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Gomes, Daniela Cabral. « Word of mouth, referral marketing e a lealdade dos clientes no contexto B2B ». Master's thesis, Instituto Superior de Economia e Gestão, 2017. http://hdl.handle.net/10400.5/14886.
Texte intégralRésumé :
Mestrado em Ciências EmpresariaisNum contexto empresarial cada mais competitivo torna-se cada vez mais importante que uma empresa se consiga destacar e a retenção de clientes torna-se fundamental. Os métodos tradicionais já não têm o mesmo efeito e o Word of Mouth surge como um dos métodos mais bem-sucedido na aquisição de clientes, principalmente em contexto B2B onde as decisões tomadas têm um maior impacto. É nesse contexto que se insere o presente estudo onde se questiona a possibilidade de poder associar positivamente os clientes adquiridos via programas de referrals ao seu estado de lealdade/ retenção a uma empresa em contexto B2B, através da análise do Caso da Empresa W. Apesar de o Programa não estar tão estruturado, como sugerem os autores, os resultados mostraram uma correlação positiva entre os Programas de Referrals, com o uso gerido do Word of Mouth., e a retenção/Lealdade dos clientes.
In an increasingly competitive business environment, it becomes increasingly important for a company to excel and customer retention becomes critical. Traditional methods no longer have the same effect and Word of Mouth emerges as one of the most successful methods of customer acquisition, especially in the B2B context where the decisions made have a greater impact. It is in this context that the present study is inserted where one questions the possibility of being able to positively associate the customers acquired through referral programs to their loyalty / retention status to a company, in a B2B context, through the analysis of the Case of Company W. Although the Program is not as structured as the authors suggest, the results showed a positive correlation between the Referral Programs, the managed use of Word of Mouth, and customer retention / loyalty.
info:eu-repo/semantics/publishedVersion
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Mo, Wentao. « A Referral-Based Recommender System for E-commerce ». NCSU, 2001. http://www.lib.ncsu.edu/theses/available/etd-20010621-231234.
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WENTAO MO. A Referral-Based Recommender System for E-Commerce (Under the direction of Dr. Munindar P. Singh).The thesis is intended to develop the technology and infrastructure to allow people to share knowledge with and learn from each other. A special kind of multiagent system, called multiagent referral system (MARS), is proposed. In MARS, each user is assigned a software agent, and software agents help automate the process of expertise location by a series of ?referral chains.? Unlike most previous approaches, our architecture is totally distributed and preserves the privacy and autonomy of their users. These agents learn models of each other in terms of expertise (ability to produce correct domain answers), and sociability (ability to produce accurate referrals).
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Silva, Silvia Helena Ferr?o. « Professoras do 3 ? ano do Ensino Fundamental frente ?s dificuldades de aprendizagem em Matem?tica e ?s decis?es de encaminhamento para apoio psicol?gico e ou refor?o escolar ». Pontif?cia Universidade Cat?lica de Campinas, 2014. http://tede.bibliotecadigital.puc-campinas.edu.br:8080/jspui/handle/tede/726.
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Previous issue date: 2014-02-03This paper presents a study on the actions taken by teachers of the 3rd year of Elementary School, related to the decisions and referrals regarding the students indicated as having learning gap in Mathematics. Our question at issue is: How and why do referrals of students in the 3rd year of Elementary School with Mathematics difficulties occur in the teachers view? The main goal was to analyze, based on pieces of information from teachers of the 3rd year of Elementary School regular and special education classes the conceptions related to the Mathematics concepts learning difficulties found by students and the need for psychological referral or pedagogical remedial help. The research development brought indications with reference to the issue of children learning difficulties in Mathematics, their emotions during the learning process and the aspects regarding Mathematics teaching and learning in school. The data arose from semi-structured interviews with three teachers of the 3rd year two from the classrooms and the resource room teacher in two different moments: in the beginning of 2013 school year and in November of the same year; and also the documentation for the student referral to remedial classes and psychological support. During the interviews the participants pointed out that the initial training course didn`t offer them enough theoretical subsidies to perform in the teaching discipline of Mathematics to the initial years of Elementary School. It was also pointed that a lot of the learning difficulties of these students is generally related to Mathematics concepts that weren`t understood by them. Teachers considerations about the referrals of students with learning difficulties were analyzed, as well as their conceptions about how and why these referrals should happen. In addition, the documentation of a 3rd year student who attended the resource class and the psychological assistance for two years was analyzed. It has been concluded that the services of resource class and psychological assistance, both offered by the city council, do not become linked, then bringing little contribution to students progress. The considerations to evaluate the student`s development are evasive, advancing little to identify their difficulties and to show alternatives to those people who will keep working with children, what provides little contribution to cognitive and psychological development.
O trabalho apresenta um estudo sobre as a??es de professoras do 3? ano do Ensino Fundamental, relacionadas ?s decis?es e encaminhamentos referentes aos alunos indicados como portadores de defasagem de aprendizagem em Matem?tica. Nossa quest?o problema assim se configura: Como e por que ocorrem os encaminhamentos de alunos com dificuldades relacionadas ? Matem?tica em sala de 3? ano do Ensino Fundamental de uma rede p?blica municipal na vis?o das professoras? Teve por objetivo analisar, a partir das informa??es de professoras do 3? ano do Ensino Fundamental da sala regular e de educa??o especial as concep??es relacionadas ?s dificuldades encontradas pelos alunos ao aprender conceitos matem?ticos e a necessidade de encaminhamento psicol?gico ou de refor?o pedag?gico. No desenvolvimento da pesquisa trouxemos apontamentos relativos ?s quest?es das dificuldades de aprendizagem das crian?as em Matem?tica, das suas emo??es no percurso da aprendizagem e de aspectos relacionados ao ensino e ? aprendizagem de Matem?tica na escola. Os dados originaram-se das entrevistas semiestruturadas realizadas com tr?s professoras de 3? ano duas de sala de aula e a professora da sala de recurso em dois momentos diferentes: no in?cio do ano letivo de 2013 e no m?s de novembro do mesmo ano. Ainda, de documenta??o relativa ao encaminhamento do aluno para sala de refor?o e de atendimento psicol?gico. Nas entrevistas as participantes indicaram que o curso de forma??o inicial n?o lhes ofereceu subs?dios te?ricos suficientes para a atua??o na doc?ncia na disciplina de Matem?tica para os anos iniciais do Ensino Fundamental. Tamb?m que muitas das dificuldades de aprendizagem destes alunos, de maneira geral est?o relacionadas com os conceitos matem?ticos n?o compreendidos por eles. Analisamos as considera??es das professoras referentes ao encaminhamento de alunos com defasagem de aprendizagem, suas concep??es sobre como e por que esses encaminhamentos devam se dar. Ainda, a documenta??o de um aluno de 3? ano, que freq?entou por dois anos a sala de recurso e o atendimento psicol?gico. Conclu?mos que os servi?os de sala de recurso e atendimento psicol?gico, ambos oferecidos pela prefeitura, n?o se articulam, trazendo pouca contribui??o para os avan?os dos alunos. As considera??es para avaliar o desenvolvimento do aluno se fazem evasivas, pouco avan?ando no sentido de identificar suas dificuldades e de apresentar alternativas para o trabalho daqueles que com a crian?a v?o continuar atuando, o que proporciona pouca contribui??o para os avan?os cognitivos e psicol?gicos.
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Chiarini, Alessandra <1976>. « Early Referral e prevenzione secondaria dell'insufficienza renale cronica benefici per il paziente e per la sostenibilità del sistema dialisi ». Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3560/1/chiarini_alessandra_tesi.pdf.
Texte intégralRésumé :
Attività di ricerca nell'ambito dell'inidirizzo nefrologia clinica, valutando: la popolazione dei pazienti in trattamento sostitutivo in particolare incidenza e prevalenza dei pazienti in trattamento renale sostitutivo nell'Azienda USL di Cesena dal 2000 al 2009 confronto con i dati del registro italiano (analisi retrospettiva). Analisi di questa popolazione e in particolare referral nefrologico e applicazione di misure atte a ridurre la progressione dell'IRC (prevenzione secondaria, terziaria e riduzione dei costi). Confronto con i dati internazionali.
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Chiarini, Alessandra <1976>. « Early Referral e prevenzione secondaria dell'insufficienza renale cronica benefici per il paziente e per la sostenibilità del sistema dialisi ». Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3560/.
Texte intégralRésumé :
Attività di ricerca nell'ambito dell'inidirizzo nefrologia clinica, valutando: la popolazione dei pazienti in trattamento sostitutivo in particolare incidenza e prevalenza dei pazienti in trattamento renale sostitutivo nell'Azienda USL di Cesena dal 2000 al 2009 confronto con i dati del registro italiano (analisi retrospettiva). Analisi di questa popolazione e in particolare referral nefrologico e applicazione di misure atte a ridurre la progressione dell'IRC (prevenzione secondaria, terziaria e riduzione dei costi). Confronto con i dati internazionali.
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John, Solomon. « The evaluation of 'Lower Gastrointestinal e-Referral Protocol' at the Primary care-Secondary care interface : a prospective study ». Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/362762/.
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The rationale for this study was born out of the need to streamline referral mechanisms for suspected colorectal cancer referrals from primary care, and also to process patients with lower gastrointestinal symptoms and suspected iron deficiency anaemia adequately. There is limited guidance on how to decide which patients need investigations and no clear guidance in primary care on where patients with various colorectal symptoms should be seen in secondary care. We hypothesized that a validated electronic referral protocol (e -RP) addressing the full spectrum of lower gastrointestinal symptoms and suspected or proven iron deficiency anaemia would help General Practitioners in making correct referral decisions. This prospective, parallel, non-randomised trial looking at the benefits of a dedicated Lower Gastrointestinal e-Referral Protocol was carried out in one secondary care hospital and surrounding general practices in the Bournemouth and South & East Dorset Primary Care Trusts. My aim was to assess the yield of CRC, whilst filtering less serious pathology, from the TWW and urgent referral system. I measured the time periods from referral by GP through first appointment/investigation to definitive diagnosis in groups of patients who were referred using the e-RP or through traditional referral methods. The use of e-RP was associated with a statistically significant increase in yield of CRC, difference in time to definitive diagnosis for colorectal cancer and a sensitivity of 100%, compared with 75% for non-use of e-RP. There were several other changes which support the use of e-RP but which did not reach statistical significance, probably due to Type II error.
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Urbonavičiūtė, Eglė. « Ambulatorinių pacientų depresijos simptomų sąsaja su pirminės asmens sveikatos priežiūros įstaigos apkrova ». Master's thesis, Lithuanian Academic Libraries Network (LABT), 2009. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2009~D_20090629_143508-21934.
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Šiame darbe išanalizuota iki šiol Lietuvoje netyrinėta sąsaja tarp depresija sergančių pacientų ambulatorinių apsilankymų ir pirminės asmens sveikatos priežiūros įstaigos apkrovos. Šis tyrimas moksline ir praktine prasme yra vertingas tolesniems depresijos simptomų patiriančių asmenų pirminės sveikatos priežiūros organizavimo bei vystymo tyrinėjimams.
Darbo tikslas. Įvertinti depresijos simptomų sąsają su ambulatorinių pacientų apsilankymų kiekiu ir pirminės asmens sveikatos priežiūros įstaigos apkrova.
Darbo uždaviniai:
1. Nustatyti depresijos simptomus patiriančių pacientų ambulatorinių apsilankymų per pusmetį pas bendrosios praktikos (šeimos) gydytojus dažnį ir palyginti su depresijos simptomų nepatiriančių pacientų apsilankymų dažniu.
2. Nustatyti depresijos simptomus patiriantiems pacientams per pusmetį suteiktų gydytojų specialistų konsultacijų dažnį ir palyginti su depresijos simptomų nepatiriančių pacientų konsultacijų dažniu.
3. Nustatyti depresijos simptomus patiriantiems pacientams per pusmetį atliktų laboratorinių tyrimų kiekį bei struktūrą ir palyginti su pacientų, nepatiriančių depresijos simptomų, laboratorinių tyrimų dažniu.
Tyrimo metodika. Tyrimui atlikti naudoti penki tyrimo metodai: mokslinės literatūros analizė ir apibendrinimas, anketinė apklausa, testavimas HADS skale, laiko biudžeto analizė ir matematinė statistika. Pagal HADS-D rezultatus, visi tyrimo dalyviai buvo suskirstyti į dvi grupes: pirmą (HADS-D>=8) sudarė 24 tiriamieji, kuriems... [toliau žr. visą tekstą]In this study we investigated the association between the symptoms of depression of ambulatory patients and the rate of outpatient visits and workload of primary health care centre. This problem was investigated for the first time in Lithuania. The results of this study are of great scientific and practical value for further investigations, cocerning the organization and development of the primary health care for patients with symptoms of depression. Aim of the study. To identify the association between the symptoms of depression of ambulatory patients and the rate of outpatient visits and the workload of the primary health care centre. Objectives: 1. To evaluate the rate of outpatient visits that patients with symptoms of depression make to the general practioner during the past six months and to compare with the patients having no symptoms of depression. 2. To evaluate the rate of consultations of specialists for patients with symptoms of depression during the past six months and to compare it with the patients having no symptoms of depression. 3. To evaluate the amount and structure of laboratory tests done for the patients with symptoms of depression during the past six months and to compare it with the patients having no symptoms of depression. Methods. Data was collected using questionnaire, Hospital Anxiety and Depression Scale (HADS), time budget analysis. According to the scores of HADS, 24 participants were assigned to the group of great or undeterminated risk... [to full text]
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Neira, Ricardo Alfredo Quintano [UNIFESP]. « Construção e avaliação de sistema de segunda opinião médica em radiologia ». Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/9253.
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Previous issue date: 2009-06-24INTRODUÇÃO. A segunda opinião médica pode ser definida como a busca de conselhos ou informações médicas entre profissionais de saúde. OBJETIVO. Este trabalho tem o objetivo de apresentar os passos da construção de um sistema de segunda opinião médica, bem como os resultados da avaliação do sistema desenvolvido. MÉTODOS. No trabalho realizou-se um estudo observacional com enfoque etnográfico de investigação empírica. Um sistema web que reproduz o processo de segunda opinião médica definido foi construído a partir de tecnologias de software livre. Para a avaliação, o sistema foi utilizado por 49 médicos residentes da Universidade Federal de São Paulo que emitiram a sua opinião para 52 solicitações de segunda opinião médica. Como instrumentos de avaliação foram utilizados questionários a respeito do conhecimento prévio, da solicitação, de opinião e de satisfação. RESULTADOS. Foram emitidas 1.891 respostas de segunda opinião pelos médicos para as 52 solicitações. Na avaliação da satisfação subjetiva do usuário, o sistema apresentou média de 87,8% no quesito facilidade de utilização e 95,6% no quesito aprendizado para a utilização do sistema. Os médicos indicaram a necessidade de incluir recursos para auxiliar a observação de imagens como, por exemplo, ampliação (zoom), brilho e contraste, em 38,2% das respostas. Apontaram também, em 47,3% das respostas, que os dados clínicos constituem a informação de maior importância para a emissão da segunda opinião. Respostas às solicitações de segunda opinião apresentaram linguagem inadequada que poderia prejudicar a colaboração entre os médicos. CONCLUSÃO. Os resultados da construção e da avaliação deixam em evidência a efetividade do processo definido para a obtenção de segunda opinião médica em radiologia à distância. Palavras-chave: Telemedicina, Consulta Remota, Referência e Consulta, Radiologia, Diagnóstico por Imagem.
INTRODUCTION. The second opinion can be defined as the search of advices or medical information between health professionals. OBJECTIVE. The objective of this work is to present the steps of the construction of a second opinion system, as well as the evaluation results of the developed system. METHODS. In this work an observational study with an empirical ethnographic research focus was implemented. A web system was developed based on open-source technologies. For the evaluation, the system was used by 49 residents from the Federal University of São Paulo that informed their opinion to 52 medical second opinion requests. Questionnaires of previous knowledge, request, opinion and satisfaction where employed as evaluation tools. RESULTS. 1.891 second opinion responses were given by the physicians to the 52 requests. Regarding to the user satisfaction evaluation, the system presents a 87,8% mean in the easy utilization item and a 95,6% mean in learning to operate the system. The physicians showed the necessity to add resources to help observing images, as example, magnifying, brightness and contrast, on 38,2% of the responses. 47,3% responses indicated also that clinical information is the most important information for a second opinion emission. Inappropriate language was found on responses for medical second opinion requests which could difficult physicians’ cooperation. CONCLUSION. The results of the development and evaluation of the second opinion system show that the defined process was effective for the achievement of remote radiology second opinion.
TEDE
BV UNIFESP: Teses e dissertações
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Cardoso, Graça Maria Pereira. « Avaliação da efectividade de uma intervenção em psiquiatria de ligação na doença coronária aguda ». Doctoral thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2005. http://hdl.handle.net/10362/5508.
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RESUMO: Várias intervenções psiquiátricas e psicossociais têm demonstrado ser eficazes
na redução da depressão e da ansiedade em indivíduos que sofreram um acidente
coronário agudo. A possiblidade de modificarem a evolução da doença coronária
e de reduzirem a mortalidade cardíaca continua, no entanto, por comprovar. Este
estudo teve como principal objectivo avaliar a efectividade de uma intervenção de
Psiquiatria de Ligação (PL) em doentes com cardiopatia isquémica aguda.
Métodos: um grupo inicial de 129 doentes consecutivos, internados por Enfarte Agudo do Miocárdio (EAM) ou Angina Instável, numa unidade de cuidados intensivos foi avaliado com a Hospital Anxiety e Depression Scale (HADS).
Os doentes que apresentaram uma pontuação ≥8 nas subescalas da Depressão ou da Ansiedade (n=72) foram aleatoriamente distribuídos por grupo de intervenção (GI) (n=37) e grupo de controlo (GC) (n=35). O GI foi sujeito a uma intervenção de PL, realizada durante o período hospitalar, que se iniciou nos primeiros dias de internamento e consistiu em pelo menos 3 sessões individuais (incluindo avaliação psiquiátrica, psicoterapia de suporte, intervenção psicoeducativa e medicação, quando necessário). A sessão pré-alta envolveu o cônjuge e abordou a modificação de comportamentos de risco, a adesão terapêutica e o regresso ao trabalho. O GC
recebeu os cuidados habituais da unidade de internamento. Todos os doentes completaram
uma entrevista inicial para avaliação do estado cognitivo (Mini Mental State Examination – MMSE), do ajustamento social (Social Problems Questionnaire – SPQ) e de aspectos sociodemográfi cos e clínicos. Os doentes foram reavaliados antes da alta, aos 45 dias, 3 e 6 meses com a HADS, o SPQ e ainda com o Nottingham Health Profi le (NHP) para avaliação da qualidade de vida. No
follow-up de 6 meses foi colhida informação sobre sobrevivência, número e duração
de reinternamentos, número de dias de baixa e regresso ao trabalho.
Resultados: na amostra de 129 doentes avaliados no início do internamento,
20,9% apresentavam níveis de depressão ≥8 na subescala da Depressão (HADS), 53,5% níveis de ansiedade ≥8 na subescala da Ansiedade (HADS) e 9,3% perturbações cognitivas (MMSE). A avaliação longitudinal desta amostra mostrou que os níveis de depressão, inicialmente baixos, aumentaram nos 45 dias após o internamento, para depois diminuírem até ao fi nal do follow-up. Os níveis de
ansiedade, que eram inicialmente altos, aumentaram nos 45 dias seguintes e antiveram-
se estáveis, mas altos, até ao fi m do estudo.
O GI apresentou uma pontuação média na subescala da depressão signifi cativamente
inferior à do GC no follow-up de 6 meses (5,8±4,1 no GI vs. 7,9±4,3 no GC, p=0,04). O número de doentes deprimidos foi signifi cativamente menor no GI nas avaliações realizadas aos 3 meses (11 vs. 18 no GC, p=0,04) e aos 6 meses (12 vs. 18 no GC, p= 0,05). O mesmo aconteceu com o número de doentes ansiosos aos 3 meses (15 no GI vs. 23 no GC, p=0,01). As dimensões do NHP “Isolamento social” aos 45 dias e “Reacção emocional” aos 45 dias e aos 3 meses, bem como a qualidade de vida geral (NHP 2ª parte) aos 3 meses, mostraram melhoria signifi cativa no grupo de intervenção. Embora a intervenção tenha reduzido o nível médio da ansiedade nas várias avaliações após a alta, esta redução não atingiu signifi cância estatística. A intervenção realizada não teve impacto na mortalidade ou nas variáveis relacionadas com a evolução da doença cardíaca no período do follow-up.
Conclusões: Os resultados do presente estudo mostram a alta prevalência de depressão e de ansiedade após um acidente coronário agudo e a manutenção de níveis altos de ansiedade nos 6 meses seguintes. Os resultados comprovam também a efectividade de uma intervenção em PL no tratamento da depressão e da ansiedade em doentes que sofreram um acidente coronário agudo. Estes resultados
apontam para a necessidade de desenvolvimento de programas de PL para este
tipo de doentes, tanto no hospital geral como nos cuidados de saúde primários.
Sugerem ainda a necessidade de desenvolvimento de investigação que permita
estabelecer o impacto específi co dos diversos tipos de intervenção, assim como
compreender os mecanismos subjacentes à associação da depressão e da ansiedade
com a doença coronária.----------ABSTRACT:Different types of psychiatric and psychochosocial interventions have proven effi cacy in
decreasing anxiety and depression in coronary heart disease. There is, however, an ongoing discussion about the impact these interventions may have on the clinical outcome and on cardiac mortality. The main objective of the current study was to evaluate the effectiveness of a consultation liaison psychiatry (CL) intervention on a group of patients admitted with Myocardial Infarction or Unstable Angina, to a Coronary Care Unit. Methods: The study had a prospective, randomised, controlled design, with a 6-month follow-up. One hundred and twenty-nine consecutive patients were assessed during the first 48 hours of admission with the Hospital Anxiety and Depression Scale (HADS). Those with a score of ≥8 on the Depression or the Anxiety subscales (n=72) were randomly allocated
to intervention (n=37) and usual care (n=35). The CL intervention, started during
the fi rst days of admission, had a minimum of 3 (60 minutes) sessions, and included
a psychiatric evaluation, supportive psychotherapy, a psychoeducational intervention, when necessary, psychotropic drugs. The last session, shortly before discharge, included the spouse and was focused on compliance, modifi cation of behavioral risk factors, and possible diffi culties upon returning to work. Cognitive status (Mini-Mental State Examination - MMSE), social adjustment (Social Problems Questionnaire - SPQ), and demographic and clinical characteristics were also assessed at baseline. Patients were reassessed before discharge, and at 45 days, 3 and 6 months after admission with HADS, SPQ, and with Nottingham Health Profile (NHP) for quality of life. Survival, number of readmissions and days of readmission, number of sickleave days and return to work were assessed at six months. Results: The initial sample of 129 patients, presented a 20.9% prevalence of depressive symptoms, 53.5% of anxiety symptoms, and 9.3% of cognitive disorders. The longitudinal evaluation of this sample showed that the initially low levels of depression were increased 45 days later, and slowlly decreased afterwards till the 6-month follow-up. Initially high anxiety
levels, somewhat decreased before discharge, had increased 45 days later, and stayed stable and high till the end of the study.
The intervention group showed a signifi cantly lower depression mean score at 6 months (5.8±4.1 vs. 7.9±4.3 in the controls, p=0.04). The number of patients considered depressed was lower in the intervention group at 3(11 vs. 18 controls, p=0.04) and 6 months (12vs. 18 controls, p=0,05). The number of anxious patients was also lower in the intervention.
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Marques, André Coelho. « Impacto da interconsulta cardiológica na evolução clínica de pacientes hospitalizados ». Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-24052012-164128/.
Texte intégralRésumé :
A interconsulta cardiológica corresponde a uma parcela considerável das atividades assistenciais e de ensino do cardiologista, refletindo gasto extra de tempo e recursos. Apesar disso, essa atividade não tem recebido a devida atenção da literatura, com poucos estudos sobre o tema. O objetivo do presente estudo foi, primariamente, comparar a evolução clínica dos pacientes envolvidos na interconsulta cardiológica que tiveram as recomendações seguidas pela equipe médica solicitante (grupo ACEITADOR) com aqueles em que as recomendações não foram seguidas (grupo NÃO ACEITADOR). De forma secundária, procuramos identificar as variáveis determinantes da aceitação das sugestões da equipe cardiológica. Para isso, foi realizado um estudo observacional envolvendo pacientes internados no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, para os quais foram solicitadas interconsultas cardiológicas, no período de março a setembro de 2008. Os dados referentes às interconsultas foram coletados pelo investigador de maneira prospectiva a partir do prontuário dos pacientes. Dentre as 589 interconsultas selecionadas para o estudo, 271 consistiam em avaliações clínicas e 318 avaliações pré-operatórias. Em relação à taxa de aceitação das recomendações cardiológicas, 77% dos pacientes foram classificados no grupo ACEITADOR e 23% classificados no grupo NÃO ACEITADOR. A análise da evolução clínica demonstrou que, dentre os pacientes do grupo NÃO ACEITADOR, 38,8% evoluíram de forma desfavorável (piora clínica ou óbito) contra 5,4% dos pacientes do grupo ACEITADOR (P<0,0001). Após análise de regressão logística, pertencer ao grupo NÃO ACEITADOR (P<0,001; OR 10,25; IC 95% 4,45 - 23,62) e a idade dos pacientes (P=0,017; OR 1,04; IC 95% 1,01 1,07) estiveram associados de forma independente a uma evolução clínica desfavorável. Foram identificados quatro preditores independentes de aceitação das recomendações: a realização de visitas de seguimento (P<0,001; OR 2,43; IC 95% 1,48 4,01), reforço verbal das recomendações (P=0,001; OR 1,86; IC 95% 1,23 2,81), número de recomendações sugeridas (P=0,001; OR 0,87; IC 95% 0,80 0,94) e idade dos pacientes (P=0,002; OR 0,98; IC 95% 0,96 0,99). Portanto, na presente análise, a não aceitação das recomendações da equipe cardiológica por parte da equipe médica solicitante esteve associada a uma evolução clínica desfavorável dos pacientes envolvidos. A realização de visitas de seguimento, reforço verbal, número limitado de recomendações e a menor idade dos pacientes estiveram associados a uma maior aceitação das recomendações da equipe cardiológicaCardiology referral represents an important part of cardiologist activities, accounting for substantial workload and demanding extra time and resources. Despite the importance of these facts, it has received little attention in the medical literature in the last years. The purpose of this study was to compare the clinical outcome of patients involved in cardiology referral who had the cardiologic recommendations followed by the requesting service (ACCEPTING group) with those whose recommendations were not followed (NON-ACCEPTING group). Secondly, we aimed to determine which of the variables involved in cardiology referral were related to acceptance to consultants recommendations. An observational study was performed at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, involving cardiology consultations during the months of March 2008 through September 2008. Data regarding consultations were prospectively extracted from the medical records by a physician-researcher. Among the 589 cardiology consultations selected for the study, 271 were clinical evaluations and 318 were preoperative evaluations. Regarding compliance of the referring service in following the recommendations offered by cardiology team, 77% of patients were classified in the ACCEPTING group and 23% in the NON-ACCEPTING group. A clinical outcome analysis was performed and showed that 38,8% of patients allocated to NON-ACCEPTING group had evolved unfavorably (clinical deterioration or death) against 5,4% of patients allocated to accepting group (P<0.0001). After logistic regression analysis, belong to NON-ACCEPTING group (P<0.001; OR 10.25; CI 95% 4.45 23.62) and patients age (P=0.017; OR 1.04; CI 95% 1.01 1.07) were variables independently associated to an unfavorable clinical outcome. The multivariate analysis indentified 4 independent predictors of acceptance to consultants recommendations: follow-up notes in the chart (P<0.001; OR 2.43; CI 95% 1.48 4.01), personal communication (P=0.001; OR 1.86; CI 95% 1.23 2.81), number of recommendations (P=0.001; OR 0.87; CI 95% 0.80 0.94) and patients age (P=0.002; OR 0.98; CI 95% 0.96 0.99). Therefore, in this analysis of cardiology referral, a poorer acceptance of cardiologic recommendations was associated to an unfavorable clinical outcome. Follow-up notes in the chart, personal communication, limited number of recommendations and lower patients age were associated to greater acceptance of cardiologic recommendations
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Pires, Ramon 1989. « Diabetic retinopathy image quality assessment, detection, screening and referral = Análise de qualidade, detecção de lesões de retinopatia diabética, triagem e verificação de necessidade de consulta a partir de imagens de retina ». [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/275614.
Texte intégralRésumé :
Orientador: Anderson de Rezende RochaDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Computação
Made available in DSpace on 2018-08-23T17:47:21Z (GMT). No. of bitstreams: 1 Pires_Ramon_M.pdf: 4429324 bytes, checksum: 4e4015bc2131a1f1a5e8aa215f24d98f (MD5) Previous issue date: 2013
Resumo: A Retinopatia Diabética (RD), complicação provocada pela diabetes, se manifesta por meio de diferentes lesões que possuem suas especificidades. Estas especificidades são exploradas na literatura como estratégia para representação, proporcionando uma discriminação satisfatória entre imagens de pacientes normais e doentes. No entanto, por estarem fortemente atrelada _as características visuais de cada anomalia, a detecção de lesões distintas exige abordagens distintas. Neste trabalho, apresentamos um arcabouço geral cujo objetivo é automatizar o procedimento de análise de imagens de fundo de olho. O trabalho é dividido em quatro etapas: avaliação de qualidade, detecção de lesões individuais, triagem e verificação de necessidade de consulta. Na primeira etapa, aplicamos diferentes técnicas de caracterização de imagens para avaliar a qualidade das imagens por meio de dois critérios: definição de campo e detecção de borramentos. Na segunda etapa deste trabalho, propomos a continuação de um trabalho anterior desenvolvido pelo nosso grupo, no qual foi aplicado um método unificado na tentativa de detecção de lesões distintas. No nosso método para detecção de qualquer lesão, exploramos diferentes alternativas de representação em baixo nível (extração densa e esparsa) e médio nível (técnicas de coding/pooling para sacolas de palavras visuais) objetivando o desenvolvimento de um conjunto eficaz de detectores de lesões individuais. As pontuações provenientes de cada detector de lesão, obtidas para cada imagem, representam uma descrição de alto nível, ponto fundamental para a terceira e a quarta etapas. Tendo em mãos um conjunto de dados descritos em alto nível (pontuações dos detectores individuais), propomos, na terceira etapa do trabalho, a aplicação de técnicas de fusão de dados para o desenvolvimento de um método de detecção de múltiplas lesões. A descrição em alto nível também é explorada na quarta etapa para o desenvolvimento de um método eficaz de avaliação de necessidade de encaminhamento a um oftalmologista no intervalo de um ano, visando evitar que o médico seja sobrecarregado, bem como dar prioridade a pacientes em estado urgente
Abstract: Diabetic Retinopathy (DR), a common complication caused by diabetes, manifests through deferent lesions that have their particularities. These particularities are explored in the literature as methods for representation, providing a satisfactory discrimination between healthy/diseased retinas. However, by being strongly linked to the visual characteristics of each anomaly, the detection of distinct lesions requires distinct approaches. In this work, we present a general framework whose objective is to automate the eye-fundus image analysis. The work comprises four steps: image quality assessment, DR-related lesion detection, screening, and referral. In the first step, we apply characterization techniques to assess image quality by two criteria: field definition and blur detection. In the second step of this work, we extend up a previous work of our group which explored a unified method for detecting distinct lesions in eye-fundus images. In our approach for detection of any lesion, we explore several alternatives for low-level (dense and sparse extraction) and mid-level (coding/pooling techniques of bag of visual words) representations, aiming at the development of an effective set of individual DR-related lesion detectors. The scores derived from each individual DR-related lesion, taken for each image, represent a high-level description, fundamental point for the third and fourth steps. Given a dataset described in high-level (scores from the individual detectors), we propose, in the third step of the work, the use of machine learning fusion techniques aiming at the development of a multi-lesion detection method. The high-level description is also explored in the fourth step for the development of an effective method for evaluating the necessity of referral of a patient to an ophthalmologist in the interval of one year, avoiding overloading medical specialist with simple cases as well as give priority to patients in an urgent state
Mestrado
Ciência da Computação
Mestre em Ciência da Computação
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Lofego, Léa. « Organização da atenção pré-natal na rede regional / ». Araçatuba, 2019. http://hdl.handle.net/11449/180993.
Texte intégralRésumé :
Orientador: Nemre Adas SalibaBanca: Doris Hissako Sumida
Banca: Symone Cristina Teixeira
Resumo: Introdução: A rede de atenção à saúde maternoinfantil foi instituída em 2011 com a finalidade de promover melhorias na eficiência da gestão dos serviços, porém ainda se apresenta como um grande desafio para os gestores. Objetivo: Analisar a rede regional de atenção à saúde da gestante no SUS. Método: Trata-se de pesquisa de caráter transversal, quanti-qualitativa, tipo inquérito. Foram realizadas entrevistas com gestores de 28 municípios, do Ambulatório de Especialidades Médicas (AME) e do Departamento Regional de Saúde (DRS) II do estado de SP, totalizando 86 entrevistados. As variáveis pesquisadas foram: realização de atividade educativa no pré-natal, existência de protocolo de atendimento e encaminhamento, organização da atenção à saúde bucal e geral à gestante, pactuação das referências e funcionalidade do sistema de referência e contrarreferência. Realizou-se análise de conteúdo para as questões discursivas e triangulação entre as respostas obtidas nos municípios, AME e DRS. Resultado: Observou-se que 78,57% dos municípios realizam atividade educativa com gestantes; 42,86% não possuíam protocolo de atendimento implantado e em 57,14% não havia critérios de encaminhamento estabelecidos. Do total de gestores municipais, 53,57% afirmaram realizar testes rápidos para detecção de HIV, Sífilis e Hepatite B e C; 46,43% teste rápido de gravidez e 39,28% relataram avaliar a situação vacinal. Quanto à atenção odontológica primária, não havia protocolo instituído em 71,43% dos munic... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: The maternal and child health care network was established in 2011 with the purpose of promoting improvements in the efficiency of service management, but still presents a great challenge for managers. Objective: To analyze the regional health care network of pregnant women in SUS. Method: This is a cross-sectional, quantitative-qualitative research type survey. Interviews were carried out with managers from 28 municipalities, from the Ambulatory of Medical Specialties (AME) and from the Regional Department of Health (DRS) II of the state of São Paulo, totaling 86 interviewees. The variables studied were: performance of prenatal educational activity, existence of a referral protocol, organization of oral and general health care for the pregnant woman, agreement of references and functionality of the referral and counter-referral system. Content analysis was performed for the discursive questions and triangulation between the responses obtained in the municipalities, AME and DRS. Result: It was observed that 78.57% of the municipalities carry out educational activities with pregnant women; 42.86% did not have an implanted care protocol and in 57.14% there were no established referral criteria. Of the total of municipal managers, 53.57% affirmed to carry out rapid tests for the detection of HIV, Syphilis and Hepatitis B and C; 46.43% rapid pregnancy test and 39.28% reported evaluating the vaccine situation. Regarding primary dental care, there was no protocol esta... (Complete abstract click electronic access below)
Mestre
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Lu, Ping-chang, et 呂秉璋. « Recommendation Behaviors on the Internet–A Case Study of E-mail Referrals ». Thesis, 2009. http://ndltd.ncl.edu.tw/handle/16237049303729167956.
Texte intégralRésumé :
碩士義守大學
資訊管理學系碩士班
97
People linked with the Internet inextricably, there are 95% of daily Internet use the Internet, of which 93% users to send and receive e-mail, of which 98% users received spam.It shows that recommendation behaviors by spam has been a serious invasion of the world''s Internet users. This study is based on Uncertainty reduction theory (URT) for the theoretical framework to explore the factors in recommendation behaviors of E-mail users, including perception of users (Perceived Risk, Relationship Permission), feature of mail(Mail subject, Attraction and server system). Three hundred and three samples were collected from land office staff of the Southern, including short-term employment for the sampling of e-mail user, with interviews to do in-depth qualitative research.After analysing, the results reveal that information seeking strategy of URT can explain most factors sufficiently. Provides strategies of E-mail marketing and stop junk mail, and offers suggestions for recommendation behaviors and anti-spam on the Internet.
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Mishra, Mayank, et Priya Sheetal. « E-commerce as a tool of expansion ». Thesis, 2020. http://dspace.dtu.ac.in:8080/jspui/handle/repository/18014.
Texte intégralRésumé :
1. Introduction
1.1. Background to the study
Advancement in technology have had a immense impact on the e-commerce world, it had transformed the way consumers get connected with brands and empowered them to shop more cost effectively. Driven by the convenience of products getting delivered to your doorstep, ecommerce has now become an integral part of everyday life. (www.Acquire.io)
“It’s the first inning. It might even be the first guys up at bat. We’re on the edge of golden age [of AI].” – Jeff Bezos CEO at Amazon
From how we live to how we work, AI plays a pivotal role in our day to day schedule. There are numerous examples of AI and the automation tools used are spam filters, voice to text features, smart personal assistants (Such as Siri, Alexa), personalisation of new feeds (www.nibusinessinfo.co.uk). In a research, it was found that 45% of millennials are already using this type of voice activated search for online shopping.
Apart from this, Augmented Reality based tools like 3D Try on are the next sensation in E- commerce world. Some are already integrating this features to give their customers better shopping experience. This not only helps the customer but the provider in terms of less churn and high profitability. For the earliest players it has given them competitive advantage over the rivals.
Along with this Referrals are playing a major role in attracting and retaining customers. It is a saying that, "Marketing is the most effective when it's not even clear that we are doing any". The best way marketer get their customers is through referral and there is high chances of conversion. A satisfied customer is most likely to recommend product or services to their friends, relatives, acquaintance and they do this not without getting paid. This is the reason why everyone trust their friend's reviews. That means having referral strategy helps the marketer to motivate their satisfied customers to take steps and recommend the products to their friends and relatives might benefit us in terms of expansion and thus revenues.
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So, in our project we focuses on identifying features which consumers think are important to them and classify them according to their relative importance. This study also includes understanding the perception about the product reviews, referrals and incentives. We have also studied user's perception about Artificial Intelligence and Augmented Reality based tools which could potentially be the next sensation in E-commerce world.ABSTRACT Now a days, Internet has become one-window for all the internet users in terms of searching for their day-to-day needs due to swift growth in the technology. For their small requirements like shoes to large appliances like refrigerator, they seek it on the internet. The variety or the product and huge number of people seeking them makes competition tighter between the e-commerce providers. In order to attract majority of the customer they have to stand out from their competitors. Referral marketing is another aspect which e-commerce platforms have been using to maximize their reach to prospect customers. They also make use of a technology to replace the offline mode of shopping such as using Augmented Reality based tools which is enhancing the online purchase experience. The study sought to determine the attributes which are important for customers; perception about the product reviews, referrals and incentives; user's perception about Augmented Reality (AR) tools during online purchase experience. For studying the behavior primary data were collected from students of Delhi Technological University and Delhi University. Using convenience sampling technique 200 responses were collected to study their behavior. The primary data for this study was collected via questionnaires. . The quantitative data was analysed by descriptive statistics using SPSS. Factor analysis was done to find the most important factors and later we need Friedman’s Test to find the most important important factors. Cross-tabulation analysis was used to show the relationship among different variables.
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Santos, Marta Sofia Da Fonseca Castro. « Barragem field lab : business plan of a luxury rehab centre - occupation rate ». Master's thesis, 2021. http://hdl.handle.net/10362/122971.
Texte intégral
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Prior, Scott. « What is an appropriate electronic referral for psychiatry ? » Thesis, 2016. http://hdl.handle.net/1828/7250.
Texte intégralRésumé :
Medical referrals are requests, typically from generalist to specialist physician, to see a patient in order to offer an opinion or further care and increasingly are conducted through information technology as electronic referrals (e-referrals). This study set out to determine an appropriate e-referral to psychiatry. A field study was conducted. The criteria and supporting information requirements for an appropriate e-referral to psychiatry were determined. These results were used in turn to conduct a gap analysis on current e-referral standards. It was possible to conclude that current standards would not meet the needs for an e-referral to psychiatry. The results were also used as a case study to address gaps in the knowledge of e-referrals. There was a recurrent theme that the development of e-referrals must account for a number of contexts and as such e-referrals should be developed conceptually before technical deployment. Next steps in research were then discussed.Graduate
0723
sbp@uvic.ca
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Hsu, Chun-Wei, et 許峻維. « An E-Referral Center based on HL7/XML ». Thesis, 2003. http://ndltd.ncl.edu.tw/handle/04103926387420302766.
Texte intégralRésumé :
碩士國立成功大學
工程科學系碩博士班
91
With the growth of the Internet, HL7(Health Level Seven) is used in data-exchanging between hospitals. The referral system is one of the best application. Exchanging referral data through internet can not only accelerate the speed of patient referral, but also avoid repeating unwanted examination to decrease the waste of medical resources. In order to promote the referral efficiency, a web-based E-referral center is implemented in Internet. We apply HL7/XML standard to transform patient’s referral data into XML format for exchanging procedure. The system was constructed in Microsoft .NET platform. The out-patients are the major served person in the referral operation system. When a patient needs to be referred, the system will transform the referral’s data into XML format and send it to the referral center as well as to a suitable hospital through internet. Meanwhile, the patient also can use WAP/GPRS mobile phone to get part of his own record from E-referral center for doctor’s reference. It seems to reach the goal for everyone who goes with his personal medical record. In this research, the prototype of the referral center is expected to reach the following functions. (1) Sharing the medical information. (2) Improving referral efficiency. (3) Saving medical resource. (4) Practicing hierarchy medical-care system. (5) Go with one’s personal medical record.
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Carrick, Curtis. « Developing an optimization algorithm within an e-referral program for clinical specialist selection, based on an extensive e-referral program analysis ». 2013. http://hdl.handle.net/1993/21711.
Texte intégralRésumé :
When referring physicians decide to refer their patients to specialist care, they rarely, if ever, make a referral decision with the benefit of having access to all of the desirable information. It is therefore highly unlikely that the referring physician will make the optimal choice of specialist for that particular referral. A specialist selection optimization algorithm was developed to guarantee that the “right specialist” for each patient’s referral was chosen. The specialist selection optimization algorithm was developed based on feedback from over 120 users of the e-referral program. The developed algorithm was simulated, tested, and validated in MATLAB. Results from the MATLAB simulation demonstrate that the algorithm functioned as it was designed to. The developed algorithm provides referring physicians with an unprecedented level of support for their decision of which specialist to refer their patient to.
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Gorner, Joshua Mark. « Advisor Networks and Referrals for Improved Trust Modelling in Multi-Agent Systems ». Thesis, 2011. http://hdl.handle.net/10012/5791.
Texte intégralRésumé :
This thesis relates to the usage of trust modelling in multi-agent systems - environments in which there are interacting software agents representing various users (for example, buyers and sellers exchanging products and services in an electronic marketplace). In such applications, trust modelling may be crucial to allow one group of agents (in the e-commerce scenario, buyers) to make effective decisions about which other agents (i.e., sellers) are the most appropriate partners. A number of existing multi-agent trust models have been proposed in the literature to help buyers accurately select the most trustworthy sellers.
Our contribution is to propose several modifications that can be applied to existing probabilistic multi-agent trust models. First, we examine how the accuracy of the model can be improved by limiting the network to a portion of the population consisting of the most trustworthy agents, such that the less trustworthy contributions of the remaining agents can be ignored. In particular, we explore how this can be accomplished by either setting a maximum size for a buyer's advisor network or setting a minimum trustworthiness threshold for agents to be accepted into that advisor network, and develop methods for appropriately selecting the values to limit the network size. We demonstrate that for two models, both the Personalized Trust Model (PTM) developed by Zhang as well as TRAVOS, these approaches will yield significant improvements to the accuracy of the trust model, as opposed to using an unrestricted advisor network.
Our final proposed modification is to use an advisor referral system in combination with one of the network-limiting approaches. This would ensure that if a particular agent within the advisor network had not met a specified level of experience with the seller under consideration, it could be replaced by another agent that had greater experience with that seller, which should in turn allow for a more accurate modelling of the seller's trustworthiness. We present a particular approach for replacing advisors, and show that this will yield additional improvements in trust-modelling accuracy with both PTM and TRAVOS, especially if the limiting step were such that it would yield a very small advisor network.
We believe that these techniques will be very useful for trust researchers seeking to improve the accuracy of their own trust models, and to that end we explain how other researchers could apply these modifications themselves, in order to identify the optimal parameters for their usage. We discuss as well the value of our proposals for identifying an "optimal" size for a social network, and the use of referral systems, for researchers in other areas of artificial intelligence.
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Belo, Bernardo Maria dos Santos de Mendonça. « Mr. Refs : rewiring human resources industry to win digital disruption : integrating crowd and referrals in recruitment processes ». Master's thesis, 2016. http://hdl.handle.net/10400.14/20176.
Texte intégralRésumé :
The main objective of the present dissertation, written in the form of case study, is to demonstrate the possibility to revolutionize the human resources industry by allowing everyone to be integrated in any recruitment process, creating a network effect much appreciated by companies and allowing them to source candidates through this system. This way, we present and analyze the story of Mr. Refs, a crowd recruitment platform based on referrals located in Lisbon, Portugal. Mr. Refs has managed to have more than 15.000 Refers (people that refer family and friends for job opportunities), 100 companies recruiting through the platform and aims to expand to other markets such as Brazil, Spain and UK.
The main question addressed was the possibility of creating a sustainable business around Crowdhunting. First, we present the reader with the main insights in the literature review, intending to provide an overview on the referrals’ importance for recruiters and the benefits for companies on having a crowd referring. Moreover, the case study tells the story behind the creation of the company and describes its activities, analysis the business model and relevant markets to expand. Finally, we make an analysis on the key success factors and suggestions that can be considered for anyone that has the intention of replicating Mr. Refs. We conclude with final remarks and limitations of the study.O principal objetivo da presente dissertação, escrita sob a forma de caso de estudo, é demonstrar a possibilidade de uma revolução na indústria recursos humanos através da integração de qualquer pessoa num processo de recrutamento duma empresa, criando interligações entre os mesmos e múltiplas vantagens para as empresas que procurem candidatos desta forma. Apresentamos e analisamos a história do Mr. Refs, uma plataforma de recrutamento baseada em referências, que se encontra localizada em Lisboa, Portugal. Mr. Refs conseguiu ter mais de 15.000 Refers (pessoas que referenciam família e amigos para oportunidades de trabalho), mais de 100 empresas a recrutar através da plataforma e prepara a sua expansão para lugares como Brasil, Espanha e Reino Unido. A principal questão à qual pretendemos responder é a possibilidade de criar um negócio sustentável em torno do Crowdhunting. Primeiro, apresentamos ao leitor os principais pontos sobre a literatura relevante, que tenciona providenciar uma síntese da importância de uma referência para os recrutadores e os benefícios para as empresas de qualquer pessoa poder referenciar. Para além disso, o caso de estudo conta a história da criação da empresa e descreve as suas principais atividades, analisa o modelo de negócio e os mercados relevantes. Finalmente, são analisados os fatores de sucesso cruciais e são elaboradas sugestões para qualquer pessoa que tencione replicar o Mr. Refs. Concluímos com observações finais e limitações do estudo.
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WU, RUI-TING, et 吳睿庭. « The Research and Implement of HL7/XML Constructing Model for E-referral ». Thesis, 2005. http://ndltd.ncl.edu.tw/handle/57700814092473527211.
Texte intégralRésumé :
碩士國立臺北大學
資訊管理研究所
93
For a long time, referral mechanism in Taiwan has still remained at the stage of “paper work”. Copying Referral data by handwriting has many defects, for example, slow to open, crudely information recorded, patient rushes in every registering window, and needless to say, has a mistake to happen frequently. In 2003, the explosion of SARS let “tardily referral information exchanging mechanism” be noticed and made the spread of disease hard to be controlled. For this reason, Department of Health and other related government institutions began to promote E-referral mechanism, many hospitals have changed their original referral mechanism to this. At present, the standard of E-referral was mainly established by Health Level Seven association of Taiwan. In the end of 2003, this association announced “the white paper of referral based of electronic medical record based on HL7/XML – v.1.103c” which was referred to “XML encoding rules for HL7 V2.x” set up by Health Level Seven association. In this white paper, it shows how to use HL7 original message structure to create HL7/XML, but just like HL7 V2.x standard, it didn’t provide an algorithm to guide user how to write a program to process the encoding of HL7 or HL7/XML. For a view of this, our research referred to “the white paper of referral based of electronic medical record based on HL7/XML – v.1.103c” and “XML encoding rules for HL7 V2.x”, designed a HL7/XML V2.x constructing algorithm according to the specifications of Health Level Seven association of Taiwan and Health Level Seven association. Furthermore, we also analyzed several HL7 commercial software, enhanced their shortcoming, plus the HL7/XML algorithm designed by our research, implemented a HL7/XML document creating in the end.
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Silva, Luísa Carina Cabodeira Viana da. « Growth hacking e consumidores oportunistas : O impacto de rewards em programas de marketing referral ». Master's thesis, 2020. http://hdl.handle.net/10362/94984.
Texte intégralRésumé :
Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Marketing IntelligenceOs programas de marketing referral têm vindo a tornar-se numa ferramenta popular entre as empresas. Os seus benefícios são um tema polémico na literatura, uma vez que são programas propensos a atraírem utilizadores com um comportamento de compra oportunista. Como resultado disso, a entrega de recompensas despoleta uma corrida ao reward por parte de utilizadores com perfil oportunista. No presente estudo, propomos um modelo matemático baseado em agentes e suportado por 20.000 simulações, capaz de estudar o impacto desta população na disseminação do programa e na sua lucratividade. Mostrámos que os agentes interessados numa recolha oportunista do reward são responsáveis pelo sucesso do programa e pela sua disseminação. Este efeito ganha dimensão quando a disparidade monetária entre o custo do serviço e o valor do reward é maior. Por fim, concluímos que o aumento do número de convites, que os oportunistas realizam, despoleta uma intensificação dos resultados supra indicados.
Referral marketing programs have become a popular tool among businesses. Its benefits are a controversial topic in the literature, as they are programs likely to attract users with opportunistic buying behavior. As a result, reward distribution triggers a rush for rewards by users who have this opportunistic behavior. In the present study, we propose a mathematical model based on agents and supported by 20.000 simulations, capable of studying the impact of this population on the dissemination of the program and its profitability. We have shown that agents interested in an opportunistic reward collection are responsible for the success of the program and its dissemination. This effect gains dimension when the monetary disparity between the cost of the service and the reward value is greater. Finally, we conclude that the increase in the number of invitations that opportunists make triggers the intensification of the above results.
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Chandran, Arun. « Determining the Factors Contributing to Electronic Referral System Adoption by Radiation Oncologists through User-centred Design ». Thesis, 2013. http://hdl.handle.net/1807/42771.
Texte intégralRésumé :
This study aimed to utilize usability engineering methods in order to identify facilitators and barriers to
electronic referral system adoption by radiation oncologists at Princess Margaret Cancer Centre, and
provide recommendations for electronic referral system design. Analyses included workflow analysis of
radiation oncologists reviewing referrals, belief elicitation interviews with radiation oncologists, a
heuristic evaluation of an existing electronic referral system interface, and cognitive walkthrough of that
interface with radiation oncologists. Based on these findings, the system interface was redesigned using
mock-up software to address identified usability issues. The existing and redesigned interfaces were
compared using observational usability testing with radiation oncologists. The redesigned system
interface yielded reduced task times and enhanced user satisfaction as compared to the existing
interface. Thus, user-centred design was useful in determining facilitators and barriers to e-referral
adoption.
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Maghsoud-Lou, Ehsan. « Integrating Protocol-driven Decision Support within E-Referral System : Supporting Primary Care Practitioners for Spinal Care Consultation and Triaging ». 2014. http://hdl.handle.net/10222/50390.
Texte intégralRésumé :
Referrals to the Halifax Infirmary Neurosurgery Department are submitted with regards to spinal conditions with different degrees of complications. Although there exists a Spinal Condition Consultation Protocol to standardize spinal referrals, the information provided from referring physicians is frequently inadequate to accurately triage the patient's condition, partly due to missing diagnostic therapies. The Neurosurgery Department receives a high volume of referrals each year, which imposes a significant administrative workload on the staff.
We propose to develop a protocol-driven decision support system to: 1) Provide primary care physicians with timely access to condition specific consultation treatment protocols; and 2) Automate the referral assessment process to eliminate processing delays and administration burden. To this aim, we transformed the Consultation Protocol into a semantic knowledgebase. The decision support services are integrated within a standardized electronic referral system. We believe this system can significantly improve the referral process at the Neurosurgery Division.
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Veiga, João Manuel Caixinha Casal da. « Analysis of the referral mechanism between family doctors and specialists using social network analysis ». Master's thesis, 2020. http://hdl.handle.net/10362/105456.
Texte intégralRésumé :
The following document represents a master thesis dissertation, that consists in the development of a research project in which its main objective is to understand the referral mechanism between primary care physicians and specialistsusing network science and other tools. The referral network of a healthcare provider denotes an important source of costs and revenue, as it can affect directly the management of its clients and employees, namely through the quality of the care being provided and the level of satisfaction being achieved. The data provided for the development of the study was given by a European industry leader in private healthcare. It is important to highlight that this research study attempts maps the relationships between general practitioners and specialists using a large dataset of doctor’s appointments during 2012 and 2017. These relationships were mapped under the assumptions that two doctors had to share at least one patient, and the period between the two appointments could not be longer than 30 days. Moreover, the impact of the dynamics of the relationships between the two types of doctors in the primary-specialty referral mechanism is done by analyzing the referral patterns exhibited in network, and the performance of the physicians in terms of the centrality measures degree, betweenness and closeness. Additionally, two regression analysis are performed with the objective of identifying potential characteristics that might be affecting the referral rates of doctors. These characteristics include the social network metrics and the physician’s backgrounds.
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Nevhutalu, Ntsako Fikile. « Improving patient referral processes through electronic health record system : a case study of rural hospitals in Limpopo province ». Diss., 2013. http://hdl.handle.net/10500/14352.
Texte intégralRésumé :
In the last decade, the deployment of Electronic Health Records has increased tremendously in many developed countries. This increasing trend intensifies the need for developing countries like South Africa to implement electronic health record systems in state owned hospitals to facilitate e-referral processes to improve health care delivery.
The aim of this research was to investigate the current process of patient record keeping, management, and the referral process of patients within the same hospital and to other hospitals and based on the findings compile an Electronic Health Record (EHR) framework to facilitate e- referral processes.
This research study was based on a qualitative case study approach. A multiple data collection technique was used which included group interviews, questionnaires, document analysis and informal discussions with the hospital workers. Data were analysed by categorization and thematic approach.
The findings obtained from state hospitals indicated that there is no EHR system which accommodates patient health record systems to facilitate e-referral processes. These findings led to a compilation of the Limpopo Electronic Health Record System (LEHRS) to aid e-referral processes in state hospitals. The increasing need for accurate, reliable, available and accessible EHR will be addressed by the implementation of LEHRS as information will be stored in a central database in a useable format and will be easily accessed.Computing
M. Tech. (Information Technology)
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Teves, Mariana Filipa Pires Coelho Medeiros. « Referenciação para Dermatologia : Estudo de Caso do Centro Hospitalar e Universitário de Coimbra ». Master's thesis, 2018. http://hdl.handle.net/10316/82415.
Texte intégralRésumé :
Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaIntrodução: As doenças cutâneas são muito prevalentes nos cuidados primários, frequentemente motivando a referenciação para a dermatologia. Muitas dessas lesões são benignas e passíveis de diagnóstico e orientação pelos médicos de família. O objetivo primário deste estudo é caracterizar a referenciação para consulta externa de dermatologia do Centro Hospitalar e Universitário de Coimbra, sendo objetivos secundários determinar quais os diagnósticos mais frequentes, estabelecer a concordância entre os diagnósticos feitos pelo não dermatologista e pelo dermatologista e determinar a necessidade de investigações adicionais após a primeira consulta. Material e Métodos: Este é um estudo retrospetivo onde foram analisadas 316 primeiras consultas externas gerais de dermatologia de pacientes adultos, decorridas no Centro Hospitalar e Universitário de Coimbra no período de 1 de Maio de 2017 até 31 de Julho de 2017. A informação foi recolhida através da consulta de processos clínicos e do sistema informático de triagem dos pedidos de consulta. Registaram-se as variáveis idade, sexo, localidade, origem do pedido, motivo da referenciação, triagem em urgente/não urgente, tempo de espera para a consulta, diagnóstico feito pelo dermatologista e investigações adicionais. A análise estatística foi realizada utilizando o IBM SPSS Statistics, versão 24. Resultados: As hipóteses diagnósticas mais frequentemente apontadas pelos não dermatologistas foram D22 - Melanocytic Nevi (39,8%), L30 - Other and unspecified dermatitis (7,3%) e L40 - Psoriasis (5,8%). Os diagnósticos mais frequentemente atribuidos pelos dermatologistas foram D22 - Melanocytic Nevi (20,1%), L82 - Seborrheic keratosis (13,3%) e L30 - Other and unspecified dermatitis (8,0%). Observou-se uma concordância diagnóstica de suficiente a boa entre médicos dermatologistas e não dermatologistas, com um valor de Kappa de Cohen de 0,5 (p<0,05) sendo que o diagnóstico de nevo melanocítico foi o que mais contribuiu para a concordância. Porém, a lesão de queratose seborreica causou grande dificuldade diagnóstica aos não dermatologistas. Conclusão: A maioria das referenciações ocorreu por condições cutâneas benignas. Deverão ser implementadas medidas de forma a melhorar o reconhecimento de condições benignas pelos médicos não dermatologistas, de modo que a referenciação ocorra de forma eficaz, priorizando os casos mais complexos e graves.
Introduction: Skin diseases are very prevalent in primary health care, frequently leading to dermatology referral. A lot of these lesions are benign and possible of diagnosis and treatment by family practitioners. The primary aim of this study is to analyze the dermatology outpatient referral in Coimbra Hospital and Universitary Centre. The secondary aims are to determine which diagnosis are more frequent, the diagnostic agreement between non dermatologists and dermatologists and define the need of additional investigations. Material and Methods: This is a retrospective study with 316 first general dermatology outpatient appointments of adult patients made in Coimbra Hospital and Universitary Centre, between 1 May 2017 and 31 July 2017. The information was collected through medical records and triage informatic system. Age, sex, locality, source of referral, reason for referral, triage in urgent/non urgent, waiting time for appointment, dermatologists' diagnosis and additional investigations were recorded. The statistical analysis was made using IBM SPSS Statistics, version 24. Results: D22 - Melanocytic Nevi (39.8%), L30 - Other and unspecified dermatitis (7.3%) and L40 - Psoriasis (5.8%) were the diagnosis hypothesis most frequently pointed out by non dermatologists. D22 - Melanocytic Nevi (20.1%), L82 - Seborrheic keratosis (13.3%) and L30 - Other and unspecified dermatitis (8.0%) were the most common diagnosis made by dermatologists. The diagnostic agreement overall was sufficient to good between dermatologists and non dermatologists with a Cohen's Kappa value of 0,5 (p<0.05). The diagnosis of melanocytic nevi was the major contributor to the agreement. However, seborrheic keratosis caused great difficulty to non dermatologists. Conclusion: Most of referrals were for benign skin conditions. Measures should be implemented to improve the recognition of benign skin conditions by non dermatologists, so that referral can be effective, prioritizing the most complex and serious cases.
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Virkutyté, Aisté. « The importance of sustaining a balance between new and loyal customers : the case of all fitting ». Master's thesis, 2016. http://hdl.handle.net/10400.14/20554.
Texte intégralRésumé :
The purpose of the study is to understand how a women-only gym can keep a balanced focus between acquiring new customers and creating customer loyalty among existing ones.
The case study focuses on All Fitting, a women-only gym in Lisbon, Portugal. It provides a selection of group fitness activities for its members. For convenience of the clients they are also aiming to consolidate different services under one roof, hence, in addition to practicing sports the clients can also use aesthetics services, nutritionist, and hairdresser.
In order to address the problem statement and answer the research questions, a literature review is provided for theoretic background. Then a thorough background of All Fitting is provided, including its activities, customers, and competitors. A market research is conducted between both current clients, to assess the drivers for satisfaction and loyalty, and prospective clients, to understand what All Fitting could do to attract new customers more effectively.
The findings show that customer retention is rather problematic at All Fitting, even if customers express high satisfaction with the gym and have high intentions to stay as a client. As for prospective clients, current strategy could be made more effective, especially by leveraging on referral marketing. A set of recommendations is provided concerning both customer groups.O objectivo deste estudo é perceber como é que um ginásio que acolhe apenas mulheres como clientes pode equilibrar a aquisição de novos clientes com a retenção e criação de lealdade das clientes já existentes. O caso de estudo baseia-se no ginásio de mulheres All Fitting, em Lisboa, Portugal, que oferece uma seleção variada de atividades desportivas para os seus membros. Adicionalmente, numa óptica de conveniência, oferece vários outros serviços no mesmo espaço, assim como serviços de estética, nutricionista e cabeleireiro. Uma Revisão de Literatura foi feita para abordar o dilema e as questões de pesquisa, bem como para recolher conhecimentos teóricos. É dada também uma visão global do All Fitting e das suas actividades, clientes e concorrentes. Adicionalmente, foi feito um estudo de mercado a actuais e potenciais clientes para perceber quais os principais factores que levam à satisfação de lealdade de clientes e, que medidas tomar para adquirir atrair novos cliente eficazmente. Os resultados do estudo indicam que a retenção de clientes é bastante problemática, mesmo que os clientes expressem grande satisfação com o ginásio e tenham intenções de permanecer como clientes. Em relação a potenciais clientes, a estratégia atual podia ser mais eficaz, especialmente através da alavancagem de marketing por recomendação. Um conjunto de recomendações é fornecida para ambos os grupos de clientes.
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Rocha, Maria Isabel Santos. « Avaliação epidemiológica dos internamentos através de um serviço de urgência de segunda linha (SII) ». Master's thesis, 2015. http://hdl.handle.net/10362/14339.
Texte intégralRésumé :
RESUMO: Introdução: A Comissão Nacional para a reestruturação dos Serviços de Saúde Mental em 2004, fez uma proposta de âmbito regional, ao nível da região de Saúde do Norte, levando a uma alteração da rede de referenciação hospitalar dos internamentos em psiquiatria.
Métodos: Realizou-se um estudo epidemiológico longitudinal para avaliar factores preditivos de internamento através de um serviço de Urgência de Segunda Linha (SII), que de algum modo reflectisse o funcionamento dos serviços de internamento na região de Saúde do Norte, ao longo de 12 anos, nomeadamente relacionando com factores organizacionais contemplados no Plano Nacional de Saúde Mental e na reorganização da rede de referenciação hospitalar.
Resultados: Durante os 12 anos do estudo, verificou-se um aumento estatisticamente significativo do número e duração de internamentos através do SII, com ponto de partida no ano 2008-2009, e de novo a partir do ano 2010-2011 (nº de internamentos), para o qual contribuiu a alteração da rede hospitalar na região de saúde do Norte, nomeadamente pelo facto do HMLemos, assumir a responsabilidade de novo, dos internamentos das áreas de Famalicão, Gondomar e Santa Maria da Feira. Em relação ao número de internamentos, e na análise exploratória, encontramos nas áreas hospitalares fora da área de influência do HMLemos, uma contribuição positiva significativa para o aumento do nº de internamentos ao longo dos anos com os Dx (290, 296, 297, 291, 309). Em relação à área do HMLemos restrita (PVC, STT, Matosinhos, Porto Ocidental), de referir a contribuição positiva significativa dos Dx 309 e 301, para o aumento do número de internamentos ao longo do tempo, sendo que a prevalência maior se mantém relacionada às Psicoses (Dx 295, 296 e 297). Não se concluiu por uma contribuição estatisticamente significativa ( positiva ou negativa), das variáveis independentes idade, sexo ou natureza do internamento em relação à variável dependente ( duração de internamentos/ano). Em relação á variável dependente (nº de internamentos/ano), relativamente aos doentes fora de área de influência do HMLemos, concluiu-se uma contribuição positiva estatisticamente significativa da variável independente idade.
Conclusões: Através da análise exploratória foi possível perceber o esforço realizado pelos hospitais no sentido de melhorar a equidade e acessibilidade dos doentes à Saúde Mental, a par da reorganização da rede hospitalar. De destacar a necessidade de encontrar alternativas às situações de internamento, com menos critérios de gravidade diagnóstica, nomeadamente reforçar a importância da criação de consultas de crises nos respectivos Hospitais de Dia dos DPSM.----------------ABSTRACT:Introduction : The National Commission for the restructuring of mental health services in 2004 , has proposed at a regional level ( North Health Region), a change in the network of hospital referrals of admissions in psychiatry. Methods: We conducted a longitudinal epidemiological study to assess predictors of hospitalization through a Second Line Emergency Service ( SII) , that somehow reflect the operation of inpatient services in North Health Region, over 12 years, particularly relating to organizational factors included in the National Mental Health Plan and reorganization of the hospital referral network. Results: During the period of the study, there was a statistically significant increase in the number and duration of hospitalizations through the SII, with starting point in the year 2008-2009 and again from 2010-2011 (number of admissions) , for which counted the change of the hospital network referral in Northern health region , in particular because Hospital Magalhães Lemos (HMLemos) , took the new responsibility of admissions from areas of Famalicão, Gondomar and Santa Maria da Feira . Regarding the number of hospitalizations, in the exploratory analysis , we found in hospital areas outside the area of influence of HMLemos , a significant positive contribution to the increase in number of admissions over the years with Diagnosis of 290, 296, 297, 291 , 309 in the ICD-9. With respect to the restricted area of HMLemos (PVC, STT , Porto Ocidental and Matosinhos) , we found a significant positive contribution of Diagnosis 309 and 301, to increase the number of hospitalizations over time, with higher prevalence rates remaining the psychoses ( Dx 295, 296 and 297 ) . Did not conclude for any statistically significant contribution (positive or negative) of the independent variables age, sex and nature of admission to the dependent variable (duration of hospitalization / year). In relation to the dependent variable (number of admissions / year) relative to patients outside the area of influence of HMLemos, it was found a statistically significant positive contribution of the independent variable age . Conclusions: Through the exploratory analysis, it was possible to see the efforts made by hospitals to improve the accessibility of patients to Mental Health, throughout the hospital network reorganization. Its important to highlight the need to find alternatives to inpatient admissions in those with less gravity diagnostic criteria, reinforcing the importance of creating specific crisis consultations in Day Hospital regime.
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Casteluber, Michelli Amaral. « A gestão escolar na sinalização do aluno com suspeita de Perturbação de Hiperatividade/ Déficit de Atenção (PHDA) ». Master's thesis, 2018. http://hdl.handle.net/10284/6847.
Texte intégralRésumé :
Esta pesquisa foi realizada no âmbito do Mestrado em Docência e Gestão da
Educação, na área de Administração Escolar e Administração Educacional da UFP. Neste
estudo foi abordada a problemática da sinalização de crianças com suspeita de
Perturbação de Hiperatividade/ Déficit de Atenção (PHDA) pela Escola e o diagnóstico
da perturbação realizado pelos profissionais da Saúde. Considerando as características e
a revisão da literatura, a criança com PHDA pode ser considerada um problema na
escola tanto por causa do déficit de atenção, que gera dificuldades de aprendizagem,
quanto por seu comportamento hiperativo e impulsivo, que gera dificuldades para o
professor em sala de aula e dificuldades relacionais dessa criança com a família, os
professores e os colegas, causando também problemas na autoestima da criança. Diante
desse quadro, observa-se no Brasil um aumento do diagnóstico de PHDA, com
conseqüente aumento da prescrição e consumo do medicamento Ritalina®
(Metilfenidato), configurando a prática de medicalização da infância.
Para responder aos objetivos da investigação realizou-se um estudo empírico,
com metodologia qualitativa, utilizando a técnica da entrevista. Este estudo foi realizado
com professores de duas escolas especializadas em educação infantil, e com
profissionais de saúde, que atuam em consultórios clínicos, do município de Colatina,
Espírito Santo, Brasil. Procurou-se conhecer, de forma mais aprofundada, o
conhecimento e a experiência que os docentes e os profissionais da saúde possuem com
relação à problemática da sinalização e do diagnóstico da PHDA e o seu papel neste
cenário.
Os resultados encontrados indicam que os professores preocupam-se em ajudar o
aluno que apresenta dificuldades na aprendizagem e comportamento sugestivo de
PHDA, porém devido ao pouco conhecimento que possuem a respeito da perturbação, a
sinalização realizada pela escola apresenta-se deficiente. Os profissionais de saúde,
entretanto, consideram que mesmo assim, a opinião da escola é fundamental para o
desenvolvimento do processo de diagnóstico e procuram trabalhar em parceria com a
escola durante esse processo e também durante o tratamento.This research was carried out within the scope of the Master in Teaching and Management of Education, in the area of School Administration and Educational Administration of UFP. In this study, the problem of the referral of children suspected of Attention Deficit/ Hyperactivity Disorder (AD/ HD) and the diagnosis of disruption by health professionals was considered. Considering the characteristics and the literature review, the child with AD/ HD may be considered a problem in the school both because of attention deficit, which generates learning difficulties, and also of its hyperactive and impulsive behavior, which generates difficulties for the teacher in the classroom and relational difficulties of this child with the family, teachers and the classmates, also causing problems in child self-esteem. As consequence, there is in Brazil an increase in the diagnosis of AD/ HD, with a consequent increase in the prescription and consumption of the drug Ritalin® (Methylphenidate), configuring the practice of medicalization of childhood. In order to answer the research objetives, an empirical study was carried out, with a qualitative methodology, using the interview technique. This study was carried out with teachers from two schools specializing in early childhood education, and with health professionals who work in clinical practices in the city of Colatina, Espírito Santo, Brazil. We sought to know, in a more detailed way, the knowledge and experience that teachers and health professionals have regarding the problem of signaling and diagnosis of the AD/ HD and its role in this scenario. The results indicate that the teachers are concerned with helping the student with learning difficulties and behavior suggestive of AD/ HD, but due to the lack of knowledge about the disorder, the signaling carried out by the school is deficient. Health professionals, however, consider that even so, school opinion is critical to the development of the diagnostic process and seek to work in partnership with the school during this process and also during treatment.
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Cunha, Andreia Maria Guerreiro Lima da. « Constrangimentos no processo de sinalização e referenciação às equipas de cuidados continuados integrados no Hospital Prof. Dr. Fernando Fonseca, EPE ». Master's thesis, 2017. http://hdl.handle.net/10362/22905.
Texte intégralRésumé :
RESUMO - O envelhecimento da população, o aumento das situações de dependência, doenças crónicas ou terminal e carência social induziram novas necessidades sociais e de saúde que requerem respostas integradas entre os vários níveis de cuidados, que respondam à procura de cuidados de saúde e apoio social e, simultaneamente, demonstrem uma gestão eficiente de recursos, uma melhoria da qualidade e acesso a cuidados adequados. Esta realidade determinou a criação de modelos de cuidados continuados integrados, as recomendações convergem no desenvolvimento de modelos com respostas de saúde e apoio social com aproximação aos cuidados domiciliários, pois são soluções mais custo-efetivas e baseiam-se nos princípios da proximidade e integração de cuidados. Perante esta realidade os profissionais de saúde assumem uma responsabilidade na articulação e integração de cuidados adequadas às necessidades da população, o que torna especialmente importante a sua consciencialização e formação, no âmbito dos circuitos de sinalização e referenciação para as Equipas de Cuidados Continuados Integrados (ECCI).
Objetivos: Identificar os constrangimentos no processo de sinalização e referenciação para as ECCI, descritos pelos profissionais do Hospital Prof. Dr. Fernando Fonseca.
Metodologia: Estudo exploratório descritivo de metodologia qualitativa com recurso a entrevistas aos profissionais que participam diretamente no processo de sinalização e referenciação às ECCI.
Resultados: Os principais constrangimentos identificados foram: pouca divulgação sobre as ECCI; critérios de inclusão pouco explícitos; falta de formação dos profissionais; ausência de planeamento de alta, sinalizações e referenciações tardias, demora no tempo de resposta e assimetrias entre as ECCI. Como sugestões de melhoria aos processos: formação de equipas; melhorar a comunicação entre os profissionais; melhorar os registos no processo clínico eletrónico e melhorar o sistema de tecnologia e informação com ferramentas que apoiem a tomada de decisão.
Conclusões: A insuficiente resposta ao nível intermédio de cuidados de saúde e apoio social conjugado, com impacto inesperado da Rede Nacional de Cuidados Continuados Integrados (RNCCI) na demora média hospitalar, tem como consequências os internamentos prolongados e desnecessários afetando a eficiência hospitalar, tornando-se imperativo aumentar a resposta nas ECCI. A formação, divulgação das ECCI, comunicação e trabalho em equipa são fundamentais no processo de sinalização e referenciação para as ECCI.ABSTRACT: The aging of the population, increased situations of incapacity and dependence, situations of chronic disease or terminal illness and situations of social deprivation created new social and health needs that require integrated responses among the various levels of care that can respond to growth provision of care and at the same time demonstrate efficient management of resources, improve the quality of care and promote access to appropriate care. This reality has determined the need to created long-term care, international recommendations converge in the development of models of continuing care with health care and social support with approach to home care, since they are more cost-effective solutions and are based on the principles proximity and integration of care. Faced this reality, health professionals assume a responsibility in the articulation and integration of care and develop interventions appropriate to the needs of the population, which makes especially important their awareness and training in the circuits of signaling and referral to home care. Objective: Identify the constraints in the signaling and referral process for domiciliary teams of integrated continuous care (ECCI) described by professionals in Prof. Doctor Fernando Fonseca Hospital. Methodology: Descriptive exploratory study of qualitative methodology using interviews with health professionals who participate directly in the process of signaling and referral to domiciliary teams of integrated continuous care. Results: The main constraints identified were: little disclosure about domiciliary teams of integrated continuous care; inclusion criteria; lack of professional training; lack of planning of discharge, signs and delayed references, the delay in the time of response of domiciliary teams of integrated continuous care and asymmetries between them. As suggestions for improving processes: team building; improved communication between professionals; improved records in the electronic clinical process and improved the technology and information system with tools to support decision. Conclusions: The insufficient response to the intermediate level of health care and social support combined with the unexpected impact of the National Network for Integrated Continuous Care on the average hospital delay results in prolonged and unnecessary hospitalizations, making it imperative to increase the response in home care. The training, dissemination of domiciliary teams of integrated continuous care, communication and teamwork are fundamental in the signaling and referral process for domiciliary teams of integrated continuous care.
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Dinis, Maria Inês da Silva. « Referenciação de crianças com problemas de comunicação e linguagem a partir dos cuidados de saúde primários ». Master's thesis, 2016. http://hdl.handle.net/10284/5490.
Texte intégralRésumé :
Os problemas de comunicação e linguagem (PCL) podem limitar a atividade e participação de um indivíduo ao longo da sua vida. Todavia, a intervenção precoce tem-se provado bastante eficaz nestes casos. Os médicos de família (MF) encontram-se numa posição privilegiada para deteção e referenciação destes problemas em idades precoces. Porém, há evidências de que a sua participação neste processo tem sido reduzida, nomeadamente no que respeita à referenciação para serviços de Intervenção Precoce. Assim, esta investigação pretende compreender qual o papel que os MF consideram ter relativamente a este processo e quais os fatores que podem influenciar a referenciação de crianças com suspeita de PCL.
Este estudo teve como base um desenho de investigação descritivo, transversal e observacional. Recorreu-se a um método de amostragem por redes para a distribuição de um questionário On-line. O instrumento foi construído pela autora e é de caráter maioritariamente quantitativo, embora integre uma questão qualitativa de resposta semiaberta. Dos questionários enviados foram devolvidos 55. A resposta semiaberta foi preenchida por 16 dos 55 MF.
Os resultados demonstram que a maioria dos MF valoriza bastante ou muito a sua participação na deteção de PCL e considera importante detetar precocemente estes problemas. Para além disso, valorizam bastante ou muito a colaboração em equipa e do terapeuta da fala. A grande parte sente-se influenciada pela preocupação dos pais, pela satisfação com os serviços e com os resultados da Escala de Avaliação de Desenvolvimento de Mary Sheridan Modificada para a referenciação de crianças com PCL. Para além disso, identificam barreiras relacionadas com recursos humanos, serviços, conhecimentos relacionados com o processo de referenciação, burocracia, lentidão do processo e com a atitude dos pais.
Considera-se que este estudo pode constituir um ponto de partida para futuras investigações, para a adequação de estratégias institucionais e implementação de práticas que aproximem profissionais e serviços, de forma a melhorar o processo de referenciação de crianças com PCL a partir dos cuidados de saúde primários.Language and communication problems often limit ones´ abilities to function in society through life. These children and their families can benefit from early intervention. Family physicians (FP) are well placed to detect and refer children in these situation in a timely manner. However referrals from the primary health care seem to occur less frequently than expected, especially to early intervention services. Thus, the aim of this study is to understand the FP perspectives on their role in the referral process and what factors contribute to the referral decision. This study is based in a descriptive, transversal and observational design. A non-probabilistic sampling method was selected. Information was collect via an online survey deigned by the author. This instrumental tool is mostly quantitative and includes a semi-open qualitative question. 55 FP responded to the survey and 16 responded to the semi-open question. Main results indicate that most FP value their role in communication and language problems detection and referral. Team work and assessment by a speech and language therapist are also valued. Moreover they seem to think that early detection and referral of these problem is important. In general they are influenced by parents’ preoccupation, services satisfaction and Mary Sheridan screening tool results. FP identified difficulties in the process related to human resources, services, knowledge about the referral process, paperwork, time involved and parents’ attitude. This study can be the starting point to other investigations. It also can contribute to the improvement of institutional strategies in order to bring professionals and services together and to upgrade the referral process for children with communication and language problems in primary health care.
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Fernandes, Abigail Gaspar Gonçalves. « The audience response to different referral reward programs’ designs in social networking sites ». Master's thesis, 2021. http://hdl.handle.net/10071/24215.
Texte intégralRésumé :
The growing connectivity of customers through Social Networking Sites (SNSs), the increasing acknowledgment of the power of online reviews, and the enrichment of brand-consumer relations online have led to a rise in interest around electronic word of mouth (eWOM).
These realizations led marketers to embrace strategies to stimulate and amplify eWOM, and one common technique is the delivery incentives (e.g., rewards). Expanding research show that the design of incentivized eWOM programs, namely Referral Reward Programs (RRPs), is expected to determine the overall effectiveness of those programs.
To be successful, RRPs need a high likelihood of referral from the referral provider and a high receptivity from the referral receiver. Thus, this thesis further examines the recipient's perspective and role in RRPs in Social Networking Sites.
The main goal of this dissertation is to analyze the impact of different reward allocations and tie strength, i.e., the relationship between the recommender and the receiver, on eWOM receivers' responses to RRPs.
To do so, this thesis drew upon the Persuasion Knowledge Model to analyze these relations, mainly focusing on three RRPs outcomes: review credibility, brand attitude, and purchase intentions.
To extract relevant conclusions, a research model and hypothesis were developed, based on a previously elaborated literature review, containing the main concepts, theories, and models that hold the present research. An experimental design was conducted employing an online questionnaire to test the research model, which gathered 526 responses. Finally, the results were discussed, and both theoretical and practical implications were deduced.A crescente conectividade entre consumidores, a gradual descoberta do poder das recomendações, e o enriquecimento das relações marca-consumidor por meio de Sites de Redes Sociais, levaram a um crescente interesse em torno do passa-a-palavra eletrónico. Consequentemente, os profissionais de marketing começaram a adotar estratégias para estimular e ampliar essa poderosa ferramenta. Uma técnica comum é a oferta de incentivos (por exemplo, recompensas). A literatura mostra que a estrutura de um programa de passa-a-palavra eletrónico incentivado, nomeadamente, de Programas de Recompensa por Referência, é fundamental para a eficácia dos mesmos. Reconhecendo que, para serem eficazes, os Programas de Referência por Recompensa precisam, tanto da iniciativa do transmissor, como da adesão do recetor, esta dissertação explora a perspetiva e o papel do recetor nestes programas, em Sites de Redes Sociais. Deste modo, o seu principal objetivo é analisar o impacto de diferentes alocações de recompensas e forças das ligações (i.e., relação entre o transmissor e o recetor) nas respostas dos recetores a Programas de Referência por Recompensa. Para tal, o Modelo de Conhecimento de Persuasão foi utilizado a fim de analisar três indicadores: credibilidade da recomendação, atitude perante a marca e intenção de compra. Para extrair conclusões relevantes, foram desenvolvidos um modelo conceptual e um conjunto de hipóteses, com base numa revisão da literatura que aborda os principais conceitos, teorias e modelos que sustentam a presente pesquisa. A posteriori, foi realizado um questionário online, que reuniu 526 respostas. Por último, os resultados foram discutidos e as implicações teóricas e práticas foram apresentadas.
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Bernardes, Inês Santos Rodrigues Franco. « The impact of monetary and in-kind rewards on customer referral programs’ success : examining the moderating role of product type on the relationship between reward type and recipients’ recommendation receptivity, purchase intention and brand valuations ». Master's thesis, 2021. http://hdl.handle.net/10400.14/35661.
Texte intégralRésumé :
Customer Referral Programs (CRPs) are a popular tool used by firms to attract new customers with high lifetime value and low churn rate. The present dissertation provides managers with valuable insights into how to develop the optimal CRP for their firm. More specifically, it investigates how the type of reward offered (monetary vs in-kind) influences recipients’ recommendation receptivity (attitudes towards the program and motive attribution), purchase intention and brand valuations (brand affect, brand trust and brand loyalty), as well as the possible moderating role of product type (utilitarian vs hedonic). Findings suggest that in-kind rewards lead to more positive recommendation receptivity, higher purchase intention and brand valuations, compared to monetary rewards. Moreover, product type is a moderator of the relationship between reward type and all dependent variables, except for motive attribution. That is, the positive impact of offering an in-kind reward (vs monetary) on recipients’ attitudes towards the program, purchase intention and brand valuations is stronger when the product promoted is hedonic (vs utilitarian). This paper reveals that, in order to choose the most appropriate reward, managers must consider the type of product promoted through the CRP. Furthermore, results indicate that a well-designed referral program has the power to enhance prospective customers’ brand perceptions.Os programas de referência de clientes (PRCs) são uma ferramenta comummente utilizada pelas empresas com o intuito de atrair novos clientes com elevado valor de vida útil e reduzida taxa de rotação. A presente dissertação oferece aos gestores ensinamentos relevantes sobre como desenvolver o PRC ideal para a sua empresa. Mais especificamente, investiga como o tipo de recompensa (monetária vs em espécie) influencia a recetividade da recomendação (atitudes relativas ao programa e atribuição de motivos), intenção de compra e avaliações da marca (afeto pela marca, confiança na marca, lealdade à marca), assim como o possível papel moderador do tipo de produto (utilitário vs hedónico). Os resultados sugerem que a recetividade da recomendação, a intenção de compra e as avaliações da marca são melhores quando a recompensa oferecida é em género, em vez de monetária. Além disso, o tipo de produto modera a relação entre o tipo de recompensa e todas as variáveis dependentes, exceto a atribuição de motivos. Isto é, o impacto positivo de oferecer uma recompensa em género (vs monetária) nas atitudes relativas ao programa, intenção de compra e avaliações da marca é mais forte quando o tipo de produto promovido é hedónico (vs utilitário). Este documento revela que, de forma a escolher a recompensa mais adequada, os gestores devem ter em conta o tipo de produto promovido pelo PRC. Adicionalmente, os resultados indicam que um programa de referências bem desenhado tem o poder de melhorar a perceção da marca junto dos potenciais clientes.