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Barrett, Geraldine. "Developing a measure of unplanned pregnancy." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2002. http://researchonline.lshtm.ac.uk/768479/.
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The incidence of unplanned pregnancy has long been used as an indicator of sexual and reproductive health. However, because of dramatic social and demographic changes, existing measures have become outdated and no satisfactory contemporary measure of this status exists. The aim of this study was to develop a measure of unplanned pregnancy which is valid, reliable and appropriate in the context of contemporary demographic trends and social mores, and can be used to establish population estimates of unplanned pregnancy. To achieve this, a two-stage study design was employed: firstly, qualitative (inductive) methods in order to delineate the construct of pregnancy planning/intention, and secondly quantitative/psychometric methods to establish the means of measurement. At the qualitative stage, 67 depth interviews were carried out with pregnant (continuing pregnancy and abortion) and postnatal women. A conceptual model of pregnancy planning/intention was developed from these data and used as the basis for item development in the quantitative stage. Standard psychometric techniques were then employed to construct the measure and test its reliability and validity (the qualitative findings informing judgements about content and construct validity). Over 1000 women participated in the psychometric field testing. The result of the study is a six-item measure of unplanned pregnancy - the first psychometric measure of this construct. Psychometric testing demonstrated the measure's high reliability (Cronbach's alpha>0.90; test-retest reliability >0.90) and high face, content, and construct validity. Women may occupy a range of positions in relation to pregnancy planning, and these are represented in the measure by the spectrum of scores (zero to 12). These scores provide a more sophisticated level of information about pregnancy planning than was previously available. The measure is suitable for use with any pregnancy regardless of outcome (i. e. birth, abortion, miscarriage) and is highly acceptable to women.
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Russell, Sarah, Randi G. Bastian, Tifani A. Fletcher, Lana McGrady, Andrea D. Clements, and Beth Bailey. "Inattention and Risk Factors for Unplanned Pregnancy." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/7257.
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Aspects of ADHD, such as inattention, may be predictive of unplanned pregnancy. An unplanned pregnancy can have negative effects on both maternal and child health. Women surprised by pregnancy may not be physically, emotionally, or financially capable of caring for a child and may postpone or neglect prenatal care.In 2006, approximately 49% of pregnancies were unplanned in the United States. Furthermore, in Tennessee, the percentage was even higher with 56% of pregnancies being unintended. Maternal Attention Deficit Hyperactive Disorder (ADHD) has been linked to decreased female contraceptive use and to increased risky sexual behavior. Failure to use contraception significantly increases the risk of unplanned pregnancy. This study examined inattention (a characteristic known to be elevated in individuals diagnosed with ADHD) and risk factors (i.e., marital status, education, depression) associated with unplanned pregnancy in Appalachian women. Information was collected from pregnant women recruited from Southern Appalachia as part of the Tennessee Intervention for Pregnant Smokers Program. As part of the larger study, women completed detailed research interviews upon entry into prenatal care. A total of 457 pregnant women had responses on the measures of interest in the current investigation. Logistic regression was performed to assess the ability of Inattention (determined by the Current Symptoms Scale) to predict the probability of a woman experiencing an unplanned pregnancy. The full logistic regression model containing all predictors was statistically significant Χ2 (7, N=457) = 92.35, p <.001 indicating that the predictors as a set reliably distinguished between those women who did, and did not, have an unplanned pregnancy. Inattention had an Adjusted Odds Ratio of 1.76, CI (1.09, 2.86) p =.02 indicating that controlling for the other variables in the model, those women who scored high on the Inattention measure were significantly more likely to experience an unplanned pregnancy. This model correctly classified 76.8% of participants. Additionally, consistent with previous research findings, women who were unmarried and had lower levels of education were also significantly more likely to have an unintended pregnancy. Furthermore, women who reported higher levels of depressive symptoms were significantly more likely toexperience an unplanned pregnancy. Ages and at-risk alcohol use (TACE) were also examined in this study but did not significantly contribute to the model. These results confirm that known risk factors were also found in this population. This study found that inattention predicted unplanned pregnancy. Because inattention is one aspect of ADHD, this could suggest that women diagnosed with ADHD would be more likely than others to experience an unplanned pregnancy. Identifying risk factors can assist health practitioners to target women who are at risk for unplanned pregnancy for purposeful discussion on contraceptive options.
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Bleeker, Jate. "An Impossible Profession: How To Plan the Unplanned?" Thesis, KTH, Urbana och regionala studier, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-200830.
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A short film about how to design informality in the city. By comparing the chaotic Lagos with the orderly Stockholm the film rethinks the role of the designer and shows that planning as a sphere of building consistently destroys lived space. It illuminates the tension between the orderly and the chaotic, the ideal and reality.
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Story, Wendi A. "The Effects of Unplanned Pregnancy Among College Women." Thesis, Virginia Tech, 1999. http://hdl.handle.net/10919/31856.
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The majority of today's college students engage in sexual intercourse (Abler & Sedlacek, 1989), generally with multiple partners (Netting, 1980). Many of these sexually active students use contraception; many do not. Since students are engaging in intercourse and some are failing to use contraceptives properly or not using contraceptives at all, it is not surprising that 12% of college students report either experiencing or being involved in unplanned pregnancy (Elliot & Brantley, 1997). Wiley, James, Funey, and Jordan-Belver (1997) estimate that this number may be closer to 23% of college students. While both studies derived their different percentages from different college student populations, both percentages are significant. Little descriptive knowledge about the experience of unplanned pregnancy for college women exists.
The purpose of this study was to describe traditional aged (18-22 years old) women's perceptions of the effects of unplanned pregnancy while enrolled full-time in an institution of higher education. The study examined the effects of the pregnancy from conception through the pregnancy's outcome. It also examined long term or on-going effects that women experienced after the termination or miscarriage. The study did not investigate the effects women attributed to the pregnancy's outcome.
Ten traditional aged college women who had experienced an unplanned pregnancy while enrolled as a full-time student in a university in the mid-Atlantic region volunteered to participate in a one to two hour interview. The interview questions focused on the effects they experienced as a result of the pregnancy. The women were recruited to the study through flyers and personal announcements I made to several large undergraduate classes and student organizations.
The sample of this study was ethnically diverse. Five of the ten women were ethnic minorities: three African American women, one Asian American woman, and one bi-racial Hispanic woman. The sample was similar in the outcome of the pregnancy. Nine women terminated the pregnancy; one woman miscarried.
There are several significant findings of the study. First, the women in this study did not become pregnant as a result of a casual sexual encounter. All of the women conceived within the context of a committed relationship. This runs counter to the stereotype that college women become pregnant as a result of careless, "one night stands." Second, women reported a significant number of long term effects associated with the pregnancy. Long term effects are those that last a year or more. The most prevalent of these effects are feelings of guilt and fear of being stigmatized for their experience. These women are haunted by feelings of guilt. The guilt makes it difficult for them to associate with peers and family because the subject of pregnancy and abortion are discussed frequently.
The women who participated in this study fear being socially marked or stigmatized because of the pregnancy. They fear they will be judged negatively by their peers and family because they experienced pregnancy and abortion. The guilt, shame, fear, and sense of stigma the participants reported are not just individual attributes but a reflection of wider social views about women's responsibility for sexuality and reproduction. Most women in this study did not tell their families of their experience. The majority of the women revealed their situation to their partner and only one or two friends. Keeping the situation a secret heightened the sense of isolation and depression experienced by the women.
The issue of unplanned pregnancy among college women is rarely discussed. The women who experienced this did not feel safe enough on campus to come forward to seek help. They suffered personal anguish and often negative academic impacts. Universities need to create safe environments for these women to disclose their experience. Educational programs and support groups run by counseling centers or women's centers would be a step toward a safer environment for these women. Families and friends of women who experience an unplanned pregnancy can assist their loved one by expressing emotional support and being cautious about the judgmental things they say about pregnancy and abortion.
Despite being conceived within a committed relationship, participants clearly saw the pregnancy as something that was their responsibility. Findings suggest that some women experience a developmental process in their response to the unplanned pregnancy, moving from a position of irresponsibility to a position of responsibility. Future research may examine the stages of this process and how it compares to existing developmental theory.Master of Arts
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Cecil, Elizabeth. "Determinants of unplanned admissions in children : investigating the relationship between primary care quality and health service use with unplanned admissions in children." Thesis, Imperial College London, 2016. http://hdl.handle.net/10044/1/63859.
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Introduction: High quality primary care is considered central to preventing avoidable health system waste such as unplanned short stay admissions (SSA) for minor conditions and alleviating health inequality. Recent policy changes in primary care (2004) may have impacted on provision, access and supply of GPs. This provides an ideal opportunity to study its role on keeping children healthy in the community. I aimed to quantify the impact of policy change; GP timeliness and access; and GP utilisation on potentially preventable admissions and health disparities in children. Methods: My studies included a segmented population based trends study design and a retrospective cohort design. I used national hospital and primary care administrative datasets, focusing on children aged ≤14 years between April 2000 and March 2013, in England. My primary outcome measures were SSA rates (< 2 days stay) for chronic conditions and infectious illness; my secondary outcome emergency department (ED) visits. I investigated: the impact of 1) primary care policy change in 2004; 2) patients’ reported access to their GP; and 3) primary care utilization on unplanned health service use and reducing deprivation gradients. Results: There was a significant increase in the number of children being admitted with chronic conditions for a short stay after primary care policy changes (11% rate increase in year of change), but not for infectious illness. Children were less likely to visit EDs or be admitted for a chronic condition if their GP offered better access. Better preventive care reduced children’s risk of an unplanned admission and deprivation gradients were narrowed in children who regularly consulted their GP. Conclusion: Primary care plays a significant role in limiting use of urgent and unplanned health service use, particularly for deprived children and those with chronic conditions. Investment in primary care is vital in a time of epidemiological transition in children.
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Törnquist, Martin. "A personal city : A city planned for the unplanned." Thesis, Umeå universitet, Arkitekthögskolan vid Umeå universitet, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-171845.
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Sharp, Jonathan. "'Unplanned but not unwanted' : a developmental perspective of teenage pregnancy." Thesis, University of East Anglia, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396729.
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Weatherspoon, Kathleen Janet. "Reducing Unplanned Hospital Readmissions| A Qualitative Exploratory Multiple-Case Study." Thesis, University of Phoenix, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13425878.
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Healthcare quality measurement and care reimbursement have become a central focus for leaders and administrators of healthcare organizations. The provision of high-quality healthcare is contingent on the skills and abilities of leaders and clinical staff who support evidence-based clinical practice through implementation strategies. The problem defined in this qualitative exploratory multiple-case study was concerned with the frequency of unplanned hospital readmissions occurring in the state of Florida specifically, in healthcare facilities located in Broward, Miami-Dade, and Monroe Counties (tri-county area). Healthcare stakeholders working in organizations located in the tri-county area report hospital readmission rates of 23%, that resulted in higher financial penalties. The purpose of this qualitative exploratory multiple-case study was to explore the reasons for higher than expected unplanned hospital readmissions in healthcare facilities located in the tri-county area of south Florida to help hospital administrators to improve healthcare quality through reducing unplanned rehospitalizations. Thirteen participants contributed to this study: 4 (31%) healthcare leaders, 4 (31%) clinicians, and 5 (38%) registered nurses. Through the collective experiences of healthcare stakeholders, two primary and two secondary themes emerged to provide a clearer understanding of the contributing factors related to unplanned hospital readmissions. Four themes namely, education, population, and cultures and resources supported existing literature and provided new knowledge related to the importance of executive leader knowledge, nurse educational and skill levels, patient literacy and language, and cultural elements when applying evidence-based clinical practices in complex healthcare environments.
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Warren, Keith Clements. "Family Environment, Affect, Ambivalence and Decisions About Unplanned Adolescent Pregnancy." Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331841/.
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This study investigated the relationships among family environment, demographic measures, the decisions made by unintentionally pregnant adolescents regarding post-delivery plans (stay single, get married, adoption), and the certainty with which these decisions were made. The Information Sheet, Family Environment Scale (Moos & Moos, 1981), and Multiple Affect Adjective Check List (Zuckerman & Lubin, 1965a) were administered to 17 5 pregnant adolescents, ages 14 through 22, who intended to carry their pregnancies to term. Pearson product-moment correlations and multiple regression analyses were utilized to assess the relationships between family environment and certainty of decision and between family environment and negative affect. Greater uncertainty was associated with nonwhite racial status and living with both natural parents or mother only. Higher levels of negative affect were related to lower levels of perceived family cohesion, independence, expressiveness, and intellectualcultural orientation. The demographic variables of age, trimester of pregnancy, and family constellation were also found to be useful in predicting levels of negative affect. Subjects who were older, further along in their pregnancies, and living with both natural parents or mother only tended to report greater negative affect. Findings of greater uncertainty and negative affect associated with living with the natural mother are consistent with previous reports of disturbed mother-daughter relationships among this population.
Discriminant analysis revealed that subjects choosing adoption were more likely to be older and to be white than those choosing to keep the child. They also tended to perceive higher levels of expressiveness and independence in their families. Comparisons between the present sample and "normal" families revealed differences which were statistically significant, but quite small in terms of raw score units. Indeed, these groups may be more similar than has often been assumed. The implications of these findings for the delivery of services and for future research efforts in this area were discussed. More intensive assessment of family functioning is needed. Based upon present results, further investigation of the family constellation variable is warranted.
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Stallings, Jamie M. "INFORMED: THE IMPACT ON DECESION MAKING DURING AN UNPLANNED PREGNANCY." CSUSB ScholarWorks, 2014. https://scholarworks.lib.csusb.edu/etd/73.
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The purpose of this research project was to determine if there was a significant difference between women who had unplanned pregnancies and the amount of information those women received about their pregnancy options regarding parenting, adoption, and abortion, and those who were not. Additionally, the level of information about pregnancy options, and whether it would reduce termination of pregnancies was examined. The aspects explored included the information available to clients and the decision making process for women who have experienced an unplanned pregnancy. The methods for this study involved using an anonymous survey via Survey Monkey. Additionally, this study examined the importance of clients being informed and the role information plays in the social work field. A detailed examination of the research which has been conducted in pregnancy options counseling and what that counseling consists of was conducted and discussed. An overview of "Woman’s Right to Know Laws" was also addressed and what theories have an impact on what woman experience during an unplanned pregnancy. Finally, an independent samples t-test was conducted to determine if there were significant differences between groups of women who had chosen to keep and parent their child, those who chose to have an abortion, and those who chose to relinquish their child for adoption and the amount of information they received about their pregnancy options. The study found a significant difference between women who chose to parent their children and women who iv
chose to have an abortion in terms of the level of information they were provided about those options. The abortion group received significantly more information about abortion than the parenting group. This may be due to the type of information received being more about cost and recovery periods versus the actual abortion procedure and mental health concerns post-abortion. Based on the findings, most women know what they will do in the case of an unplanned pregnancy and only a significant intervention will change their course of action. Based on the findings, educating women about their pregnancy options will not change their decision to keep, abort or relinquish their child for adoption. Instead, prevention efforts are more effective in preventing abortion than providing them with information.
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Khethiwe, Thandokazi Theo. "Factors contributing towards and support groups for young women who are experiencing unwanted pregnancies." Thesis, University of Zululand, 2012. http://hdl.handle.net/10530/1274.
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Submitted in fulfillment of the requirements for the degree Masters in Psychology in the Department of Psychology, Faculty of Arts at the University of Zululand, South Africa, 2012.Unwanted pregnancy among young unmarried South African women still remains a challenge. It has been identified that young unmarried women who are living in rural areas are more vulnerable to unwanted pregnancy. Bronfenbrenner.s theory of systems has been used in the study. The participants were sourced from eMbobeni location, a rural area in Bizana in the Eastern Cape Province. The data was collected through focus group interviews and analysed through content analysis. Group interviews were tape recorded and transcribed. Group support was provided for the participants in the focus group. Through the study it has emerged that lack of knowledge about sexuality and the protection of oneself still remains a challenge. Factors contributing towards unwanted pregnancy among young unmarried women were identified as being lack of parental support; lack of knowledge and the stigma towards contraception; pressures from the partner; ignorance, carelessness and restrictions; and shift of responsibility.
National Research Foundation (NRF)
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Henning, John Gordon. "Evaluation of long-hole mine design influences on unplanned ore dilution." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102985.
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Unplanned ore dilution or stope overbreak, which has a direct and large influence on the cost of a stope, and ultimately on the profitability of a mining operation, can be attributed to both the mining process and to geologic setting. The research undertaken in this document, applicable to a wide range of underground mines employing the blasthole mining method to extract tabular orebodies, focuses on examining factors attributable to the generation of unstable stope hanging-walls.The primary objective of the research undertaken is to establish new models for stope and orezone design, with respect to anticipated stope overbreak, focusing on the position and type of stope within the orezone extraction sequence. Identified factors influencing unplanned dilution, such as: induced stress environment, stope geometry, and the setting of individual stopes are considered.
The research undertaken incorporates a variety of components, including (i) parametric 3-D numerical modelling to examine influences of individual factors on hanging-wall overbreak, (ii) case example analysis, and (iii) orezone extraction sequence simulation, using 3-D elastic numerical modelling. Design criteria, developed from the parametric modelling, was applied to the orezone sequence modelling to develop trends for stope dilution, as functions of stope design and construction.
It was found that hanging-wall overbreak is not significantly influenced by depth alone, and that stopes with large vertical and short horizontal dimensions or stopes having long horizontal and short vertical dimensions are more stable than large square-like stopes. Also, through parametric and case studies, it was demonstrated that, in addition to stope dimension, the amount of unplanned dilution differed according to stope type. Five stope types were identified, based on their position within a tabular blasthole mining sequence. Measured overbreak varies with stope type, with secondary stopes generating a greater volume of hanging-wall dilution than do primary stopes. A pillarless mining sequence will generate less overall dilution than a primary stope: secondary pillar mining sequence.
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Pierce, Tamarha. "Experimental priming of interpersonal expectations and coping with an unplanned pregnancy." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23286.
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This study examined the influence of activated and chronic interpersonal expectations on primary and secondary appraisal of a stressful life event. Fifty-one female undergraduates were asked to imagine themselves facing an unplanned pregnancy, after which affective state and coping strategies were assessed. A subliminal priming technique was used during the experimental session to activate either positive, negative or neutral interpersonal expectations. Chronic interpersonal expectations were assessed in a telephone interview, using the Collins and Read (1990) attachment scale. Activated negative interpersonal expectations reduced positive affect; chronic interpersonal anxiety heightened overall negative affect, while chronic comfort with closeness and feeling one can depend on others were associated with less feelings of depression. Both activated and chronically accessible positive interpersonal expectations increased intentions to seek emotional support. Chronic anxiety in relationships was related to hostile coping, while a lack of comfort with closeness and depending on others were conducive to self-blaming. Implications of these findings for close relationships and stressful life events and for future priming research are discussed.
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Higham, Sue. "Protecting, providing and participating : fathers and their children's unplanned hospital admission." Thesis, Swansea University, 2011. https://cronfa.swan.ac.uk/Record/cronfa42988.
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Fathers are being encouraged to be more involved with all aspects of their children's lives and patterns of responsibility for earning income and childcare within families are changing. Yet fathers have been overlooked in previous nursing research into the experiences of the parents of sick children in hospital, leaving nurses wishing to practice family-centred care without an evidence base for their practice with fathers. In this thesis an investigation is presented into the experiences of fathers of children admitted to general children's wards in a District General Hospital following acute illness or injury. A critical realist ethnographic approach was adopted in a study design incorporating participant observation, interviews with nurses and post-discharge interviews with fathers. Data were analysed through a process of content analysis and interpretation. Interpretation was guided by domain theory, reflecting the understanding that the social world is multidimensional. This enabled the complexity of fathers' experiences and the factors which influence them to be identified. Whilst fathers were often seen by health care professionals to be marginal to the child's illness, the study showed that many fathers played significant roles in the families' experiences of hospitalisation of a child for acute illness. Fathers could face barriers to involvement in the child's care which mothers did not. Such barriers arose from their own understandings and circumstances, but also from mothers' and nurses' behaviour in addition to institutional processes and routines. Nurses had received no training or education on working with fathers and therefore based their practice on experiential knowledge. The study indicates the need for changes in nurse education to better prepare nurses to practice family-centred care with 21st century families. It also demonstrates the need for practitioners, institutions and policy makers to take both mothers and fathers into account in the planning and delivery of children's acute in-patient care.
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Gotts, N. M. "Unplanned wayfinding in path-networks : a theoretical study of human problem solving." Thesis, University of Sussex, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.233103.
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Mackenzie, Matthew Robert. "Understanding anesthesia's role in the unplanned admission of pediatric ambulatory surgical patients." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12496.
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Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Introduction: Pediatric ambulatory surgery has experienced a surge in popularity as new surgical and anesthetic techniques have made it a more viable option for a host of surgical procedures. While the vast majority of patients are successfully discharged upon recovery from anesthesia, a small proportion 1-2.5% in previous studies must be admitted to the hospital's inpatient unit. Many of these patients present with conditions such as uncontrollable post-operative pain and nausea and vomiting associated with anesthesia. As such we sought to characterize the unplanned admissions population at Children's Hospital Boston, a tertiary care pediatric hospital and investigate Anesthesia's role in their care. Methods: Patients were identified as possible candidates for inclusion into this study if they experienced a status change in the Children's Hospital Boston records system from "Day Surgery Unit" to "Inpatient Unit". Data from these patients was gathered using Anesthesia records, medical record number summaries, growth charts, and other electronic medical records. Results: The unplanned admission rate at Children's Hospital Boston was 1.29% from January 2010 through June 2011, representing 347 patients from a day surgery population of 26,951. No statistically significant differences were observed in regards to patient fitness, as measured by American Association of Anesthesiologist classification, when compared to patients successfully discharged. The leading causes of admission were uncontrollable postoperative pain (n=117, 39.8%) and post-operative nausea and vomiting (n=94, 32.0%). When compared to the successfully discharged patient population; orthopedic surgery experienced a statistically significant increase in its contribution rate while genitourinary surgery experienced a statistically significant decrease. Pre-operative acetaminophen usage was only 19%, while midazolam pre-medication was 51.4%. Regional anesthesia was utilized in only 11.5% of cases overall and 27.3% of orthopedic patients. Patients experiencing post-operative nausea and vomiting were primarily treated with ondansetron and dexamethasone as prophylaxis while overwhelmingly receiving a re-dosing of ondansetron post operatively. Post-operative utilization of metaclopramide in these patients was 3.7%. Conclusion: At Children's Hospital Boston 71.8% of unplanned admissions are either for pain or nausea and vomiting, two conditions that are intimately related. It is reasonable to presume that an increased emphasis on prophylaxis analgesia in the form of pre-operative acetaminophen and regional anesthesia would help alleviate a portion of these cases directly related to uncontrollable pain. It is also not unreasonable to assume that these options may decrease post-operative opioid usage, a significant risk factor for post-operative nausea and vomiting. In cases where nausea and vomiting is still present and patients have received ondansetron and dexamethasone intraoperatively, there seems to be a reliance on re-dosing with ondansetron, whereas based on physiological pathways of nausea patients, a third drug-class may be a better option. Improvements in these areas could decrease the unplanned admission rate at Children's Hospital Boston.
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Britton, Donna Marie. "Modified Interdisciplinary Rounds/Progression of Care Rounds| Decreasing 30-day Unplanned Readmissions." Thesis, Grand Canyon University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10837264.
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The continuously growing readmission rates within 30-days of discharge point toward compromising quality outcomes such as fragmented health care. The purpose of this project was to compare the effectiveness of pre-intervention traditional interdisciplinary rounds (IR)/ progression of care rounds (POCR) members, in comparison to the intervention of modified IR/POCR members, by adding a disease-specific educator (DSE) member to the team, as measured by the 30-day unplanned readmissions rate in patients discharged from a single cardiology unit in Galveston, Texas. A comparison of 30-day unplanned readmissions during two different timeframes was performed using the planned readmission tool. The Iowa model of evidence-based practice and the model of collaborative care supported the project. A comparative quantitative methodology was used to analyze the data. The final sample consisted of 50 (N = 50) patients discharged during the pre-intervention and 53 (N = 53) during post-intervention. The data was analyzed using descriptive statistics and an unpaired t-test. The pre-intervention IR/POCR team members period 30-day readmissions were 7 compared to 3 during the post-intervention IR/POCR team members. The standard deviation of pre-intervention IR/POCR and post-intervention was 3.95980 and 2.12132 respectively. The results show a significant value of 0.106 (95% CI, -1.04243 to 5.04243). The implementation of the DSE to the IR/POCR team assisted in identifying and closing the gap associated with quality patient outcomes and reduced 30-day unplanned readmission rates. Further research is needed due to a limited practice site.
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Prudencio, Denise Angelo Moreno. "Discharge Phone Call on Unplanned Readmission Due to Chemotherapy Among Cancer Patients." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7060.
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The transition after hospitalization is a vulnerable period when adverse events like unplanned readmissions may occur. Unplanned readmissions with patients undergoing chemotherapy that are the result of gaps in communicating the discharge plan may be preventable. Several transitional care interventions have been explored, and one of these is the nurse discharge phone call. This project explored the effect of a nurse-led transitional discharge phone call within 30-days after hospital discharge on unplanned readmission due to chemotherapy among patients in the medical-oncology compared to patients without a nurse-led transitional discharge phone call. A nurse-led transitional discharge phone call was implemented within 48 to 72 hours after discharge from the medical-oncology unit of a hospital in the northeastern region of United States to determine its effectiveness in reducing the number of unplanned readmissions due to chemotherapy. The Donabedian model, the Iowa model of evidence-based practice to promote quality care, the diffusion of innovation theory, and the health belief model served as the theoretical underpinnings of the project. Seven patients undergoing chemotherapy received the discharge phone call, and none were readmitted due to cancer-related complications. The unplanned hospital readmission rate was 0% compared to the 14.17% in 2017. The findings of this project might contribute to positive social change by helping the community of patients on chemotherapy to have a better transition process through acquiring necessary information for their postdischarge care and thus mitigating the possible causes of unplanned hospital readmission.
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Karanja, Faith Njoki. "Use of knowledge based systems for the detection and monitoring of unplanned developments." [S.l.] : [s.n.], 2002. http://deposit.ddb.de/cgi-bin/dokserv?idn=966084659.
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Hoskins, R. "Why do patients seek unplanned follow up after treatment in the emergency department?" Thesis, University of the West of England, Bristol, 2014. http://eprints.uwe.ac.uk/22758/.
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Aims: This study explored why patients seek unplanned follow up after treatment in an emergency department, if participants could identify the healthcare professional they were treated by, and whether the patient’s perception of, and confidence in, the healthcare professional had an impact on their subsequent decision to seek follow up. Methods: A mixed method pragmatic approach was used in order to quantify and explore the aims of the study. Participants were followed up two weeks later by telephone and finally invited to take part in a focus group to explore their experience and perceptions of their visit to the emergency department. Results: 18% of patients sought unplanned follow up in the 2 weeks following their initial visit, with no statistically significant difference between healthcare professional groups. 19% of patients incorrectly identified the healthcare professional treating them, with evidence of a gender bias. Discussion: The qualitative elements of the study explored the quantitative results. Participants were more likely to believe the healthcare professional was a doctor if they were male and had effective communication skills. A number of practical issues were identified in reducing unplanned follow up rates. The most common were issuing fitness to work certificates, explaining the trajectory of an illness or injury and addressing specific pain management issues. A change in policy would be required for non –medical health care professionals to be able to issue fitness to work certificates but in this study it was found to be the single most effective strategy to reduce reconsultantion rates. Conclusion: Patients seek unplanned follow up for a variety of reasons. This study shows that non-medical HCPs do not have a higher planned or unplanned follow-up rate, and they may have some advantages over junior medical staff in terms of effective consultation skills, high patient satisfaction and reduced reconsultation rates.
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Kohtz, Cindy Rhodes Dent Crumpler Thomas P. "Alternative pedagogies and non-conventional teaching methods in nursing education unplanned and limited change /." Normal, Ill. : Illinois State University, 2006. http://proquest.umi.com/pqdweb?index=0&did=1251836291&SrchMode=1&sid=3&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1178889759&clientId=43838.
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Thesis (Ed. D.)--Illinois State University, 2006.Title from title page screen, viewed on May 11, 2007. Dissertation Committee: Dent Rhodes, Thomas Crumpler (co-chairs), Sara L. Campbell. Includes bibliographical references (leaves 182-191) and abstract. Also available in print.
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Williams, Peter Alan. "Exploratory study of mapping outcomes of executive coaching with specific focus on unplanned outcomes." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/97433.
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Thesis (MPhil)--Stellenbosch University, 2014.ENGLISH ABSTRACT:This research assignment is an exploratory qualitative study into mapping unplanned outcomes of executive coaching. The research purpose was twofold: to address the lack of a common and comprehensive framework for the mapping of outcomes of executive coaching, and to add to the body of knowledge regarding unplanned outcomes of executive coaching. In developing the mapping framework, the available literature was reviewed and, through an inductive process, a framework, model, taxonomy and mapping tool were developed. Based on core concepts attributable to Kirkpatrick, Wilber and Jaques, the mapping tool developed was then tested, using data obtained from a purposive sample of seven semi-structured interviews with Gauteng based coachees. The sample excluded any individuals who had been coached by the researcher. During the data analysis, the planned outcomes were mapped using the mapping tool and related processes. Thereafter the actual outcomes were mapped, identifying those outcomes that matched planned outcomes and those that supported the planned outcomes. A technique named ‘outcome chains’ was developed and used for this process. The unplanned outcomes were identified by a process of elimination, being those that remained unallocated in the planned chain process. It was found that outcomes of executive coaching can be mapped using a framework based on the principles of Kirkpatrick, Wilber and Jaques, with all identified outcomes being mapped successfully. Four categories of unplanned outcomes were identified, namely those that hinder the attainment of planned outcomes, insufficient evidence of achieving planned outcomes, actual outcomes related to planned outcomes but with scope different to planned and, fourthly, actual outcomes unrelated to planned outcomes. Additionally, three themes of unplanned outcomes, each with two sub-themes, were identified, namely personal (sub-themes: physical and spiritual), family (sub-themes: immediate and extended) and work (sub-themes: positive and negative). The most surprising finding was that all seven coachees experienced unplanned outcomes, which is markedly different to previous research findings and may be due to the inclusion of non-work related outcomes. The key recommendations arising from this research assignment embrace the research into, and practice of, executive coaching. Regarding the research elements, it is recommended that the mapping framework developed in this research be further refined and tested as a holistic standard for evaluating the outcomes of executive coaching, including those outcomes that impact the coachee as an individual. For the executive coaching fraternity, it is recommended that coaches challenge themselves and their practices regarding the probability, categories and impact of unplanned outcomes, and introduce measures to maximise the upside and minimise the risks of unplanned outcomes. Finally, the regular testing and recording of the coachee’s reaction to executive coaching is recommended as a predictor of coaching efficacy.
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Dennis-Brinson, Alisha. "A Discovery of How Women with Unplanned PregnancyExperience Spiritual Community at Akron Pregnancy Services." Ashland Theological Seminary / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=atssem1581156517405563.
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Busby, John. "Preventing unnecessary unplanned hospital admissions and achieving timely discharge; an analysis of geographic variation." Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702487.
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Background. Reducing unplanned hospital admissions and achieving timely discharge are key issues for healthcare systems worldwide. Policymakers have focussed on admissions for ambulatory care sensitive conditions (ACSCs) as they are potentially avoidable. Exploring geographic variation could identify variable care pathways. Aims. To investigate the magnitude and causes of geographic variation in unplanned ACSC care. To explore key methodological issues pertinent to small-area variation studies and how this data can inform local decisions. Methods. I conducted a systematic review exploring the magnitude and causes of geographic variation. I estimated geographic variation in ACSC admission rates, length of stay and.readmission rates between PCTs and general practices. I investigated what might be driving these differences. I contrasted geographic variation across patient subgroups. I examined how methodological issues impacted the conclusions of small-area variation studies. I explored how benchmarking is used locally. Results. ACSCs are a large and growing problem. Care processes were highly variable for most, although not all, conditions. Admissions for younger patients, or those with low illness severity, were consistently more variable. Areas with greater bed availability, reduced care continuity and increased A&E proximity had consistently higher admission rates. A range of methodologies were used to quantify geographic variation which can impact conclusions and hinder comparisons. Benchmarking is widely used locally however perceptions of poor data reliability sometimes undermined its utility. Conclusions. There are important differences in ACSC care processes across England. Further work is needed to understand the causes of these differences and should initially focus on the most variable conditions and patient subgroups. Several factors are strongly associated with admission rates; where possible the causal effect of these should be tested using more robust study designs. Improvements in the reliability of routinely collected data, and the methodological rigor of small-area variation studies, is needed to improve their utility.
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Jang, Hyong Doo. "Unplanned dilution and ore-loss optimisation in underground mines via cooperative neuro-fuzzy network." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/997.
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The aim of study is to establish a proper unplanned dilution and ore-loss (UB: uneven break) management system. To achieve the goal, UB prediction and consultation systems were established using artificial neural network (ANN) and fuzzy expert system (FES). Attempts have been made to illuminate the UB mechanism by scrutinising the contributions of potential UB influence factors. Ultimately, the proposed UB prediction and consultation systems were unified as a cooperative neuro fuzzy system.
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Atkinson, Thomas. "The end of the line: Managing unplanned changes in an urban stormwater treatment wetland." Thesis, Atkinson, Thomas (2015) The end of the line: Managing unplanned changes in an urban stormwater treatment wetland. Masters by Research thesis, Murdoch University, 2015. https://researchrepository.murdoch.edu.au/id/eprint/25675/.
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This study looked at the problem of constructed wetlands deviating from their initial design parameters to the detriment of treatment performance, in the context of a contemporary storm water treatment wetland in Perth, Western Australia. The study investigated the system components and internal process management of the wetland, and their impact on its capacity to remove nutrients and contaminants from urban stormwater over a seven year period. It found that a designed feature of the wetland, specifically permanent inundation, compromised the ability of the wetland to accommodate inputs of organic material and sulfate, resulting in intensified substrate reduction. Strongly reduced sediments containing dissolved sulfides and other phytotoxins accumulated to concentrations sufficient to cause vegetation dieback; and the cover and health of the emergent macrophytes within the wetland declined dramatically. Loss of emergent macrophytes coincided with changes in nitrogen removal, not in the reduction of nitrate but in the increase of ammonium, consistent with the increasingly reduced conditions. There was not a significant change in phosphorus removal, perhaps suggesting that phosphorus removal was primarily through physical means (sedimentation) rather than chemical. It was considered that the broadscale deoxygenation of the wetland was detrimental both to its nutrient removal capacity and biodiversity attributes. Applying active adaptive management, a trial was conducted involving manipulation of inundation depths, such that redox potentials were increased in a passively aerated treatment. The growth of the emergent macrophyte species Baumea articulata was demonstrated to improve significantly within this treatment, suggesting a similar modification to the hydraulics of the wetland could improve emergent macrophyte growth. The importance of macrophytes to treatment processes is well established and so this modification is expected to improve the water treatment function of the wetland. The study successfully demonstrated that the design of urban constructed wetlands must be site specific and adaptive to ensure specific ecosystem services, such as water treatment, are maintained.
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MacPherson, C. "A study to examine the risk factors and consequences associated with unplanned and unwanted pregnancy." Thesis, Queen's University Belfast, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273056.
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Spencer, Carolyn R., and n/a. "Cognitive Schemata and Project Manager Regulation of Unplanned Change: Categorical Analysis of Structured Interview Reports." Griffith University. School of Applied Psychology, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040721.092038.
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A significant risk area for project sponsors is managing unplanned change. Theorists of organisational behaviour have attempted to understand the circumstances of how activity change occurs on projects and have identified the significant impact that time has on activity. This current research takes the study of cognition into the real world setting of project management at a level of analysis that is viable across diverse projects and industries to study project manager regulation of unplanned change. The project managers' cognitive representation of meaningful aspects of a project (their 'cognitive schemata'), which guides activity change during the project, was investigated and the effect of feedback evaluated in order to address the central research question of what triggers change on group projects. In the present research, leading edge projects from six major Australian industries (telecommunications, banking and insurance, information technology, railway signalling, inorganic chemistry and construction) were monitored at three key points through their lifecycle to understand how feedback impacts on project activity through the project managers cognition leading to change. Six key categories of feedback were identified, which potentially represented the foci of project-related schemata, within a project management mental model. These were validated as important indicators for project management performance by a panel of Australia's leading experts in project management. Sixteen project managers participated in the field study, with their verbal reports being collected through structured interviews (incorporating a 'laddered' interview technique), which were developed and piloted across diverse projects for this purpose. Interview data were coded for analysis in terms of sensitivity to each of the six feedback foci and one control category, for five types of feedback and five types of change. Reliability of the content coding was checked through independent coding and found to be high. The research investigation was conducted within a schematic information processing conceptual framework developed for application within the domain of project management. Strong evidence was found that linked key schemata to the hypothesized effects of feedback. Overall, the effects were found to be general across all industries, individuals and projects. A contrasting effect was observed for one type of feedback where schemata were poorly developed in inexpert project managers, which raised the issue of measurable differences in behaviour arising from project management competency. The findings of strong relationships between the variables led to the proposed model of project manager cognition, which reveals an underlying structure in the schemata between key areas of sensitivity to feedback and unplanned change. The model is proposed as underpinning observed behaviour in this and prior research and suggests a relationship between competency and change regulation.
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Spencer, Carolyn R. "Cognitive Schemata and Project Manager Regulation of Unplanned Change: Categorical Analysis of Structured Interview Reports." Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366716.
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A significant risk area for project sponsors is managing unplanned change. Theorists of organisational behaviour have attempted to understand the circumstances of how activity change occurs on projects and have identified the significant impact that time has on activity. This current research takes the study of cognition into the real world setting of project management at a level of analysis that is viable across diverse projects and industries to study project manager regulation of unplanned change. The project managers' cognitive representation of meaningful aspects of a project (their 'cognitive schemata'), which guides activity change during the project, was investigated and the effect of feedback evaluated in order to address the central research question of what triggers change on group projects. In the present research, leading edge projects from six major Australian industries (telecommunications, banking and insurance, information technology, railway signalling, inorganic chemistry and construction) were monitored at three key points through their lifecycle to understand how feedback impacts on project activity through the project manager’s cognition leading to change. Six key categories of feedback were identified, which potentially represented the foci of project-related schemata, within a project management mental model. These were validated as important indicators for project management performance by a panel of Australia's leading experts in project management. Sixteen project managers participated in the field study, with their verbal reports being collected through structured interviews (incorporating a 'laddered' interview technique), which were developed and piloted across diverse projects for this purpose. Interview data were coded for analysis in terms of sensitivity to each of the six feedback foci and one control category, for five types of feedback and five types of change. Reliability of the content coding was checked through independent coding and found to be high. The research investigation was conducted within a schematic information processing conceptual framework developed for application within the domain of project management. Strong evidence was found that linked key schemata to the hypothesized effects of feedback. Overall, the effects were found to be general across all industries, individuals and projects. A contrasting effect was observed for one type of feedback where schemata were poorly developed in inexpert project managers, which raised the issue of measurable differences in behaviour arising from project management competency. The findings of strong relationships between the variables led to the proposed model of project manager cognition, which reveals an underlying structure in the schemata between key areas of sensitivity to feedback and unplanned change. The model is proposed as underpinning observed behaviour in this and prior research and suggests a relationship between competency and change regulation.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology (Health)
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Heller, Rebecca Lily. "No missed opportunity : expanding sexual healthcare provision beyond current service delivery models." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/28997.
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Background: Despite a wide range of contraceptive options available in the United Kingdom, the unplanned pregnancy rate remains high. Contraceptive services are currently delivered by general practitioners, sexual health clinics and pharmacies, but there may be scope to expand the places that these are offered, and increase the options available within each service. Doing so could increase the uptake of contraceptive methods, particularly the most effective methods, and therefore reduce the unplanned pregnancy rate. Aim and objectives: Research in this thesis aimed to investigate novel delivery models of contraception. The research had two main areas of focus. Firstly the capacity of the pharmacy to deliver regular contraception was examined, in the context of existing literature, and then through a pilot study. After that the expansion of contraception care to maternity services was investigated, first in the literature and then using an observational study. Methods: In undertaking this thesis I used a variety of methods. Two patient surveys were employed to investigate patients’ perspectives on proposed novel methods of contraceptive delivery. A pilot study investigated the feasibility and acceptability of delivery of the contraceptive injection at the pharmacy. Quantitative results about the numbers of injections given were collected, as were patient questionnaires. Qualitative one-to-one interviews were conducted with participating pharmacists, these were recorded, transcribed and analysed. An observational study was also undertaken to assess routine delivery of insertion of intra-uterine contraception at the time of caesarean section. Patients were seen at six weeks following insertion, and contacted by telephone at three, six and 12 months about satisfaction and continuation of the method. Results: 220 women completed a questionnaire about attending the community pharmacy to receive a contraception injection. 33% of current non-users indicated that they would consider using this method if it was available at the pharmacy. 50 established users of the contraceptive injection participated in a pilot project receiving up to three injections from the community pharmacy. Only 48 injections of a possible 150 were delivered at the community pharmacy. Only 7 participants received all three injections at the pharmacy, and participants reported mixed experiences accessing the pharmacy. The practical obstacles around pharmacy engagement and the challenges of retaining participants were significant, and more research is necessary before proceeding with a randomised controlled trial. 250 women on a postnatal ward completed questionnaires about their pregnancy intentions. 96.7% were not planning a baby in the next year, but only 23.6% were planning on using the most effective methods of contraception. One in three respondents described themselves as likely to use either an implant or intra-uterine contraception if it could be inserted before they left the hospital. In an observational study, 120/877 women opted to have intra-uterine contraception inserted at the time of caesarean section. Continuation rates at 12 months were 84.8% of those contacted, and 92.6% were either ‘very’ or ‘fairly’ happy with their contraception. Conclusion: Although patients are receptive to contraception being delivered using novel service models, alternatives to current practice need careful investigation. Contraceptive injections at the community pharmacy are not necessarily more convenient for patients, and therefore may not increase uptake of this method. However, offering intrauterine contraception to patients at the time of caesarean section is highly acceptable to patients, and results in a substantial majority continuing this highly effective method. Robust and careful research using a range of methods can help to identify which innovative approaches to contraceptive delivery offer the most promise.
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Glenn, Nadia Arrella. "THE MEANING AND UNDERSTANDING OF UNINTENDED PREGNANCY: A QUALITATIVE STUDY OF PREGNANCY AMONG AFRICAN AMERICAN WOMEN LIVING WITH HIV." Diss., Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/555618.
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Public HealthPh.D.
Few studies explore the phenomenon of unintended pregnancy among women living with the Human Immunodeficiency Virus (HIV). To decrease mother-to-child transmission and transmission to a sexual partner, contraceptive methods, cultural beliefs, in addition to protocols pertaining to preconception, pregnancy, labor, delivery and the postpartum period among persons living with HIV must be considered. Half of the pregnancies that occur among HIV-positive women are unintended and requires monitoring and additional prenatal care to reduce adverse health outcomes. This qualitative study sought to increase knowledge of the meaning and understanding of unintended pregnancy among a sample of twelve urban HIV-seropositive African American women. Women shared their experiences related to pregnancy, risk and living with HIV. The majority of participants reported they experienced an unintended pregnancy, discussed lapses in contraception use, knowledge of pregnancy and antiretrovirals, vertical transmission of the virus, sexual risk, and differences in adherence to antiretrovirals during and after pregnancy. Guided by grounded theory the major themes that emerged were used to develop a model that explained unintended pregnancy among the participants. The major themes included resilience, disclosure, and an instinct to protect. Additionally, culture, stigma, social support, contraception, and partner safety were secondary themes. Our review suggests that a model of unintended pregnancy containing social-ecological aspects can describe predictors of pregnancy and potential prevention strategies. Furthermore, the future exploration of the challenges that African American women living with HIV experience with unintended pregnancies, efforts to manage their condition and prepare for a pregnancy are needed.
Temple University--Theses
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Zhao, Jing Mechanical & Manufacturing Engineering Faculty of Engineering UNSW. "A decision support tool for unplanned maintenance at ramp time including aviation regulations and scheduling disruption." Awarded by:University of New South Wales. School of Mechanical and Manufacturing Engineering, 2007. http://handle.unsw.edu.au/1959.4/27449.
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This thesis describes the development of a decision support tool for unplanned maintenance of aircraft at ramp time during airport operations. Ramp time is the time between an aircraft arrival and its next departure. Clearance of an aircraft for flight is controlled by aviation regulations. Therefore decisions regarding maintenance are taken by engineers who have to comply with the regulations that are governed outside the organizational structure of the airline. Unplanned maintenance also often disrupts the normal operational scheduling and leads to significant costs. Therefore, the decision support tool must include the relevant aviation regulations, be capable of rescheduling to minimise disruption and be able to optimise solutions based on cost. In this project an aircraft schedule is used to demonstrate the procedures. An assumed fleet of six airplanes fly between three cities. Consultation with aviation experts ensured the size of the fleet and operations are realistic. A regulation database was developed based on the Master Minimum Equipment List (MMEL) for the aircraft, and a computer programme was developed to provide different options that comply with the regulations and take into account scheduling disruption and costs. In certain cases the regulations allow an aircraft to fly with some components inoperable so long as backup systems can perform the tasks. It is possible then to postpone the maintenance until the aircraft arrives at a properly equipped airport, or until a longer scheduled stopover reduces the disruption to operations. To address the engineering aspects of the project, maintenance of a single component that appears in the MMEL for the chosen aircraft is considered. To plan maintenance following a failure, the cause of the failure needs to be identified. Only then can the resources and time required to repair the defect be defined. The programme validation has confirmed it is able to balance different aspects of decisions related to unplanned aircraft ramp maintenance. Although the programme is based on an assumed fleet operation, the structure of the programme will allow it to be applied to other fleet and route configurations.
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Lei, Ming. "Entertainment education and gender how do they contribute to the prevention of teen and unplanned pregnancy? /." Online access for everyone, 2008. http://www.dissertations.wsu.edu/Thesis/Summer2008/m_lei_072108.pdf.
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MacNeill, Virginia Margaret. "The effectiveness of services intended to prevent young people from leaving home in an unplanned way." Thesis, Royal Holloway, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249753.
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Xie, Jingying, and 谢静颖. "A cross-sectional knowledge, attitude and practice study among women with unplanned pregnancy in Guangzhou, China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46943729.
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Roux, Samantha Lynne. "An exploratory study of mothers perceptions and experiences of an unplanned Caesarean section / Samantha Lynne Roux." Thesis, North-West University, 2010. http://hdl.handle.net/10394/4943.
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Objective The present study aimed to explore women's perceptions and experiences of childbirth by unplanned Caesarean section. Background New motherhood is characterised as a profound change, and research suggests that the psychological effects of childbirth can be significant and far–reaching for some women. The processes occurring during a traumatic birth experience could affect a woman's emotional and psychological state, and she may experience considerable adjustment difficulties in adapting to unfulfilled expectations of delivering her baby naturally. Methods In–depth interviews explored 10 women's lived experiences of childbirth, after which thematic content analysis was used to synthesise data. The elements of phenomenological theory served as a broad framework for the structuring, organizing and categorizing of data, with interpretation aimed at gaining a greater understanding of women's internalised childbirth accounts. Findings Women described their contact with medical personnel, as well as the physical, environmental, and emotional aspects of their unplanned Caesarean sections, as distressing and traumatic. A sense of loss of control was the most significant contributor to women's negative childbirth experiences. Feelings of failure and disappointment were primarily related to unmet expectations and a lack of preparedness. Negative experiences were mediated by attentive caregiving, inclusion in decision–making, and support from loved ones.Thesis (M.Sc. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.
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RANGEL, FABIO DE BARROS. "IMPULSIVE BUYING IN TRAVEL RETAIL ENVIRONMENT: THE INFLUENCE OF THE ENVIRONMENT ON UNPLANNED PURCHASES AT AIRPORTS." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2014. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=24715@1.
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Este estudo busca analisar o efeito do ambiente do varejo aeroportuário no comportamento do consumidor nas compras não planejadas. Foi utilizado o modelo conceitual de Mohan (2013), com a finalidade de testar tanto os elementos inerentes à loja (música, iluminação, lay out e atendentes) quanto as características individuais dos consumidores no que tange o lado afetivo, tanto o positivo quanto o negativo, assim como a necessidade de compra de determinado produto. Foi enviado por e-mail um survey para os clientes que compraram no Free Shop na loja do desembarque de São Paulo dentro do mês de janeiro 2014. Os resultados do estudo indicam a importância do ambiente da loja e principalmente da relevância dos atendentes dentro do modelo estudado.This study analyzes the effect of airport retail environment on consumer behavior in unplanned purchases. The conceptual model of Mohan (2013) was used for the purpose we test both the both the positive elements inherent to the store (music, lighting, lay out and attendants) and the individual characteristics of consumers regarding the affective side as negative, as well as the need to purchase a particular product. Was sent by e-mail a survey to customers who bought in Duty Free in arrival from Sao Paulo to store at least 1 month. The study results show how this set of elements within the dynamic purchasing influence consumption.
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Ng, Cheong Tin Marie Melina. "ERP projects : an examination of the factors influencing additional unplanned effort in the project life-cycle." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/11348.
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Includes bibliographical references (leaves 125-143).For over a decade, ERP systems have been the target of significant amounts of investment in organisations. Some have reaped the benefits anticipated while others struggle to achieve the required level of success. In fact, based on available statistics, numerous organisations have faced problems in keeping their allocated budget and time schedules on track often facing the threat of failure, escalation or significant redirection in their projects. As a result, organisations are seen to spend what can be termed as additional unplanned effort (AUE) in order to try and achieve a certain level of success given budget and time constraints. Using the concept called AUE, derived from topics such as ERP project success and failure, the ERP life-cycle framework and critical success factors (CSFs) relevant to the life-cycle phases, this study attempted to investigate the factors that influence AUE in the phases ofthe ERP life-cycle which in this study consist of the pre-implementation and implementation phases specifically. A sub-objective was also to investigate the possible influence that the presence of factors, responsible for escalation of commitment (EoC) in IT projects, have on AUE in ERP projects. Based on a qualitative mUltiple case-study of 5 ERP projects at different organisations, results showed that there are several factors that influence AUE in satisfying CSFs in each phase of the life-cycle. Particularly, in the pre-implementation phase, factors such as the justification for ERP adoption, the formalisation of an ERP vision, the finalisation of an ERP package choice, the stability of organisational structure, the organisation and flow of the acquisition process, the nature of market conditions and the type of internal and external partnership were found important in influencing AUE in that phase. In the implementation phase factors such as the formalisation of an implementation strategy, the management of organisational momentum and resistance to change, the maintenance of external partnership relationships, conditions external to the organisation, the nature of the organisation and the management of project factors were found important.
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Chapman, Steven Edward. "The impact of unintended and unplanned pregnancy on maternal health care a panel study of Morocco /." Available to US Hopkins community, 2002. http://wwwlib.umi.com/dissertations/dlnow/3068130.
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Lubensky, Micah Elan. "An unplanned trade-off? : the potential conflict between reducing prejudice and supporting engagement in collective action /." Diss., Digital Dissertations Database. Restricted to UC campuses, 2004. http://uclibs.org/PID/11984.
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Skogstad, Shannon Nancy. "Deinstitutionalization : the unplanned parenting paradigm." 2003. http://hdl.handle.net/1993/17904.
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Huang, Jhih-Siou, and 黃智琇. "Predicator of Unplanned Readmission of Pneumonia Patient." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/54101225042235566820.
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碩士中臺科技大學
醫療暨健康產業管理系碩士班
103
Background: Readmission denotes the event that a patient has been hospitalized again after being discharged in a certain period. Readmission is caused by failed treatment or a new or worsening comorbid illness. and manifests two significant problems: deteriorated health care quality and increased health care cost. Hence, readmission is treated as an indicator for evaluating the overall health care quality. Decrease in pneumonia-related readmission has been recognized as a benchmark of quality care. Objectives: This study aims to find the demographic factors, readmission rate, disease factors, treatment factors, comorbidities, and the other risk factors to predict readmissions and to design a model to predicting readmission for pneumonia patients within 30 days after discharge. Methods: The patients with age greater than 18 years old, who had been hospitalized from January 2013 to December 2013, were recruited for this study. The patients were divided into 2 groups. The study group included patients who had been readmitted within 30days after discharge, while patient who hadn’t been readmitted within 30days after discharge were assigned in the control group. Data contain a total of 66 variables, including demographic information, disease factors, treatment factors, and comorbidities, were retrieved from the hospital information system of a regional teaching hospital. After single-variate inferential analyses (Student’s t-test and Pearson χ2) and logistic regression analysis, significant variables which reached significant level (p<0.05) were selected for construct the predictive model. The performance was evaluated with predictive accuracy (or misclassification rate) and receiver operating characteristic (ROC) curve. Result: It was observed that a total of 17,222 patients were discharged from the hospital during the study period; among them, 781 patients with principal diagnosis of pneumonia and age greater 18 years old. After excluding patients who died before discharge (n=15), transferred to other hospitals (n=21), and discharged against medical advice (n=22), data of 723 cases were used for analysis. Of these patients, men accounted for 66.9% with mean age of 72.2 (SD 16.5), and 82 cases were followed by a 30-day readmission (readmission rate 11.3%). The top five primary diagnoses were pneumonia, urinary tract infection, pneumonitis due to inhalation of food or vomitus, chronic airway obstruction, acute respiratory failure, and heart failure. The age (P<0.001), age group (χ2=31.314, P<0.001), length of admission (P<0.05), BUN (P<0.05), Neutrophil (P<0.05), number of medication (P<0.01), number of treatment process (P<0.001), oxygen use (χ2=4.584, P<0.05), inhalation treatment (χ2=2.974, P<0.05), airway suction (χ2=13.973, P<0.001), nasal gastric tube feeding (χ2= 14.604, P<0.001), use of indwelling catheters (χ2=19.961, P<0.001), congestive heart failure (χ2=3.424, P<0.05), and cardiac arrhythmia (χ2 = 8.121, P<0.05) were found to be significantly different between 2 groups. After logistic regression analysis, only 10 variables, including age, length of admission, number of medication, number of treatment procedure, oxygen use, use of indwelling catheter, nasal gastric tube feeding, BUN, cardiac arrhythmia, and valvular disease were significant and selected for constructing the prediction model with a Cox-Snell R2 of 0.75, a predictive accuracy of 87.7%, and an area under ROC curve (AUC) of 0.747. Conclusions: The model constructed using 10 variables for predicting readmission achieved an accuracy of 87.7%. Among these 10 variables, age, indwelling catheters use, and cardiac arrhythmia were the most important predictive factors for readmission prediction. These 3 factors can be evaluated at the time of discharge and are can be used to predict patients who have higher probability to be readmitted. A post-discharge heath care plan can be conducted to prevent patient readmission, thereby increasing the patient safety and reducing the healthcare cost.
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Hosford, Helen Cristin Farah. "Psychosocial factors affecting choices in unplanned pregnancy." Thesis, 2012. http://hdl.handle.net/10210/4290.
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M.A.The aim of this study was to ascertain which variables affect and influence women when making choices in unplanned pregnancy. In addition, to determine if there were any significant differences between the pregnancy and termination of pregnancy (TOP) group, indicating a specific profile for the respective group. Comparatively little research has been conducted on unplanned pregnancy and abortion within South Africa, as compared with international studies. Future longterm studies are recommended. The research conducted was of a quantitative quasi-experimental research design, wherein the researcher compared the following variables between the two groups: Biographic/demographic data, Personality Styles, perceived Family Environments and Coping Resources. Subjects were not randomly assigned, but selected by the nursing staff and researcher. Statistical analysis reflected that the two groups differed significantly on four variables. The majority of women in the TOP group were found to be the sole earners within their families. Conversely, women in the pregnancy group had more financial resources and lower levels of employment. A lack of sufficient finances was shown to be the strongest determining factor for those electing abortions. A compounding factor, were the nature of the relationships from where conception arose, 71% of the women who elected abortion described difficulties with the partnerin- conception. These included poor relationships due to excessive drinking, extramarital affairs, disinterest in the pregnancy, subsequent abandonment and divorce. Although the two groups had similar profiles in terms of the religious variable, many of the women who elected to remain pregnant, cited religion and/or their beliefs as the primary reason for continuing their pregnancies. In contrast, the TOP group reported a higher level of conflict within their family of origin, compared to the pregnancy group. IV No underlying pathology was found to exist in the group electing terminations, with both groups presenting similar personality styles. The two groups were also found to use comparable coping skills and resources. This research indicates, that most of the women experiencing an unplanned pregnancy based their decisions to abort on external variables; such as their relationships, financial position and religious beliefs. Studies indicate that these women are more likely to experience deleterious consequences, than those who make this decision based on their own personal needs. Many of these women made their decisions based on limitations not preference. This study may be considered to show important findings, as it reflects the need for effective pre- and post-abortion intervention/counselling services, which should be easily accessible to the public. The psychological well-being of the individual is critical for the overall well-being of the community, and ultimately therefore, society.
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Chang, Ting-Yu, and 張廷宇. "Is In-App Purchases an Unplanned Behavior?" Thesis, 2012. http://ndltd.ncl.edu.tw/handle/63682244171001919505.
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碩士國立中央大學
資訊管理研究所
100
In recent years, smart phones have gradually replaced feature phones in the mobile market. Along with the rapid growth of smart phones, mobile phone’s application (app) also receive public acceptance. By the end of 2011, the number of apps available on both the Apple App Store and the Google Play all surpassed 50,000. In addition, Apple App Store has reached 25 billion in app download count by March 2012. With the growth of App’s market, the App revenue model has gradually transformed from “one-time purchases” to “in-app purchases.” Of all App categories, Games have netted the most revenue. This study attempts to look into the phenomenon of “in-app purchases,” trying to explain the seemingly impulsive behavior. We extended the “Theory of Planned Behavior (TPB)” with “Flow theory.” In this study, data was collected from 326 valid respondents through web-based questionnaires distributed through relevant discussion groups. PLS and SPSS were employed as data analysis tools. Result revealed that: (1) the extended TPB model is effective in explaining the respondent’s in-app purchases behavior; (2) “flow experience” has a directly effect on respondent’s actual behavior; and (3) descriptive norm is more likely to influence the respondents than injunctive norm in in-app purchase behavior.
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Gama, Nothando Nokuthula. "The effects of unplanned pregnancy on female students of the University of Zululand." Thesis, 2008. http://hdl.handle.net/10530/132.
Full textAbstract:
A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE MASTERS DEGREE IN (COMMUNITY WORK)
IN THE SOCIAL WORK DEPARTMENT (FACULTY OF ARTS) AT THE
UNIVERSITY OF ZULULAND, 2008.The study investigated the effects of unplanned pregnancy on female students at the University of Zululand. The sample consisted of 22 female students whose ages range from 15-26+. Female students who are sexually active were more likely to use no contraceptives, which puts them at a high risk of unplanned pregnancy. Some are influenced by their partners regarding birth control or they forget to use contraceptives altogether. University students engage in sexual intercourse, generally with multiple partners. The University of Zululand female students are faced with the problem of unplanned pregnancies, which is very high. It has become imperative, therefore, to get some answers to the questions as to why some fall pregnant and say it was unplanned and some do not know who impregnated them. The researcher wanted to examine perceptions of the effects of unplanned pregnancy on female students; to examine long term or on-going effects that female students might experience after termination of pregnancy or miscarriage, and to investigate the level of knowledge related to contraceptives and other means of preventing unplanned pregnancy. The findings show that it is the young adults (15-19) years of age that are mostly affected by unplanned pregnancies. Racial group are the blacks, those who are not married, are mostly experiencing unplanned pregnancy. There are a few people who are using contraceptives; this also indicates that there is lot that needs to be done in educating people about the use of contraceptives.
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Williamson, Micheal. "unplanned wanderings: and the discovery of a pier." 2008. http://hdl.handle.net/1993/3089.
Full textAbstract:
My question here revolves around my orientation with my own work; my own frustrations and inability to so often answer the question “can a meaningful place be designed?”
This journey examines the theory of semiotics. Through this, three strategies have been developed to explore the branches of semiotic research in Landscape Architecture.
The first strategy allows meaning to develop through time, and it is with the repeated usage of people that meaning will accrue. The second strategy shows how meaning can be determined before the design through mapping current and desired locations of meaning in space. And, the third strategy reflects on how meaning emerges from the earth when no interference from designers or users occurs.
The result of the three individual strategies is a combination of solutions, illustrating how to create places of true richness. This new space will engage visitors, pull in new visitors, and help create something memorable for those engaging in a space.October 2008
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Tsai, I.-Ying, and 蔡易穎. "The Impact of Unplanned Hemodialysis on Healthcare Costs." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/93564326464465902919.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
101
Background: The clinical and socioeconomic impact of unplanned dialysis is significant. Access to nephrology care before initiation of chronic dialysis is associated with improved outcomes. There have been no reports of unplanned hemodialysis (HD) initiation in Taiwan. The aim of this study is to evaluate the impact of healthcare utilization and healthcare cost, and to analyze whether the healthcare utilization in the predialysis period correlates with the planned start among incident hemodialysis patients. Study design: retrospective cohort study. Setting &; Participants: We conducted the study of adult patients, who initiated first long-term hemodialysis therapy between January 1, 2005 and December 31, 2007. We used the sampling file of one million people in 2005, in Taiwan National Health Insurance Research Database (NHIRD). The study period for each patient extended from 2 years before to 90 days after the initiation of HD therapy. Predictors: Patient characteristics (sex, age, diabetes, hypertension, peripheral vascular disease, congestive heart failure, myocardial infarction) and healthcare utilization (nephrology care, western medicine outpatient department (OPD) visits, and emergency department (ED) visits) in the predialysis period. Predictors of the planned starts were evaluated with logistic regression. Outcome and measurements: ED visits hospitalization rates, cause-specific hospitalizations, length of hospitalization and total hospitalization costs per patient in the postdialysis period. Results: A total 927 patients were included (mean age, 63 years old; 53% male; 67% unplanned dialysis initiation). In the postdialysis period, the proportion of hospitalization (17.6% vs. 48.5%, p < 0.001) and ED visits (26.7% vs. 37.8%, p = 0.006) were significantly higher in the unplanned group. In all hospitalized patients, the median length of hospitalization (7 days vs. 13 days, p = 0.009) was significantly higher in the unplanned group. For all cardiovascular hospital admissions, the median length of hospitalization (4 days vs. 14 days, p = 0.036), and the median unadjusted total hospitalization costs per patient ($1492 vs. $2711, p = 0.046) were significantly higher in the unplanned group. For all infectious hospital admissions, the median length of hospitalization (8 days vs. 16.5 days, p = 0.003), unadjusted median total hospitalization cost per patient ($1651 vs. $2884, p = 0.033) were also significantly higher in the unplanned group. Total annualized hospital costs related to unplanned dialysis was $ 350,000 (about $10.5 million TWD). Reducing the rate of unplanned dialysis by one-half yielded savings about $208,000 (about 6.2 million TWD), when we used the total number of new ESRD in 2005 as the estimation. In a model using only patients’ characteristics as the risk factor, logistic regression showed lower ORs for advancing age 0.99 (95% CI, 0.99-1.00), diabetes 0.52 (95% CI , 0.38-0.71), and myocardial infarction 0.36 (95% CI, 0.14-0.94), and higher ORs for hypertension 1.72 (95% CI, 1.17-2.63). In the expanded model II, odds were lower for advancing age 0.95 (95% CI, 0.97-1.00), diabetes 0.51 (95% CI, 0.37-0.73), and the number of ED visits 0.73 (95% CI, 0.62-0.87). Odds were higher for predialysis nephrology care for over 90 days before HD 1.97 (95% CI, 1.31-2.96), the number of nephrology care 1.28 (95% CI, 1.21-1.37) and the number of western medical OPD visits, except nephrology care 1.05 (95% CI, 1.03-1.08). Limitations: Clinical outcomes, laboratory data, and social-economic status were not feasible due to the nature of the database. Conclusions: Between 2005 and 2007, the proportion of unplanned starts of HD was high in Taiwan. Unplanned starts are linked to more ED visits and more hospitalizations in the postdialysis period. All infection and all cardiovascular causes related hospitalizations play a major part of the total hospitalization costs, especially in the unplanned group. Increasing predialysis nephrology care, increasing OPD visits and decreasing ED visits were associated with increased odds of planned starts. That said the impact of unplanned dialysis is significant in the healthcare cost and utilization. Further research and the implementation of initiatives are needed to reduce the rate of unplanned HD starts and the significant reduction of related healthcare costs. Key words: unplanned start, hemodialysis, healthcare costs, utilization, hospitalization
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Yeh, Nai-Chi, and 葉乃綺. "The Effect of Cash Rewards on Unplanned Buying." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/10683116317083266187.
Full textAbstract:
碩士國立成功大學
國際企業研究所碩博士班
92
As globalization became a trend, competence of businesses is more and more severe. In order to making profit and existing, many companies raise marketing budget and use various new type promotion activities to attract consumers. Cash Rewards, a new type promotion tool, which was applied on many famous department stores, apparel retailing chain and grocery stores etc., for it could stimulate consumption and bring short-term performance rising. What effect the new type promotion tool has to attract consumers and let them be willing to buy more goods? In this article, author through cash rewards to discuss how promotion usage influences on final purchase behaviors? What will affect artificial buying desire? And how unplanned purchases happened? The main purposes of this article are: (1) Using consumer motivation, expected benefit and expected regret to develop dimension of artificial buying desire.(2)To discuss different cash rewards programs have influence on artificial buying desire.(3)To discuss effects of the amount of paid money may influence artificial buying desire.(4)To discuss effects of the artificial buying desire may influence unplanned purchase.(5)To discuss mediator effects of add –purchase goods’ price, preference of goods alternatives. (6)To provide suggestions of pricing cash rewards promotion tool. The main results are as follows: (1)When a company use the same discount to provide different cash rewards programs, there are no different degree of artificial buying desire of consumers. (2)The more amounts of paid money, the higher degree of consumer’s artificial buying desire. (3)When a company use cash reward promotion, higher artificial buying desire will bring higher rate of unplanned purchase. (4)Add-purchase goods price has no influence on final unplanned purchase. (5)Preference factors have influence on final unplanned purchase.
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Shen, Li-Pen, and 沈麗盆. "Correlates of the unplanned replacement of peripheral intravenous catheters." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/08897421872663197664.
Full textAbstract:
碩士高雄醫學大學
護理學研究所
98
The purpose of this study was to explore predictors for the medical patients̛unplanned replacement of peripheral intravenous catheters. An observational and propctive study, Since June 1, 2009 to November 10, 2009, with a purposive sampling, a total of 210 patients and 105 nurses, in a medical center involving nine medical wards was recruited in southern Taiwan. The results showed that unplanned replacement rate of peripheral intravenous catheters accounted for 43.8%; whether unplanned replacement peripheral intravenous catheter or not was significantly different with either injection of a large volume of solution or not, or either application of alcohol povidone-iodine solution for the sterilizing puncture of the skin or not. with multivariate logistic regression analysis, it showed that injection of a large volume of solution was the determinant for unplanned replacement of peripheral intravenous catheters. The odds ratio (odds ratio, OR) was 1.97. The results of this study could provide an indicator for unplanned replacement of peripheral intravenous catheters in order to enhance the quality of nursing care for the peripheral intravenous catheter.
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Hu, Hsiao-Chen, and 胡曉珍. "The unplanned readmission and relative factors in cancer patient." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/72163645598050626464.
Full textAbstract:
碩士國立臺北護理健康大學
護理研究所
99
The purpose of this study was to explore the association between unplanned readmission within 31 days and demography, disease characteristics, activities of daily living, nutritional status, nursing direction, and discharge planning need. This is a chart review study. We linked cancer registry database and patients information system to select patients who hospitalized in general ward from Jan. 2008 to Jun. 2009 and newly diagnosed with lung, liver, colorectal and breast cancer in a medical centers of northern Taiwan. In these patients, there were 60 patients unplanned readmission within 31 days. We randomized another 60 patients according to cancer diagnosis from these patients. Information of patients’ nutrition data, activities of daily living, nursing direction and discharge planning needs were collected form medical chart and discharge planning system. The SPSS Version 17.0 statistical analysis program was used for data management and analysis. The mean age of 120 patients was 61.2 years (SD = 13.9). Most patients were male(55%), married(87.5%), living with their families(95%). The average length of stay was 9.9 days(SD = 11.0). The majority patients had chronic diseases (60.8%), cancer stage III(37.5%), hemoglobin below than 12 g / dl (60.8%), and BMI range from 18.5 to 23.9 (47.5%). About 26.7% patients were unplanned readmission within 31 days due to disease symptoms related to cancer. The logistic regression model indicated that age, cancer metastasis, activities of daily living, and needs of discharge planning related to unplanned readmission significantly. Patients with discharge planning need had higher risk of unplanned readmission than those without need (OR=4.01, CI=1.25-12.85 ). Patients with metastasis also had higher unplanned readmission risk than those without (OR= 3.79, CI=1.44-9.98). The total explanation variance accounted for 25.3%. However, hemoglobin, BMI and nursing direction couldn’t predict unplanned readmission in our study. This study proves that discharge planning is the risk factor of unplanned readmission. We should discuss the function and features of discharge plan to build up complete discharge service that meets cancer patients’ needs. The relationships between nutrition status, nursing direction and unplanned readmission need more research to be verified.