Dissertations / Theses on the topic 'Health gap'
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Whitehead, Margaret. "Bridging the gap : working towards equity in health and health care /." Sundbyberg, 1997. http://diss.kib.ki.se/1997/19970926whit.
Full textBoehler, Christian Ernst Heinrich. "Mind the gap! : geographic transferability of economic evaluation in health." Thesis, Brunel University, 2013. http://bura.brunel.ac.uk/handle/2438/7170.
Full textSamuelsson, Jonas. "Partner age gap and child health in Sub-Saharan Africa." Thesis, Stockholms universitet, Sociologiska institutionen, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-186304.
Full textCourtney, Claire. "The Pleasure Gap: Harnessing Pleasure to Increase Global Condom Use." Scholarship @ Claremont, 2014. http://scholarship.claremont.edu/scripps_theses/354.
Full textMcKenzie, Fiona G. "Health and environmental protection in international trade law : bridging the gap." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/24153.
Full textRoberts, Max T. "Contributors to Wisconsin’s Persistent Black-White Gap in Life Expectancy." DigitalCommons@USU, 2017. https://digitalcommons.usu.edu/etd/6756.
Full textBhandari, Ramjee. "Mind the gap : geographical inequalities in health during the age of austerity." Thesis, Durham University, 2018. http://etheses.dur.ac.uk/12803/.
Full textAlatinga, Kennedy A. "Poverty and access to health care in Ghana: the challenge of bridging the equity gap with health insurance." Thesis, University of the Western Cape, 2014. http://hdl.handle.net/11394/3852.
Full textThis study addresses the issue of the low participation in or enrolment of the poor in Ghana’s National Health Insurance Scheme (NHIS). The low enrolment of the poor in the NHIS is attributed to the difficulty in identifying who qualifies for exemptions from paying health insurance premiums. In an attempt to address this problem, the purpose of this study was, therefore, to develop a model for identifying very poor households for health insurance premium exemptions in the Kassena-Nankana District of Northern Ghana in an effort to increase their access to equitable health care
Jansen, Maria Wilhelmina Jacoba. "Mind the gap: collaboration between practice, policy and research in local public health." [Maastricht] : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=8851.
Full textHoffer, Ga'bor. "Defining and exploring the gap in undertaking essential public health functions in Hungary." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407385.
Full textArnold, Kathryn. "The Clinical Scholar Model| A strategy to bridge the theory-practice gap." Thesis, Florida Atlantic University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3571441.
Full textThe purpose of this study was to evaluate student outcomes following implementation of a clinical scholar model of clinical education in one of four placement sites of a college of nursing grounded in a caring philosophy. The question guiding the study was to determine if the clinical scholar model has an influence on student perceptions and outcomes when used with second-degree accelerated BSN students.
Watson’s Human Caring theory, based on ten caritas processes, serves as the theoretical framework for this study (Watson, 2007). A sequential mixed-methods approach that combined quantitative and qualitative data collection techniques was implemented using a pre-experimental, post-test only design with non-equivalent groups to determine differences between the Traditional Model (TM) and Clinical Scholar Model (CSM) in clinical nursing education.
Participants in this study completed four scales to assess their perception of: 1) caring efficacy using the Caring Efficacy Scale (Coates, 1997), 2) clinical learning environment using the Student Evaluation of the Clinical Education Environment (Sand-Jecklin, 2009), 3) clinical faculty caring through the Nursing Students’ Perceptions of Instructor Caring (Wade & Kasper, 2006), and 4) socialization to the professional role, measured by the Lawler-Stone Health Care Professional Attitude Inventory (Lawler, 1988). T-tests were completed on data to determine differences between CSM and TM students on the scales. Additionally, a focus group of four CSM students was completed, transcribed and analyzed for qualitative themes.
There were no significant differences between CSM and TM students on caring efficacy, overall perceptions of the clinical learning environment, and overall socialization to the professional role. There were significant differences between scores on instructor facilitation of learning, perceptions of instructor caring, compassion, superordinate and impatience for change.
Limitations of this study include low sample size and are partially due to limitations of the class size and low survey participation. Additionally, only CSM students attended a focus group, which prevented comparisons of qualitative feedback between groups. Even with these limitations CSM students scored as well or better than TM students, indicating that the CSM could be a viable model for nursing clinical education.
Richter, Sundberg Linda. "Mind the Gap : exploring evidence-based policymaking for improved preventive and mental health services in the Swedish health system." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-118179.
Full textTollman, Stephen M. "Closing the gap : applying health and socio-demographic surveillance to complex health transitions in South and sub-Saharan Africa." Doctoral thesis, Umeå : Epidemology and Public Health Sciences, Departmet of Public Health and Clinical Medicine, Umeå University, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1909.
Full textYuan, Haige. "Essays on higher education and gender gap in investments in children's health and education." Thesis, University of Leicester, 2018. http://hdl.handle.net/2381/43059.
Full textCordell, Laura Michele Portune. "Bridging the Gap, Transitioning Vocalists from Academia to Career." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1311268981.
Full textOzano, K. A. "Mind the gap! : an investigation into the optimisation of public health skills, knowledge and practices of health workers in Cambodia." Thesis, Liverpool John Moores University, 2017. http://researchonline.ljmu.ac.uk/6975/.
Full textLiu, Chaojie (George), and c. liu@latrobe edu au. "Closing the gap between policy and reality: a study of community health services in Chengdu and Panzhihua." La Trobe University. Public Health, 2003. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050303.102952.
Full textLiu, Chaojie. "Closing the gap between policy and reality : a study of community health services in Chengdu and Panzhihua /." Access full text, 2003. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20050303.102952/index.html.
Full textZeelie, Andrea. "Closing the gap: a review of factors affecting quality improvement interventions at the primary care level." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/14364.
Full textCarney, Caitlin. "Clinical Simulation Laboratories: Bridging the gap between academia and the private care hospital setting." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/honors/41.
Full textMonaghan, Karen R. "Mind the gap| The integration of physical and mental healthcare in federally qualified health centers." Thesis, University of Massachusetts Boston, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3706472.
Full textIn the United States, approximately 50 percent of people experience mental illness during their lifetimes (Cunningham, 2009). However, previous studies estimate that up to 80 percent of people living with a mental illness do not access services (Mackenzie et al., 2007). While there are numerous explanations for such disparity, this study posited that stigma associated with mental illness is a significant contributory factor.
In an attempt to address the gap between prevalence of mental illness and access to services, the Patient Protection and Affordable Care Act (PPACA), 2010 (US Government Printing Office, (a) 2011) mandated that Federally Qualified Health Centers (FQHCs) integrate physical and mental healthcare. This research employed case study methods to examine the implementation of this federal policy in FQHCs, focusing on what role, if any, stigma plays in such implementation. Analyzing data obtained from in-depth interviews and direct observations at two case study sites, as well as key informant interviews, and background information, this research explores the following questions: Does stigma impact the implementation of mental health policy and affect access to treatment in FQHCs for people living with mental illness? And, if stigma does impact mental health policy implementation and access to mental healthcare in FQHCs, how does this occur?
Study findings include: multiple definitions of and approaches for integrating physical and mental healthcare; mental healthcare being subsumed into, rather than integrated with, the medical model; and institutional stigma persisting in the agencies studied, resulting in the reinforcement of exclusionary policies and practices and limited access to mental healthcare for FQHC patients.
Empirical findings inform a new theoretical framework that identifies the role of institutional stigma in mental health policy development and implementation in FQHCs. Policy recommendations include: the adoption of non-stigmatizing practices in FQHCs; the inclusion of a single clear definition of integration within enabling legislation; restructuring of mental healthcare funding streams to facilitate agencies' access to resources; and federally mandated reporting of mental health outcomes to improve FQHC accountability. These recommendations aim to promote the equitable implementation of integration policy within FQHCs and increase access to mental healthcare for those persons in need.
Patel, Suraj Jagdish. "Identification of a gap junction communication pathway critical in innate immunity." Thesis, Massachusetts Institute of Technology, 2010. http://hdl.handle.net/1721.1/62520.
Full textPage 84 blank. Cataloged from PDF version of thesis.
Includes bibliographical references.
The innate immune system is the first line of host defense, and its ability to propagate antimicrobial and inflammatory signals from the cellular microenvironment to the tissue at-large is critical for survival. In a remarkably complex microenvironment, cells are constantly processing external cues, initiating convoluted intracellular signaling cascades, and interacting with neighboring cells to generate a global, unified response. At the onset of infection or sterile injury, individual cells sense danger or damage signals and elicit innate immune responses that spread from the challenged cells to surrounding cells, thereby establishing an overall inflammatory state. However, little is known about how these dynamic spatiotemporal responses unfold. Through the use GFP reporters, in vitro transplant coculture systems, and in vivo models of infection and sterile injury, this thesis describes identification of a gap junction intercellular communication pathway for amplifying immune and inflammatory responses, and demonstrates its importance in host innate immunity. The first section describes development of stable GFP reporters to study the spatiotemporal activation patterns of two key transcription factors in inflammation and innate immunity: Nuclear factor-KappaB (NFKB) and Interferon regulatory factor 3 (IRF3). Stimulation of NFKB-GFP reporters resulted in a spatially homogeneous pattern of activation, found to be largely mediated by paracrine action of the pro-inflammatory cytokine TNFa. In contrast, the activation of IRF3 was spatially heterogeneous, resulting in the formation of multicellular colonies of activated cells in an otherwise latent background. This pattern of activation was demonstrated to be dependent on cell-cell contact mediated communication between neighboring cells, and not on paracrine signaling. The second section describes the discovery of a gap junction intercellular communication pathway responsible for the formation of IRF3 active colonies in response to immune activation. Cell sorting and gene expression profiling revealed that the activated reporter colonies, collectively, serve as the major source of critical antimicrobial and inflammatory cytokines. Using in vitro transplant coculture systems, colony formation was found to be dependent on gap junction communication. Blocking gap junctions with genetic specificity severely compromised the innate immune system's ability to mount antiviral and inflammatory responses. The third section illustrates an application of the gap junction-induced amplification of innate immunity phenomenon in an animal model of sterile injury. Drug-induced liver injury was shown to be dependent on gap junction communication for amplifying sterile inflammatory signals. Mice deficient in hepatic gap junction protein connexin 32 (Cx32) were protected against liver damage, inflammation, and death in response to hepatotoxic drugs. Co-administration of a selective pharmacologic Cx32 inhibitor with hepatotoxic drugs significantly limited hepatocyte damage and sterile inflammation, and completely abrogated mortality. These finds suggests that co-formulation of gap junction inhibitors with hepatotoxic drugs may prevent liver failure in humans, and potentially limit other forms of sterile injury. In summary, this thesis demonstrates the development of novel tools for investigating the spatiotemporal dynamics of cellular responses, describes how these tools were utilized to discover a basic gap junction communication pathway critical in innate immunity, and provides evidence for the clinical relevance of this pathway in sterile inflammatory injury.
by Suraj Jagdish Patel.
Ph.D.
Li, Zehua, and Dan Luo. "A Web- and App- Based Interaction System Bridging the Gap between Patients and Doctors." Thesis, Mittuniversitetet, Avdelningen för informations- och kommunikationssystem, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-22515.
Full textSörlin, Ann. "Health and the elusive gender equality : Can the impact of gender equality on health be measured?" Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-46298.
Full textCrawford, Cecelia L. "Using a collaborative center for integrative reviews and evidence summaries to narrow the education-practice-research gap." Thesis, Western University of Health Sciences, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3557774.
Full textThe overarching purpose of this dissertation project was to design a collaborative center for integrative reviews and evidence summaries (CCIRES) to advance the state of the art and science of nursing knowledge and narrow the education-practice-research gap. The CCIRES program was created as a web-based platform embedded in the Kaiser Permanente Southern California infrastructure. The specific purpose of this project was to implement CCIRES via that infrastructure, and evaluate the implementation, structures, processes, and usability of CCIRES. The Diffusion of Innovations was the theoretical framework, as supported by the Model of Diffusion in Service Organizations and the Colorado Patient-Centered Interprofessional Evidence-Based Practice Model. These theoretical perspectives and models informed the structures and processes for the design, implementation, and evaluation of the CCIRES innovation. The literature captured the history of the education-practice-research gap and the use of translational research to support evidence-based nursing practice. A rigorous methodology involving formative and summative evaluation structured data collection and analyses. Four expert members of CCIRES comprised the sample targeted for voluntary participation in the SWOT web-based survey and construction of a logic model providing the data outcomes. NVIVO was the qualitative software program chosen for SWOT data storage and management. The SWOT analysis identified nine individual themes, with three themes spanning all categories and four themes populating four separate categories. These data results allowed deep examination of the essential core functions needed to achieve CCIRES' goals and succeed as a program. Group consensus during a webinar meeting was the data analysis technique for the construction of the 2012 CCIRES logic model. CCIRES members analyzed the alignment of multiple model components to understand the gaps, commonalities, and interrelated elements needed for a successful academic-service partnership program. Secondary outcomes included increased membership, website design, increased evidence review competencies, development of resources, and tool testing. CCIRES' goal of narrowing the education-practice-research gap facilitates the delivery of meaningful knowledge into the caring hands of professional nurses. CCIRES next bold step is to partner with other influential groups seeking to increase the breadth, depth, and rigor of the evidence. By heeding this call to action, CCIRES can translate, diffuse, and disseminate 21st Century nursing knowledge that has meaning for the two people who seek it and need it most—the nurse and the patient.
Penney, Lauren. "Mind the Gap: The Dynamics and Work of Aging and Caring at Home." Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/301552.
Full textFrankovic, Ivan, and Michael Kuhn. "Access to health care, medical progress and the emergence of the longevity gap: A general equilibrium analysis." Elsevier, 2019. http://dx.doi.org/10.1016/j.jeoa.2019.01.002.
Full textCooper, S. "Prising open the black box : the production of knowledge on the mental health 'treatment gap' in Africa." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2531621/.
Full textChoden, Phuntsho. "Gender gap in household investment : a study on Bhutan." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/52725/1/Phuntsho_Choden_Thesis.pdf.
Full textDelshad, Meti Jennifer, and Mariam Abbas. "Sexuell hälsa och kardiovaskulära sjukdomar – “A Silent Gap”. : - en kvantitativ litteraturöversikt." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-47489.
Full textBakgrund: Kardiovaskulära sjukdomar är några av de vanligaste sjukdomarna runtom i världen. Det är påvisat att det finns en koppling mellan kardiovaskulära sjukdomar och sexuell ohälsa. Den sexuella hälsan är en väsentlig del av individens liv och bör behandlas med respekt utifrån sjuksköterskans ansvarsområde. Syfte: Att beskriva faktorer som påverkar sjuksköterskans arbete med sexuell hälsa för patienter med kardiovaskulär sjukdom. Metod: En kvantitativ litteraturöversikt med induktiv ansats sammanställdes utifrån 13 vetenskapliga artiklar. Resultat: Analysen resulterade i två huvudteman; “Sjuksköterskans perspektiv påverkar” och “Organisatoriska hinder påverkar” som följs av sex subteman; ”Attityder, värderingar och känslor”, “Erfarenhet, kunskap och utbildning”, “Ansvar”, “Patientens ålder och kön”, “Riktlinjer och rutiner” samt “Tidsbrist och prioritering”. Slutsats: Baserat på sjuksköterskor globalt, bör det ske en utveckling kring området sexuell hälsa hos patienter med kardiovaskulära sjukdomar. Det finns flera hinder i arbetet som leder till att området hamnat i skymundan. Negativa attityder, inkompetens, fördomar och organisationsrelaterade faktorer är några av de barriärer som framkommer bland sjuksköterskor.
Enochs, Shannon. "Bridging the Gap between Emotional Trauma Practice Guidelines and Care Delivery in the Primary Care Setting." Thesis, Brandman University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13428017.
Full textWhen patients present with complaints of anxiety or depression, providers in the primary care setting often prescribe anxiolytics or antidepressants without conducting an early emotional trauma or adverse childhood experiences assessment. Several studies demonstrate the link between early emotional trauma (EET) or adverse childhood experiences (ACEs) and the increased risk of anxiety or depression as adults. This Clinical Scholarly Project (CSP) implemented the use of the Adverse Childhood Experience (ACE) Questionnaire with patients who had a diagnosis of anxiety or depression in the primary care setting to increase patient access to resources and align clinical practice with practice guidelines. Participants included eight primary care providers, 30 patients and 21 chart review patients. The CSP utilized a quasi-experimental design to determine if the use of the ACE Questionnaire by patients with anxiety or depression would result in patients receiving more community resources (to include counseling), strengthen the provider-patient relationship, increase provider comfort in discussing ACEs with their patients and result in patients receiving care that was evidence based. Patient sample participants received significantly more resources (M = 8.27, SD = 2.27) than the chart audit sample (M = 0.90, SD = 0.30). Patient sample members received an average of eight resources (M = 8.27) and utilized an average of five resources (M = 5.07). Use of the ACE Questionnaire resulted in more trust in provider-patient relationship by patients (80.0%) and the majority of the provider sample more comfortable discussing ACEs after the project (85.7%).
Gretak, Leal Alyssa P. "A Gap Analysis of Reentry Services for Corrections-Involved Populations in Rural East Tennessee." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/etd/3954.
Full textOberoi, Pankaj. "In vivo physiology of gap junctions between supporting cells in the organ of Corti." Thesis, Massachusetts Institute of Technology, 1999. http://hdl.handle.net/1721.1/85264.
Full textIncludes bibliographical references (p. 188-195).
by Pankaj Oberoi.
Ph.D.
He, Dingsheng. "Connexins 40 and 43 form heteromeric gap junction channels in vascular smooth muscle cells." Diss., The University of Arizona, 1999. http://hdl.handle.net/10150/284991.
Full textHenry, Jade Vu. "Theorising the design-reality gap in ICTD : matters of care in mobile learning for Kenyan community health workers." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10058036/.
Full textRen, Xiaoyuan S. M. (Xiaoyuan Charlene) Massachusetts Institute of Technology. "Mining the gap : pathways towards an integrated water, sanitation and health framework for outbreak control in rural India." Thesis, Massachusetts Institute of Technology, 2017. http://hdl.handle.net/1721.1/111396.
Full textCataloged from student-submitted PDF version of thesis.
Includes bibliographical references (pages 173-176).
The scientific connection between sanitation, water quality and health is well established. However, in the present Indian scenario, monitoring and governance of the three sectors is handled separately. At present, the need to integrate sanitation, water quality, and health is felt during waterborne disease outbreaks such as large-scale diarrhea, typhoid or cholera. Despite the general interest shown for a cross-sector integrated framework in outbreak control, numerous administrative and technical gaps exist preventing the implementation of this framework. This study attempts to address these implementation barriers through the analysis of governing institutions and data integration of large public databases for the selected districts of Gujarat, India. Interagency collaboration barrier is analyzed through a comprehensive institutional analysis on the water, sanitation and health monitoring sectors. The lack of administrative incentive due to the narrow definition of monitoring targets is identified as the primary barrier for collaboration. Districts that already achieved 100% open-defecation-free status are identified as key entry points for potential pilot implementation of an integrated framework. National Informatics Center and Water and Sanitation Management Organization (WASMO) are considered key nodal points for building channels of interagency connections. Data integration and utilization barriers are analyzed through habitation-level matching of the 3 separate monitoring databases - namely, Swatch Bharat Mission (SBM) database for sanitation, Integrated Management Information System (IMIS) database for rural drinking water quality and Integrated Disease Surveillance Programme (IDSP) for outbreak data. The most critical data barrier is the discrepancy between administrative units across the databases, resulting in 25% mismatched habitation data and variables with 30% contradictory data entries. Quality concerns over inconsistent and missing data are also raised, especially for data collected by grassroots workers. A decision support model based on the integrated database is constructed through a Driver-Pressure- State-Exposure-Effect-Action (DPSEEA) framework. A significant correlation is observed between chains connecting sanitation initiatives and water quality. Significant risk factors associated with outbreak occurrence cannot be identified at the current stage. Even though implementing this model is within reach, and doing so promises to offer an efficient tool for integrated governance of the three sectors, incomplete datasets is currently the key barrier to a comprehensive assessment of model effectiveness.
by Xiaoyuan "Charlene" Ren.
S.M. in Technology and Policy
Wang, Yunmei. "Bridging the medical knowledge and practice gap: antecedents of successful scientist-physician collaboration." Case Western Reserve University School of Graduate Studies / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1396616643.
Full textSaleh, Mahvash. "A collaborative model to assist in bridging the gap between nursing education and nursing service in Iran." Thesis, Glasgow Caledonian University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241883.
Full textAnderson, LaKesha Nichole. "Bridging the Gap between Medical Science and Communication: An Interpretive Analysis of Messages Portrayed on Endometriosis Websites." [Johnson City, Tenn. : East Tennessee State University], 2004. http://etd-submit.etsu.edu/etd/theses/available/etd-0329104-223652/unrestricted/AndersonN041204.pdf.
Full textTitle from electronic submission form. ETSU ETD database URN: etd-0329104-223652. Includes bibliographical references. Also available via Internet at the UMI web site.
Abrams, Widdicombe Aimee Samantha. "State-Provided Paid Family Leave and the Gender Wage Gap." Scholarship @ Claremont, 2016. http://scholarship.claremont.edu/scripps_theses/792.
Full textDiamond-Caravella, Monica L. Diamond-Caravella. "Reopening a Dialog on Open Airways for Schools: Closing the Educational Gap Using a Multi-Site Academic-Practice Partnership." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1512210590712455.
Full textMolnar, Frank J. "The development of "clinically sensible" tools to screen for cognitive impairment in community-dwelling elderly persons. Bridging the gap between research and clinical practice by balancing discriminant ability vs. practicality." Thesis, University of Ottawa (Canada), 2001. http://hdl.handle.net/10393/9434.
Full textKołtowska-Häggström, Maria. "Quality of Life in Adult Patients with Growth Hormone Deficiency : Bridging the gap between clinical evaluation and health economic assessment." Doctoral thesis, Uppsala University, Department of Pharmacy, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8353.
Full textThe goals of this thesis are to evaluate quality of life (QoL) in adult patients with growth hormone deficiency (GHD) in relation to population normative data, to construct a preference-weighted index (utility) from a disease-specific QoL measure and to assess it in a clinical context.
The study included samples from the general population and patients with GHD from four European populations: England & Wales, the Netherlands, Spain and Sweden. The country-specific patient cohorts were retrieved from KIMS (Pfizer International Metabolic Database).
A questionnaire was developed that contained items from existing QoL questionnaires including, among others, Quality of Life Assessment in Growth Hormone Deficiency in Adults (QoL-AGHDA) and the EQ-5D. The QoL-AGHDA is a disease-specific measure for use in adults with GHD. The EQ-5D is a generic instrument which describes health states for which country-specific preference-based weights are available. Thus, it was possible to generate preference-weighted indices (utilities) based on data generated by both instruments.
This thesis reports QoL-AGHDA normative values for the populations of England & Wales, the Netherlands, Spain and Sweden, and confirms the extent of QoL impairment in patients with GHD in comparison with the general population. Long-term GH replacement resulted in sustained improvements in overall QoL towards normative country-specific values, as well in most of the dimensions that were impaired before treatment.
For use in health economic evaluations, models for generating utilities (QoL-AGHDAutility) from QoL-AGHDA were developed. It is believed that these models may facilitate medical decision making, given that they provide a tool for obtaining utilities in the absence of directly collected preference-weighted indices.
QoL-AGHDAutility effectively monitored treatment effects in patients with GHD. Moreover, this study confirmed a QoL-AGHDAutility deficit before treatment and a gain after starting GH replacement.
The novel aspect of the present approach was to apply preference-weighted indices derived from a disease-specific measure to assess QoL in the clinical context, together with patient demographic and clinical characteristics. The robustness of this analysis is reinforced by the fact that utilities in both general and patient populations were generated using the same methodology.
Kołtowska-Häggström, Maria. "Quality of life in adult patients with growth hormone deficiency : bridging the gap between clinical evaluation and health economic assessment /." Uppsala : Acta Universitatis Upsaliensis, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8353.
Full textNjozing, Barnabas N. "Bridging the Gap : implementing tuberculosis and HIV/AIDS collaborative activities in the Northwest Region of Cameroon." Doctoral thesis, Umeå universitet, Institutionen för folkhälsa och klinisk medicin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-43847.
Full textIntroduction L’épidémie du virus de l’immunodéficience humaine (VIH) a conduit à une augmentation globale de la tuberculose(TB), particulièrement dans les régions à forte prévalence du VIH. Il y’avait par le passé un manque de coordination tant sur le plan mondial que national, des programmes de lutte contre la TB et le VIH pour freiner les effets dévastateurs liés à la co-infection des deux pathogènes. Cependant, l’initiative pilote “ProTEST” conduite en 1997 en Afrique sub-saharienne a démontré que les programmes de lutte contre le VIH et la TB pouvaient collaborer avec succès en combinant leurs services. Cette étude pilote a inévitablement incité a un changement de politique du bureau intérimaire a l’Organisation Mondiale de la Santé (OMS), de lutte contre le VIH/TB à mettre sur pieds en 2004 des objectifs pour la réduction de l’impact du VIH/TB parmi les populations atteintes des deux infections. Cette thèse explore comment la collaboration entre les activités des programmes de lutte VIH/TB a été établie au Cameroun, et comment son application se fait dans la région du nord ouest. Il est également mis en exergue et les réalisations les difficultés que rencontrent les services combinés lors de la dispensation des soins aux malades de TB avec une coïnfection au VIH. Méthodes L’étude a été faite dans la région du nord ouest, une des 10 régions du Cameroun, avec le taux de prévalence au VIH le plus élevé. L’étude utilise le système de recherche en santé combinant des méthodes qualitatives et quantitatives pour explorer les objectifs de la recherche. Les méthodes qualitatives ont été utilisées pour enregistrer les données suivantes: i) centre offrant les services combinés; les personnes en charge au niveau central, régional, et des districts, qui sont responsables de l’intégration au processus et qui d’autre part veillent a ce que les malades de TB bénéficient des services du VIH ; et ii) les malades de TB qui considèrent le dépistage du VIH comme porte d’entrée dans les services VIH. Des méthodes quantitatives ont été utilisées pour confirmer l’accès des malades de TB aux soins de services VIH offerts par la collaboration. Résultats L’étude a démontré que bien qu’il y ait plusieurs niveaux de collaborations entre les programmes de VIH et TB depuis le sommet jusqu’ à la base du système de santé, la provision de services combinés est faisable. Malgré les difficultés rencontrées par les malades de TB pour avoir accès au dépistage du VIH, l’application en somme de la collaboration des activités entre les programmes de VIH et de TB a augmenté l’acceptation et l’accessibilité des malades de TB aux services de VIH. Ceci fut facilité par l’amélioration de la coopération au niveau des opérations des deux programmes permettant ainsi la facilitation de l’établissement d’une alliance entre le personnel de soin et le patient, alliance qui fut primordiale dans l’élaboration du rapport de confiance que le malade doit avoir à l’endroit du system de santé. La collaboration a également conduit à un travail d’équipe et une formation croisée entre les équipes des deux programmes, il a été également établi une amélioration du réseau d’échange entre les personnels de soins et toutes personnes actives dans le secteur du VIH et TB. Néanmoins, il a été relevé des défis dans le système de santé telle une insuffisance dans le leadership et la gestion de fréquente interruption dans la chaine de distribution des médicaments essentiels et du matériel de laboratoire. Conclusion La collaboration des activités des programmes VIH/TB a amélioré la qualité des soins et services avec pour résultante une meilleure accessibilité des malades de TB aux services de VIH. Néanmoins, une conduite appropriée qui garantie une planification mixte, une évaluation et un suivi des activités essentielles, ainsi qu’une gestion fiable a tous les niveaux du système de santé est indispensable. Outre, les difficultés liées au système de santé identifiées par cette étude et qui méritent une évaluation, du fait qu’elles pourraient affecter négativement l’application effective du but recherché et la collaboration durable entre les deux services.
Munodawafa, Memory Nyasha Lynnette. "Filling the gap: development and qualitative process evaluation of a task sharing psycho-social counselling intervention for perinatal depression in Khayelitsha, South Africa." Doctoral thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29776.
Full textBjärntoft, Sofie. "Uppfattningar kring hälsofrämjande ledarskap : En mixad studie om jämförelsen mellan första linjens chefers och medarbetares uppfattning av hälsofrämjande ledarskapsaspekter och dess relation till medarbetarnas välbefinnande." Thesis, Högskolan i Gävle, Avdelningen för arbets- och folkhälsovetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-21737.
Full textAim: Based on the concept of health promotion leadership, the purpose is to examine how the first-line managers perceive their own leadership in comparison to employees' perceptions of the leadership, and whether this relates to employee well-being at work. Methods: This study is a recess of the project GodA and it’s based on a cross-sectional design with both quantitative and qualitative methods. To make a comparison between managers and employees perception of leadership, a selection of survey questions from GodA was used. The manager’s valuation of the health promotive leadership aspects were examined through semi-structured interviews. Main results: The results shows that there was a wide perception of health promotive leadership among managers. Although it can be interpreted that the managers work from the health promoting leadership aspects, there was a gap between the manager and employee perception of leadership. In half of the groups there was a significant difference. There was also a positive significant correlation between gap and employee well-being, then a larger gap resulted in a lower estimated well-being. Summary: Previous research shows that managers often overrate their leadership and a gap can affect employee well-being. It is therefore important to further investigate what the differences between the manager and the employees can depend on and how the gap can be reduced. It is also important to create a clear definition of a health promotive leadership in order to develop health promotion strategies at work.
Adams, Ubanesia Lolita. "Reinterpreting the implementation gap : a case based analysis of District Health System implementation in the Western Cape Province in South Africa." Thesis, University of Sussex, 2011. http://sro.sussex.ac.uk/id/eprint/6921/.
Full textPhan, Vernon Truong. "The Ras-GAP proteins Ira2 and neurofibromin are negatively regulated by ubiquitin-associated proteins Gpb1 in yeast and ETEA/UBXD8 in human cells." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3297797.
Full textSWAISGOOD, ERIN K. "A STUDY OF THE RANDOM GAP DETECTION TEST-A TEST USED TO IDENTIFY DISORDERS OF AUDITORY TIMING." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin990633500.
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