1. To compare the incidence of neonatal septicaemia at RBWH and Danang NICU. 2. To compare of the epidemiological characteristics of nosocomial infections in the two NICUs. 3. To study risk factors associated with nosocomial infection in the two NICUs (including staff numbers, infant numbers and nursing workload). 4. To review published guidelines on healthcare physical environments and staffing levels and to survey the GSNU & Danang NICU in relation to these. 5. To develop a prospective surveillance system to monitor infection episodes in Danang NICU 6. To recommend strategies for the control of neonatal sepsis in Danang NICU. The GSNU at the RBWH, Australia is a 71 bed neonatal care facility with an established infection surveillance system in a well resource environment. Danang NICU, Vietnam provides care to a high risk neonatal population with no established infection surveillance system in a developing country with more limited resources. This study found the GSNU had a low rate of neonatal septicaemia, during the ten year period from 1997 to 2006 with 253 babies (2.1%) diagnosed with septicaemia. In Danang NICU, in the year 2007 alone, there were 52 cases (2.9%) of septicaemia documented but the incidence of neonatal infection is likely to have underestimated due to (i) the failure to collect blood culture before commencing antibiotic treatment. (ii) Difficulties associated with data retrieval from maternal and neonatal records and (iii) lack of a systematic surveillance system with prospectively collected data. The organisms causing early onset and late onset septicaemia were substantially different in the two NICUs. Group B streptococcus (GBS) and Escherichia coli were the major organisms causing early onset sepsis (EOS) at the GSNU, accounting for 37.8% and 29.7% respectively, whilst coagulase-negative staphylococcus (CONS) was the commonest organism (25.7%) for late onset sepsis (LOS). In Danang NICU, Klebsiella spp was the major pathogen and was responsible for 75% of neonatal septicaemia in both early and late onset sepsis. The isolation of Klebsiella spp in a high proportion of infants at less than 48 hours may suggest nosocomial or maternal route of acquisition. The rate of GBS infections in Danang Hospital, Vietnam, is hard to estimate and interpret due to limited microbiologic data. The anti-serum used to classify the Streptococcal types is not readily available in Danang Hospital. In some cases, organisms that are isolated are suspected to be GBS however, this is not confirmed microbiologically. The study identifies a high prevalence of neonatal septicaemia in Danang NICU. It identifies a close relationship between rates of infection and poor nursing care practices and limited resources. The standard care system used at the GSNU as well as the international literature was studied in relation to infection control practices. This was then used to develop the following recommendations that specifically target a reduction in infection rates in Danang NICU: 1. Implement an infection surveillance system 2. Report regularly from the database and embed discussion of the data into unit management policy 3. Revise neonatal and pathology practice in relation to blood cultures 4. Use shorter duration of antibiotics course based on culture results 5. Modify care practices that expose infants to cross infection 6. Identify specific staff with particular responsibilities in maintenance of standards

Magister Commercii - MCom / This study explores the relationship between knowledge creation and organisational and managerial control. I explore how organisational control impacts, influences, shapes, fashions and lay the foundation for the creation of the various types of knowledge within a research organisation. In particular, the aim of the study is to explore the influence that organisational control systems have on knowledge workers' capacity to generate new research knowledge. The literature on knowledge management reveals that there has been a lot of focus on knowledge creation. However, from my review of the literature there have not been sufficient research studies that explore organisational control mechanisms in facilitating or inhibiting the creation of knowledge. In addressing the research problem, this study intends to explore this gap. From an organisational control aspect, I draw on the Foucauldian toolbox using disciplinary power, pastoral power, and technologies of the self. Thereafter I develop a conceptual model in which I integrate knowledge creation and organisational control mechanisms. The research approach that I employed is a qualitative approach. In particular, I adopted a case study research design. Data was primarily collected using interviews and observation. Data analysis was conducted using a thematic approach. The research site was a national research company with their head office in Cape Town. All individuals within the organisation, including the managing director were comprehensively interviewed. From the data analysis, using the conceptual model I formulated, I made the claim that mechanisms of organisational and managerial control aided and facilitated certain modes of knowledge creation. Furthermore, the findings highlighted that employees acknowledged that organisational and managerial practices aided them in producing knowledge. The data analysis further confirmed the explanatory power of my conceptual model. The original model was structured on the premise that a particular organisational mechanism was dominate for each of the various stages in the knowledge creation process. The data provided evidence that all organisational control mechanism overlapped for each of the knowledge creation processes and therefore the model was re-worked. However, due to certain limitations, more research in this field is required to be able to explore further the nature of the relationship between knowledge creation and organisational control practices.

Dans les sports de combat à catégories de poids, les compétiteurs ont l'obligation de "faire le poids" de leur catégorie, au moment de la pesée réalisée officiellement avant chaque compétition. La thèse vise à appréhender les pratiques de contrôle de poids chez les judokates et les judokas de haut niveau. Elle s'intéresse au vécu quotidien des sportifs, au mode de diffusion des pratiques et des savoirs et à leur évolution dans un monde où la quête de performance est un enjeu permanent. L'approche interactionniste se situe à l'interface de la sociologie du sport, de la sociologie de la santé et de la sociologie du risque. Les concepts de « carrière » et de « trajectoire » sont mobilisés pour comprendre la construction des pratiques de contrôle du poids dans la carrière de judoka(te) et leur évolution dans une trajectoire qui leur est propre. L'approche qualitative prend appui sur une enquête ethnographique d'une durée de 230 jours réalisée dans une dizaine de pays à l'occasion de stages préparatoires et de compétitions internationales. Elle a été complétée par 48 « récits de vie » réalisés auprès de 21 femmes et 27 hommes âgés de 18 à 41 ans, athlètes de haut niveau. Le processus de construction des pratiques de contrôle du poids est saisi dans le cadre de carrières, permettant de rendre compte aussi bien de faits objectifs relevant de la structure sportive, que de changement dans les connaissances, les conceptions et les désirs des athlètes. Les pratiques de contrôle du poids dont les bases sont généralement construites à la fin de l'adolescence se développent selon une trajectoire qui tend à s'autonomiser de la carrière de judoka(te). L'analyse met en lumière des situations de vulnérabilité tant dans la carrière sportive qu'au sein de la trajectoire elle-même / In combat sports with weight classes, competitors are required to "offer counterweight" in their category at the time of the weighing that is officially held before each competition. The thesis aims to understand the weight control practices among female and male judokas of high ranking. Its interests are the everyday life of athletes, the dissemination mode of practices and knowledge, and their evolution in a world where the quest for performance is an ongoing challenge. The interactional approach is located at the interface of sports sociology, health sociology, and risk sociology. The concepts of "career" and "direction" are mobilized to understand the building of weight control practices in female and male judokas career, and the evolution of these practices in a direction of their own. The qualitative approach is based on a 230-day ethnographic survey conducted in about 10 countries during preparatory internships and international competitions. The survey was complemented by 48 "life stories" conducted with athletes of high ranking, 21 women and 27 men aged 18 to 41. The construction process of weight control practices is acquired in the career framework, reporting both objective facts within the sports structure, and the change in expertise, the notions, and athletes’ desires. These weight control practices, of which bases are generally constructed at the end of the adolescence, develop along a trajectory that tends to become independent of the judokas career. The analysis highlights situations of vulnerability in both the sports career and the direction itself

No description available.

As precauções-padrão preconizadas pelo Centers for Disease Control and Prevention e ratificadas pelo Ministério da Saúde, são medidas que minimizam a exposição ocupacional a material biológico potencialmente contaminado e previnem as infecções relacionadas à assistência em saúde. No entanto, constata-se que a adesão a essas medidas é problema dentre os profissionais de enfermagem e instrumentos para estudar a adesão de enfermeiros a essas medidas foram construídos para apoiar intervenções. Considerando-se que a adaptação e validação de um instrumento utilizado em diferentes culturas garante a sua maior confiabilidade e validade e que a viabilidade de um instrumento fidedigno, para aferir conhecimento e adesão de enfermeiros às precauções-padrão, se faz necessário no contexto brasileiro, este estudo teve por objetivos adaptar para enfermeiros brasileiros e validar o questionário de adesão às precauções-padrão e o questionário de conhecimento sobre as precauções-padrão (Questionnaires for Knowledge and Compliance with Standard Precaution).Trata-se de estudo metodológico, cujo processo de adaptação dos questionários seguiu as etapas: tradução inicial; síntese e consenso das traduções; realização do comitê de especialistas; retrotradução; validação semântica e pré-teste da versão final. O processo de adaptação contou com uma amostra de 42 enfermeiros de uma unidade de emergência vinculada a um hospital de ensino do interior de São Paulo, sendo que 12 enfermeiros participaram da validação semântica e 30 do pré- teste. O processo de validação foi realizado com uma amostra aleatória de 121 enfermeiros, sendo 91 pertencentes a estabelecimentos de saúde de alta complexidade e 30 enfermeiros pertencentes a estabelecimentos de saúde de média complexidade de outro município do interior de São Paulo (sendo um hospital filantrópico, um hospital privado e uma unidade de pronto atendimento vinculada a um plano de saúde). Para o Questionário de Adesão às Precauções-Padrão, a consistência interna foi calculada pelo alfa de Cronbach e a estabilidade pelo Coeficiente de Correlação Intraclasse. A validade de construto convergente foi calculada pela correlação com a percepção de clima de segurança organizacional e a validade de construto divergente por meio da correlação com a menor percepção de obstáculos, para seguir as precauções-padrão. A validade de construto por grupos conhecidos foi calculada entre enfermeiros que relataram ter recebido e enfermeiros que relataram não ter recebido treinamento e entre as diferentes instituições estudadas. A presença de efeito máximo e mínimo (floor and ceiling) foi avaliada. Para o Questionário de Conhecimento sobre as Precauções-Padrão foi calculada a concordância pelo coeficiente Kappa e a estabilidade foi avaliada pelo Coeficiente de Correlação Intraclasse. A validade de construto entre grupos conhecidos foi calculada entre enfermeiros com maior e menor titulação e enfermeiros que receberam e que não receberam treinamento sobre as precauções-padrão. Os resultados obtidos mostram que os questionários estão compreensíveis, fáceis de responder e adequados ao português do Brasil. O pré-teste confirmou a versão obtida pela validação semântica. O questionário de adesão apresentou consistência interna de 0,80 e estabilidade de 0,97. A validade de construto convergente e divergente evidenciaram forte correlação com a maior percepção de clima de segurança (r=0,614) e com a menor percepção de obstáculos, (r=0-537). A validade de construto entre grupos conhecidos revelou maior adesão entre os enfermeiros que receberam treinamento (p=0,028) e que os participantes pertencentes aos estabelecimentos de alta complexidade apresentaram maior adesão quando comparados aos demais estabelecimentos (p=0,006). Foi verificado efeito máximo e mínimo no Questionário de Adesão às Precauções-Padrão, o que compromete a responsividade do instrumento; porém, auto-relatos de adesão são frequentemente superiores aos índices constatados em estudos observacionais. Com relação ao Questionário de Conhecimento sobre as Precauções-Padrão, as respostas dos enfermeiros se mostraram concordantes e a estabilidade foi de 0,91, o que confirma a capacidade do instrumento de detectar possíveis alterações em características na amostra estudada. A validade por grupos conhecidos não evidenciou diferença estatisticamente significante entre os enfermeiros pela titulação e presença de treinamento (p=0,706 e p=0,209, respectivamente). Os resultados evidenciam que o Questionário de Adesão às Precauções-Padrão obteve índices psicométricos satisfatórios, o que confirma a hipótese de que o instrumento afere o construto adesão. O Questionário de Conhecimento sobre as Precauções-Padrão revelou boa concordância e estabilidade. Conclui-se que os questionários adaptados e validados são fidedignos e podem ser utilizados para medir a adesão e o conhecimento de enfermeiros brasileiros às precauções-padrão e subsidiarão a proposição de medidas intervencionistas, visando a saúde do trabalhador e a segurança do paciente / The standard precautions, established by the Centers for Disease Control and Prevention and ratified by the Brazilian Ministry of Health, are measures that minimize the occupational exposure to potentially contaminated biological material and prevent healthcare-related infections. As verified, however, compliance with these measures is a problem among nursing professionals and tools to study the nurses\' compliance with these measures have been constructed to support interventions. Considering that the adaptation and validation of a tool used in different cultures guarantees its greater reliability and validity and that the feasibility of a reliable tool to verify nurses\' knowledge and compliance with the standard precautions is necessary in the Brazilian context, the objectives in this study were to adapt for Brazilian nurses and validate the Questionnaires for Knowledge and Compliance with Standard Precaution. In this methodological study, the adaptation process of the questionnaires followed a number of phases: initial translation; synthesis and consensus of the translations; expert committee; back translation; semantic validation and pretest of the final version. The adaptation process involved a sample of 42 nurses from the emergency service of a teaching hospital in a city from São Paulo state, 12 of whom participated in the semantic validation and 30 in the pretest. The validation process was accomplished with a random sample of 121 nurses, 91 were located in high complexity healthcare institutions and 30 from intermediate healthcare institutions in another city from São Paulo state (including one non-for-profit hospital, one private hospital and the emergency service of a health insurance). For the Questionnaire for Compliance with Standard Precaution, the internal consistency was calculated using Cronbach\'s alpha and the stability using the Intraclass Correlation Coefficient. The convergent construct validity was calculated through the correlation with the perceived organizational safety climate and the divergent construct validity through the correlation with the lesser perception of obstacles to compliance with the standard precautions. The construct validity using the known-groups method was calculated among nurses who indicated they had received and nurses who indicated they had not received training and among the different institutions under analysis. The presence of floor and ceiling effects was assessed. For the Questionnaire for Knowledge about Standard Precaution, the agreement was calculated using the Kappa coefficient and stability was assessed through the Intraclass Correlation Coeficient. The construct validity among known groups was calculated between nurses with higher and lower degrees and nurses who did and did not receive training about the standard precautions. The obtained results show that the questionnaires are understandable, easy to answer and appropriate to Brazilian Portuguese. The pretest confirmed the version obtained in the semantic validation procedure. The internal consistency of the compliance questionnaire equaled 0.80 and the stability 0.97. The convergent and divergent construct validity showed a strong correlation with a greater perceived safety climate (r=0.614) and a lesser perception of obstacles (r=0-537). The construct validity among known groups revealed greater compliance among the nurses who received training (p=0.028) and that the subjects at the high complexity healthcare institutions showed higher compliance levels when compared to the other institutions (p=0.006). Floor and ceiling effects were found in the Questionnaire for Compliance with Standard Precaution, which compromises the responsiveness of the tool; nevertheless, self-reported compliance levels are frequently higher than the indices found in observation studies. As regards the Questionnaire for Knowledge about Standard Precaution, the nurses\' answers demonstrated agreement and the stability corresponded to 0.91, which confirms that tool\'s ability to detect possible alterations in characteristics of the study sample. The validity among known groups did not show a statistically significant difference among the nurses according to the degree and presence of training (p=0.706 and p=0.209, respectively). The results show that the Questionnaires for Compliance with Standard Precautions obtained satisfactory psychometric coefficients, which confirms the hypothesis that the tool verifies the compliance construct. The Questionnaire for Knowledge about Standard Precaution revealed good agreement and stability coefficients. In conclusion, the adapted and validated questionnaires are reliable and can be used to measure the compliance and knowledge of Brazilian nurses about the standard precaution and will support the proposal of intervention measures directed at occupational health and patient safety

One of the major constraints limiting the efficiency of sheep production is the control of gastrointestinal nematode parasites. Parasite control by strategic use of anthelmintics is threatened by the emergence of nematode populations that are resistant to the drugs available. It is therefore increasingly apparent that steps toward maintaining sustainable productivity in the growing face of anthelmintic resistance (AR) is required by farmers. To facilitate the uptake of sustainable approaches to parasite management, a comprehensive understanding of the various factors that may influence farmers’ decision-making processes is required. In order to establish which factors are influential, and determine their impact on farmers’ roundworm control behaviours, both qualitative and quantitative research methods were used including focus groups as well as attitudinal and behavioural questionnaires. A retrospective analysis was initially conducted of historical surveys designed to identify farm specific characteristics and parasite management practices including anthelmintic usage. The objectives of the analysis were to identify factors associated with uptake of best practice advice including farm characteristics and information sourcing. In addition, the implementation of sustainable roundworm control practices was investigated using two surveys conducted in 2000 and 2010. Logistic regression models were applied for univariable and multivariable analysis of dependent and independent variables. The next step was to conduct a series of focus groups in different geographic regions of Scotland. The main purposes were to explore sheep farmers’ attitudes towards different aspects of roundworm management, as well as to identify potential motivators and barriers to uptake of sustainable parasite control practices. The findings aided in the development of an attitudinal questionnaire used to canvass opinions representative on a national level. The concluding study involved a telephone survey of 400 Scottish sheep farmers, designed to elicit attitudes regarding roundworm control, AR and sustainable roundworm control practices. A quantitative statistical analysis technique (Structural Equation Modelling) was then used to test the relationships between socio-psychological factors and the uptake of sustainable roundworm control practices. The analysis of historical questionnaire data demonstrated evidence of a shift towards the use of practices to reduce the rate of AR development, most notably a decline in the practice of ‘dose and move’ as well as an overall reduction in treatment frequency. Statistical analysis identified significant associations between farm characteristics and specific treatment strategies. For example, larger farms were more likely to adopt a set treatment regimen (P=0.036), compared with smaller farms, which were more likely to treat based on clinical signs of infection (P=0.021). Sourcing of roundworm control information primarily from veterinarians was most associated with treatment timings with no parallels between time points. From the qualitative focus group studies conducted we identified four overarching themes impacting on sheep producers’ attitudes to roundworm control and best practice advice. These themes comprised: a lack of perceived need to change, the complexity of advice, the ease of implementation of recommended practices and the effectiveness of extension approaches. Additionally, the most important and implementable guidelines identified by sheep farmers were: ‘working out a roundworm control strategy with an advisor’ and ‘administering anthelmintics effectively’ with regard to correct drenching practice i.e. appropriate dosing, administration and drug storage procedures. These findings exhibited similarities with veterinarians’ rankings with also, ‘testing for AR’, ‘preserving susceptible parasites’ and ‘reducing dependence on anthelmintics’ receiving the lowest rankings for importance and implementability. The quantitative analysis from the attitudinal/behavioural questionnaire identified eleven factors with significant influences on the adoption of sustainable roundworm control practices. The key influences on overall adoption were farmers’ baseline understanding about roundworm control and self-reported confirmation of anthelmintic resistance in their flock. Additional positive influences included, positive attitudes to veterinary services, enterprise type and perceived risk of AR. Factors that were shown to have the greatest relative effects on individual parasite control practices included; the perceived resource requirements for implementing a quarantine strategy, farmers’ AR suspicions for instigating AR testing and the confirmation of AR for adopting faecal egg count monitoring. The findings have highlighted several factors which can influence sheep farmers’ decisions to reject or adopt recommended roundworm control practices. It is evident that the perceived complexity, lack of need and practicality of the current recommendations necessitates changes to how extension is designed and disseminated to farmers. The findings also suggest that improving farmers’ acceptance and uptake of diagnostic testing and improving underlying knowledge and awareness about nematode control is a significant target to influencing adoption of best practice behaviours. The importance of veterinarians as highly-trusted information resources validates the need for further engagement with veterinarians concerning sustainable parasite control approaches, to facilitate collaboration with farmers. The need for interaction between farmers and their advisors is key to resolving the issues raised to enable the necessary explanation, justification and execution of recommended practices to suit farmers’ needs and farming conditions.

As precauções-padrão preconizadas pelo Centers for Disease Control and Prevention e ratificadas pelo Ministério da Saúde, são medidas que minimizam a exposição ocupacional a material biológico potencialmente contaminado e previnem as infecções relacionadas à assistência em saúde. No entanto, constata-se que a adesão a essas medidas é problema dentre os profissionais de enfermagem e instrumentos para estudar a adesão de enfermeiros a essas medidas foram construídos para apoiar intervenções. Considerando-se que a adaptação e validação de um instrumento utilizado em diferentes culturas garante a sua maior confiabilidade e validade e que a viabilidade de um instrumento fidedigno, para aferir conhecimento e adesão de enfermeiros às precauções-padrão, se faz necessário no contexto brasileiro, este estudo teve por objetivos adaptar para enfermeiros brasileiros e validar o questionário de adesão às precauções-padrão e o questionário de conhecimento sobre as precauções-padrão (Questionnaires for Knowledge and Compliance with Standard Precaution).Trata-se de estudo metodológico, cujo processo de adaptação dos questionários seguiu as etapas: tradução inicial; síntese e consenso das traduções; realização do comitê de especialistas; retrotradução; validação semântica e pré-teste da versão final. O processo de adaptação contou com uma amostra de 42 enfermeiros de uma unidade de emergência vinculada a um hospital de ensino do interior de São Paulo, sendo que 12 enfermeiros participaram da validação semântica e 30 do pré- teste. O processo de validação foi realizado com uma amostra aleatória de 121 enfermeiros, sendo 91 pertencentes a estabelecimentos de saúde de alta complexidade e 30 enfermeiros pertencentes a estabelecimentos de saúde de média complexidade de outro município do interior de São Paulo (sendo um hospital filantrópico, um hospital privado e uma unidade de pronto atendimento vinculada a um plano de saúde). Para o Questionário de Adesão às Precauções-Padrão, a consistência interna foi calculada pelo alfa de Cronbach e a estabilidade pelo Coeficiente de Correlação Intraclasse. A validade de construto convergente foi calculada pela correlação com a percepção de clima de segurança organizacional e a validade de construto divergente por meio da correlação com a menor percepção de obstáculos, para seguir as precauções-padrão. A validade de construto por grupos conhecidos foi calculada entre enfermeiros que relataram ter recebido e enfermeiros que relataram não ter recebido treinamento e entre as diferentes instituições estudadas. A presença de efeito máximo e mínimo (floor and ceiling) foi avaliada. Para o Questionário de Conhecimento sobre as Precauções-Padrão foi calculada a concordância pelo coeficiente Kappa e a estabilidade foi avaliada pelo Coeficiente de Correlação Intraclasse. A validade de construto entre grupos conhecidos foi calculada entre enfermeiros com maior e menor titulação e enfermeiros que receberam e que não receberam treinamento sobre as precauções-padrão. Os resultados obtidos mostram que os questionários estão compreensíveis, fáceis de responder e adequados ao português do Brasil. O pré-teste confirmou a versão obtida pela validação semântica. O questionário de adesão apresentou consistência interna de 0,80 e estabilidade de 0,97. A validade de construto convergente e divergente evidenciaram forte correlação com a maior percepção de clima de segurança (r=0,614) e com a menor percepção de obstáculos, (r=0-537). A validade de construto entre grupos conhecidos revelou maior adesão entre os enfermeiros que receberam treinamento (p=0,028) e que os participantes pertencentes aos estabelecimentos de alta complexidade apresentaram maior adesão quando comparados aos demais estabelecimentos (p=0,006). Foi verificado efeito máximo e mínimo no Questionário de Adesão às Precauções-Padrão, o que compromete a responsividade do instrumento; porém, auto-relatos de adesão são frequentemente superiores aos índices constatados em estudos observacionais. Com relação ao Questionário de Conhecimento sobre as Precauções-Padrão, as respostas dos enfermeiros se mostraram concordantes e a estabilidade foi de 0,91, o que confirma a capacidade do instrumento de detectar possíveis alterações em características na amostra estudada. A validade por grupos conhecidos não evidenciou diferença estatisticamente significante entre os enfermeiros pela titulação e presença de treinamento (p=0,706 e p=0,209, respectivamente). Os resultados evidenciam que o Questionário de Adesão às Precauções-Padrão obteve índices psicométricos satisfatórios, o que confirma a hipótese de que o instrumento afere o construto adesão. O Questionário de Conhecimento sobre as Precauções-Padrão revelou boa concordância e estabilidade. Conclui-se que os questionários adaptados e validados são fidedignos e podem ser utilizados para medir a adesão e o conhecimento de enfermeiros brasileiros às precauções-padrão e subsidiarão a proposição de medidas intervencionistas, visando a saúde do trabalhador e a segurança do paciente / The standard precautions, established by the Centers for Disease Control and Prevention and ratified by the Brazilian Ministry of Health, are measures that minimize the occupational exposure to potentially contaminated biological material and prevent healthcare-related infections. As verified, however, compliance with these measures is a problem among nursing professionals and tools to study the nurses\' compliance with these measures have been constructed to support interventions. Considering that the adaptation and validation of a tool used in different cultures guarantees its greater reliability and validity and that the feasibility of a reliable tool to verify nurses\' knowledge and compliance with the standard precautions is necessary in the Brazilian context, the objectives in this study were to adapt for Brazilian nurses and validate the Questionnaires for Knowledge and Compliance with Standard Precaution. In this methodological study, the adaptation process of the questionnaires followed a number of phases: initial translation; synthesis and consensus of the translations; expert committee; back translation; semantic validation and pretest of the final version. The adaptation process involved a sample of 42 nurses from the emergency service of a teaching hospital in a city from São Paulo state, 12 of whom participated in the semantic validation and 30 in the pretest. The validation process was accomplished with a random sample of 121 nurses, 91 were located in high complexity healthcare institutions and 30 from intermediate healthcare institutions in another city from São Paulo state (including one non-for-profit hospital, one private hospital and the emergency service of a health insurance). For the Questionnaire for Compliance with Standard Precaution, the internal consistency was calculated using Cronbach\'s alpha and the stability using the Intraclass Correlation Coefficient. The convergent construct validity was calculated through the correlation with the perceived organizational safety climate and the divergent construct validity through the correlation with the lesser perception of obstacles to compliance with the standard precautions. The construct validity using the known-groups method was calculated among nurses who indicated they had received and nurses who indicated they had not received training and among the different institutions under analysis. The presence of floor and ceiling effects was assessed. For the Questionnaire for Knowledge about Standard Precaution, the agreement was calculated using the Kappa coefficient and stability was assessed through the Intraclass Correlation Coeficient. The construct validity among known groups was calculated between nurses with higher and lower degrees and nurses who did and did not receive training about the standard precautions. The obtained results show that the questionnaires are understandable, easy to answer and appropriate to Brazilian Portuguese. The pretest confirmed the version obtained in the semantic validation procedure. The internal consistency of the compliance questionnaire equaled 0.80 and the stability 0.97. The convergent and divergent construct validity showed a strong correlation with a greater perceived safety climate (r=0.614) and a lesser perception of obstacles (r=0-537). The construct validity among known groups revealed greater compliance among the nurses who received training (p=0.028) and that the subjects at the high complexity healthcare institutions showed higher compliance levels when compared to the other institutions (p=0.006). Floor and ceiling effects were found in the Questionnaire for Compliance with Standard Precaution, which compromises the responsiveness of the tool; nevertheless, self-reported compliance levels are frequently higher than the indices found in observation studies. As regards the Questionnaire for Knowledge about Standard Precaution, the nurses\' answers demonstrated agreement and the stability corresponded to 0.91, which confirms that tool\'s ability to detect possible alterations in characteristics of the study sample. The validity among known groups did not show a statistically significant difference among the nurses according to the degree and presence of training (p=0.706 and p=0.209, respectively). The results show that the Questionnaires for Compliance with Standard Precautions obtained satisfactory psychometric coefficients, which confirms the hypothesis that the tool verifies the compliance construct. The Questionnaire for Knowledge about Standard Precaution revealed good agreement and stability coefficients. In conclusion, the adapted and validated questionnaires are reliable and can be used to measure the compliance and knowledge of Brazilian nurses about the standard precaution and will support the proposal of intervention measures directed at occupational health and patient safety

Abstract This dissertation provides a comprehensive picture of IFRS adoption from the perspective of preparers of accounting information in a continental European context. The dissertation examines the differences between IFRS and continental European accounting and analyses whether these differences influence and have implications for accounting and controlling practices and, if so, in what ways. The dissertation, therefore, presents case studies on accounting and controlling practices and develops theoretical explanations for these practices. This dissertation develops theoretical explanations of why and how business becomes involved in accounting (or accounting and business come closer to each other) and identifies different ways in which business becomes involved in accounting. Moreover, the dissertation provides insights into the implications of business involvements for accounting and control practices at three different levels, i.e. organisation, accounting function and individual accountants. In more general terms, this dissertation provides evidence of how financial accounting becomes more horizontal and has implications for both accounting and control practices. On the one hand, the dissertation examines management across two worlds, i.e. accounting and business, and focuses on the role of boundary objects used to mediate different worlds. On the other hand, the dissertation highlights learning at the boundaries and shows how boundary crossing was used as a strategy to fulfil the requirements of financial and corporate reporting. Finally, the dissertation argues that, rather than describing financial accounting and corporate reporting purely as a vertical process, we should pay attention to the lateral processing of information as required by the standards as well as the needs of management. / Tiivistelmä Tämä väitöskirja tarjoaa laajan kokonaiskuvan IFRS-standardiston käyttöönottoon tilinpäätösinformaation laatijan näkökulmasta. Tutkimus tarkastelee käyttöönottoa ja laatijan näkökulmaa erityisesti mannereurooppalaisessa kontekstissa. Tutkimus analysoi niin kutsutun mannereurooppalaisen normiston ja IFRS-standardiston välisiä eroja sekä näiden seuraamuksia laskenta- ja kontrollikäytäntöihin. Tutkimus tarjoaa tapaustutkimuksia laskenta- ja kontrollikäytännöistä sekä löytää ja kehittää teoreettisia selityksiä näille käytännöille. Tutkimus löytää teoreettisen selityksen sille, miksi ja miten liiketoiminta on läsnä raportoitavan informaation laatimisessa tai miksi liiketoiminnan johtaminen ja raportoitavan informaation laatiminen lähenevät toisiaan. Lisäksi tutkimus identifioi eri tapoja sille, miten liiketoiminta on läsnä informaation laatimisessa. Tutkimus tarjoaa tietoa liiketoiminnan läsnäolon seuraamuksista laskenta- ja kontrollikäytäntöihin kolmella eri tasolla: yrityksen, taloushallinnon funktion sekä taloushallinnon henkilöstön tasolla. Tämä väitöskirja osoittaa, miten tilinpäätösraportointi tulee IFRS-standardiston käyttöönoton myötä horisontaalisemmaksi ja miten tällä on seuraamuksia laskenta- ja kontrollikäytäntöihin. Tutkimus analysoi kahden maailman, ts. laskennan ja liiketoiminnan, välistä johtamista ja keskittyy rajaobjektien roolien tarkastelemiseen. Lisäksi tutkimus korostaa rajavyöhykkeellä tapahtuvaa oppimista ja osoittaa, kuinka rajanylitystä käytetään täyttämään sekä tilinpäätösraportoinnin että yhtiöiden sisäisten raportointien tarpeet. Tämä tutkimus osoittaa, että tilinpäätösraportoinnin ja yhtiötason raportoinnin horisontaalisiin piirteisiin tulisi kiinnittää huomiota sen sijaan, että ne kuvattaisiin puhtaasti vertikaalisina prosesseina. Tutkimus osoittaa, että sekä tilinpäätösstandardit että yhtiön johdon tarpeet vaativat raportoinnilta lateraalisia prosesseja.

Lean construction is often suggested as way of enhancing the productivity of the construction industry. There are no clear definitions of lean construction, but it is often referred to as a construction management philosophy that aims to minimize waste and maximise customer value. Adopting lean construction in a project can be difficult and there are several critical factors for successful implementation; one of which is the use of lean construction practices. Lean construction practices are tools, techniques and strategies through which the principles of lean construction can be implemented. It has been pointed out that there is lack of information on the number of existing practices and their exact area of use. This master thesis report identified lean practices that have been implemented in commercial construction projects, and categorised them according to the phases of lean construction. The report also explored which lean production-planning-and-control- practices have been adopted by a commercial construction contractor. To identify the lean practices, a literature analysis was conducted based on the documents reviewed by Babalola et al. (2019) in their article ‘Implementation of lean practices in the construction industry: A systematic review’. This revealed 22 different lean practices that have been implemented in commercial construction projects, with the Last Planner System having been reported the most followed by Just in Time and Pull Scheduling. The literature analysis also resulted in the project delivery stages in which each identified practice had been adopted. This helped categorise the practices according to the phases of lean construction. The phases were defined by the conceptual framework ‘The Lean Project Delivery System’ as Project Definition, Lean Design, Lean Supply, Lean Assembly and Lean Use. The categorisation showed that (out of the 22 identified practices) 3 practices belong to the phase Project Definition, while 8, 9, 15 and 0 practices belong to the other phases respectively. To explore which lean production-planning-and-control-practices have been adopted by a commercial construction contractor, a case study was conducted of the production phase of a large-sized project referred to as Project X. Seven members of the production team were interviewed as to reveal the contractor’s working methods in the planning and control of production in terms of time, activity and logistics. The revealed working methods were then compared to 9 out of the 22 identified lean practices, since they were interpreted as production-planning-and-control-practices. This analysis showed that six of those practices were seemingly implemented in the production of Project X, while one was partially implemented and two were not implemented. / Lean byggproduktion föreslås ofta som ett sätt att öka produktiviteten i byggbranschen. Det finns inga tydliga definitioner av lean byggproduktion, men konceptet beskrivs ofta som en filosofi för byggledning som ämnar minimera avfall och maximera kundvärdet. Att anta lean byggproduktion i ett projekt kan vara svårt och det finns ett antal kritiska faktorer för lyckad implementering, varav en är användandet av lean byggverktyg. Lean byggverktyg är verktyg, tekniker och strategier genom vilka principerna av lean byggproduktion kan implementeras. Det har påpekats att det finns brist på information om antalet befintliga lean byggverktyg och deras användningsområden. Denna rapport identifierade lean verktyg som har implementerats i kommersiella byggprojekt, och kategoriserade de enligt faserna av lean byggproduktion. Rapporten utforskade också vilka lean verktyg för planering och styrning av produktion som har antagits av en kommersiell byggentreprenör. För att identifiera leanverktyg i kommersiella byggprojekt så genomfördes en litteraturanalys baserat på de dokument som granskats av Babalola et al. (2019) i deras artikel ‘Implementation of lean practices in the construction industry: A systematic review’. Detta avslöjade 22 olika lean byggverktyg som implementerats i diverse kommersiella byggprojekt, där Last Planner System har rapporterats mest följt av Just in Time och Pull Scheduling. Litteraturanalysen resulterade också i projektleveransstadierna där varje identifierat verktyg hade implementerats. Detta hjälpte att kategorisera verktygen enligt faserna av lean byggproduktion. Faserna definierades av det konceptuella ramverket ’The Lean Project Delivery System’ som Project Definition, Lean Design, Lean Supply, Lean Assembly och Lean Use. Kategoriseringen visade att (utav de 22 identifierade verktygen) 3 verktyg tillhör fasen Project Definition, medan de resterande faserna innefattar 8, 9, 15 respektive 0 verktyg. För att utforska vilka lean verktyg för planering och styrning av produktion som har antagits av en kommersiell byggentreprenör så utfördes en fallstudie av produktionsfasen av ett stort projekt såkallat Projekt X. Sju medlemmar av produktionsteamet intervjuades för att uppenbara entreprenörens arbetsmetoder vid planering och styrning av produktion beträffande tid, aktivitet och logistik. De uppenbarade arbetsmetoderna jämfördes sedan med 9 av de 22 identifierade leanverktygen eftersom just de tolkades som verktyg för planering och styrning av produktion. Denna analys visade att sex av dessa verktyg var till synes implementerade i produktionen av Projekt X, medan en var delvis implementerad och två inte alls implementerade.

The study aims to identify the impact of adopting the program for Centers of Support for Innovation Management (Programa de Núcleos de Apoio à Gestão da Inovação - NAGI) on management control. This descriptive research carried out a survey, having as sample 12 Brazilian companies that joined the program. Data were analyzed using descriptive statistics and information entropy. Results showed that companies started using the researched systems more intensively, especially performance evaluation, strategic planning, contribution margin, simulations and budget. It was found that the companies started to use financial statements for decision-making, and strategic planning became a standard management control practice. The changes in management control practices after introducing innovationsystems in the organizations were consistent with those observed by Sulaiman and Mitchell (2005), especially in planning, control and financial practices. / El estudio tiene como objetivo identificar los efectos causador al adoptar el Programa de Núcleos de Apoyo para la Gestión de Innovación (Programa de Núcleos de Apoio à Gestão da Inovação - NAGI) en las prácticas de controlde gestión. El estudio descriptivo se realizó a partir de una encuesta, con una muestra de 12 empresas brasileñas adheridas al programa. Los datos fueron analizados con estadística descriptiva y entropía de la información. Losresultados muestran que las empresas comenzaron a utilizar más los sistemas investigados, destacándose la evaluación del desempeño, la planificación estratégica, el margen de contribución, simulaciones y presupuesto. Se encontró que las empresas comenzaron a utilizar los estados financieros para tomar decisiones; y la planificación estratégica se ha convertido en una práctica de control de gestión adoptada de forma homogénea. Los cambios ocurridos en el control de gestión después de introducir estas innovaciones en las organizaciones son consistentes con los cambios observados por Sulaiman y Mitchell (2005), especialmente en las prácticas de planificación, control y costeo. / O estudo objetiva identificar os reflexos da adoção do Programa de Núcleos de Apoio à Gestão da Inovação (NAGI) nas práticas de controle gerencial. Pesquisa descritiva foi realizada a partir de um levantamento, tendo como amostra 12empresas brasileiras respondentes do questionário que aderiram ao Programa. Os dados foram analisados com aplicação de estatística descritiva e entropia informacional. Os resultados mostram que as empresas passaram a utilizar com maior intensidade os artefatos investigados, destacando-se a avaliação de desempenho, o planejamento estratégico, a margem de contribuição, simulações e o orçamento. Constatou-se que as empresas passaram a utilizar as demonstrações contábeis na tomada de decisão e o planejamento estratégico tornou-se uma prática de controle gerencial adotada de forma homogênea. Os níveis de mudanças ocorridos nas práticas de controle gerencial com a introdução de inovações nas organizações coadunam com os observados por Sulaiman e Mitchel (2005), em especial nas práticas de planejamento, controle e custeio.