Liderança coaching : questionários de avaliação de percepções de líderes e liderados na enfermagem

Objective : To describe the development, content analysis, and reliability of two questionnaires to assess the perception of nurse leaders, nurse technicians, and licensed practical nurses − coached in the practice of leadership and the relation with the dimensions of the coaching process. Methods : This was a methodological study with a quantitative and qualitative approach, which had the goal of instrumentation in reference to the construction and validation of measuring instruments. The instrument proposition design was based on the literature on leadership, coaching, and assessment of psychometric properties, subjected to content validation as to clarity, relevance, and applicability in order to validate the propositions through the consensus of judges, using the Delphi technique, in 2010. The final version of the questionnaires was administered to 279 nurses and 608 nurse technicians and licensed practical nurses, at two university hospitals and two private hospitals. Results : The Cronbach’s alpha value with all items of the self-perception instrument was very high (0.911). The team members’ instrument of perception showed that for all determinants and for each dimension of the coaching process, Cronbach’s overall alpha value (0.952) was considered quite high, pointing to a very strong consistency of the scale. Confirmatory analysis showed that the models were well adjusted. Conclusion : From the statistical validation we compared the possibility of reusing the questionnaires for other study samples, because there was evidence of reliability and applicability.Objetivo : Apresentar o desenvolvimento, a análise de conteúdo e a confiabilidade de dois questionários para avaliar a percepção de enfermeiros-líderes, técnicos e auxiliares de enfermagem – liderados sobre a prática da liderança e a relação com as dimensões do processo coaching . Métodos : trata-se de um estudo metodológico, de abordagem quanti-qualitativa, que teve como meta a instrumentação que se refere à construção e à validação de instrumentos de medida. A concepção das proposições dos instrumentos foi fundamentada na literatura sobre liderança, coaching e aferição das propriedades psicométricas, submetida à validação de conteúdo quanto a clareza, relevância e aplicabilidade, com o objetivo de validar as proposições por meio do consenso de juízes, utilizando a técnica Delphi, em 2010. A versão final dos questionários foi aplicada a 279 enfermeiros e 608 técnicos e auxiliares de enfermagem em dois hospitais universitários e dois hospitais privados. Resultados : O valor do alfa de Cronbach com todos os itens do instrumento de autopercepção foi muito alto (0,911). O instrumento de percepção dos liderados demonstrou que, tanto para todos os determinantes como para cada dimensão do processo coaching , o valor de alfa de Cronbach total (0,952) foi considerado bastante alto, apontando fortíssima consistência da escala. A análise confirmatória demonstrou que os modelos estavam bem ajustados. Conclusão : Pela validação estatística, comparou-se a possibilidade de reutilização dos questionários para outras amostras de estudo, pois houve evidências de confiabilidade e aplicabilidade.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, EPESciEL

The Benefit of Probabilistic Flood Forecasting on European Scale Results of the European Flood Alert System for 2005/2006

Results of the European Flood Alert System for 2005/2006JRC.H.7-Land management and natural hazard

Liderazgo Coaching: un modelo de referencia para el ejercicio del enfermero-líder en el contexto hospitalario

The objectives of the present study was to evaluate the leadership of nurses by using the coaching strategy as a managerial tool, and identify, measure and analyze the acquisition of competencies from the view of nurse-coaches. This is a descriptive, cross-sectional, exploratory and field study that was performed using a quantitative approach. Situational Leadership was selected as the theoretical framework and the research instrument was submitted to statistical and content analyses and was applied on 11 nurse leaders of a large scale private general hospital located in São Paulo. The results showed that participants gained new knowledge, confirmed the Situational Leadership model as the recognized being a coach leader, with a style that is mainly aimed at tasks and people, according to the situation involved, and pointed out the following skills as determinant of coaches: communication, giving and receiving feedback, assigning and gaining power and having an influence. Finally, the attitudes reflected the practice of coaching.El estudio objetivó evaluar el liderazgo ejercido por enfermeras con uso de coaching como herramienta gerencial, identificar, mensurar y analizar la adquisición de competencias percibidas por enfermeras que actúan como coachs. Estudio descriptivo, transversal, exploratorio, de campo, con abordaje cuantitativo. El Liderazgo Situacional se seleccionó como referencial teórico y el instrumento investigativo fue sometido a análisis estadísticos y de contenido, aplicado a 111 enfermeras líderes en hospital general privado de gran porte de San Paulo. Los resultados evidenciaron que hubo incorporación de nuevos conocimientos, confirmaron el modelo de Liderazgo Situacional al reconocer al líder coach teniendo un estilo predominantemente orientado a tareas y personas, según la situación involucrada, y también indicaron con foco en las habilidades preponderantes del coach: comunicación, dar y recibir feedback, dar y ganar poder y ejercer influencia; que las actitudes reflejaron el ejercicio de liderazgo coaching.O presente estudo teve por objetivos avaliar a liderança exercida pelas enfermeiras com uso do coaching como ferramenta gerencial, identificar, mensurar e analisar a aquisição de competências percebidas pelas enfermeiras que atuam como coaches, Trata-se de um estudo descritivo, transversal, exploratório e de campo, com abordagem quantitativa. A Liderança Situacional foi selecionada como referencial teórico e o instrumento de pesquisa foi submetido a análises estatísticas e de conteúdo, aplicado em 111 enfermeiras líderes em um hospital geral, privado, de grande porte da cidade de São Paulo. Os resultados evidenciaram que houve incorporação de novos conhecimentos, confirmaram o modelo de Liderança Situacional ao reconhecer ser líder coach, tendo o estilo predominantemente orientado às tarefas e às pessoas, segundo a situação envolvida, e ainda, indicaram como habilidades preponderantes do coach: a comunicação, dar e receber feedback, dar e ganhar poder e exercer influência, que as atitudes refletiram o exercício o liderança coaching.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, EPESciEL

Mathematical modeling of pressurized system behaviour with entrapped air

The presence of entrapped air in pressurized hydraulic systems is considered a critical condition for the infrastructure security, due to the transient pressure enhancement related with its dynamic behaviour, similar to non-linear spring action. A mathematical model for the assessment of hydraulic transients resulting from rapid pressurizations, under referred condition is presented. Water movement was modeled through the elastic column theory considering a moving liquid boundary and the entrapped air pocket as lumped gas mass, where the acoustic effects are negligible. The method of characteristics was used to obtain the numerical solution of the liquid flow. The resulting model is applied to an experimental set-up having entrapped air in the top of a vertical pipe section and the numerical results are analyzed

Surge damping analysis in pipe systems: modelling and experiments

The current study focuses on the analysis of pressure surge damping in single pipeline systems generated by a fast change of flow, conditions. A dimensionless form of pressurised transient flow equations was developed. presenting the main advantage of being independent of the system characteristics. In lack of flow velocity profiles. the unsteady friction in turbulent regimes is analysed based on two new empirical corrective-coefficients associated with local and convective acceleration terms. A new, surge damping approach is also presented taking into account the pressure peak time variation. The observed attenuation effect in the pressure wave for high deformable pipe materials can be described by a combination of the non-elastic behaviour of the pipe-wall with steady and unsteady friction effects. Several simulations and experimental tests have been carried out. in order to analyse the dynamic response of single pipelines with different characteristics, such as pipe materials. diameters. thickness. lengths and transient conditions

Computational evaluation of hydraulic system behaviour with entrapped air under rapid pressurization

The pressurization of hydraulic systems containing entrapped air is considered a critical condition for the infrastructure's security due to transient pressure variations often occurred. The objective of the present study is the computational evaluation of trends observed in variation of maximum surge pressure resulting from rapid pressurizations. The comparison of the results with those obtained in previous studies is also undertaken. A brief state of art in this domain is presented. This research work is applied to an experimental system having entrapped air in the top of a vertical pipe section. The evaluation is developed through the elastic model based on the method of characteristics, considering a moving liquid boundary, with the results being compared with those achieved with the rigid liquid column model

Discriminant analysis of patients with primary open-angle glaucoma by color Doppler exam and visual field

PURPOSE: To determine if variables from color Doppler and visual field exam could discriminate normal from glaucomatous eyes. METHODS: Prospectively, 36 patients with primary open-angle glaucoma (glaucoma group) and 20 normal volunteers (control group) were studied. Gender, age, central corneal thickness, intraocular pressure, Octopus automated perimetry global indices (mean defect and loss variance) and several parameters of the color Doppler (peak systolic velocity and resistivity index) were compared between groups. RESULTS: There was no statistically significant difference in age, central corneal thickness and intraocular pressure. Discriminant analysis showed that the variables: resistivity index (RI) in the short posterior ciliary artery (SPCA), mean defect (MD) and loss variance (LV) had presented significant influence for the positive diagnosis of glaucoma. The gotten discriminant function was: -3.637 + 0.109 x MD + 0.028 x LV + 4.325 x RI SPCA. Considering score -1.61, the probability of positive diagnosis of glaucoma was 90%. CONCLUSION: Through discriminant analysis it was possible to identify which of the color Doppler variables that associated to the visual field variables allowed differentiate normal from glaucomatous patients. These variables were: resistivity index in the short posterior ciliary artery, and the visual field variables, mean defect and loss variance.OBJETIVO: Determinar se as variáveis obtidas com exame Doppler colorido associadas às de campo visual são capazes de discriminar olhos normais de olhos glaucomatosos. MÉTODOS: Foram avaliados prospectivamente 36 pacientes portadores de glaucoma primário de ângulo aberto em uso de medicação antiglaucomatosa (grupo glaucoma) e 20 voluntários normais (grupo controle). Analisou-se a distribuição dos grupos quanto ao sexo, idade, espessura corneana central, pressão intraocular, índices globais da perimetria computadorizada Octopus (mean defect e loss variance) e os parâmetros do Doppler colorido (velocidade sistólica máxima e índice de resistência). RESULTADOS: Não houve diferença estatística significativa entre os grupos em relação à idade, espessura corneana e pressão intraocular. A análise discriminante mostrou que as variáveis: índice de resistência (IR) da artéria ciliar curta posterior (ACCP), mean defect (MD) e loss variance (LV) apresentaram influência estatisticamente significativa para o diagnóstico positivo de glaucoma. A função discriminante obtida foi: -3,637 + 0,109 MD + 0,028 LV + 4,325 IR ACCP. A probabilidade do diagnóstico positivo do glaucoma a partir do score -1,61 foi de 90%. CONCLUSÃO: Foi possível identificar através da análise discriminante, quais das variáveis do Doppler colorido que, associados às do campo visual, permitiram diferenciar pacientes glaucomatosos de normais. Essas variáveis foram: índice de resistência da artéria ciliar curta posterior e índices da perimetria computadorizada mean defect e loss variance.Universidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaFondation Ophtalmologique Adolphe Rothschild Le Service d'ImagerieUniversidade Federal do Triângulo Mineiro Faculdade de Medicina Departamento de OftalmologiaUNIFESP, Depto. de OftalmologiaSciEL

The European Flood Alert System EFAS - Part 2: Statistical Skill Assessment of Probabilistic and Deterministic Operational Forecasts

Since 2005 the European Flood Alert System (EFAS) has been producing probabilistic hydrological forecasts in pre-operational mode at the Joint Research Centre (JRC) of the European Commission. EFAS aims at increasing preparedness for floods in trans-national European river basins by providing medium-range deterministic and probabilistic flood forecasting information from 3 to 10 days in advance, to national hydrometeorological services. This paper is Part 2 of a study presenting the development and skill assessment of EFAS. In Part 1, the scientific approach adopted in the development of the system has been presented, as well as its basic principles and forecast products. In the present article, two years of existing operational EFAS forecasts are statistically assessed and the skill of EFAS forecasts is analysed with several skill scores. The analysis is based on the comparison of threshold exceedances between proxy-observed and forecasted discharges. Skill is assessed both with and without taking into account the persistence of the forecasted signal during consecutive forecasts. Skill assessment approaches are mostly adopted from meteorology and the analysis also compares probabilistic and deterministic aspects of EFAS. Furthermore, the utility of different skill scores is discussed and their strengths and shortcomings illustrated. The analysis shows the benefit of incorporating past forecasts in the probability analysis, for medium-range forecasts, which effectively increases the skill of the forecasts.JRC.A.1-Work programme E

Determinant factors of functional status among the elderly

OBJECTIVE: To investigate the impact of health-related demographic and socioeconomic factors, as well as the impact of factors associated to social activity and the subjective health evaluation on the functional status of elderly people. METHODS: A cross-sectional multicentric study was conducted in a representative population sample in the city of São Paulo, Brazil, in 1989. Functional status was evaluated using a scale of activities of personal and instrumental daily living. It was studied as a dichotomous variable: absence of dependency - disability/difficulty in none of the activities in contrast with moderate/severe dependency - disability/difficulty in 4 or more activities. Multiple regression analysis was applied to hierarchically clustered factors. RESULTS: Those with the following features were more associated to moderate/severe dependency: illiterate, retired, pensioner, housekeeper, living in a rented home, age over 65 years, multigenerational family composition, hospitalization in the last 6 months, mental health screening case, no visiting friends, and having a pessimistic perception of his/her own health when compared to their peers. CONCLUSIONS: The identified features associated to moderate/severe dependency suggest a complex net of causes for the declining functional status. However, one can assume that preventive measures directed to specific factors can benefit these population by improving their well-being.OBJETIVO; Investigar a influência de fatores socioeconômicos e demográficos relativos à saúde, bem como os fatores ligados às atividades sociais e à avaliação subjetiva da saúde sobre a capacidade funcional dos idosos. MÉTODOS: Estudo transversal, integrante de estudo multicêntrico, em amostra representativa do município de São Paulo, realizado em 1989. A capacidade funcional foi avaliada através da escala de atividades da vida diária pessoal e instrumental e investigada como variável dicotômica: ausência de dependência - incapacidade/dificuldade em nenhuma das atividades versus presença de dependência moderada/grave - incapacidade/dificuldade em 4 ou mais atividades. Análise de regressão logística múltipla foi aplicada aos fatores hierarquicamente agrupados. RESULTADOS: As características que se associaram com a dependência moderada/grave foram analfabetismo, ser aposentado, ser pensionista, ser dona de casa, não ser proprietário da moradia, ter mais de 65 anos, ter composição familiar multigeracional, ter sido internado nos últimos 6 meses, ser caso no rastreamento de saúde mental, não visitar amigos, ter problemas de visão, ter história de derrame, não visitar parentes e ter avaliação pessimista da saúde ao se comparar com seus pares. CONCLUSÕES: As características identificadas que se associaram à dependência moderada/grave sugerem uma complexa rede causal do declínio da capacidade funcional. Pode-se supor, entretanto, que ações preventivas especificamente voltadas para certos fatores podem propiciar benefícios para o prolongamento do bem estar da população idosa.Secretaria de Estado da Saúde de São Paulo Instituto de SaúdeUniversidade de São Paulo Faculdade de Saúde PúblicaUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

The European Flood Alert System - Part I: Concept and Development

Abstract This paper presents the development of the European Flood Alert System (EFAS), which aims at increasing preparedness for floods in trans-national European river basins by providing local water authorities with medium-range and probabilistic flood forecasting information 3 to 10 days in advance. The EFAS research project started in 2003 with the development of a prototype at the European Commission Joint Research Centre (JRC), in close collaboration with the national hydrological and meteorological services. The prototype covers the whole of Europe on a 5 km grid. In parallel, different high-resolution data sets have been collected for the Elbe and Danube river basins, allowing the potential of the system under optimum conditions and on a higher resolution to be assessed. Flood warning lead-times of 3-10 days are achieved through the incorporation of medium-range weather forecasts from the Deutscher Wetterdienst (DWD) and the European Centre for Medium-Range Weather Forecasts (ECMWF), comprising a full set of 51 probabilistic forecasts from the Ensemble Prediction System (EPS) provided by ECMWF. The ensemble of different hydrographs is analysed and combined to produce early flood warning information, which is disseminated to the hydrological services that have agreed to participate in the development of the system. In Part I of this paper, the scientific approach adopted in the development of the system is presented. The rational of the project, the system¿s set-up, its underlying components, basic principles and products are described. In Part II, results of a detailed statistical analysis of the performance of the system are shown, with regard to both probabilistic and deterministic forecasts.JRC.H.7-Land management and natural hazard