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1
Kamathi, Anand. "B-Activ - Health care Android framework". Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10142978.
Testo completoAbstract (sommario):
The healthcare application domain has potential for research in the computer science field and Android domain. The built-in sensors and interfaces for virtual reality plugged in to the Android platform makes it a viable option for developers and end users. The B-Activ Android application builds a platform, which unlike other healthcare applications, ensures that the user is provided with essential input to indulge in an active life. External factors such as climate, pollution levels in the vicinity, and the user’s Body Mass Index (BMI) affect a person’s involvement in exercise and are central to the B-Activ application. B-Activ allows users to interact through traffic and pollution updates with people in the same city. The scope of B-Activ is to ensure that the user is active enough through simple exercises in order to control the cholesterol level and obesity thereby reducing the chances of deadly diseases.
2
Jeffs, Lynda Caron, e n/a. "A culturally safe public health research framework". University of Otago. Christchurch School of Medicine & Health Sciences, 1999. http://adt.otago.ac.nz./public/adt-NZDU20070524.120343.
Testo completoAbstract (sommario):
The concept of cultural safety arose in Aotearoa me Te Waipounamu/New Zealand in the late 1980�s in response to the differential health experience and negative health outcomes of the first nation people of Aotearoa me Te Waipounamu/New Zealand, the New Zealand Maori. It was introduced and developed by Maori nurses initially, as they recognised the effect culture had on health and understood safety as a common nursing concept. The concept of cultural safety has developed into a disipline which is taught as part of all nursing and midwifery curricula in Aotearoa me Te Waipounamu/New Zealand. As cultural safety has developed the concept of culture has been extended to include people who differ from the nurse by reason of: age, migrant status, sexual preference, socioeconomic status, religious persuasion, gender, ethnicity, and in Aotearoa me Te Waipounamu/New Zealand, the Treaty of Waitangi status of the nurse and recipient/s of her/his care.
Nationally and internationally, health experience and health outcomes are poorer for people of minority group status than for people who are part of the dominant group. Public-health research is therefore generally conducted on, or with, people with minority group status. Public-health researchers, by education, are members of the dominant culture and may be unaware that their own and their clients; responses may relate to one/other or both cultures being diminished do not always ensure the safety of their own culture or the culture being researched.
This study�s objective was to develop a flexible, culturally safe public health research framework for researches to use when researching people who are culturally different from themselves. The study will argue that the use of such a framework will contribute significantly to improved health outcomes for people with minority status and will assist the movement towards emancipatory social change.
The methods undertaken included: gaining permission from Irihapeti Ramsden, the architect of cultural safety to undertake the research, conducting a literature review, consideration of primary sources and their key concepts, consulting widely with people in the field of public health and cultural safety, self reflecting on the writers own personal and professional experience and finally designing the culturally safe public health research framework.
3
Wood, David. "Framework for Global Health and Global Health Electives Opportunities at Quillen COM". Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7680.
Testo completo
4
Rabih, Joyce. "TQM implementation in health care : a proposed framework". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ39974.pdf.
Testo completo
5
Alalwany, Hamid. "Cross disciplinary evaluation framework for e-health services". Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/8216.
Testo completoAbstract (sommario):
E-health is an emerging field in the intersection of information systems, healthcare and business management, referring mainly to healthcare services delivered and enhanced through the use of information and communication technologies (ICT). In a broader sense, the term characterizes not only a technical development, but also a wider way of thinking, an attitude, and a commitment for a network to improve and connect provider, patients and governments. Such a network will be used to educate and inform healthcare professionals, managers and healthcare users; to stimulate innovation in care delivery and health system management; and to improve the healthcare system locally, regionally, and globally. The evaluation of e-health services in both theory and practice has proved to be important and complex. E-health evaluation will help achieve better user services utilization, justify the enormous investments of governments on delivering e-health services, and address the aspects that are hampering healthcare services from embracing the full potential of ICT towards successful e-health initiatives. The complexity of evaluation is mostly due to the challenges faced at the intersection of three areas, each well-known for its complexity; healthcare services, information systems, and evaluation methodologies. However, despite the importance of the evaluation of e-health services, literature shows that e-health evaluation is still in its infancy in terms of development and management. The aim of this research study is to develop, and assess a cross disciplinary evaluation framework for e-health services and to propose evaluation criteria for better user’s utilization and satisfaction of e-health services. The evaluation framework is criteria based, while the criteria are determined by an evaluation matrix of three elements, the evaluation rationales, the evaluation timeframes, and the evaluation stakeholders. The evaluation criteria have to be multi-dimensional as well as grounded in, or derived from, one or more specific perspectives or theories. The framework is designed to deal effectively with the challenges of e-health evaluation and overcome the limitation of existing evaluation frameworks. The cross disciplinary evaluation framework has been examined and validated by adopting an interpretive case study methodology. The chosen case study is NHS direct which is currently one of the largest e-health services in the world. The data collection process has been carried out by using three research methods; archival records, documentation analysis and semi-structured interviews. The use of multiple methods is essential to generate comparable data patterns and structures, and enhance the reliability of conclusions through data triangulation. The contribution of the research study is in bridging the gap between the theory and practice in the evaluation of e-health services by providing an efficient evaluation framework that can be applied to a wide range of e-health application and able to answer real-world concerns. The study also offers three sets of well-argued and balanced hierarchies of evaluation criteria that influence user’s utilization and satisfaction of e-health services. The evaluation criteria can be used to help achieve better user services utilization, to serve as part of e-health evaluation framework, and to address areas that require further attention in the development of future e-health initiatives.
6
Bodnari, Andreea. "A medication extraction framework for electronic health records". Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/78463.
Testo completoAbstract (sommario):
Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2012.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 71-76).
This thesis addresses the problem of concept and relation extraction in medical documents. We present a medical concept and relation extraction system (medNERR) that incorporates hand-built rules and constrained conditional models. We focus on two concept types (i.e., medications and medical conditions) and the pairwise administered-for relation between these two concepts. For medication extraction, we design a rule-based baseline medNERRgreedy med that identifies medications using the UMLS dictionary. We enhance medNERRgreedy med with information from topic models and additional corpus-derived heuristics, and show that the final medication extraction system outperforms the baseline and improves on state-of-the-art systems. For medical conditions extraction we design a Hidden Markov Model with conditional constraints. The conditional constraints frame world knowledge into a probabilistic model and help support model decisions. We approach relation extraction as a sequence labeling task, where we label the context between the medications and the medical concepts that are involved in an administered-for relation. We use a Hidden Markov Model with conditional constraints for labeling the relation context. We show that the relation extraction system outperforms current state of the art systems and that its main advantage comes from the incorporation of domain knowledge through conditional constraints. We compare our sequence labeling approach for relation extraction to a classification approach and show that our approach improves final system performance.
by Andreea Bodnari.
S.M.
7
Iwaya, Leonardo Horn. "A security framework for mobile health data collection". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/3/3141/tde-23122014-143956/.
Testo completoAbstract (sommario):
Mobile health (mHealth) can be defined as the practice of medicine and public health supported by mobile computing technologies, such as mobile phones, PDAs, tablets, sensors and other wireless devices. Particularly in the case of mobile phones, there has been a significant increase in the number of lines, equipment, and network infrastructure in Low- and Middle-Income Countries (LMIC), allowing the adoption of mHealth systems efficiently. There are now several cases of systems for data collection focused on primary care, health surveillance and epidemiological research, which were adopted in these countries. Such systems provide health care managers information with higher quality and in a shorter time, which in turn improves their ability to plan actions and respond to emergencies. However, security is not included among the main requirements of such systems. Aiming to address this issue, we developed a survey about mHealth applications and research initiatives in Brazil, which shows that a reasonable number of papers only briefly (13%) or simply do not mention (40%) their security requirements. This survey also provides a discussion about the current state-of-art of Brazilian mHealth researches, including the main types of applications, target users, devices employed and the research barriers identified. After that, we present the SecourHealth, a security framework for mHealth data collection applications. SecourHealth was designed to cope with six main security requirements: support user registration and authentication mechanisms; treat network disconnections and delays; provide a secure data storage - even in case of possible theft or loss of equipment; allow secure data exchange between the device and server; enabling device sharing between users (i.e., health workers); and allow trade-offs between security, performance and usability. This thesis also describes in detail the framework modeling and development steps showing how it was integrated into an application for the Android platform. Finally, we benchmarked the cryptographic algorithms implemented, when compared to the overhead of using HTTPS protocol.Saúde Móvel (mHealth) pode ser definida como a prática médica e a saúde pública suportadas por tecnologias de computação móvel, como: telefones celulares, PDAs, tablets, sensores e outros dispositivos sem fio. Particularmente no caso dos celulares, há um aumento expressivo no número de linhas, aparelhos, e na infraestrutura de rede em países de média e baixa renda (Low- Middle- Income Countries, LMIC), permitindo a adoção de sistemas mHealth de maneira eficiente. Existem, hoje, vários casos de sistemas de coleta de dados voltadas à atenção primária, vigilância (em saúde) e pesquisas epidemiológicas adotados nesses países. Tais sistemas fornecem aos gestores de saúde uma informação de melhor qualidade em menor tempo, que por sua vez melhoram a capacidade de planejamento e resposta a emergências. Contudo, nota-se um relaxamento no cumprimento de requisitos de segurança nestes sistemas. Com base nisso, foi feito um levantamento de aplicações e iniciativas de pesquisa em mHealth no Brasil, no qual se constatou que um número razoável de trabalhos mencionam fracamente (13%) ou não menciona (40%) os requisitos de segurança. Este levantamento também discute sobre o estado atual das pesquisas de mHealth no Brasil, os principais tipos de aplicações, os grupos de usuários, os dispositivos utilizados e as barreiras de pesquisa identificadas. Em seguida, este trabalho apresenta o SecourHealth, um framework de segurança voltado ao desenvolvimento de aplicações de mhealth para coleta de dados. O SecourHealth foi projetado com base em seis requisitos principais de segurança: suportar o registro e a autenticação do usuário; tratar a desconexão e os atrasos na rede; prover o armazenamento seguro de dados prevendo possibilidades de furto ou perda dos aparelhos; fazer transmissão segura de dados entre o aparelho e o servidor; permitir o compartilhamento de dispositivos entre os usuários (e.g., agentes de saúde); e considerar opções de compromisso entre segurança, desempenho e usabilidade. O trabalho também descreve com detalhes as etapas de modelagem e desenvolvimento do framework - que foi integrado a uma aplicação para a plataforma Android. Finalmente, é feita uma análise do desempenho dos algoritmos criptográficos implementados, considerando o overhead pelo simples uso do protocolo HTTPS.
8
Lee, Fock Choy. "A quantitative performace measurement framework for health care systems". Diss., Columbia, Mo. : University of Missouri-Columbia, 2006. http://hdl.handle.net/10355/4583.
Testo completoAbstract (sommario):
Thesis (M.S.) University of Missouri-Columbia, 2006.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (June 26, 2007) Includes bibliographical references.
9
Mnjama, Javan Joshua. "Towards a threat assessment framework for consumer health wearables". Thesis, Rhodes University, 2018. http://hdl.handle.net/10962/62649.
Testo completoAbstract (sommario):
The collection of health data such as physical activity, consumption and physiological data through the use of consumer health wearables via fitness trackers are very beneficial for the promotion of physical wellness. However, consumer health wearables and their associated applications are known to have privacy and security concerns that can potentially make the collected personal health data vulnerable to hackers. These concerns are attributed to security theoretical frameworks not sufficiently addressing the entirety of privacy and security concerns relating to the diverse technological ecosystem of consumer health wearables. The objective of this research was therefore to develop a threat assessment framework that can be used to guide the detection of vulnerabilities which affect consumer health wearables and their associated applications. To meet this objective, the Design Science Research methodology was used to develop the desired artefact (Consumer Health Wearable Threat Assessment Framework). The framework is comprised of fourteen vulnerabilities classified according to Authentication, Authorization, Availability, Confidentiality, Non-Repudiation and Integrity. Through developing the artefact, the threat assessment framework was demonstrated on two fitness trackers and their associated applications. It was discovered, that the framework was able to identify how these vulnerabilities affected, these two test cases based on the classification categories of the framework. The framework was also evaluated by four security experts who assessed the quality, utility and efficacy of the framework. Experts, supported the use of the framework as a relevant and comprehensive framework to guide the detection of vulnerabilities towards consumer health wearables and their associated applications. The implication of this research study is that the framework can be used by developers to better identify the vulnerabilities of consumer health wearables and their associated applications. This will assist in creating a more securer environment for the storage and use of health data by consumer health wearables.
10
Sweeney, Fee Sharon K. "An expanding framework for rural patients who travel for health care". Diss., The University of Arizona, 2004. http://hdl.handle.net/10150/289238.
Testo completoAbstract (sommario):
This exploratory study utilized Donabedian's Quality model to develop a framework to study patients who must migrate for health care. One year of the Arizona Department of Health Services Discharge Database was used to analyze patient characteristics that influenced discharge travel and the impact of distance on risk adjusted patient outcomes. Geographic Interface software was used to identify rural patients, defined as those with zip codes farther than thirty miles from hospitals. Zip Code analysis was used to create distance variables between 31 and over 300 miles. The key findings for patients who traveled greater distances included larger hospitals, emergency admission type, private insurance, critical care services, and Neuro/Ortho/Trauma diagnosis group. Patients which traveled shorter distances included smaller hospitals, referral or transfer admit source, AHCCCS insurance (or Medicaid) and Women's Health diagnosis group. Outcomes were risk adjusted using age and distance was significant for both number of procedures and length of stay. Patients who traveled farther received fewer procedures and had a greater length of stay. A preliminary cost analysis of the length of stay outliers identified approximately four million dollars in potentially non-reimbursable charges.
11
Liu, Xia. "A requirement engineering framework for assessing health care information systems". Thesis, University of Ottawa (Canada), 2010. http://hdl.handle.net/10393/28534.
Testo completoAbstract (sommario):
Health care is increasingly being provided by collaborative teams that involve multiple health care providers at multiple locations. To date, most of that collaboration is on an ad-hoc basis via phone calls, faxes, and paper based documentation. However, Internet and wireless technologies provide an opportunity to improve this situation via electronic data sharing. These new technologies make possible new ways of working and collaboration but it can be difficult for health care organizations to understand how to adopt new technologies while still ensuring that their policies and objectives are being met. It is also important to have a systematic approach to validate that e-health processes deliver the performance improvements that are expected. Using a case study of a palliative care patient receiving home care from a team of collaborating healthcare providers and organizations, we introduce a framework for assessing health care information systems based on requirements engineering. Key concerns and objectives were identified and modeled. Business processes which will use the new health care information system are modeled in terms of these concerns and objectives to assess their impact and ensure that electronic data sharing is well regulated and effective. The work in the thesis is design-oriented research to show the utility of our proposed requirement engineering framework compared to existing evaluation approaches for healthcare IT. The approach is evaluated based on a set of criteria drawn from our literature review and a gap analysis of our case study for palliative care.
12
Caron, Catherine M. "A conceptual framework for community interventions in successful aging". Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/26864.
Testo completoAbstract (sommario):
As the number and percentage of elderly Canadians increase, it becomes imperative to understand successful aging in order to keep this growing segment of our population healthy and productive. Conceptual models of successful aging have been proposed in a number of disciplines (biology, psychology, sociology, epidemiology), but these have yet to be integrated. There is not even agreement on how to define successful aging, or on whether it is a state of being or an adaptive process.
To date, there have been relatively few interventions to promote successful aging, and the lack of a theoretical approach makes it more difficult to design them and to assess the results of any interventions that have been attempted.
In this thesis, I build upon the insights from existing literatures, and I propose a conceptual model for successful aging. I then discuss the application of this model to guide community interventions for Successful Aging Ottawa.
13
Brown, Douglas W. "A prognostic health management based framework for fault-tolerant control". Diss., Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/41132.
Testo completoAbstract (sommario):
The emergence of complex and autonomous systems, such as modern aircraft, unmanned aerial vehicles (UAVs) and automated industrial processes is driving the development and implementation of new control technologies aimed at accommodating incipient failures to maintain system operation during an emergency. The motivation for this research began in the area of avionics and flight control systems for the purpose to improve aircraft safety. A prognostics health management (PHM) based fault-tolerant control architecture can increase safety and reliability by detecting and accommodating impending failures thereby minimizing the occurrence of unexpected, costly and possibly life-threatening mission failures; reduce unnecessary maintenance actions; and extend system availability / reliability.
Recent developments in failure prognosis and fault tolerant control (FTC) provide a basis for a prognosis based reconfigurable control framework. Key work in this area considers: (1) long-term lifetime predictions as a design constraint using optimal control; (2) the use of model predictive control to retrofit existing controllers with real-time fault detection and diagnosis routines; (3) hybrid hierarchical approaches to FTC taking advantage of control reconfiguration at multiple levels, or layers, enabling the possibility of set-point reconfiguration, system restructuring and path / mission re-planning. Combining these control elements in a hierarchical structure allows for the development of a comprehensive framework for prognosis based FTC.
First, the PHM-based reconfigurable controls framework presented in this thesis is given as one approach to a much larger hierarchical control scheme. This begins with a brief overview of a much broader three-tier hierarchical control architecture defined as having three layers: supervisory, intermediate, and low-level. The supervisory layer manages high-level objectives. The intermediate layer redistributes component loads among multiple sub-systems. The low-level layer reconfigures the set-points used by the local production controller thereby trading-off system performance for an increase in remaining useful life (RUL).
Next, a low-level reconfigurable controller is defined as a time-varying multi-objective criterion function and appropriate constraints to determine optimal set-point reconfiguration. A set of necessary conditions are established to ensure the stability and boundedness of the composite system. In addition, the error bounds corresponding to long-term state-space prediction are examined. From these error bounds, the point estimate and corresponding uncertainty boundaries for the RUL estimate can be obtained. Also, the computational efficiency of the controller is examined by using the number of average floating point operations per iteration as a standard metric of comparison.
Finally, results are obtained for an avionics grade triplex-redundant electro-mechanical actuator with a specific fault mode; insulation breakdown between winding turns in a brushless DC motor is used as a test case for the fault-mode. A prognostic model is developed relating motor operating conditions to RUL. Standard metrics for determining the feasibility of RUL reconfiguration are defined and used to study the performance of the reconfigured system; more specifically, the effects of the prediction horizon, model uncertainty, operating conditions and load disturbance on the RUL during reconfiguration are simulated using MATLAB and Simulink. Contributions of this work include defining a control architecture, proving stability and boundedness, deriving the control algorithm and demonstrating feasibility with an example.
14
Pick, William M. "Regionalization of health services in the Cape Province : a framework". Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/27193.
Testo completoAbstract (sommario):
Post-graduate students specializing in Community Health, are attached to different health authorities during their training. During these attachments they are exposed to the day-to-day management of health services and experience at first hand, the difficulties as well as the successes that are encountered in tending to the health needs of communities. It is also expected that post-graduate students do research projects during their attachments, usually on topics on which the health services managers need information. The topic discussed in this report was an assignment given to the author at the start of his attachment to the department of Hospital (Health) Services of the Cape Provincial Administration. The period of attachment was from February to May 1987. The whole question of the regionalization of health services is a complex one, and it is necessary that any proposals for a system of regionalization benefit from the inputs of many experts in different fields. However, as has been the experience in the United States of America, such inputs are no guarantee -that a successful system of regionalization will result. (1) In the local front, the Department of Works, at the request of the Director of Hospital Services, began an investigation into the existing system of regionalization of hospital services in 1985. This attempt was aborted, possibly because of the magnitude of the task, among other things. (2). What follows hereafter should therefore be seen as merely a framework for the development of a system of regionalization rather than as a blueprint for such a system. Perhaps a few remarks about the age-old problem of line-staff conflict would not be amiss at this stage. During the development of this framework, it became apparent that line officials might be expecting a quick proposal of regions and/ or sub-regions for the delivery of health services based on a purely management approach. As a staff official, the author naturally had different expectations. The report is an attempt to marry the two sets of expectations and it is left to the reader to judge to what extent, if at all, the author has succeeded in this attempt. Much of the data used in the study are new, and computation was done largely by hand. The generation of the data, was therefore time-consuming and much of the first phase of the study was devoted to the generation of the data and collection of data that were available from other sources. The study has proved to be a fascinating one and it is hoped that permission will be obtained to pursue the study in more detail. This report should therefore be seen as a preliminary report which addresses the question of regionalization of health services in the Cape Province in 'macro' terms. And finally, the author hopes that some of the information in this report may prove of value to those responsible for the delivery of health services to the people of the Cape Province.
15
Coleman, Alfred. "Developing an e-health framework through electronic healthcare readiness assessment". Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1519.
Testo completoAbstract (sommario):
The major socio-economic development challenges facing most African countries include economic diversification, poverty, unemployment, diseases and the unsustainable use of natural resources. The challenge of quality healthcare provisioning is compounded by the HIV/AIDS pandemic in Sub Saharan Africa. However, there is a great potential in using electronic healthcare (e-health) as one of the supportive systems within the healthcare sector to address these pressing challenges facing healthcare systems in developing countries, including solving inequalities in healthcare delivery between rural and urban hospitals/clinics. The purpose of this study was to compile a Provincial E-health Framework (PEHF) based on the feedback from electronic healthcare readiness assessments conducted in selected rural and urban hospitals/clinics in the North West Province in South Africa. The e-healthcare readiness assessment was conducted in the light of effective use of ICT in patient healthcare record system, consultation among healthcare professionals, prescription of medication, referral of patients and training of healthcare professionals in ICT usage. The study was divided into two phases which were phases 1 and 2 and a qualitative design supported by a case study approach was used. Data were collected using different techniques to enhance triangulation of data. The techniques included group interviews, qualitative questionnaires, photographs, document analysis and expert opinions. The outcome of the assessment led to the compilation of the PEHF which was based on Service Oriented Architecture (SOA). SOA was chosen to integrate the hospitals/clinics‟ ICT infrastructure yet allowing each hospital/clinic the autonomy to control its own ICT environment. To assist hospitals/clinics integrate their ICT resources, this research study proposed an Infrastructure Network Architecture which clustered hospitals/clinics to share common ICT infrastructure instead of duplicating these resources. Furthermore, processes of the e-health services (e-patient health IV record system, e-consultation system, e-prescription system, e-referral system and e-training system) were provided to assist in the implementation of the PEHF. Finally, a set of guidelines were provided by the research study to aid the implementation of the PEHF.
16
Van, der Westhuizen Eldridge Welner. "A framework for personal health records in online social networking". Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1012382.
Testo completoAbstract (sommario):
Since the early 20th century, the view has developed that high quality health care can be delivered only when all the pertinent data about the health of a patient is available to the clinician. Various types of health records have emerged to serve the needs of healthcare providers and more recently, patients or consumers. These health records include, but are not limited to, Personal Health Records, Electronic Heath Records, Electronic Medical Records and Payer-Based Health Records. Payer-Based Health Records emerged to serve the needs of medical aids or health care plans. Electronic Medical Records and Electronic Health Records were targeted at the healthcare provider market, whereas a gap developed in the patient market. Personal Health Records were developed to address the patient market, but adoption was slow at first. The success of online social networking reignited the flame that Personal Health Records needed and online consumer-based Personal Health Records were developed. Despite all the various types of health records, there still seems to be a lack of meaningful use of personal health records in modern society. The purpose of this dissertation is to propose a framework for Personal Health Records in online social networking, to address the issue of a lack of a central, accessible repository for health records. In order for a Personal Health Record to serve this need it has to be of meaningful use. The capability of a PHR to be of meaningful use is core to this research. In order to determine whether a Personal Health Record is of meaningful use, a tool is developed to evaluate Personal Health Records. This evaluation tool takes into account all the attributes that a Personal Health Record which is of meaningful use should comprise of. Suitable ratings are allocated to enable measuring of each attribute. A model is compiled to facilitate the selection of six Personal Health Records to be evaluated. One of these six Personal Health Records acts as a pilot site to test the evaluation tool in order to determine the tool’s utility and effect improvements. The other five Personal Health Records are then evaluated to measure their adherence to the attributes of meaningful use. These findings, together with a literature study on the various types of health records and the evaluation tool, inform the building blocks used to present the framework. It is hoped that the framework for Personal Health Records in online social networking proposed in this research, may be of benefit to provide clear guidance for the achievement of a central or integrated, accessible repository for health records through the meaningful use of Personal Health Records.
17
Ouma, Stella. "M-health user experience framework for the public healthcare sector". Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020793.
Testo completoAbstract (sommario):
The public healthcare sectors within developing nations face a lot of challenges because of constrained resources available to them. The South African public healthcare sector is no different. Although it serves the majority of the South African population, most of the financial resources are directed towards the private sector, which serves very few individuals when compared to the public healthcare sector. Apart from that, other challenges that the National Department of Health has to deal with include the lack of sufficiently trained healthcare employees who can work on the different levels of the public healthcare sector, as well as the burden of diseases such as HIV and Aids, tuberculosis and other chronic diseases. In order to improve service delivery, the National Department of Health is introducing Information and Communications Technology interventions that can increase efficiency and reduce costs, thereby improving the quality of service delivery. This research delivers an m-health application user experience framework to be proposed to the National Department of Health in South Africa, in order to assist in scaling up of m-health applications. The m-health applications that can benefit the South African population if scaled up successfully include those that can be used in remote data collection, treatment and compliance, accessing patients records, remote monitoring, communication and training for healthcare workers and applications that can be used for education and awareness. The study focused on three domains: the Human-Computer Interaction domain, public healthcare domain and Health Informatics domain. The proposed framework was realized by investigating mobile user experience components, mobile health requirements and the South African public healthcare domain components that contribute to the m-health user experience framework. This research was conducted through the interpretivist philosophy. Due to the exploratory nature of the study, an application of qualitative methodology was used. The conceptual theoretical framework was validated through a single case study approach by m-health user experience experts, who reside in South Africa. Data were analysed inductively. An m-health user experience framework was provided at the end of the study. An m-health user experience framework can assist the National Department of Health to look into design issues, address m-health requirements and put the domain needs in place, thus enabling the Department to successfully scale up implementations of m-health applications nationwide.
18
Chau, Fangxiao Leena Wu. "Examining the delivery of mental health services in primary care and public health collaborations using a population health framework". Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59989.
Testo completoAbstract (sommario):
Background: More than 6.7 million people in Canada experience a mental illness during a one-year period. Mental illnesses are highly influenced by the determinants of health, which are the social, economic, and physical environments that contribute to an individual’s health status. Addressing mental illnesses requires a population health approach involving joint action across multiple sectors to focus on the determinants of health. This thesis examines the extent to which Primary Care (PC) and Public Health (PH) collaborations incorporated a population health approach to address mental illnesses. Methods: A secondary analysis of data collected through a multi-province (British Columbia, Ontario, Nova Scotia) study that examined factors related to strengthening primary health care through PC and PH collaboration was conducted. Focus group data from four cases of PC-PH collaborations that addressed mental health were used to examine whether mental health activities incorporated a population health approach, as well as to identify the enablers and barriers to carrying out the activities. A qualitative descriptive approach and thematic analysis were used. A coding framework and themes were developed deductively, based on the Public Health Agency of Canada’s population health framework, and through inductive analysis. Results: Twenty-nine themes and eighteen subthemes were identified that correspond to the Public Health Agency of Canada’s population health framework. Key enablers included working in a multidisciplinary team, addressing the determinants of health, and engaging the community. Key barriers were poor data systems, a lack of service integration, and a lack of action on demonstrating accountability for outcomes. Conclusions: Findings highlighted the relevance of a population health approach and demonstrate that certain aspects of the population health framework are more actionable than others in the area of mental health, thus identifying areas for the framework’s further development. The research also identifies enablers and barriers to conducting mental health activities, offering guidance on how to facilitate population health implementation. The results could help provide insight at the program and policy levels for PC and PH as well as other sectors related to collaborative strategies that could strengthen the delivery of mental health services by incorporating a population health approach.Medicine, Faculty of
Graduate
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Alvaro, Eusebio Martins. "Misanthropy and persuasion: Test of a theoretical framework". Diss., The University of Arizona, 2000. http://hdl.handle.net/10150/284084.
Testo completoAbstract (sommario):
The goal of this research effort is twofold. First, this project revises and extends a propositional framework delineating the nature of the interplay between misanthropy and persuasion. Of special concern is the delineation of successful persuasion approaches given the validity of the underlying theoretical frame. A second major goal of this effort is to propose a series of studies designed to test theoretically-derived hypotheses. Study 1 tests theoretical hypotheses in a sample of adolescents. Study 2 extends earlier work on misanthropy by testing theoretical hypotheses in an adult sample (Alvaro & Burgoon, 1995) and replicating tests of some of the hypotheses from study 1.
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Sexton, Mary. "Patient-centredness : a conceptual framework for musculoskeletal physiotherapy". Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/7b5f1fd2-cfdd-47ba-b05f-f5d4d12d96e1.
Testo completoAbstract (sommario):
Introduction The centrality of the patient to health care has been increasingly recognised both politically and professionally. Patient-centred care has become synonymous with high-quality care and a number of studies have reinforced patient's desire for, and the positive impact of the approach. Although the concept emerged over 30 years ago, it is still not clear what it is, upon what theories it is based, or how to measure it. Whilst the concept has been explored within medicine, nursing and other allied health professions, within physiotherapy there has only been minimal discussion. The aim of this research was to explore the meaning of patient-centred care in relation to low back pain, from the perspective of musculoskeletal physiotherapists. Methods Purposive sampling was initially used to select participants. Subsequently theoretical sampling was adopted whereby analysis of the data informed the sample selection. Nine musculoskeletal physiotherapists agreed to participate in the study. They ranged in experience from five to 25 years. Individual semi- structured interviews were adopted as the method of data collection. The interviews were audio taped and then transcribed verbatim. Analysis broadly followed the Grounded Theory approach outlined by Strauss and Corbin (1990). It consisted of a process of open, axial and selective coding. Constant comparative analysis resulted in the identification with a core category and three inter-related sub-categories and the development of a substantive theory of patient-centred care.
21
Kseib, Khalil. "Addressing adult obesity : a psychological framework". Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/21659/.
Testo completoAbstract (sommario):
Background: Obesity remains a significant public health priority despite ongoing efforts, with few notable advances made in recent years. Individual behaviour change mechanisms, or 'active ingredients', can only partially explain and predict successful weight loss. In addition, maintenance following a period of initial weight loss is rare and relies upon unique combinations of interrelated and overlapping factors. Whilst the outcome of weight loss and its maintenance has been the focus of much research, the individual weight loss journey as a process has been largely overlooked. By looking through the lens of the lived experience, there lies an opportunity to sequence the temporal and contextual dimensions of the weight journey and gain greater insight into this process. Aims: The current study aimed to examine the temporal and contextual dynamics of the weight loss journey by listening to the personal narratives of people who had attended a psychologically-led weight loss intervention, in this way revealing the barriers and enablers to their initial weight loss and maintenance over time. Methods: The study adopted a qualitative approach, using a combination of focus groups and 1-1 interviews with participants who had previously attended a psychologically-based weight management intervention. Results: The study recruited a total of 46 individuals who took part in either a focus group (n=40) or 1-1 interview (n=6). A conceptual linear framework was devised which highlighted three core superordinate themes; Alienation, Connectedness and The Future (Abandonment or Autonomy), representing distinct stages of the weight journey. In exploring the conditions under which individuals migrate across stages results indicated a role for the development of a self-identity which assumes personal responsibility for meeting psychological and emotional needs beyond the physical realm of weight loss. Although most personal narratives reflected a sense of abandonment post intervention and associated weight relapse, a small minority engendered a sense of autonomy and a focus upon psychological and emotional capacities as a metric for their weight loss journey. Conclusions: Bringing into view temporal and contextual dimensions involved in managing weight over time, the findings have implications for addressing the issue of weight as a symptom rather than as a cause and centralise the importance of meeting psychological and emotional needs over and above a unilateral focus on weight loss.
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Fraser, Michael Swain. "Development and implementation of an integrated framework for structural health monitoring". Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2006. http://wwwlib.umi.com/cr/ucsd/fullcit?p3203494.
Testo completoAbstract (sommario):
Thesis (Ph. D.)--University of California, San Diego, 2006.Title from first page of PDF file (viewed March 1, 2006). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 514-522).
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Adams, Owen. "A Population Health Framework: Assessing Its Applicability for Primary Care Physicians". Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/26111.
Testo completoAbstract (sommario):
Population health is concerned with analyzing the factors that determine the uneven distribution of health in a population and it also proposes interventions to narrow health inequalities. Kindig has proposed a population health management strategy that would engage the health and other sectors on population health improvement through a financial incentive linked to health outcomes. Proposed elements of a population health approach in health care at the patient encounter level include paying attention to health determinants for the patient and ensuring interprofessional collaboration; at the system level the approach includes developing and advocating for interventions that address health inequalities, such as delivering services to under-serviced areas and vulnerable populations. There has been virtually no research among frontline clinicians on the awareness and salience of a population health approach.
In order to address this gap an exploratory study was conducted among family physicians in Primary Care Networks (PCNs) in Alberta, Canada. PCNs include capitation funding that is used to purchase services such as nursing, pharmacy and dietetics.
The physicians were able to describe their patient populations in terms of a full range of social determinants and the health status inequalities they produce. They emphasized the importance of preventive screening and counseling in contributing to the health of their patients, and cited the key contributions of other team members to these activities, as well as the electronic medical record (EMR). They reported ambivalence toward the effectiveness of financial incentives for population health improvement, and while there was some collaboration with schools, inter-sectoral collaboration has yet to develop outside the health sector.
This thesis has demonstrated the potential for primary care physicians to adopt a population health approach. However, there is a considerable distance to go in introducing an incentive approach for outcome-based population health management, as envisioned by Kindig.
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Ying, Yujie. "A Data-Driven Framework for Ultrasonic Structural Health Monitoring of Pipes". Research Showcase @ CMU, 2012. http://repository.cmu.edu/dissertations/92.
Testo completoAbstract (sommario):
Cylindrical shells serve important roles in broad engineering applications, such as oil and natural gas pipelines, and pressurized industrial piping systems. To ensure the safety of pipe structures, various inspection equipment and platforms have been developed based on nondestructive testing (NDT) technologies. However, most existing approaches are time and labor intensive, and are only conducted intermittently. Drawbacks of current NDT methods suggest a proactive, automated and long-term monitoring system. Structural health monitoring (SHM) techniques continuously assess structural integrity through permanently installed transducers, allowing condition-based maintenance to replace the current practice of economically inefficient schedule-based maintenance.
Ultrasonics is an appealing SHM technology in which guided waves interrogate long stretches of a pipe with high sensitivity to damage, and can be generated by a surface-mounted, small-size piezoelectric wafer transducer (PZT). The challenges of implementing ultrasonic SHM with PZTs as active sensing devices lie in: (1) the wave pattern is complex and difficult to interpret; (2) it is even more difficult to differentiate changes produced by damage from changes produced by benign environmental and operational variability
The ultimate goal of this research is to develop an ultrasonic sensing and data analysis system for continuous and reliable monitoring of pipe structures. The objective of this dissertation is to devise a data-driven framework for effective and robust analysis of guided wave signals to detect and localize damage in steel pipes under environmental and operational variations. The framework is composed of a three-stage SHM scheme: damage detection,damage localization and damage characterization, supported by a multilayer data processing architecture incorporating statistical analysis, signal processing, and machine leaning techniques.
The data-driven methodology was first investigated through laboratory experiments conducted on a pipe specimen with varying internal air pressure. The sensed ultrasonic data were characterized and mapped onto a high dimensional feature space using various statistical and signal processing techniques. Machine learning algorithms were applied to automatically identify effective features, and to detect and localize a weak scatterer on the pipe. The reliability and generality of the data-driven framework was further validated through field tests performed on an in-service hot-water pipe under large, complex and uncontrollable operating conditions.
This data-driven SHM methodology involves an integrated process of sensing, data acquisition, statistical analysis, signal processing, and pattern recognition, for continuous tracking of the structural functionality in an adaptive and cost-effective manner. The techniques developed in this dissertation are expected to have broader applications related to the regular inspection, maintenance, and management of critical infrastructures not just limited to pipes.
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Laurenson, Mary Catherine. "Interprofessionalism in health and social care : working towards an inclusive framework". Thesis, University of Huddersfield, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438073.
Testo completo
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Paschane, David Michael. "A theoretical framework for the medical geography of health service politics /". Thesis, Connect to this title online; UW restricted, 2003. http://hdl.handle.net/1773/5649.
Testo completo
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Meads, David Michael. "An economic framework for user financial incentives for health behaviour change". Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/13458/.
Testo completoAbstract (sommario):
Background: Diseases such as stroke and heart disease are chiefly caused by unhealthy behaviours and are a major societal burden. User financial incentives are being explored as a way to encourage healthier lifestyles. This research developed a framework to provide information on pricing and cost-effectiveness of incentives and guide design of future incentive schemes. Methods: The workstreams were: a) structured, configurative literature review to identify neo-classical/behavioural economic explanations for behaviour change and incentives; b) contingent valuation survey to identify willingness to accept (WTA) and incentive pricing; c) systematic review and meta-analysis of incentives for weight loss; d) development of decision-analytic model to estimate cost-effectiveness of incentives for weight loss. Results: The reviews identified a number of factors important for understanding the effect of incentives including internal motivation, self-control and time preference. A theoretical framework of incentive impact was developed to facilitate WTA survey design. The WTA survey was completed by 112 people (n=56 at 3 months). 57% strongly disagreed with incentive use. The mean incentive required per month depended on behaviour, ranging £103.69 for smoking cessation to £45.43 for reducing alcohol intake. The most important predictors of WTA were self-control, perceived difficulty of change and attitudes to incentives. There was some evidence that WTA incentives increased over time. Review and meta-regression provided efficacy parameters for the decision-analytic model which comprised the following health states: healthy, type II diabetes, stroke, myocardial infarction and dead. Analyses from NHS and employer perspectives indicated incentives for weight loss are cost-effective over a lifetime as they dominated usual care. Discussion: Incentives may be most powerful if they are personalised to account for individual factors and attitudes and are dynamic in response to these. Incentives may be cost-effective in a number of scenarios. Further research is required on the long term outcomes of incentives and financing models.
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Novinskey, Christina. "Determining policy priorities in a devolved health system : an analytical framework". Thesis, London School of Economics and Political Science (University of London), 2015. http://etheses.lse.ac.uk/3513/.
Testo completoAbstract (sommario):
This dissertation develops an analytical framework for studying the effects of health system devolution on the health policymaking process and policy choices made by subnational governments. It addresses two research questions: (1) How does devolution change the structure and agency of the health policymaking process? (2) What is the resulting impact on health policy priorities? A critical literature review covers decentralization, devolution, and interest-based approaches for analysing the policymaking process, structure and agency. An analytical framework for uppermiddle and high-income countries is constructed by integrating (i) a modified version of Bossert’s decision-space approach for decentralized health systems; (ii) BlomHansen’s combined policy network and rational-choice institutionalist approach, which analyses the intergovernmental relations within the national health policymaking environment; and (iii) an original conceptualisation and analysis of informal intergovernmental policymaking at the subnational government level. Empirical evaluation uses information on Spain’s 2001 health system devolution reform, focusing on the regional cases of Extremadura and Madrid. Primary data from stakeholder interviews and secondary data are analysed primarily using qualitative, case study and content analysis methods. The decision space granted to regional governments in Spain is examined before and after the reform, developing a decision-space map for Extremadura and Madrid and showing the shifts in the range of choice allowed for each health system function over time. Next, the compositions of the national and subnational health policy networks are determined for before and after devolution, and the policy priorities for each are estimated ex ante. Finally, the dissertation analyses the ex post priorities and results of health policy decisions made by Spain, Extremadura and Madrid in the period after devolution. Overall results show that the analytical framework is only partially successful in anticipating health policy priorities. Suggestions for improving the framework are proposed, and policy implications and lessons are drawn from the case studies.
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Moreno, Conde A. "Quality framework for semantic interoperability in health informatics : definition and implementation". Thesis, University College London (University of London), 2016. http://discovery.ucl.ac.uk/1529311/.
Testo completoAbstract (sommario):
Aligned with the increased adoption of Electronic Health Record (EHR) systems, it is recognized that semantic interoperability provides benefits for promoting patient safety and continuity of care. This thesis proposes a framework of quality metrics and recommendations for developing semantic interoperability resources specially focused on clinical information models, which are defined as formal specifications of structure and semantics for representing EHR information for a specific domain or use case. This research started with an exploratory stage that performed a systematic literature review with an international survey about the clinical information modelling best practice and barriers. The results obtained were used to define a set of quality models that were validated through Delphi study methodologies and end user survey, and also compared with related quality standards in those areas that standardization bodies had a related work programme. According to the obtained research results, the defined framework is based in the following models: Development process quality model: evaluates the alignment with the best practice in clinical information modelling and defines metrics for evaluating the tools applied as part of this process. Product quality model: evaluates the semantic interoperability capabilities of clinical information models based on the defined meta-data, data elements and terminology bindings. Quality in use model: evaluates the suitability of adopting semantic interoperability resources by end users in their local projects and organisations. Finally, the quality in use model was implemented within the European Interoperability Asset register developed by the EXPAND project with the aim of applying this quality model in a broader scope to contain any relevant material for guiding the definition, development and implementation of interoperable eHealth systems in our continent. Several European projects already expressed interest in using the register, which will now be sustained by the European Institute for Innovation through Health Data.
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Aviña, Aldo. "A Spatially Explicit Environmental Health Surveillance Framework for Tick-Borne Diseases". Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc30432/.
Testo completoAbstract (sommario):
In this paper, I will show how applying a spatially explicit context to an existing environmental health surveillance framework is vital for more complete surveillance of disease, and for disease prevention and intervention strategies. As a case study to test the viability of a spatial approach to this existing framework, the risk of human exposure to Lyme disease will be estimated. This spatially explicit framework divides the surveillance process into three components: hazard surveillance, exposure surveillance, and outcome surveillance. The components will be used both collectively and individually, to assess exposure risk to infected ticks. By utilizing all surveillance components, I will identify different areas of risk which would not have been identified otherwise. Hazard surveillance uses maximum entropy modeling and geographically weighted regression analysis to create spatial models that predict the geographic distribution of ticks in Texas. Exposure surveillance uses GIS methods to estimate the risk of human exposures to infected ticks, resulting in a map that predicts the likelihood of human-tick interactions across Texas, using LandScan 2008TM population data. Lastly, outcome surveillance uses kernel density estimation-based methods to describe and analyze the spatial patterns of tick-borne diseases, which results in a continuous map that reflects disease rates based on population location. Data for this study was obtained from the Texas Department of Health Services and the University of North Texas Health Science Center. The data includes disease data on Lyme disease from 2004-2008, and the tick distribution estimates are based on field collections across Texas from 2004-2008.
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Mahmud, S. "Cloud enabled data analytics and visualization framework for health-shock prediction". Thesis, Coventry University, 2016. http://curve.coventry.ac.uk/open/items/deba667c-5142-4330-9fd0-c86db4a8c088/1.
Testo completoAbstract (sommario):
Health-shock can be defined as a health event that causes severe hardship to the household because of the financial burden for healthcare payments and the income loss due to inability to work. It is one of the most prevalent shocks faced by the people of underdeveloped and developing countries. In Pakistan especially, policy makers and healthcare sector face an uphill battle in dealing with health-shock due to the lack of a publicly available dataset and an effective data analytics approach. In order to address this problem, this thesis presents a data analytics and visualization framework for health-shock prediction based on a large-scale health informatics dataset. The framework is developed using cloud computing services based on Amazon web services integrated with Geographical Information Systems (GIS) to facilitate the capture, storage, indexing and visualization of big data for different stakeholders using smart devices. The data was collected through offline questionnaires and an online mobile based system through Begum Memhooda Welfare Trust (BMWT). All data was coded in the online system for the purpose of analysis and visualization. In order to develop a predictive model for health-shock, a user study was conducted to collect a multidimensional dataset from 1000 households in rural and remotely accessible regions of Pakistan, focusing on their health, access to health care facilities and social welfare, as well as economic and environmental factors. The collected data was used to generate a predictive model using a fuzzy rule summarization technique, which can provide stakeholders with interpretable linguistic rules to explain the causal factors affecting health-shock. The evaluation of the proposed system in terms of the interpretability and accuracy of the generated data models for classifying health-shock shows promising results. The prediction accuracy of the fuzzy model based on a k-fold crossvalidation of the data samples shows above 89% performance in predicting health-shock based on the given factors. Such a framework will not only help the government and policy makers to manage and mitigate health-shock effectively and timely, but will also provide a low-cost, flexible, scalable, and secure architecture for data analytics and visualization. Future work includes extending this study to form Pakistan’s first publicly available health informatics tool to help government and healthcare professionals to form policies and healthcare reforms. This study has implications at a national and international level to facilitate large-scale health data analytics through cloud computing in order to minimize the resource commitments needed to predict and manage health-shock.
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Abdelmotleb, Fakhureldein Abdusalam. "Development of Total Quality Management framework for Libyan health care organisations". Thesis, Sheffield Hallam University, 2008. http://shura.shu.ac.uk/17146/.
Testo completoAbstract (sommario):
Primary health care is the first stage for the national health. As such it is considered as the first stage of communication between the citizen, family and the society. The main objective for any primary healthcare is to meet the need of the individual at high quality, and improve the performance of the healthcare system. The quality here is what the patient receives with regard to excellent and safe medical and health services. According to the available literature and based on the author’s many visits and preliminary investigation regarding Libyan healthcare sector in general and Tripoli healthcare sector in particular, itjjas been proven that the reality of government hospitals in Libya is that: these hospitals are facing many problems opposing their improvement, continuity and ability to compete. Based on a series of comprehensive questionnaires, the weakness in the current system are identified, and also found that Total Quality Management (TQM) would provide the solution for Libyan Healthcare system. TQM is a way of managing to improve the effectiveness, efficiency, flexibility, and competitiveness of a business as a whole. The literature illustrated that there are many models and frameworks in the field of TQM. However, the quality gurus have never agreed about a specific fiamework or implementation procedure. In addition, there is lack of a general model in health care, and there is no clear agreement as to the way in which TQM should be implemented in a health care sector. Therefore, the focus of this study is to identify an appropriate TQM framework for Libyan Jiealth care, organisations and benchmarking them and distinguish their competitive advantage, in order to achieve performance excellence. A comprehensive literature review related to TQM is carried out to have a clear insight into the TQM and its application in health service, ^questionnaire survey method is adopted to gather the data and information, which form the basis for the development of the proposed TQM framework. Statistical Package for the Social Sciences SPSS and Analytical Hierarchy Process AHP are utilised to analyse the collected data and views frommanagers. and employees in the organisations under investigation. In addition, in order to achieve the aim of this study two models are developed and TQM framework that covers most aspects of TQM starting from top management awareness until even promoting continuous improvement is developed. The verification and validation process of the proposed TQM framework and its implementation stage implied that the proposed framework factors and stages are important for improving the quality performance of healthcare service in the organisation under investigation.
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John, Stephen David. "Vulnerability, risk and disease : a normative framework for public health policy". Thesis, University of Cambridge, 2008. https://www.repository.cam.ac.uk/handle/1810/252076.
Testo completoAbstract (sommario):
In this thesis, I provide an account of the ethical and epistemic norms that ought to guide public health policy. In Chapter 1, I argue that assessment of physical well-being should ask not only whether we have met our “vital needs”, but how “secure” we are. I motivate this claim by analogy with epistemology: the reasons we equate epistemic well-being with knowledge also support the claim that physical well-being consists in security. In Chapter 2, I use my account of physical well-being to explain why public health policy is valuable. I contrast my account of public health policy with accounts which locate its value in terms of individuals’ health (or opportunity for good health). I argue that a “security”-based account of well-being is preferable to a “capabilities”-based account. In Chapter 3, I outline the normative considerations that ought to guide public health policy. I develop a theory of when risks are and when they are not tolerable. I show how my theory of tolerability generates a novel account of public health ethics which places familiar problems in a new light. I show how my arguments relate to sufficientarian positions in political philosophy. In Chapter 4, I apply my arguments to debates over the ethical legitimacy of medical research. I first argue that it might be legitimate for the State to enforce participation in medical research. I show how such arguments relate to problems over the distribution of medical care. In Chapter 5, I consider the defensibility of the “precautionary principle” in public health policy. I argue that we can best understand the principle as an epistemic rule governing the generation of fact-inputs into policy. In the second half of the chapter, I defend my policy recommendation against the charge that it is un- or anti-scientific.
34
Allen, Dawn. "Child and adolescent mental health : the strategic framework and its implementation in Wales". Thesis, University of South Wales, 2010. https://pure.southwales.ac.uk/en/studentthesis/child-and-adolescent-mental-health(5d009658-a303-4cfe-bba6-18ba0f2276a3).html.
Testo completoAbstract (sommario):
This research comprises three linked projects stemming from the first project which aimed to define “long-term” pupil absence from school and discover the principal reasons for such absence. The second project focussed on the area of Child and Adolescent Mental Health Services (CAMHS), an issue emerging from the first project. The CAMHS 4-Tier Strategic Framework (or “CAMHS Concept”), including links between CAMHS providers were examined and referral pathways investigated and measured against published criteria. The third project explored the new CAMHS Strategic Framework and considered whether implementation problems were to blame for its lack of transformational impact.
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Uhlíř, Tomáš. "Medical leadership compensation framework". Master's thesis, Vysoká škola ekonomická v Praze, 2009. http://www.nusl.cz/ntk/nusl-9322.
Testo completoAbstract (sommario):
This master thesis deals with outlining the rationale of redesigning medical leadership compensation framework within Interior Health Authority (IH). In particular, reviews IH's organizational structure, analyses job descriptions for medical leaders, recommends improvements of communication flow across the authority and designs medical leader's compensation model.
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Thomas, Stephen. "Managing actors in South African health financing reform : testing a conceptual framework". Doctoral thesis, University of Cape Town, 2003. http://hdl.handle.net/11427/9350.
Testo completoAbstract (sommario):
Bibliography: leaves 302-333.Health financing reforms, especially those aimed at improving equity, are prone to opposition. Those driving health reforms frequently find themselves pitted against vested interests. The thesis explores how best a reform driver might manage other actors in the reform process to achieve key goals. This involves creating and testing a conceptual framework. A review of the international health care reform literature identifies key gaps in knowledge. Additional bodies of theory, mainly from economics, are selected for review on the basis of their potential insight into relationships between reform drivers and actors. Their findings are compared and contrasted and taken forward into a conceptual framework. This is then tested against four case studies of health financing reform in South Africa: geographic resource allocation, health insurance and the removal of user fees, largely between 1994 and 1999, and the reform of the Conditional Grant for Tertiary hospitals, from 2000 to 2002. Two different approaches are used for testing the conceptual framework. First, key themes about managing actors are drawn from actor interviews in three case studies of health financing reform. With the second, more deductive, approach reform drivers in-- an additional case study were questioned on every element of the conceptual framework to see whether it provided an adequate description and understanding of how reform processes occurred. These two very different approaches acted as a check against each other but produced similar findings. The thesis suggests that an awareness of actor characteristics (such as resources, constraints, reputation and interests) can help a reform driver better manage reform development to achieve desired change. Reform drivers should build up teams of actors that can at the very least bring power, technical skills and specialist knowledge to the reform effort. Team building will also require careful consideration of the different forms of motivation appropriate to each actor. Ideally reform drivers should avoid opposing actors. Yet the prevailing context may indicate this is not possible. In such case reform drivers should limit information exchange, present and discuss reforms at a conceptual level, undermine technically any counter-reform design and choose carefully in which arena to fight.
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Hsieh, Sheau-Ling 1952. "Distributed multimedia collaborative system framework for tele-healthcare remote consultation systems". Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/284034.
Testo completoAbstract (sommario):
The Remote Consultation and Diagnosis (RCD) in Global Picture Archiving and Communication System (Global PACS) is a unique suite of multimedia telemedicine applications developed at the University of Arizona. The applications support real-time patients' data, image files, audio and video consultation and diagnosis annotation exchanges. The RCD enables joint collaboration between pathologists, radiologists, or physicians while they are at distant geographical locations. This project provides four RCD scenarios, i.e., Case Review, Case Acquire, Store and Forward Analysis, as well as Interactive Diagnosis and Consultation. The RCD Global PACS environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the RCD Global PACS resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL, ORB, Event Service, IIOP, JDBC/ODBC, legacy system wrapping and Java implementation are explored. This distributed collaborative CORBA/JDBC based framework will challenge the advanced, medical information management requirements. It also makes the RCD Global PACS both hardware and software technologically independent. As our research and development extend, we will continue to incorporate the latest advances in computer technology. RCD Global PACS is not another new tool in telemedicine, but rather a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes. It is a whole new way of practicing in telemedicine. We ensure that the RCD Global PACS project has long-term, comprehensive solutions for today and tomorrow's healthcare needs.
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Marin, Luis Franco. "SELinux policy management framework for HIS". Queensland University of Technology, 2008. http://eprints.qut.edu.au/26358/.
Testo completoAbstract (sommario):
Health Information Systems (HIS) make extensive use of Information and Communication Technologies (ICT). The use of ICT aids in improving the quality and efficiency of healthcare services by making healthcare information available at the point of care (Goldstein, Groen, Ponkshe, and Wine, 2007). The increasing availability of healthcare data presents security and privacy issues which have not yet been fully addressed (Liu, Caelli, May, and Croll, 2008a). Healthcare organisations have to comply with the security and privacy requirements stated in laws, regulations and ethical standards, while managing healthcare information. Protecting the security and privacy of healthcare information is a very complex task (Liu, May, Caelli and Croll, 2008b). In order to simplify the complexity of providing security and privacy in HIS, appropriate information security services and mechanisms have to be implemented. Solutions at the application layer have already been implemented in HIS such as those existing in healthcare web services (Weaver et al., 2003). In addition, Discretionary Access Control (DAC) is the most commonly implemented access control model to restrict access to resources at the OS layer (Liu, Caelli, May, Croll and Henricksen, 2007a). Nevertheless, the combination of application security mechanisms and DAC at the OS layer has been stated to be insufficient in satisfying security requirements in computer systems (Loscocco et al., 1998). This thesis investigates the feasibility of implementing Security Enhanced Linux (SELinux) to enforce a Role-Based Access Control (RBAC) policy to help protect resources at the Operating System (OS) layer. SELinux provides Mandatory Access Control (MAC) mechanisms at the OS layer. These mechanisms can contain the damage from compromised applications and restrict access to resources according to the security policy implemented. The main contribution of this research is to provide a modern framework to implement and manage SELinux in HIS. The proposed framework introduces SELinux Profiles to restrict access permissions over the system resources to authorised users. The feasibility of using SELinux profiles in HIS was demonstrated through the creation of a prototype, which was submitted to various attack scenarios. The prototype was also subjected to testing during emergency scenarios, where changes to the security policies had to be made on the spot. Attack scenarios were based on vulnerabilities common at the application layer. SELinux demonstrated that it could effectively contain attacks at the application layer and provide adequate flexibility during emergency situations. However, even with the use of current tools, the development of SELinux policies can be very complex. Further research has to be made in order to simplify the management of SELinux policies and access permissions. In addition, SELinux related technologies, such as the Policy Management Server by Tresys Technologies, need to be researched in order to provide solutions at different layers of protection.
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Adekunle, Toluwani E. "Towards Health System Strengthening: Analyzing the adoption of the WHO Health Systems Thinking Framework in the Nigerian and Botswana National Health Policies". Ohio University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1430146924.
Testo completo
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Ellsworth, Samuel Blake. "A Framework for Clinical Healthcare Process Design: Investigating Applicability to Lean". TopSCHOLAR®, 2015. http://digitalcommons.wku.edu/theses/1458.
Testo completoAbstract (sommario):
Healthcare delivery is a process-driven sequence of patient care treatments and services. A prescribed method for process design is required in order for healthcare organizations of the future not just to innovate, but to safely provide highly-reliable patient care. Some healthcare organizations have established the utilization of lean methodologies as a tool for process improvement. Other philosophies and methods such as Six-Sigma have also been introduced into hospitals to guide quality. Many of these efforts have provided theories or perspectives of quality improvement without being firmly connected to a model of application relative to clinical process design, process formulation, or process readiness. Hospitals often fail to recognize this gap and subsequently roll out multiple overarching quality improvement initiatives. This research examines some of the methods and activities of continuous healthcare improvement that frame clinical process design. In addition to providing an overview of current activities and methods, this research will explore to what extent standardized models for process design were followed in the course of using lean or other quality improvement initiatives. The research will conclude with a recommended best practice discussion for a healthcare process design framework and future applicability to the work of code blue standardization.
41
Horn, Lynette Margaret. "Virtue ethics in the development of a framework for public health policymaking". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5418.
Testo completoAbstract (sommario):
Thesis (DPhil (Philosophy))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: This dissertation has two quite separate and rather different starting points. The first centres on the significant renaissance of virtue ethics as a moral theory that has occurred in the last 50 years. The second starting point is embedded in the recent discourse about the need for an ethical framework for public-health policymaking. (Up until now the ethical theories of deontology, manifested as either a ‘principlebased’ or ‘human-rights’ approach, and utilitarianism, have provided the theoretical background to this discourse.) When these two starting points fuse, the question arising – can character or virtue ethics contribute positively to the moral debates surrounding many vexing public-health issues? – seeks an answer. Broadly speaking, the ethics of public-health policymaking deals with ethical issues that occur within the macro-environment and that arise out of relationships between entities other than individuals, for example, states, regions, institutions, etcetera, and the policies in terms of which these interactions are regulated. Public health ethics ‘seeks to find a balance between the notions of ‘common good’ or ‘public interest’ and individual autonomy. I plan to investigate whether a virtue-based ethics, -which is concerned with a notion of human flourishing that is not primarily atomistic but intricately linked to the mutual well being of others and to notions of what the ‘good life for man’ means within the context of a shared history and connectedness with fellow human beings,- could contribute positively to current ‘public health ethics’ discourse. I believe that an exploration of the ethical basis of public health decision-making, focusing particularly on virtue ethics, but also examining other approaches like utilitarianism, principlebased approaches and the human-rights approach, will make a positive and original contribution to this area of philosophical discourse. Chapter one is an introduction which provides the rationale and motivation for the dissertation and briefly introduces the layout of each subsequent chapter. Chapter two is a concept analysis of ‘public health’ and justifies why I argue that the concept of public health is contingent, and ought to be contingent on an inextricably linked, and context appropriate concept of social justice. In this chapter I clarify the scope of the concept of public health used for this dissertation. Chapter three is an in-depth literature review of virtue ethics and similarly the next chapter is a literature review of the current status of public health ethics. Chapter five is entitled “Virtue Ethics, Social Justice and Public health”. My overall aim in this dissertation is to consider if virtue ethics as a moral theory can contribute positively to the practice of public health and thus by inference to an underlying concept of social justice. This receives in-depth consideration in this chapter. In chapter six I explore virtue theory in relation to public health from various other perspectives. In particular I return to MacIntyre to consider his concept of a ‘practice’1 which I apply specifically to the domain of public health, exploring the concepts of “extrinsic goods” and “intrinsic goods”, and how they translate to the practice of public health. Chapter VII is entitled “Theory and Practice: Critical Perspectives”. In this chapter I explore the challenges of adapting philosophical theory to actual context. I focus particularly on the problems of public health policy within a Southern African context. I conclude this dissertation by conceding that while virtue ethics can indeed make a positive contribution in some respects, its applicability is largely limited to public health problems that pertain to specific localised contexts. It has very limited applicability as an ethical theory or framework for trans-global public health issues, and public health issues influenced by global politics and economics.
AFRIKAANSE OPSOMMING: Hierdie verhandeling het twee heeltemal afsonderlike en taamlik uiteenlopende uitgangspunte. Die eerste handel oor die beduidende oplewing in deugde-etiek as 'n morele teorie oor die afgelope 50 jaar. Die tweede uitgangspunt is veranker in die onlangse diskoers oor die behoefte aan 'n etiese raamwerk vir die bepaling van openbaregesondheidsbeleid. (Tot dusver het die etiese teoriee van deontologie, hetsy in die vorm van . 'beginselgegronde' of 'menseregte'-benadering, en utilitarisme as teoretiese grondslag vir hierdie diskoers gedien.) Wanneer hierdie twee uitgangspunte egter byeenkom, ontstaan die vraag: Kan karakter- of deugdeetiek 'n positiewe bydrae tot die morele debatte oor talle netelige openbaregesondheidskwessies lewer? Oor die algemeen handel etiek in die bepaling van openbaregesondheidsbeleid oor etiese kwessies in die makro-omgewing wat ontstaan vanuit die wisselwerking tussen entiteite anders as individue, soos state, streke en instellings, en die beleid wat hierdie wisselwerking reguleer. Openbaregesondheidsetiek is daarop uit om 'n balans te vind tussen die konsepte 'algemene welsyn' of 'openbare belang', en individuele outonomie. Hierdie ondersoek beoog om vas te stel of 'n deugdegegronde etiek 'n wat gemoeid is met 'n konsep van menslike welstand wat nie grootliks atomisties is nie, maar ten nouste verband hou met die onderlinge welstand van ander, en 'n begrip van 'die goeie lewe' in die konteks van 'n gedeelde geskiedenis en verbondenheid met ander mense 'n positief tot die huidige diskoers oor 'openbaregesondheidsetiek' kan bydra. Die navorser argumenteer dat 'n ondersoek van die etiese grondslag van besluitneming oor openbare gesondheid, met 'n bepaalde klem op deugde-etiek, dog ook 'n nuwe bydrae tot ander benaderings soos 'n utilitaristiese benadering, beginselgegronde benaderings en die menseregtebenadering, 'n positiewe en oorspronklike bydrae tot hierdie filosofiese diskoers (kan) lewer. Hoofstuk 1 bied 'n inleiding wat die beweegrede en motivering vir die verhandeling uiteensit, en verduidelik kortliks die uitleg van elke daaropvolgende hoofstuk. Hoofstuk 2 is 'n konseptuele ontleding van 'openbare gesondheid', en ondersteun die navorser se betoog dat die konsep van openbare gesondheid afhanklik is en afhanklik behoort te wees van . kontekstoepaslike begrip van sosiale geregtigheid wat onlosmaaklik daarmee verbind is. In hierdie hoofstuk word die betekenis en omvang van die begrip 'openbare gesondheid' soos dit in hierdie verhandeling gebruik word, ook verduidelik. Hoofstuk 3 bevat 'n omvattende literatuuroorsig van deugde-etiek, terwyl die daaropvolgende hoofstuk eweneens 'n literatuuroorsig van die huidige stand van openbaregesondheidsetiek behels. Hoofstuk 5 is getiteld 'Deugde-etiek, sosiale geregtigheid en openbare gesondheid'. Die oorkoepelende doelwit van hierdie verhandeling is om daaroor te besin of deugde-etiek as 'n morele teorie positief tot die praktyk van openbare gesondheid, en dus ook tot 'n onderliggende konsep van maatskaplike geregtigheid, kan bydra. Dit word omvattend in hierdie hoofstuk bespreek. In hoofstuk 6 ondersoek die navorser deugde-teorie met betrekking tot openbare gesondheid uit verskeie ander oogpunte. Die studie konsentreer in besonder op MacIntyre se konsep van . 'praktyk',2 wat bepaald op die gebied van openbare gesondheid toegepas word om so die begrippe 'ekstrinsieke goedere' en 'intrinsieke goedere', en hoe dit in die praktyk van openbare gesondheid omgesit word, te bestudeer. Hoofstuk 7, getiteld 'Teorie en praktyk: Kritiese perspektiewe', bevat . ondersoek van die uitdagings om filosofiese teorie by die werklike konteks aan te pas. Die navorser konsentreer veral op die probleme van openbaregesondheidsbeleid in Suider-Afrikaanse verband. Die verhandeling sluit af deur toe te gee dat, hoewel deugde-etiek inderdaad in sommige opsigte 'n positiewe bydrae kan lewer, die toepaslikheid daarvan grootliks tot openbaregesondheidsprobleme in bepaalde gelokaliseerde kontekste beperk is. Dit het 'n uiters beperkte nut as 'n etiek-teorie of raamwerk vir globale openbaregesondheidskwessies, en openbaregesondheidskwessies wat deur die wereldpolitiek en -ekonomie geraak word.
42
Honekamp, Wilfried, e Herwig Ostermann. "Application of the FITT framework to evaluate a prototype health information system". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2011. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-69401.
Testo completoAbstract (sommario):
We developed a prototype information system with an integrated expert system for headache patients. The FITT (fit between individual, task and technology) framework was used to evaluate the prototype health information system and to determine which deltas to work on in future developments. We positively evaluated the system in all FITT dimensions. The framework provided a proper tool for evaluating the prototype health information system and determining which deltas to work on in future developments.
43
De, Solà Morales Serra Oriol. "Health technology assessment as a framework for translation and valuation of innovation". Doctoral thesis, Universitat Rovira i Virgili, 2013. http://hdl.handle.net/10803/276155.
Testo completoAbstract (sommario):
L’Avaluació de Tecnologies Sanitàries (ATS) pretén informar els decisors sobre els
potencials impactes de la introducció de nova tecnologia en l’entorn sanitari. Tanmateix,
es reconeixen diferents mancances en el procés. L’objectiu d’aquesta tesi és demostrar
que l’ATS pot ser utilitzada abans (ex-ante) i després (ex-post) de la introducció d’una
tecnologia i proposar una metodologia multidimensional que redueixi la incertesa en
l’avaluació de la innovació en salut.
Es presenten 3 articles (amb metodologia qualitativa) que demostren les limitacions de
l’avaluació abans (ex-ante) i després (ex-post) de la introducció d’una tecnologia i la
dificultat en l’atribució de l’impacte a la introducció d’una nova tecnologia. S’analitzen
alhora models multidimensionals per a l’avaluació d’intervencions complexes, i es proposa
una nova metodologia per a reduir la incertesa a l’hora d’introduir innovació.
En conclusió, l’ATS és un procés vàlid per a l’avaluació ex-ante i ex-post, que pot ser
superat per un model multidimensional que utilitza la mateixa base metodològica de
l’ATS.Health Technology Assessment (HTA) aims to inform decision makers about the potential impact of the introduction of new technology in the healthcare scenario. However, several deficiencies are recognized in the process. The objective of this thesis is to prove that HTA can be used before and after the introduction of technology and to propose a multidimensional methodology that reduces uncertainty in the assessment of innovation in healthcare. Three peer-reviewed publications show the limitations of ex-ante and ex-post evaluation and the limitations in attributing the impact to the introduction of a new technology. Several multidimensional evaluation models are analised, and a new methodology to reduce the uncertainty in introducing innovation is proposed. In conclusion, despite its limitations, the HTA process is valid for the ex-ante and ex-post evaluation, but can also be improved by a multidimensional model that uses the same methodological bases of HTA.
La Evaluación de Tecnologías Sanitarias (ETS) pretende informar a los decisores sobre los potenciales impactos de la introducción de nueva tecnología en el panorama sanitario. Sin embargo, se reconocen diferentes carencias en el proceso. El objetivo de esta tesis es demostrar que la ETS puede ser utilizada antes y después de la introducción de una tecnología y proponer una metodología multidimensional que reduzca la incertidumbre en la evaluación de la innovación en salud. Se presentan 3 artículos que demuestran las limitaciones de la evaluación ex-ante y ex-post y las limitaciones en la atribución del impacto a la introducción de una nueva tecnología. Se analizan algunos modelos multidimensionales para la evaluación de intervenciones complejas, y se propone una nueva metodología para reducir la incertidumbre a la hora de introducir innovación. Se concluye que a pesar de sus limitaciones, la ETS es un proceso válido para la evaluación ex-ante y ex-post, pero que a la vez puede ser superado por un modelo multidimensional que utiliza la misma base metodológica que la ETS.
44
Lima, Ieti. "Tafesilafa'i: exploring Samoan alcohol use and health within the framework of fa'asamoa". Thesis, University of Auckland, 2004. http://hdl.handle.net/2292/2171.
Testo completoAbstract (sommario):
This study seeks to establish how cultural change is transforming Samoan perceptions of alcohol and its role in social life by comparing understandings of, attitudes to, and patterns of alcohol use in successive generations of Samoans to establish how these are changing, and how trends in alcohol use might be expected to affect Samoan health status. It examines the complex relationships between alcohol and culture, and how such relationships interact to influence health. As well, it explores how Samoan culture, fa'asamoa, has changed since contact with Europeans, how, these changes have influenced Samoan people's perceptions and use of alcohol, and the role alcohol now plays in Samoan social life. Moreover, the thesis documents the social history of alcohol in Samoa since the nineteenth century, and explores the roles of some of the Europeans in shaping Samoan people's attitudes and behaviours towards alcohol and its use. Additionally, it examines the commercial and political economic interests of early European agencies in Samoa such as beachcombers, traders, colonial administrators, and missionaries which impacted on and influenced, to a considerable extent, Samoan people's drinking patterns. The study uses a qualitative methodological approach, utilizing qualitative interviewing as the main method of gathering data and various other methods to supplement the data. The sample population included Samoan men and women, of various religious denominations, drinkers and abstainers, born and raised in Samoa and in New Zealand. Unstructured interviews with thirty-nine participants, and eight key informants were conducted in Apia, Auckland, and Christchurch. The key informants included: a bishop of the Church of Latter Day Saints, the Samoan Police Commissioner, and the Secretary of the Samoan Liquor Authority who were interviewed in Apia; a pastor/lecturer of the Congregational Christian Church of American Samoa who was interviewed in Pago Pago, American Samoa; while two Samoan-born medical health professionals, a pastor of the Congregational Christian Church of Samoa, and one New Zealand-born woman researcher were interviewed in Auckland. The study found that alcohol and the drinking of it has secured a place in the social life of Samoans in the islands and in migrant communities such as those in Auckland, and to a lesser extent, Christchurch. It also found that while older women's and men's experiences and attitudes to alcohol differ significantly, particularly those born and raised in the islands, some similarities in the attitudes and practices of younger people towards alcohol, especially those born- and raised in New Zealand have emerged.
45
Wintrup, Julie. "Ethics education in health and social care: a framework for foundation degrees". Thesis, University of Southampton, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.494542.
Testo completo
46
Fenwick, Elisabeth. "An iterative framework for health technology assessment employing Bayesian statistical decision theory". Thesis, University of York, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.423768.
Testo completo
47
Ujewe, Samuel Jonathan. "Just health care in Nigeria : the foundations for an African ethical framework". Thesis, University of Central Lancashire, 2016. http://clok.uclan.ac.uk/16731/.
Testo completoAbstract (sommario):
Countries in Sub-Saharan Africa share at least three things: cultural heritage, a high burden of disease and a low financial commitment to health care. This thesis asks questions of justice about health care systems in Sub-Saharan Africa, in particular Nigeria. The questions are about access to the available health resources and services within African health care systems. While the sub-region as a whole cannot boast of good health care, certain population groups are relatively more disadvantaged. This suggests either or both of two problems: a) that access to basic health care is not proportionate to the populations’ needs; and/or b) that the distribution of the available health care resources favour some over others. Attempts to improve population health have focused on empirical, economic or social strategies. These tend to overlook the ethical dynamics surrounding access to and the distribution of health care. In view of this moral challenge, Norman Daniels has proposed the ethical framework of Accountability for Reasonableness, which can provide basic guidelines for just health care reforms in Africa. While his approach has been effective in the United States, the theoretical basis has fundamental value differentials from African ideals of justice. Starting from Daniels’ Just Health – Meeting Health Needs Fairly, this PhD study develops an African ethical framework that could inform reforms in African health care systems. Specifically, it establishes four key attributes of the African moral outlook, and three principles of African justice. It further abstracts an African method of ethical analysis: process equilibrium. Against this background, the thesis develops a harmonised framework of just health care. Daniels’ principles are matched with African principles to create a Just Health Theory, which is adapted to the Sub-Saharan Africa context. The resulting African principles are mapped onto the health care sector and finally blended into the Harmonised Framework of Just Health Care. By combining the insights from Daniels with African values and approaches, it is possible that just health care will be attained in Nigeria and beyond.
48
Ten, Joon Yoon. "The integration of safety and health aspects in chemical product design framework". Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/48711/.
Testo completoAbstract (sommario):
Computer aided molecular design (CAMD) is a powerful technique to design molecules or chemical mixtures that fulfil a set of desirable target properties as specified by users. Molecular physical and thermodynamic properties are selected as the target properties to ensure that the designed molecules can achieve the property functionalities. However, the aspects of safety and health are not strongly emphasised as design objectives in many CAMD problems. In order to ensure that the synthesised molecule does not cause much harm and health-related risks to the consumers, it is critical to integrate both safety and health aspects as design factors in the current CAMD approaches. The main focus of this research is to develop a novel chemical product design methodology that integrates the concept of inherent safety and occupational health aspects in a CAMD framework. The generated molecules that are optimised with respect to the target properties must be evaluated in terms of their safety and health performance. The assessment is conducted by safety and health-related parameters/sub-indexes that have significant adverse impact on both aspects. This proposed approach ensures that a product that possesses the desirable properties, and at the same time meets the safety and health criteria, is produced. The next focus of this research is to generate optimal molecules with the desired functionalities and favourable safety and health attributes in a single-stage CAMD framework. Besides target properties, the concept of inherent safety and health is also considered as design objective to ensure that the synthesised molecules are simultaneously optimised with regards to both criteria. Fuzzy optimisation approach is applied to optimise these two principal design criteria in this work. As molecular properties are utilised as the parameters to examine the safety and health features of the molecules, these properties are often estimated through property prediction models. This research also focuses on the management of uncertainty resulted from properties used in the sub-indexes. The quantification of uncertainty helps to revise the safety and health measurement so that it can better reflect the inherent hazard level of the molecules. The fourth focus of this research is to address the limitations present in the current method of molecular hazard quantification. The enhancement is carried out by adopting the ordered weighted averaging (OWA) operator method with the analytic hierarchy process (AHP) approach in the safety and health assessment. Two case studies on solvent design are considered to demonstrate the presented methodologies.
49
Hughes, Ruby Wai Chung. "SIMT : a holistic framework for embedding simulation into the health care systems". Thesis, Sheffield Hallam University, 2010. http://shura.shu.ac.uk/19844/.
Testo completoAbstract (sommario):
Simulation and Modelling (S&M) have been proven as very valuable tools in the health care sector. In recent years, the sector has experienced a rapid increase in applications. However, it appears that health care organisations have failed to sustain the use of these powerful techniques. In this research, an extensive literature review is carried out to identify the main challenges of the use of health care simulation and the underlying barriers of implementing S&M in the sector. In order to address these issues, it identifies the need to fully embed S&M into the sector through a systematic approach. However, the literature in this subject area has not provided such a holistic approach to the use of simulation. With the view to embed these techniques in health care decision making processes, this research develops a new framework, known as SIMulation Thinking (SIMT), to overcome the identified challenges and barriers. SIMT includes five key components: infrastructure, management, culture change, methodology and modelling. Whilst the SIMT framework presents the important elements that need to be considered to make S&M mainstream tools, this research also presents an implementation framework which transforms SIMT into a practical and applicable approach to embed S&M in health care organisations. The implementation framework includes two main stages: planning stage and action stage. Questionnaire and case study approach are conducted to validate the usefulness and importance of the SIMT components and the proposed implementation framework. The questionnaire is used to understand how the selected group of experts consider the SIMT components and the planning stage of the implementation framework as a valuable guideline. To validate the action stage of the implementation framework, this research uses the case study approach which introduces the proposed methodologies and modelling best practices into a local hospital. The feedback received from the hospital is used to evaluate the usefulness and practicable of the proposed approach.
50
Arora, Anubhav S. M. Massachusetts Institute of Technology. "Designing behavioral health integration in primary care : a practical outcomes-based framework". Thesis, Massachusetts Institute of Technology, 2019. https://hdl.handle.net/1721.1/122337.
Testo completoAbstract (sommario):
Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, System Design and Management Program, 2019Cataloged from PDF version of thesis.
Includes bibliographical references (pages 77-79).
Patients with comorbid physical, behavioral, and social needs-often referred to as high-need patients-tend to be the most frequent utilizers of the health care system. The US health care system, with fragmented behavioral and medical health care sectors, is unable to effectively meet the complex needs of high-need patients. This results in high health care utilization, increased health care costs, and poor health outcomes among this population. Behavioral Health Integration in Primary Care (BHIPC) is widely promoted as a means to improve access, quality and continuity of health care services in a more efficient way, especially for people with complex needs. Hundreds of BHIPC programs are being implemented across health care settings in the US. However, the concept of BHIPC is wide-ranging, and it has been used as an overarching approach to describe integration efforts that vary in design, scope, and value. Research on how BHIPC is implemented in practice is limited. Practitioners and policymakers find it challenging to evaluate BHIPC programs and identify and scale-up its most critical elements. In this thesis, I develop a design-based framework that deconstructs the ambiguous concept of BHIPC into a set of tangible design elements and decisions. Furthermore, in order to inform how BHIPC is implemented in practice, I use this design-based framework to examine the behavioral health integration programs in four community health centers in Massachusetts. I found that by just comparing the underlying design elements, it is difficult to assess BHIPC programs and distinguish a successful program from an unsuccessful one. I therefore recommend and propose an outcomes-based framework for differentiating and evaluating BHIPC programs. I also recommend that future researchers refine and standardize the process measures I introduce so that they can be used as guideposts by primary care practitioners to develop their BHIPC programs.
by Anubhav Arora.
S.M. in Engineering and Management
S.M.inEngineeringandManagement Massachusetts Institute of Technology, System Design and Management Program