Análisis de roles de trabajo en equipo : un enfoque centrado en comportamientos /

Consultable des del TDXTítol obtingut de la portada digitalitzadaEl objetivo general de la tesis, es aportar una mayor comprensión de los comportamientos de rol que realizan las personas cuando participan en los equipos de trabajo en las organizaciones, y que los investigadores han relacionado con la eficacia del trabajo equipo. La investigación se centra en: I) identificar un conjunto de comportamientos que se dan durante el desarrollo del trabajo en equipo. II) diferenciar los diferentes comportamientos de rol de equipo, III) describir y redefinir estos comportamientos de rol para poder ser observados por cualquier persona que tenga que diseñar o liderar equipos de trabajo. En la primera parte se realiza una revisión del la literatura y del marco teórico del trabajo en equipo, estructurada en cuatro capítulos. En el primer capitulo se realiza una revisión de las diferentes teorías de la organización, para contextualizar lo que supone el trabajo de los grupos, desde una perspectiva critica, en cuanto a los factores que favorecen o inhiben el trabajo en equipo. El capitulo segundo se centra en una revisión de la amplia literatura, que aborda el concepto de equipos de trabajo, la construcción de los equipos, tratando de reflexionar sobre que se entiende por trabajo en equipo. En el capitulo tercero, se analiza el concepto de rol, y se abordan las diferentes teorías acerca de los roles de equipo. Finalmente, en el capitulo cuarto se realiza una revisión acerca de la gestión por competencias, abordando los diferentes modelos propuestos por los investigaciones actuales, para focalizar nuestro interés en la competencia del trabajo en equipo. En la segunda parte se definen las estrategias y el diseño de la investigación, basada en una metodología cualitativa, y de carácter observacional, en un universo de 584 personas que han participado en 22 sesiones de trabajo en equipo, durante el periodo 2000-2005. Para el análisis cualitativo del corpus visual (poco habitual en las ciencias sociales), se ha utilizado una herramienta informática del tipo CAQDAS, más concretamente el Atlas-ti, para la cual, se ha tratado de explicar con el mayor detalle posible, como se ha procedido durante la investigación. La investigación, aporta una plantilla de observación, configurada por 51 comportamientos observables, configurados en nueve roles, que desarrollan las personas, en una dinámica de trabajo grupal y que contribuyen al trabajo en equipo. Para cada uno de estos comportamientos, se realiza una detallada descripción del mismo, y además se facilitan unos ejemplos ilustrativos obtenidos a partir de la investigación. Estos comportamientos se han manifestado, de forma recurrente a lo largo del periodo analizado, con independencia de las personas y de las sesiones de trabajo, por lo que resultan fácilmente observables en un contexto organizacional, incluso por personas no expertas en psicología. Son por tanto unos comportamientos más unívocos, que ofrecen un menor margen de interpretación. Esta plantilla de observación, aporta conocimiento a los profesionales que habitualmente diseñan y lideran equipos, que les permitirá trabajar de forma más eficaz, para aprovechar las contribuciones de las personas trabajando en equipo. En cuanto a la gestión por competencias, la investigación aporta unas evidencias mas claras y cualitativas, respecto de cómo se desarrolla la competencia del trabajo en equipo. Finalmente, la tesis plantea futuras líneas de investigación sobre: la idoneidad de cada uno de estos comportamientos, en las diferentes etapas que atraviesan los equipos; la combinación ideal de roles de equipo en función de las diferentes modalidades de grupos (GTA, Círculos de Calidad, Tasck Force, Comités, etc.); su aplicación dentro Balanced Scorecard (indicadores de efecto) para inducir y evaluar la realización de productos colectivos por parte de los equipos; una investigación más cuantitativa de estos comportamientos en determinadas situaciones y/o tareas.The general aim of the thesis is to contribute to a major comprehension of the behaviours within the roles that people realizes when they take part in work teams within organizations, and to determine what the investigators have related to the efficiency of the work team. The investigation centers on: I) Identifying a set of behaviours that are showed during the development of the work in a team. II) Differentiating the different behaviours of roles within a team. III) Describing and to re-defining these behaviours of roles, so that they can be observed by any person who should have to design or to lead work teams. In the first part a review of the literature and of the theoretical framework of the work in team is made, constructed in four chapters. In the first chapter a review is made of different theories of the organization, to contextualize the work of the group does, from critical perspective taking into account the factors that they favour or inhibit the participants working in a team. The second chapter centers on a review of the vast amount of literature that broaches the concept of work teams and the construction of such teams, trying to reflect on that can be understood by working in a team. In the third chapter, the role concept and different theories over team's roles has been analyzed. Finally, in the fourth chapter, a review is made over the management for competences, approaching the different models proposed by current investigations, to focalize our interest in the competence of work in teams. In the second part, the design and strategies of the research, based on a qualitative methodology, and of character observation of a test group of 584 persons who have participated in 22 sessions of teamwork, during the period 2000-2005. For the qualitative analysis of the visual corpus (not very common in the social sciences), the informatics tool CAQDAS, more correctly the Atlas-ti, has been used, so that an explanation of how the investigation proceeded has been given with as much detail as possible. The research puts forward a template for observations consisting of 51 observable behaviours, formed into nine roles which people develop in a group dynamic and that contribute to teamwork. A detailed description is given for each one of these behaviours. In addition there are some illustrative examples obtained from the research. These behaviours have been demonstrated repeatedly over throughout the analyzed period, separately from the people and the work sessions, so that they can easily be observed in organizational context, even by those who are not experts in psychology. There are, therefore, some beaviours that offer a lesser margin of interpretation. This observation template, provides an understanding for professionals that usually design and lead teams, which will allow them to work more effectively in order to make the most of the contributions from each team member. As for the management of competences, the research provides clearer and more qualitative evidence in relation to how competence develops within a team. Finally, the thesis poses future lines of research on: The suitability of each of these behaviours and the different stages that the teams goes trough; the ideal combination of roles in a team depending on the different modalities of groups (Circles of Quality, Tasks Force, Committees, etc.); its application within Balanced Scorecard (indicators of effect) to induce and to evaluate the realization of collective products on the part of the teams; a more quantitative research of these behaviours in several situations and tasks

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies

[Background]: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. [Objective]: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts.[Design]: We assessed 18,566 participants in the “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality.[Results]: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII).[Conclusion]: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.Supported by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to R.E.; RTIC RD 06/0045, to Miguel A. Martínez-González) and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional (Proyecto de Investigación (PI) 04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, PI13/00462, PI13/00615, PI13/01090, PI14/01668, PI14/01798, PI14/01764), Ministerio de Ciencia e Innovación (Recursos y teconologia agroalimentarias(AGL)-2009-13906-C02 and AGL2010-22319-C03 and AGL2013-49083-C3-1- R), Fundación Mapfre 2010, the Consejería de Salud de la Junta de Andalucía (PI0105/2007), the Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (Generalitat Valenciana Ayuda Complementaria (GVACOMP) 06109, GVACOMP2010-181, GVACOMP2011-151), Conselleria de Sanitat y, PI14/01764 AP; Atención Primaria (CS) 2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011).). Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases