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1
Backhouse, Peter. "Medical knowledge, medical power : doctors and health policy in Australia /." Title page, contents and abstract only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09phb126.pdf.
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Patterson, Jan. "Consumers and complaints systems in health care /." Title page, contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09PH/09php3174.pdf.
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Click, Ivy A., Abbey K. Mann, Morgan Buda, Anahita Rahimi-Saber, Abby Schultz, K. Maureen Shelton, and Leigh Johnson. "Transgender Health Education for Medical Students." Digital Commons @ East Tennessee State University, 2019. https://doi.org/10.1111/tct.13074.
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Background Transgender individuals face numerous health disparities and report negative experiences with health care providers related to their gender identity. Significant gaps in medical education regarding transgender health persist despite calls for increased sexual and gender minority content. The purpose of this student‐led study was to assess the effectiveness of a half‐day educational intervention on first‐ and second‐year medical students’ attitudes and knowledge of transgender health. Methods Students and faculty members collaborated to develop an educational session on transgender health. This content was presented to first‐ and second‐year medical students at Integrated Grand Rounds, a pedagogical method in which basic science and clinical faculty members co‐present didactic content interspersed between live patient interviews and student‐led small group discussions. Student participants (n = 138) completed voluntary 9‐item pre‐ and post‐session surveys assessing comfort with and knowledge of transgender medicine. Results Students’ comfort with and perceived knowledge about transgender patients increased significantly between pre‐ and post‐test. Students’ knowledge of transgender medicine standards of care also improved, though not all items reached significance. Discussion A half‐day educational intervention improved many facets of medical students’ attitudes and knowledge about transgender patients. The significant disparities in physical health, mental health and access to care currently experienced by transgender persons in the United States warrants the continued testing and refinement of educational interventions for future and practising providers.
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Sinclair, Andrew James, and n/a. "The primary health care experiences of gay men in Australia." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060713.084655.
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The present research, consisting of two studies, was designed to examine the
primary health care experiences of gay men in Australia and assess doctors? attitudes and
training with regard to gay men and their health care. In the first study, 195 gay men were
surveyed regarding their health issues and their primary health care experiences. The
most important health concerns of gay men were stress and depression followed by
HIV/AIDS, body image disorder and other sexually transmissible infections. Including
those participants who were unsure, approximately one-half reported experiencing
homophobia and almost one?quarter reported experiencing discrimination in the
provision of health care. Despite this, respondents were generally satisfied with their
primary health care, although respondents felt that all GPs should receive additional
undergraduate medical education regarding gay men?s health. In the second study, 25
doctors (13 gay specialists and 12 non-gay specialists) were surveyed regarding their
knowledge of gay men?s health and their comfort working with gay men. Non-gay
specialist GPs were less comfortable treating gay men, reported poorer communication
and were more homophobic than their gay specialist counterparts. Further, doctors
perceived their medical education regarding gay men?s health has been inadequate.
Together, the results of the two current studies suggest that disclosure of sexuality is an
important issue for both gay men and doctors, and has the potential to impact on the
quality of health care that gay men receive. In order to improve the level of disclosure,
the pervasiveness of homophobia and discrimination in primary health care must be
reduced. Finally, the results indicate that medical education must be updated to reflect
current knowledge regarding the health issues of gay men. Failure to address these issues
will condemn gay men to continued health inequality.
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Brummitt, Rosalind Barbara. "Two health worlds : Aboriginal medical transfers from Central Australia to Adelaide /." Title page, contents and abstract only, 1987. http://web4.library.adelaide.edu.au/theses/09AR/09arb893.pdf.
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McGuiness, Clare Frances. "Client perceptions : a useful measure of coordination of health care." View thesis entry in Australian Digital Theses Program, 2001. http://thesis.anu.edu.au/public/adt-ANU20020124.141250/index.html.
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Blavos, Alexis Angela. "Medical Marijuana: The Impact on College Students." University of Toledo / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1439298235.
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O'Keefe, Maree Frances. "Maternal perspectives of child health consultations by medical students." Title page, contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09pho4121.pdf.
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"June 2002" Errata inside back cover. Bibliography: leaves 244-256. The first aim of this thesis was to determine the relationship between medical student clinical competence and patient-centredness, and maternal satisfaction and subsequent recall of information in child health consultations. The second aim was to test the application of this knowledge in medical student teaching programmes. The study demonstrated the ability of mothers to assess the clinical competence and patient-centredness of medical students in videotaped consultations. Applications in medical student learning were also developed and evaluated.
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Knight, Jason Anthony. "An Anatomy Based Health Education Curriculum Taught by Medical Students May Improve High School Students Health Knowledge." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-110025/.
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To date, few high school based interventions have been shown to have lasting effects on adolescents' health behaviors. The need for health interventions targeting adolescents is underscored by data showing that several health behaviors with significant short and long term adverse effects begin in early adolescence and become progressively more prevalent toward late adolescence. This project tested the efficacy of a novel anatomy based health education curriculum at increasing health knowledge. The course was taught by first year Yale medical students. The curriculum placed emphasis on nutrition, physical activity and infectious disease. Forty Juniors from Career High School visited Yale's anatomy lab once every two weeks for ten hour-long sessions. In addition to visits to the anatomy lab, students completed two class projects, one covered nutrition and the other focused on exercise. Four additional sessions at Career High School were dedicated to the class projects. Pre and post test analysis showed an improvement in health knowledge with a thirteen percentage point improvement on a standardized health knowledge survey. The students' performance was compared to a control cohort of thirty-one students who were not exposed to the curriculum. Students exposed to the curriculum had a nineteen percentage point advantage compared to control students who had not been exposed. Curriculum efficacy as demonstrated by this small cohort validate further testing with larger cohorts and more vigorous controls as well as separate testing to measure changes in health behavior attributable to curriculum exposure.
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Loh, Shi Lin. "Irradiated Trajectories: Medical Radiology in Modern Japan." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493463.
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This dissertation examines the history of modern Japan via a study of rentogen, or X-rays, in medical practice. Conventional milestones in Japan’s encounters with nuclear science all date from 1945: the atomic bombings of Hiroshima and Nagasaki that same year, the Bikini Atoll fallout incident in 1954, the construction of nuclear power plants from the late 1950s onwards, and most recently, the Fukushima Daiichi meltdown in 2011. All these events produced hibakusha – the Japanese term for survivors of nuclear-related accidents, or people suffering the effects of exposure to ionising radiation.
In contrast, this project locates the first hibakusha in an earlier period, revealing a history of radiation exposure in Japan before the atomic bombings. It reaches into the late nineteenth and early twentieth centuries to find Japanese bodies exposed through the development of radiology. In modern Japan, as in Western Europe and America, X-rays constituted the first source of ionizing radiation that produced victims of burns, cancers, and deaths. This study highlights the political, social and cultural impact of modern Western medicine on Japanese society from the Meiji period onwards, showing how electric-powered machines and Western expertise came to define medical practice in the emergent field of radiology.East Asian Languages and Civilizations
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Riordan, Geraldine M. "Triage in Health Department of Western Australia accident and emergency departments." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1995. https://ro.ecu.edu.au/theses/1182.
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A survey of triage systems used in Health Department of Western Australia accident and emergency departments was undertaken to examine differences in practices between departments with and without designated triage nurses (TNs). One questionnaire surveyed 93 nurses in seven departments with TNs, a similar second questionnaire surveyed 89 nurses in 16 departments without TNs, and a third questionnaire was used in a structured telephone interview of receptionists in hospitals without TNs. Data were analysed using frequencies, percentages, means, standard deviations and ranges with common themes identified for open ended questions. The study was guided by Donabedian's systems evaluation model. The structures and processes of triage within each department were examined in relation to the outcome standards recommended by the Australian Council on Healthcare Standards. The study results revealed that triage nurses were employed in all departments where patient attendances exceeded 300 per week and nursing staff coverage in the department was higher than five per day. Three departments had introduced triage on weekends only, and these departments had the lowest nurse-patient ratio of one nurse per day to 74 patients per week. The highest nurse-patient ratio was in departments with TNs (1-35). Conclusions drawn from the findings suggest that when receptionists are the first person to see patients, they triage patients using an unsatisfactory two category priority system. The average waiting time to see nursing staff is too long in departments without TNs, 7.6 minutes, as compared to 3. 7 minutes in department with TNs. Nursing staff perceived that triage systems could be improved by having only experienced staff as the triageur. The surveillance of patients entering the department is unsatisfactory as 81% of departments without TNs and 43% of departments with TNs are unable to provide nurse surveillance. The surveillance of the waiting room is similarly unsatisfactory in many departments. All triage areas are inadequate, as facilities for private conversation, hand washing and physical assessment are not always available. The majority of departments without TNs do not have a satisfactory triage priority category system in place. The average time taken by nursing staff to triage patients is an acceptable 3.2 minutes in departments with TNs, and 5.3 minutes in departments without TNs. The practice of redirecting patients away from the department could compromise patient safety as patients are redirected away from most departments by any level of staff employed in the department, without any written documentation kept or any written criteria for the redirection of these non-urgent patients. The practice of ordering investigations and treating minor problems without referring to a doctor could also compromise patient safety, as most departments do not have written policies and guidelines to cover this practice. Most departments offer an inadequate triage training program of preceptoring only. Recommendations are focused on the reviewing of existing triage practices to comply with the standards identified.
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Poldre, Peeter Antonio. "Collaboration in health care, medical students' perceptions, observations and suggestions." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0012/NQ35412.pdf.
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Augustincic, Polec Lana. "Global Health Competency Skills: A Self-assessment for Medical Students." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23275.
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Global health is an emerging concern in a rapidly changing world in which health issues transcend international borders. This study developed and validated a new self-report questionnaire to assess self-perceived global health competencies among international medical students and how they are influenced by international clinical experiences. A tool consisted of two scales and four subscales with moderate internal consistency. Comparisons between participants who completed retrospective pretest (after the intervention retrospectively) and those who completed traditional pretest (before the intervention) revealed that those participants who completed the questionnaires retrospectively provided lower pretest scores, suggesting that response-shift bias had occurred. Significant increases in scores after international clinical experience were reported for the majority of global health competency measures in IFMSA group. Linear regression identified participant’s age, gross national income (GNI) of country of medical studies, GNI of the country visited, duration of international clinical experience and years of medical school completed, as significant predictors of global health scores. This study contributes valuable information about the newly developed global health competencies measurement tool.
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Eisenbrandt, Lydia L., Jill D. Stinson, and Carrie C. LeMay. "Mental Health Training for Medical Students: Implications for Integrated Care." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7945.
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Ramsay, Lourina. "Investigating third year medical students' racial and mental health attitudes." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/18513/.
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Objective: To develop a current understanding of the differences in how physicians communicate with Black and Minority Ethnic (BME) patients in comparison to non-BME patients. Methods: Systematic searches of electronic databases and references lists were performed. Data from the included studies were extracted in line with the review’s aims, and the studies’ quality was assessed using a standardised criteria. Results: Sixteen studies were included. The results indicated that physicians communicated differently with BME patients compared to non-BME patients as a consequence of patients’ race. Physicians were found to show less participative and affective behaviours towards BME patients and black patients received more information giving behaviours than other ethnicities. Additionally, BME patients displayed less conversational behaviours in comparison to non-BME patients. Studies have also begun to relate other culture related variables to communication but their relationship was less established. Conclusion: While physicians’ communication behaviours varied across patients’ race, there still continues to remain a gap in relation to the literature base being able to sufficiently explain, (a) how race exerts its effect on physician communication and (b) what other variables can account for the differences in physicians’ communication. This gap may reflect the complexity of communication and the measures used. The review firstly reinforces the need for a diverse workforce and the necessity to incorporate affective dimensions of communication in physicians’ cultural communication training, and secondly, calls for future research to expand explanations beyond patients’ race.
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Solomon, Clifford E. "Evaluating spatial abilities in health sciences students /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7680.
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Wollin, Judy A. "A comparative study of aspects of health care valued by residents with multiple sclerosis and staff at a residential setting." Thesis, Queensland University of Technology, 1993. https://eprints.qut.edu.au/36811/1/36811_Digitised%20Thesis.pdf.
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This research was undertaken in response to the implementation of a program of de-institutionalisation under the auspices of the Disability Services Act 1986, involving people with Multiple Sclerosis {MS) . The impact of de-institutionalisation on people with MS has not been researched before in Australia.
The aim of the research was to identify and compare aspects of health care valued by people with Multiple Sclerosis and staff at an assisted accommodation unit in suburban Australia.
The research participants included the residents and staff of a residential centre for people with MS. Elements of quantitative and qualitative research methods were used. Data were collected using unstructured interviews and sequential questionnaires. These data were analysed using recurrent theme identification technique.
The research shows that the current program of deinstitutionalisation has resulted in changes affecting both residents and staff. The findings of the research were similar for both groups, who wish to see the Centre remain as much as possible as it is, with in-house services continued. Changes resulting in the abolition or reduction of services are not supported by either group.
While the overall objectives of the Disability Services Act 1986 are supported by residents and staff, the major conclusion of the study is that its implementation should more closely reflect the needs of people with MS already living in an assisted accommodation unit.
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Conroy, Sherrill. "Moral inclinations of medical, nursing and physiotherapy students." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367447.
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Williams, Rachel. "Sharps Injuries in Medical Training: Higher Risk for Residents Than for Medical Students." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3409.
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Because of their relative inexperience in performing procedures and handling sharps devices, medical students and resident physicians are considered to be at high risk for sharps injuries. A higher rate of sharps injuries for medical trainees implies a higher risk for occupationally-acquired infection with bloodborne pathogens and may have financial and legal implications for training institutions. This study examines the prevalence of sharps injuries among US medical students and resident physicians. A systematic review of the literature yielded 10 studies that gave data on sharps injuries for US medical students or residents, and those data were combined with data from our institution to produce pooled prevalences. Results from our institution showed that residents had a significantly higher risk of sharps injuries than medical students. While sharps injuries increased with students' years of training, residents' rates decreased with increasing level of training. Resident rates were highest in the department of Surgery and lowest for Pediatrics. Comparing pooled prevalences of US trainees revealed that residents were 6 times more likely than medical students to have a sharps injury. This information can be used by training programs to inform changes in residency training curricula and infection control policies, as well as to forecast Worker's Compensation and long-term disability insurance coverage requirements. Medical training institutions must continue to provide opportunities for students and residents to perfect their procedural skills, but at the same time, trainees must be protected from the risk of sharps injuries and exposure to bloodborne pathogens.
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Miller, Molly Rae. "College Students’ Perceptions of the Impact of Volunteering in a Medical Center." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1383066125.
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Sorensen, Ros Public Health & Community Medicine Faculty of Medicine UNSW. "The dilemma of health reform : managing the limits of policymaking, managerialism and professionalism in health care reform." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/33194.
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Hospitals worldwide are under pressure to perform and models abound to remedy poor performance. Reform, however, is contested, uneven and slow. One reason is that few models address a core issue in reform: the management of clinical work. A further reason is that stakeholder groups, specifically policymakers, managers and clinicians, limit opportunities for collaborative problem solving as they seek to impose their own frame of reference in the struggle for control. I hypothesise that performance will be relatively better in hospitals that have in place strategies of agreement to set the objectives of reform, such as participative problem identification, problem solving and decision making, together with a method to manage clinical work. This hypothesis was tested in twelve public hospitals in three Australian states between 1999 and 2001 using both quantitative and qualitative research methods. Government and hospital policy documents were assessed and semi-structured interviews were conducted to gauge the attitudes and practices of managers and clinicians regarding health care reform. The results of the research show that hospitals with inclusive strategies for change, principally strategies of agreement, joint education and skills development, team-based incentives to direct and reward effort and a method of clinical work management, performed better than those without. Findings indicate that policy was developed and communicated as a rational top-down process that tended to exclude diverse views. Although the effect of different jurisdictional policy processes on hospital performance was not clear, they had considerable impact on the environment of reform. Cost containment and patient safety dominated as policy objectives. These alone did not engage clinician interest or address service quality. The connection between the quality of care and its cost did not appear to be understood. Organisational structures and processes necessary to support reform, that is communication forums for objective setting and performance review, integrated clinical and corporate accountability systems and organisational capacity building were not in place in the majority of hospitals studied. An organisational model of clinical work management was developed to improve cost-effectiveness by balancing clinical autonomy and clinical accountability based on the research results.
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Howard, Morgan, Gina Botsko, and Taylor Harris. "Utilizing Medical Simulation as Exposure to Ignite Interest in the Medical Field for High School Students from Rural Appalachia." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/2.
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Around 20% of America’s population lives in rural communities; however, only 9% of all physicians practice within these rural areas. Consequently, there is a consistent shortage of healthcare resources for these populations.1 To help this shortage, medical institutions should reach out to their local youth because a majority of the physicians who practice medicine in rural areas experienced their childhood in similar communities.2,3 The simulated Medicine in Action camp at Quillen College of Medicine provided an opportunity for local, rural high school students to learn more about the healthcare field in the hopes of eventually playing a role in alleviating the rural healthcare deficiencies.
Twenty-one high school students from rural Appalachia with an interest in the healthcare field were recruited by the Simulated Medicine in Action camp to participate in a five-day medical simulation experience developed by the Quillen College of Medicine Center for Experiential Learning. The program employed interactive simulation platforms to provide education to students about various aspects of patient centered care, including communication skills, physical exam skills, technical skills, and integrative clinical reasoning skills. Through a lecture followed by simulation format, students exercised real world medical skills to assess, diagnose, and treat their “patients” in clinical scenarios. This format challenged the students to work as a team and provided students with the opportunity to experience the role of medical professionals. The curriculum also provided students with the opportunity to listen to a panel of physicians as well as a panel of other healthcare professionals to provide exposure to the breadth of the healthcare.
Participants completed two surveys using the Likert scale: an entrance survey on the first day of camp and an exit survey on the final day. The likert scoring scale is as follows: 5=strongly agree, 4=agree, 3=neutral, 2=disagree, and 1=strongly disagree. Students responded to the following prompts in both of the entrance survey and the exit survey: (1) I have had enough exposure to the medical field to know that I am interested or not interested in the field; (2) If I decide that I want to be a physician, I believe that I am capable of achieving that goal; (3) If I decide I want to be a physician, I think I know enough about the educational process to pursue that career. Entrance survey had an average of 3.8, 4.5, and 3.7 respectfully. Exit survey had an average of 4.2, 4.7, 4.2 respectfully.
Students also responded to the following prompts exclusively in the exit survey with the respected results: The Simulated Medicine in Action Camp improved my desire to pursue a career in healthcare (4.8); The Simulated Medicine in Action Camp improved my desire to become a physician (4.5); The Simulated Medicine in Action Camp improved my desire to pursue further education (4.7).
Due to the upward trend and the high Likert scores in the exit survey, we conclude that using medical simulation experience with hands on opportunities and exposure to healthcare providers both clarifies and increases interest among high school students in regards to entering the healthcare field. We hope that this interest propels them into their careers where they may potentially serve their local rural community.
References:
1Rosenblatt, R. A., & Hart, L. G. (2000). Physicians and rural America. The Western journal of medicine, 173(5), 348–351. doi:10.1136/ewjm.173.5.348
2Easterbrook, M., Godwin, M., Wilson, R., Hodgetts, G., Brown, G., Pong, R. and Najgebauer, E. (2019). Rural background and clinical rural rotations during medical training: effect on practice location. [online] CMAJ. Available at: http://www.cmaj.ca/content/160/8/1159.short [Accessed 18 Sep. 2019].
3Feldman, Kymm, et al. "The difference between medical students interested in rural family medicine versus urban family or specialty medicine." Canadian Journal of Rural Medicine, vol. 13, no. 2, 2008, p. 73+. Gale Academic Onefile, Accessed 18 Sept. 2019.
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Jotterand, Fabrice 1967. "Does virtue ethics contribute to medical ethics? : an examination of Stanley Hauerwas' ethics of virtue and its relevance to medical ethics." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33292.
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The aim of this thesis is to examine the concept of virtue ethics in Stanley Hauerwas's understanding of virtue and delineate how that contributes to his ethical reasoning and his comprehension of medical ethics. The first chapter focuses on the shift that occurred in moral theory under the stance of the Enlightenment that eroded the traditional idea of morality as the formation of the self, allowing space for new concepts that dismissed the importance of the agent in the ethical task of seeking the good. In the second chapter, the three main ideas (character, vision, and narrative) that make up Hauerwas' ethical theory are examined with a particular attention to the importance of agency in moral life. The third chapter describes how Hauerwas' medical ethics, informed by his moral theory based on character, vision, and narrative, is relevant to medical ethics. Hauerwas argues that because medicine is a form of human activity with internal goods and standards of excellence intrinsic to its practice, it requires taking into account the notion of agency in the healing relationship. Finally, in the last chapter the specific religious discourse of Hauerwas' ethics is discussed in relation to secular medical ethics. In other words, this thesis raises the question of whether the reduction of medical ethics to a set of principles, as it is mostly the case today, represents a suitable picture of the reality of moral life in medicine.
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van, Vliet Helen E. Psychiatry Faculty of Medicine UNSW. "Mental health prevention: design and evaluation of an internet-delivered universal program for use in schools with adolescents." Awarded by:University of New South Wales. School of Psychiatry, 2007. http://handle.unsw.edu.au/1959.4/31899.
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This research describes the design and evaluation of an internet-based universal program for use in schools with adolescent students to prevent common mental disorders and promote mental health. The research began in response to investigations that showed that rates of mental illness in Australian children, teenagers and adults were high, that these illnesses caused significant burden to individuals and society, and that there were insufficient services to treat. When current interventions are unable to alleviate disease burden it is important to focus on prevention. Mental health prevention should target youth before disorders cause disability and restriction of life choices. A review of the mental health prevention literature supported a universal cognitive behavioural approach in schools. Internet delivery was used to maintain content integrity, enable access to people living in regional and remote areas, and to appeal to young people. Internet delivery makes universal prevention cost effective and feasible. The Intervention Mapping approach was used to direct the design of the program. A feasibility study was conducted to gain opinions from students and teaching staff. Changes were made in light of results from this study and 463 students were then exposed to the program in an effectiveness trial. The effectiveness trial was a before-after design with no control group. Results from this trial provided evidence that the program was acceptable and effective for use by teachers in the intervention schools. Also student behaviour and mood changed in beneficial ways after program administration. Specifically, student reported significantly increased knowledge about stress and coping, use of help-seeking behaviours, and life satisfaction, and significantly decreased use of avoidance behaviours, total difficulties and psychological distress. The study design allows causal inferences to be surmised concerning exposure to the intervention and changes in behaviour and mood, but further evidence is needed before firm conclusions about effectiveness can be posited and generalizations made concerning different populations, settings and times. In conclusion, this thesis provides evidence that a computerised, cognitive behavioural mental health prevention program delivered to adolescent school students by teachers can potentially change student coping behaviours and mood in beneficial ways.
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McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm1682.pdf.
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MURPHY, CATHRYN LOUISE School of Health Services Management UNSW. "INFECTION CONTROL IN THE AUSTRALIAN HEALTH CARE SETTING." Awarded by:University of New South Wales. School of Health Services Management, 1999. http://handle.unsw.edu.au/1959.4/17600.
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1,708 members of the Australian Infection Control Association were surveyed to describe the practices of Australian infection control practitioners. The study details the methods infection control practitioners use to co-ordinate and measure nosocomial infections as clinical outcomes of Australian infection surveillance and control programs. Administrators' and clinicians' perceptions of the elements and infrastructure of infection surveillance and control programs and the role of the infection control were measured in 316 hospitals in New South Wales, Australia. A literature review found that the development of Australian infection surveillance and control programs is behind that of U.S.A and the United Kingdom. The survey of the infection control practitioners identified that their role and duties varied between facilities as did the time allocated to infection control tasks. The survey of infection control practitioners demonstrated variation in their levels of skill, education and experience. Infection control practitioners' use and application of evidence and associated skills was examined and found to be limited in relation to clinical decision making and policy development. The survey also examined the methods infection control practitioners use to undertake surveillance of nosocomial infections. The methods reported indicated non-standard approaches to surveillance activity. A survey of administrators and clinicians in NSW hospitals was undertaken to identify variation in administrator and clinician perceptions and to describe their level of support for recommended essential infrastructure and criteria for infection surveillance and control programs and the role of the infection control practitioner in accordance with Scheckler's model. The survey indicated divergent views regarding the role of the infection control practitioner and the essential elements of infection surveillance and control programs. The study identified that education of infection control practitioners is necessary to facilitate standard approaches to co-ordinating infection surveillance and control activity. The development of Australian infection surveillance and control programs require a strategic alliance between stakeholders. to define essential elements of infection surveillance and control programs. In addition, the role of the infection control practitioner must be defined before key stakeholders can agree on the minimum skills, qualifications and experience required by an infection control practitioner.
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Draper, Catherine. "Medical students' attitudes towards and perceptions of the Primary Health Care approach." Doctoral thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/9357.
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Includes bibliographical references (p. 229-246).The aim of this research was to provide an understanding of medical students' attitudes towards and perceptions of the PHC approach, and this was done using mainly qualitative methods, namely focus groups, interviews, and one questionnaire. This research also investigated students' views of the way in which the PHC approach was taught, their understanding of the PHC approach, what could influence students' views of the PHC approach, the appropriateness of the PHC approach in South Africa, their opinions of the fact that UCT has a PHC-driven MBChB curriculum, their views of the role of doctors in the PHC approach, and a number of other related issues. The main findings were that students enter their medical degree with an expectation of a biomedical emphasis and a lecture-based curriculum.
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Frisby, Anthony J. "Self-directed learning readiness in medical students at the Ohio State University /." The Ohio State University, 1991. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487688507502934.
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Odisho, Helen, and Hina Khan. "Oral health knowledge among nursing students." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Oral hälsa, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-36308.
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Background: Oral health is a part of general health and it is therefore important that nurses are able to detect abnormalities in the mouth to refer to dental care. Aim: The aim of this study was to examine oral health knowledge regarding oral diseases and oral hygiene among nursing students at two universities - InHolland University and University of Victoria [UVic]. Method: This study has a quantitative cross-sectional design based on a questionnaire. Chi-square tests were made to discover differences between the two universities. Results: The study consists of a total of 105 questionnaires. The participants had good knowledge of oral hygiene. Concerning knowledge about dental caries, gingivitis, and periodontitis, limited knowledge and several statistical significant differences between the universities were found. The extent of the oral health education was between 1-10 hours in the respective universities. Several nurses considered that they did not feel ready or were unsure if they have enough knowledge about oral health for their future work. Conclusion: The study has shown that the nursing students at both InHolland University and UVic have basic knowledge regarding oral hygiene but moderate knowledge in oral diseases regarding development and prevention of dental caries, gingivitis and periodontitis.Bakgrund: Oral hälsa är en del av allmän hälsa och därför är det viktigt att sjuksköterskor kan upptäcka eventuella avvikelser i munnen för att remittera vidare till tandvård. Syfte: Syftet med studien var att undersöka kunskap om oral hälsa gällande orala sjukdomar och munhygien bland sjuksköterskestudenter vid InHolland University och University of Victoria [UVic]. Metod: En kvantitativ tvärsnittsstudie med enkät som datainsamlingsmetod genomfördes bland tredje års sjuksköterskestudenter vid InHolland University och UVic. Chi-2 tester utfördes för att jämföra variabler mellan universiteten. Resultat: Studien består av totalt 105 enkäter. Resultatet avseende munhygien visade på goda kunskaper inom ämnet. Resultatet avseende kunskaper om karies, gingivit samt parodontit visade på en begränsad kunskap och skillnader återfanns mellan universiteten. Omfattningen av utbildning inom oral hälsa på programmen låg mellan 1-10 timmar på båda universiteten. Flera sjuksköterskestudenter ansåg att de inte kände sig redo eller var osäkra på om de var redo att tillämpa sina kunskaper inom oral hälsa, genom att upptäcka och jobba preventivt, i framtida arbetet. Slutsats: Studien visar att sjuksköterskestudenter har grundläggande kunskaper avseende munhygienen men måttlig kunskap inom orala sjukdomar avseende uppkomst och prevention av karies, gingivit och parodontit.
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Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." University of Sydney, 2007. http://hdl.handle.net/2123/3538.
Full textAbstract:
Master of PhilosophyAs Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.
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Sinclair, Andrew. "The primary health care experiences of gay men in Australia." Connect to this title online, 2006. http://adt.lib.swin.edu.au/public/adt-VSWT20060713.084655/.
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Leach, J. S. R. "Organisational responses to students' mental health needs : social, psychological and medical perspectives." Thesis, Oxford Brookes University, 2004. http://radar.brookes.ac.uk/radar/items/e5eca0f1-9e7c-d32d-a439-94d33c8459de/1.
Full textAbstract:
This research examines the support offered to students with mental and emotional problems in Oxford, based on a theoretical model which distinguishes between social, psychological and medical/biological approaches. Although there has been a long-running debate about the contribution of each of these approaches, their impact on the provision of formal and informal support for students has not been previously studied. Using a case study research design, 76 semi-structured interviews were conducted with 'students and staff within three educational institutions and two healthcare trusts, with additional information coming from meetings of the Oxford Student Mental Health Network and other documentary evidence. The case studies found that concerns about stigma, confidentiality, damaged career prospects and beliefs about the nature of the support provided all impacted on students' willingness to seek help. Sources of social support included friends, family, student officers, academic, residential and administrative staff. Psychological support came from university counsellors and National Health Service psychotherapists. General Practitioners provided the first line of medical support, with psychiatrists and other mental health professionals becoming involved with the more severe cases. There were gaps between the different levels of support, concerns about the difficulty in accessing secondary and tertiary levels of care, and sometimes mutual suspicion between different types of supporters. The distinctions between social, psychological and medical approaches to mental health which tend to be polarised in the literature, were not articulated so forcefully by the majority of the respondents. Integrating different forms of support was seen as providing students with the best chance of completing their studies successfully, but raises challenges of working across organisational and professional boundaries. Whilst there were established pathways for referring students into psychological and medical services at times of crisis, there were not such well organised pathways back in to the social levels of support upon recovery.
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Hegarty, Benjamin. "Attitudes among Swedish medical students towards assisted dying." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-90275.
Full textAbstract:
IntroductionOver the last decades a positive shift in attitudes towards legalisation of assisted dying (AD) (AD including euthanasia (EUT) and physician-assisted suicide (PAS)) have occurred in western Europe. Physicians are generally more negative than the general public toward legalisation. Medical students’ attitudes, as future practitioners, are important to assess when addressing this ethically complex issue.AimThe aim was to explore the attitudes among medical students at Örebro university, Sweden regarding assisted dying and their stance on the legalisation of assisted dying and to evaluate if religious beliefs, current term of study, gender, and a shift of legal framing would affect medical students´ attitudes.MethodsA cross-sectional online-based anonymous survey containing eight different patient scenarios was distributed to all medical students enlisted at Örebro university Sweden (n=657). Association between demographics and positive attitudes towards AD was tested using logistic regression, and McNemar for difference of proportion in attitudes between various scenario framings.ResultsThirty five percent (n=229) of the medical students responded with completed questionnaires. Sixty percent of the respondents believed PAS for terminally ill patients should be legalized in Sweden. Shifting of legal framing resulted in statistically significant differences of position in all eight scenarios (p<0.05). Strong religious beliefs were associated with decreased likelihood for positive attitudes towards AD in scenario 1-6 (p<0.05).ConclusionsMost respondents in this study believed PAS should be legalised. Held attitudes toward AD were affected by religious beliefs and legal framework. Additional studies to further explore medical students´ attitudes are deemed necessary.
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West, Crystal D. D. "Eating and Physical Activity Habits of College Students." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/honors/45.
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Schaffer, Lisa. "The Lived Experience of Transgender College-Aged Students Receiving Healthcare." ScholarWorks @ UVM, 2015. http://scholarworks.uvm.edu/graddis/318.
Full textAbstract:
Background
There is a relative dearth of information regarding transgender patient perceptions of healthcare provider interactions and experiences. Previous studies have examined the experiences of transgender patients across multiple generations.
Purpose
This research focuses on understanding the lived experience of transgender college-aged students receiving healthcare. The goal of this research is to help inform the practices of healthcare providers in order to improve care experiences.
Methods
Hermeneutic phenomenology was utilized to illuminate the lived experiences of three college-aged transgender patients receiving healthcare. Interviews were conducted with research participants. After transcription, interview content was read and re-read for significant statements. Significant statements were then grouped to identify themes.
Results
Theme 1: provider knowledge. Study participants noted that provider knowledge was associated with several behaviors and impacted their feelings regarding the experience and willingness to seek future healthcare. The trans-friendly provider was identified as a provider who uses preferred language, shares decision-making, and is aware of medical treatments.
Theme 2: being defined. Study participants felt defined through a variety of provider interactions. These included experiences wherein providers question timelines of transition and question the patient regarding their identity using static terminology.
Theme 3: loss of power. Participants noted the experience of loss of control when receiving healthcare. Loss of control was felt in a variety of ways including: loss of control over naming, identity, and care decisions.
Conclusions
This research begins to identify emerging themes expressed by transgender college-aged patients. By identifying these themes, future research can be conducted to further clarify patient feelings associated with their experiences in seeking healthcare in order to inform provider behaviors. More research is needed regarding transgender patient experiences receiving healthcare and whether these experiences impact health outcomes.
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
Full textAbstract:
Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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Brahmi, Frances A. "Medical students' perception of lifelong learning at Indiana University School of Medicine." [Bloomington, Ind.] : Indiana University, 2007. 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:3297081.
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Thesis (Ph.D.)--Indiana University, School of Library and Information Science, 2007.Title from dissertation home page (viewed Sept. 24, 2008). Source: Dissertation Abstracts International, Volume: 69-02, Section: A, page: 0414. Adviser: Debora Shaw.
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Sopitshi, Athenkosi. "Attitudes, knowledge and beliefs around homosexuality: exploring the views of 5th year medical students." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/22930.
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Introduction: Discrimination from health workers has been found to be a deterrent for lesbian, gay, bisexual and transgender (LGBTI) people seeking healthcare. Despite these findings, LGBTI-focused healthcare remains understated in medical training and university curricular. Learning about medical students' attitudes can provide useful ways of identifying interventions to capacitate health professionals to address LGBTI health. Methods: This study is a mixed methods study, data were collected using a 25 item homophobia scale with additional questions designed for the South African context, and focus group discussions with semi-structured questions. Results: 157 Medical students in the 5th year class at a university in the Western Cape, South Africa completed the survey, 20 of them formed part of three focus group discussions. Outcomes showed significant gaps in student's curriculum in the area of LGBTI health which influenced their lack of knowledge and preparedness. Considering that homophobia and heterosexism remain widespread in the students' contexts, the findings point to generally favourable views of LGBTI people. In this respect, two thirds of the participants indicated that they are not bothered by seeing same-sex partners together and 64% felt that homosexuality was not immoral and showed support for LGBTI rights. The qualitative findings indicate that a contributing factor in shifting their attitudes based on their own perspectives was a change in environments from their hometowns to university. Students showed a keen interest in early integration of LGBTI health in their curriculum which is encouraging. Conclusion: Medical training needs to be responsive and intentional about addressing student attitudes towards LGBTI people, as this has implications on the students' perceived competency and affects the quality of healthcare they deliver.
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Horton, Graeme Leonard. "The attitudes of Australian medical students to the inclusion of the topic of "health impacts of climate change" in the medical curriculum." Thesis, 2018. http://hdl.handle.net/1959.13/1384937.
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Research Doctorate - Doctor of Philosophy (PhD)Medical education must prepare doctors to be able to work with patients and communities as they face emerging challenges. Climate change has been described by leading authorities as the defining issue for public health during this century and the greatest of threats to health. Educational interventions are best devised with input from students as stakeholders. This project explored the attitudes of Australian medical students about the health impacts of climate change and the relevance of these issues to medical school curricula. The project also explored the implications of these student attitudes to curriculum planning from the perspective of medical educators. This study is a mixed methods design in three stages. This design was selected because in this new area of educational research, it enabled the exploration of beliefs and ideas for change from stakeholders; the assessment of how representative certain views were amongst the student population, and finally a study of the perceived implications of student opinion on future curriculum design. In Stage 1, 27 students from two universities were interviewed about climate change, and what methods of learning they would most engage with in exploring topics relating to climate change and health. In Stage 2, 283 students from four universities in three states of Australia (RR=8.7%) completed a questionnaire which was informed by issues raised by students in Stage 1. Students indicated support for climate change in the curriculum, but raised concerns about potential loss of other important curriculum content. Analyses showed that support for climate change issues in the curriculum was associated with female gender and with understanding climate change to be relevant to patient care. In Stage 3, fourteen medical educators were asked about their own views on climate change and how the findings from Stages 1 and 2 could influence medical curriculum planning. Climate change was seen as a politically-charged topic. The range of views which students bring to such discussion were seen to require sensitive and skilful management so as to ensure safe learning environments. Our findings indicate that the use of examples relating to climate change health impacts and environmental sustainability in the medical curriculum may be used to teach core knowledge and competencies for doctors, and to give an accurate understanding of the evolving determinants of health in a changing world.
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Tito, Wheatland Fiona. "Patient harm and medical error as threats to the Doctor Identity - a new lens for improving patient safety?" Phd thesis, 2017. http://hdl.handle.net/1885/117703.
Full textAbstract:
Preventable patient harm and medical error occur frequently in
health care. Despite the apparent widespread commitment to the
“First do no harm” aphorism in medicine, it has proved
difficult to get prompt, effective and sustained action to detect
and prevent these. The existence of preventable patient harm and
medical error has been well established over the past 50 years
and its high frequency has been confirmed in many international
studies over the past two decades.
The thesis used a secondary source research methodology across a
wide range of disciplines that have looked at medical error,
preventable harm and doctor behaviour to explore possible
explanations for these phenomena. The thesis concludes that
there is an alternative plausible explanation for why action on
identification and action on these issues by doctors, as leaders
in health care, have been so slow and inconsistent. The thesis
provides evidence in support of three hypotheses that form part
of this explanation.
Hypothesis 1: the occurrence of patient harm and medical error
can be perceived psychologically by a doctor as a fundamental
threat to his or her identity;
Hypothesis 2: a serious threat to identity causes a range of
psychological defences, often rooted in the biological responses
of the brain to threats to existence, and these defences can make
it hard for a doctor to recognise, identify or accept the risk of
patient harm;
Hypothesis 3: elements of the Doctor Identity deny ordinary human
psychological responses and physical limitations, and thus
promote unrealistic self or group perceptions. This creates risks
to both doctors and patients. Many of these risks may be
avoidable through modifying these perceptions and developing more
realistic self-and professional schemas.
The thesis concludes that these hypotheses provide potential new
ways to address the issues, and reduce harm caused to both
patients and doctors.
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Backhouse, Peter. "Medical knowledge, medical power : doctors and health policy in Australia / Peter John Backhouse." Thesis, 1994. http://hdl.handle.net/2440/21496.
Full textAbstract:
Bibliography: leaves 494-519.ix, 519 leaves ; 30 cm.
Examines the influence of the medical profession on health policy in Australia. Case studies of policy struggles under Federal Labor governments since 1983 illustrate both the nature and scope of that influence.
Thesis (Ph.D.)--University of Adelaide, Dept. of Politics and Dept. of Community Medicine, 1994
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Patterson, Jan. "Consumers and complaints systems in health care / Jan Patterson." Thesis, 1996. http://hdl.handle.net/2440/19008.
Full textAbstract:
Bibliography: leaves 463-496.ix, 497 leaves ; 30 cm.
This thesis explores the dimensions of the actions of consumers, governments and service providers influential in contributing to the climate of reform in the health care area in Australia and the subsequent developments. There are clearly defined consumer models of complaints-handling for the health area, ascertainable from examination of the broader context of the development of the consumer movement and consumer organisations ; and specifically drawing on the common elements from the contribution of the consumer movement in health. A consumer model for complaints-handling at the local level is proposed.
Thesis (Ph.D.)--University of Adelaide, Dept. of Community Medicine, 1997?
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Gray, Gwendolyn. "Health policy in two federations." Phd thesis, 1987. http://hdl.handle.net/1885/142644.
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Monteiro, Jorge Miguel Araújo. "Academic Cheating Among Medical Students." Master's thesis, 2016. https://repositorio-aberto.up.pt/handle/10216/89460.
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Monteiro, Jorge Miguel Araújo. "Academic Cheating Among Medical Students." Dissertação, 2016. https://repositorio-aberto.up.pt/handle/10216/89460.
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Sidorenko, Alexandra A. "Health insurance and demand for medical care : theory and application to Australia." Phd thesis, 2001. http://hdl.handle.net/1885/109953.
Full textAbstract:
Private health insurance plays an important role in Australian health care
finance, complementing the universal health insurance system, Medicare,
established in 1984. The road to the current health insurance system was long and
winding, filled with political passions and debates. This study covers the major
historical steps leading to the introduction of Medicare, and analyses specific
features of the Australian private health insurance sector.
After the recent policy change, regulations of the private health insurance
industry were somewhat eased, and a new range of benefits permitted to be
provided. This thesis seeks to analyse the likely effects of the policies, and develops
a theoretical model which adds to the existing literature on the demand for health.
Studies of demand for medical care and health insurance constitute an
important part of the health economics literature. Grossman’s theory of demand for
health has become a major framework for the analysis. Generalisations of the
Grossman model to incorporate uncertainty about health status and insurance
against medical expenditure are major challenges for theoretical economists
working in this area. This thesis proposes a new dynamic continuous time
stochastic optimisation model of demand for medical care, in which uncertainty
about health and wealth is modelled by correlated Wiener processes. Consumption
and leisure decisions are included in the model. A health insurance contract with
coinsurance rate is introduced in this model, and a two-stage procedure of choosing
an optimal ex-ante coinsurance rate, and optimal ex-post amount of medical care,
consumption and leisure is discussed.
The theoretical model is then applied to the 1993-94 Household Expenditure
Survey, Australia. Even though the full structure of the model cannot be tested on
this dataset, some empirical evidence is found in support of the new theoretical
model. A two-part bivariate probit model and quantile regression analysis allowed
the estimation of the income elasticity of demand for medical care and health
insurance, which was shown to vary with income. To study the quantitative effect
of the recent policy change based on the new theoretical model, a finer level of data
is needed.
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Parslow, Ruth Adeline. "A study of Australians' access to health services for common mental health problems." Phd thesis, 2002. http://hdl.handle.net/1885/146160.
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Rogers, G. D. "Feeling queer : can a primary health care approach mitigate health inequity experienced by homosexually active South Australian men ?" 2005. http://hdl.handle.net/2440/37819.
Full textAbstract:
Health inequity refers to differences in health status between populations ( health inequalities ) that are unnecessary and avoidable and, additionally, are considered unfair or unjust. The history of the concept is reviewed and the mechanisms by which inequity affects health surveyed, with a focus on multi - level models of health production. The origins and development of the Primary Health Care approach is then considered with an emphasis on the Australian setting and on HIV / AIDS policy. The construct of homosexuality is then explored and concepts of sexual attraction, ' orientation ', identity and behaviour differentiated. What is known about the health characteristics of homosexually active men in the First World is then surveyed by means of a systematic literature review. It is concluded that there is evidence that they are affected by substantial health inequality in a range of areas including mortality, suicidality, depressive disorders, anxiety disorders, report of childhood sexual abuse and problematic substance use. Few of these inequalities have been confirmed in the Australian context, however, and almost none have been confirmed specifically in South Australia. The background to the development of a Primary Health Care programme focused on homosexually active men, is then described. The baseline health characteristics of the programme ' s cohort of 542 homosexually active South Australian men ( including their sexual behaviour in the context of HIV transmission ) are described and compared with other samples of men to identify inequalities. It is concluded that men in the cohort were subject to health inequality in a wide range of health parameters including mortality, suicidality, sexually transmitted infections, depressive and anxiety disorders, levels of substance use and self - rated health on the short - form 36 ( sf36 ) instrument. The relationships between these characteristics and factors indicative of disadvantage and victimisation are then explored. It is concluded that many of the health inequalities identified were related to sociohistorical factors such as emotional withdrawal by one ' s father, low income, unemployment, reduced educational attainment, and recent experience of violence and abuse from strangers. It is argued that some of these factors can be considered to be examples of unfairness and injustice and that, as a consequence, at least some of the health inequality experienced by this population is also health inequity. The elements of the Primary Health Care programme devised to meet the needs of homosexually active men is described and the trajectory of health characteristics of its participants over three time points is examined. 210 homosexually active men had reached Second Review, an average of thirty - six months after enrolment, by the time of analysis. Among this group, significant sustained improvement in a range of health outcomes, including prevalence of depressive disorders, sf36 scores and rate of recent suicidal ideation, is reported in association with involvement in the programme. Participant ' s subjective satisfaction with the programme is then described and their beliefs about the causes of their improved health explored using a qualitative methodology. It is concluded that the programme had largely met the needs of participants and they believed that it had been responsible for their improved health. Limitations of the study are considered and discussed. Limitations of the investigation to identify health inequality include questions of external validity arising from the absence of a perfect comparator group and concerns with construct validity related to the possibility of geographical and cultural variation in definitions of ' homosexually active men '. In the investigation to determine the extent to which health inequalities were also examples of inequity, issues of conclusion validity are discussed particularly in relation to multiple comparisons and the balance between Type I and Type II errors. In the evaluation of the impact of the Primary Health Care programme, there are concerns about internal validity resulting from the absence of randomisation and an uncontrolled design. The components of this issue are discussed and some support for internal validity is found in the reported subjective beliefs of participants about the cause of their health improvement and the outcomes of critical reflection by the programme team. The implications of the findings for policy, practice and further research are explored. It is argued that the health inequity experienced by people of sexual diversity will require profound social change for complete resolution. In the meantime, however, focused Primary Health Care with a community of sexual diversity has the potential to mitigate the health inequity its members experience and to help them to survive and function while they wait for a fairer and kinder society.Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2005.
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Rogers, Gary David. "Feeling queer : can a primary health care approach mitigate health inequity experienced by homosexually active South Australian men ?" Thesis, 2005. http://hdl.handle.net/2440/37819.
Full textAbstract:
Health inequity refers to differences in health status between populations ( health inequalities ) that are unnecessary and avoidable and, additionally, are considered unfair or unjust.
The history of the concept is reviewed and the mechanisms by which inequity affects health surveyed, with a focus on multi - level models of health production. The origins and development of the Primary Health Care approach is then considered with an emphasis on the Australian setting and on HIV / AIDS policy.
The construct of homosexuality is then explored and concepts of sexual attraction, ' orientation ', identity and behaviour differentiated. What is known about the health characteristics of homosexually active men in the First World is then surveyed by means of a systematic literature review. It is concluded that
there is evidence that they are affected by substantial health inequality in a range of areas including mortality, suicidality, depressive disorders, anxiety disorders, report of childhood sexual abuse and problematic substance use.
Few of these inequalities have been confirmed in the Australian context, however, and almost none have been confirmed specifically in South Australia.
The background to the development of a Primary Health Care programme focused on homosexually active men, is then described. The baseline health
characteristics of the programme ' s cohort of 542 homosexually active South Australian men ( including their sexual behaviour in the context of HIV transmission ) are described and compared with other samples of men to identify inequalities. It is concluded that men in the cohort were subject to health inequality in a wide range of health parameters including mortality, suicidality, sexually transmitted infections, depressive and anxiety disorders,
levels of substance use and self - rated health on the short - form 36 ( sf36 ) instrument.
The relationships between these characteristics and factors indicative of disadvantage and victimisation are then explored. It is concluded that many of the health inequalities identified were related to sociohistorical factors such as
emotional withdrawal by one ' s father, low income, unemployment, reduced educational attainment, and recent experience of violence and abuse from strangers. It is argued that some of these factors can be considered to be examples of unfairness and injustice and that, as a consequence, at least some of the health inequality experienced by this population is also health inequity.
The elements of the Primary Health Care programme devised to meet the needs of homosexually active men is described and the trajectory of health
characteristics of its participants over three time points is examined.
210 homosexually active men had reached Second Review, an average of thirty - six months after enrolment, by the time of analysis. Among this group, significant sustained improvement in a range of health outcomes, including prevalence of depressive disorders, sf36 scores and rate of recent suicidal ideation, is reported in association with involvement in the programme.
Participant ' s subjective satisfaction with the programme is then described and
their beliefs about the causes of their improved health explored using a qualitative methodology. It is concluded that the programme had largely met
the needs of participants and they believed that it had been responsible for their improved health.
Limitations of the study are considered and discussed. Limitations of the investigation to identify health inequality include questions of external validity arising from the absence of a perfect comparator group and concerns with
construct validity related to the possibility of geographical and cultural variation in definitions of ' homosexually active men '. In the investigation to determine the extent to which health inequalities were also examples of inequity, issues of conclusion validity are discussed particularly in relation to multiple comparisons and the balance between Type I and Type II errors.
In the evaluation of the impact of the Primary Health Care programme, there are concerns about internal validity resulting from the absence of randomisation and an uncontrolled design. The components of this issue are discussed and
some support for internal validity is found in the reported subjective beliefs of participants about the cause of their health improvement and the outcomes of critical reflection by the programme team.
The implications of the findings for policy, practice and further research are explored. It is argued that the health inequity experienced by people of sexual diversity will require profound social change for complete resolution. In the
meantime, however, focused Primary Health Care with a community of sexual diversity has the potential to mitigate the health inequity its members experience and to help them to survive and function while they wait for a fairer and kinder society.Thesis (Ph.D.)--University of Adelaide, School of Population Health and Clinical Practice, 2005.
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Gill, Anne C. Byrd Theresa DesVignes-Kendrick Mary. "The population health performance of medical students at two medical schools." 2007. http://proquest.umi.com.www5.sph.uth.tmc.edu:2048/pqdweb?did=1428854441&sid=2&Fmt=2&clientId=92&RQT=309&VName=PQD.
Full textAbstract:
Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007.Source: Dissertation Abstracts International, Volume: 68-10, Section: B, page: 6614. Adviser: Jay H. Glasser. Includes bibliographical references.