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1
Ponce, Michael. "Healthcare fraud and non-fraud healthcare crimes: A comparison". CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3233.
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Healthcare fraud is a major problem within the healthcare industry. The study examined medical fraud, its laws, and punishments on federal and state levels. It compared medical fraud to non-fraud crimes done in the healthcare industry. This comparison will be done on a state level. The study attempted to analyze the severity of fraud against non-fraud and that doctors would commit fraud offenses more often than non-fraud offenses.
2
Maesela, Matlou Tlakale. "The analysis of public and private healthcare in South Africa". Diss., University of Pretoria, 2019. http://hdl.handle.net/2263/73473.
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The Bill of Rights enshrines the rights of all people in our country and affirms the democratic values of human dignity, equality and freedom. The state must respect, protect, promote and fulfil the rights in the Bill of Rights. Every human being on earth has the right to life. In general, the state's positive and negative duties are set out in section 7(2) of the Constitution of South Africa, which requires the state to respect, protect, promote and fulfil all human rights.
The Constitution of the Republic of South Africa adopted and in 1996 is the supreme law of the land and supersedes all other laws in the country. The main key to having a more eloquent and fulfilling governing system is to align it with the Constitution. This is empirical to developing and implementing health law and policy, which regulates in at least five important ways:
• It regulates the structure of government.
• It regulates the way in which various branches of government operate.
• It sets out the framework for raising taxes and allocating revenue.
• It guides the content of all laws and policies, primarily through the Bill of Rights.
• It regulates the role of government and non-state actors such as private corporations in realising the right of access to health care services. Furthermore, it emphasizes that every person has the right “to have access to health care services, including reproductive health care”.Mini Dissertation (LLM)--University of Pretoria, 2019.
Public Law
MPhil
Restricted
3
Fisher, Anthony Colin Joseph. "The principles of distributive justice considered with reference to the allocation of healthcare". Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260002.
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Silva, João José Francisco da. "Obama's law : analysis of a breakthrough law on healthcare access and lessons for the Portuguese health system management". Master's thesis, Universidade Nova de Lisboa. Escola Nacional de Saúde Pública, 2012. http://hdl.handle.net/10362/9667.
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ABSTRACT - The Patient Protection and Affordable Care Act shook the foundations of the US health system, offering all Americans access to health care by changing the way the health insurance industry works. As President Obama signed the Act on 23 March 2010, he said that it stood for “the core principle that everybody should have some basic security when it comes to their health care”. Unlike the U.S., the Article 64 of the Portuguese Constitution provides, since 1976, the right to universal access to health care. However, facing a severe economic crisis, Portugal has, under the supervision of the Troika, a tight schedule to implement measures to improve the efficiency of the National Health Service. Both countries are therefore despite their different situation, in a conjuncture of reform and the use of new health management measures.
The present work, using a qualitative research methodology examines the Affordable Care Act in order to describe its principles and enforcement mechanisms. In order to describe the reality in Portugal, the Portuguese health system and the measures imposed by Troika are also analyzed.
The intention of this entire analysis is not only to disclose the innovative U.S. law, but to find some innovative measures that could serve health management in Portugal. Essentially we identified the Exchanges and Wellness Programs, described throughout this work, leaving also the idea of the possibility of using them in the Portuguese national health system.RESUMO - O Patient Protection and Affordable Care Act abalou recentemente as bases do sistema de saúde dos EUA, possibilitando a todos os cidadãos Americanos o acesso aos cuidados de saúde, alterando os mecanismos em que a indústria de seguros de saúde funcionava naquele país. Ao assinar a citada lei a 23 de Março de 2010, o Presidente Obama afirmou que defendia "o princípio fundamental de que todos devem ter alguma segurança básica quando se trata dos seus cuidados de saúde". Ao contrário dos EUA, o artigo 64 º da Constituição da República Portuguesa prevê desde 1976 o direito de acesso universal aos cuidados de saúde. No entanto, enfrentando uma forte crise económica, Portugal tem, sob a vigilância da Troika, um calendário apertado para implementar medidas que permitam melhorar a eficiência do Serviço Nacional de Saúde. Ambos os países se encontram, pois, apesar das situações serem diferentes, numa conjuntura de reforma e de utilização de novas medidas de gestão em saúde. O presente trabalho, utilizando uma metodologia (qualitativa) de pesquisa documental, analisa essencialmente o Affordable Care Act de forma a descrever os seus princípios e mecanismos de aplicação. O sistema de saúde português e as medidas a cumprir na área da saúde, ao abrigo do Memorandum da Troika são também analisadas no sentido de descrever a realidade portuguesa. O conjunto desta análise tem como finalidade, não só dar a conhecer a inovadora lei norte-americana, mas, sobretudo tentar encontrar algumas medidas inovadoras que pudessem servir a gestão da saúde em Portugal. Identificámos essencialmente as Exchanges e os Wellness Programs, as quais descrevemos no âmbito do trabalho, deixando a ideia de uma possível utilização das mesmas no sistema de saúde nacional.
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Maiketso, Johnson Tsoro. "Trade in healthcare services by a developing country: the case of Botswana". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16596.
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Includes bibliographical referencesThis research presents an analysis of the health sector in Botswana in the context of a middle income developing country that endeavours to harness benefits from trade in health services. It finds that the health sector is still dominated by public sector provision amidst a gradually developing private sector that is mainly supported by domestic investments. The participation of foreign firms is predominantly through management of local private hospitals by South African hospital groups. Botswana remains a net importer of health services, especially through consumption abroad from the neighbouring South Africa. Nonetheless, import substitution is gradually taking root through the growing private sector that provides services that were previously imported. There remains a significant level of dependence on foreign health professionals, especially specialist medical doctors to augment shortages in the domestic healthcare system. Despite local media reports indicating concerns about Botswana health professionals working outside the country, lack of data impedes the ability to analyse and appreciate the magnitude and possible impact of this movement on the economy and the health sector. The need for further research remains especially on the possible impact of liberalisation of trade in the health sector in order to adequately guide policy. Also, the current inadequacy of data makes it difficult to appreciate the trends in trade in health services, thus, there is need to develop data sets to support analysis and policy debates on the subject.
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Brown, Karen Jane. "Intersex, discrimination and the healthcare environment : a critical investigation of current English law". Thesis, London Metropolitan University, 2016. http://repository.londonmet.ac.uk/1030/.
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Of the two thousand babies born each day in England and Wales, at least twenty will have an intersex condition (also known as Disorder of Sex Development). For some, the condition lies dormant for many years, if not for the remainder of their lives, whilst others are born with genital differences to such a degree that it is not possible at birth to inform parents whether their child is ‘male’ or ‘female’. This ‘devastating’ announcement commences a lifetime of potential discrimination for these children (and arguably for their parents) both in the healthcare environment and in society in general. It might have been thought that when the Equality Act 2010 was passed such discrimination would cease as, according to the summary of the Act, its two main purposes are to harmonise discrimination law and enhance legal mechanisms to allow equality for everyone. However, the category of 'intersex' is not included in the Act. This thesis aims to build on existing literature, and to investigate and analyse whether current English law prevents or promotes discrimination against the intersexed in the healthcare environment in England today. It further endeavours to propose suitable amendments to current law where such discrimination is identified. Previous literature has indicated that discrimination may arise as a result of pre-implantation genetic diagnosis (PGD), selective abortions of the intersexed fetus, and ‘normalising’ genital operations of the intersexed child. Further, activists have noted that the withholding of medical records is detrimental to the person concerned. However, to date there has been sparsity of literature to address current English law in these areas. Results of investigations carried out for this thesis indicate that in some aspects, for example access to medical records, current English law supports the rights of the intersexed patient. Research also indicates that in regard to selective abortions current law can be justified. However, in other areas, notably PGD and genital modification operations, English law can be said to discriminate against the intersexed, whilst for neonatal testing, current healthcare policies and procedures can be considered discriminatory. Such provisions require reconsideration. In this respect, legal amendments are proposed to assist in overcoming discrimination. This includes an amendment to the Equality Act itself.
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Nieuwkamp, Garry Anthony Aloysius, i res cand@acu edu au. "The Theory of Informed Consent in Medicine: problems and prospects for improvement". Australian Catholic University. School of Philosophy, 2007. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp166.22072008.
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Practice and law around informed consent in healthcare have undergone a revolution for the better over recent decades. However the way we obtain informed consent remains problematic and is imbued with irreducible but not ineliminable uncertainty. The reasons for this uncertainty are varied. The uncertainty is partly due to the conceptual opacity of important core concepts. The complexity of communication in clinical encounters is another. The role of autonomy, and the changing nature of the clinician patient relationship, have also contributed to this uncertainty remaining. This thesis is not a panacea for these difficulties. However there have been two quite profound revolutions in healthcare over the last decade or so, namely, the introduction of evidence-based medicine into clinical decision making, and the institutionalization of clinical governance and the application of quality improvement philosophy. I have examined ways in which these two “movements” can help in reducing some of the uncertainty in the practice of informed consent.
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Moreton, Kirsty Leigh. "The ethics of care and healthcare decision-making involving children in mid-childhood". Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7579/.
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This thesis contends that the traditional legal and ethical approach to healthcare decision-making for children in mid-childhood is insufficient to meet the needs of those children, their families and the professionals that care for them. To address this failing I present a normative framework based on the Ethics of Care to aid in decision-making. My unique contribution to knowledge is first, to focus on children in mid-childhood (age 8 -14 years old); a neglected group in the jurisprudence, and contend that the current interpretation of Gillick competence and best interests fail to fully appreciate the child’s capabilities or accommodate the families views. Secondly, I assert that the Ethics of Care is well placed to address the needs of children in this age group, whilst fostering child participation. To this end I develop a novel Ethic of Care framework, based upon the work of Jo Bridgeman. Thirdly, I undertake a systematic review of the case law, spanning a 26-year period, and chart patterns and trends in judicial thinking. Finally, I test the utility of the framework by applying it to three areas on the legal fringes: end of life care, living organ donation and treatment for gender dysphoria.
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Johnston, Carolyn. "Divergence in healthcare decision-making : seeking a consensus on the meaning and application of 'best interests'". Thesis, Kingston University, 2011. http://eprints.kingston.ac.uk/22365/.
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The concept of best interests lies at the core of my work. 'Best interests' underpins all healthcare decision-making whether orientated to treatment of an individual or which impact on a community. My publications explore the respect accorded to an individual's view of his own best interests in healthcare decision-making, both for contemporary and future decisions and how this may conflict with patient welfare, objectively perceived. They also consider the weight given to different perspectives of those involved in deciding what treatment option is 'best' for a patient lacking capacity and whose view predominates when there is conflict. I have also written on the tension between individual best interests and the wider interests of society. My publications have increasingly moved from describing the meaning and application of 'best interests', particularly with reference to the Mental Capacity Act 2005 (MCA), to focusing on how the legal provisions may be interpreted in practice - a translational approach. I have also explored the role of medical education in equipping doctors of tomorrow to make informed decisions about best interests and how clinical ethics committees may elucidate the meaning, and ensure the proper analysis, of best interests in a process for resolving conflicts in healthcare decision- making. The importance of the assessment of best interests in healthcare decision-making cannot be overstated. Failure to acknowledge and give respect to the views of competent patients or the parents of young children may result in loss of trust in healthcare professionals and disengagement with services. Giving due regard to the values and wishes of adult patients who lack capacity is fundamental to protect and promote the interests of the most vulnerable members of society. However, the mere mantra of 'best interests' belies the complexity of the assessment and its application in practice. Clinicians, parents, family members and the patient himself may have differing interpretations of best interests. The weight given to these perspectives may depend not only on the level of evidence required to adduce these views but also on how far they move away from promoting the basic interests of the patient, such as dignity, freedom from pain and suffering, and life itself. My thinking on this topic has developed through my research and writing, particularly through the qualitative research I have undertaken, and I now come to the view that best interests imposes a normative standard which is interpreted through the subjective lens of the various stakeholders in the decision making process, as Atkins notes, "the problem of trying to capture something unique using tools proper to the general" (Atkins, 2000 p 73). My approach to best interests in healthcare decision-making derives from a wide range of professional experience. After training as a solicitor I took an LLM in law and nearly 20 years ago 3 started teaching at Kingston University on a fractional appointment. I developed an interest in medical law and ethics, and following an MA in Medical Law and Ethics I taught this subject to final year law students at Kingston. Thus my initial emphasis was on the interpretation and development of best interests in case law and statute. My work with The Ethox Centre, University of Oxford focusing on clinical ethics support, enabled me to gain insight in to the role of clinical ethics COmmittees as part of the process of decision-making and as a member of three clinical ethics COmmittees I am able to observe the range of different clinical settings which give rise to challenging issues in best interests. More recently I have been involved with the Institute of Medical Ethics Education Project in developing the core medical undergraduate curriculum in medical ethics and law. If medical students are not confident about their knowledge of key medico-legal and ethical issues then as young doctors they will not feel able to challenge poor practice or promote better patient care "through using legal rules and an understanding of how law relates to and underpins good medical practice" (Preston - Shoot, 2011, P 6). I also teach medical law and ethics at the School of Medicine, King's College London and this gives me first-hand experience of the way both medical students and clinicians approach the tension between respecting patient autonomy and the duty to 'benefit' the patient. Through my qualitative research focusing on practitioners' interpretations of best interests my recent publications on adolescent decision-making (2009) and clinical ethics committees (2010) set the legal analysis in the context of the practice of medicine and methods of resolving divergence in decision-making.
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O'Brien, Dominic Andrew. "A child's right to healthcare : the obligation and enforcement of international human rights law". Thesis, Northumbria University, 2016. http://nrl.northumbria.ac.uk/32280/.
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The obligation of the State to ensure children have access to healthcare is surprisingly contentious with Western capitalism demanding open markets free from interference. Such a view holds healthcare services as a commodity to be traded. A ‘right’ to health is only a goal to many, not a tangible guarantee States can rationally be expected to ensure because of the enormous costs and the difficulties presented to a court in adjudicating this right. On this view it is impossible for a child to have a legal right to access healthcare. This thesis combats such arguments. The obligation of the State is discussed from a moral standpoint, finding that the child’s right to health must be a State and a global obligation in any just society. Pragmatic discussion addresses the problem of legalising the obligation and showing the right can be a tangible guarantee. This is done through two paradigms: firstly, by looking at current international law and its implementation; and secondly, by looking at countries with a right to healthcare in their written constitution and adjudication of such a right. This combats the legal right arguments as well as provides lessons that international law can learn from. This thesis contributes to discussion around the effective enforcement and implementation of human rights, especially economic, social and cultural rights. It does this by examining the scope of a child’s right to health, and arguing for a moral obligation for its provision, as well as more pragmatic discussion on how to enforce such rights and adjudicate them to make them worth more than words on paper. The final chapter brings together various proposals for tackling the global challenge to ensure every child in the world has access to basic minimum healthcare.
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Duncan, William H. "The private juridic person a viable alternative for structuring a Catholic healthcare facility /". Theological Research Exchange Network (TREN), 2002. http://www.tren.com.
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Largent, Emily. "The Promise and Peril of Using the Law to Promote Ethical Outcomes in Health and Healthcare". Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493517.
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NOTA: NOT A GOOD ACT FOR TISSUES TO FOLLOW
The National Organ Transplant Act of 1984 (NOTA) articulates the U.S. federal policy for organ transplantation. It seeks to ensure equitable allocation of donor organs and strives to increase the number of organs available for transplant. A trio of ethical concerns—commodification, exploitation, and coercion—motivated passage of NOTA broadly and the prohibition on organ sales in particular. Notably, NOTA does not distinguish between organs and tissues, a devastating oversight given the differences between the two, which include: who can donate; when donation can occur; how donated items are procured, processed, and stored; who receives the donated item and why; and government oversight. Tissues are not like organs in the ways that made NOTA an appropriate legislative solution to commodification, exploitation, and coercion. Rather, NOTA failed to address tissue-specific concerns both ethical and practical in nature. Thus, there is an acute need to develop tissue-specific legislation that enhances informed consent to protect donor autonomy; sets a schedule of payments for donors and intermediaries to promote distributive justice; and improves tracking of donated tissues to address patient safety concerns.
REGULATORY UNCERTAINTY, CONCEPTUAL CONFUSION, AND A PATH FORWARD ON OFFERS OF PAYMENT TO RESEARCH PARTICIPANTS
The practice of offering payment to individuals in exchange for their participation in clinical research is widespread and longstanding. Nevertheless, such payment remains the source of substantial debate, in particular about whether or the extent to which offers of payment coerce and/or unduly induce individuals to participate. Yet, the various laws, regulations, and ethical guidelines that govern the conduct of human subjects research offer relatively little in the way of specific guidance regarding what makes a payment offer ethically acceptable. This paper systematically examines the legal and ethical dimensions of offering payment to research participants. It argues that concerns about offers of payment to research participants can be attributed to the misguided view that such offers ought to be treated differently than offers of payment in other contexts, a form of “research exceptionalism.” We show that rejection of research exceptionalism with respect to payment helps settle open debates about both how best to define coercion and undue influence, and how to understand the relation between these concepts and offers of payment. We argue for adoption of our preferred definitions, ideally by regulatory authorities, and against the conventional conservatism toward payment of research participants. Instead, we draw attention to the rarely asked, even radical, question: are research participants paid enough? We conclude by arguing that we ought to change the default to favor, rather than encourage suspicion of, offers of payment to research participants.
EBOLA & FDA: REVIEWING THE RESPONSE TO FIND LESSONS FOR THE FUTURE
In 2014, West Africa confronted the most severe outbreak of Ebola virus disease (EVD) in history. At the onset of the outbreak—as now—there were no therapies approved by the U.S. Food and Drug Administration (FDA) for prevention of, post-exposure prophylaxis against, or treatment of EVD. As a result, the outbreak spurred interest in developing novel treatments and vaccines; sparked calls to use experimental interventions in the field; and highlighted challenges to the standard approach to FDA approval of new drugs. Although the outbreak was geographically centered in West Africa, it brought to the fore issues of food and drug law and showcased FDA’s global role in drug development, approval, and access. FDA’s response to EVD highlights the panoply of Agency powers and demonstrates the flexibility of FDA’s regulatory framework. This paper evaluates the strengths and weaknesses of FDA’s response and makes policy recommendations regarding how FDA should respond to new and re-emerging public health threats going forward. The current pandemic of Zika virus infection is but one example of an emerging health threat that will require FDA involvement in order to achieve a successful response.Health Policy
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Edozien, Leroy Chuma. "Protecting self-determination in healthcare : a comparative study of the consent model and a novel property model". Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4265/.
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It is generally accepted in legal and bioethical discourse that the patient has a right to self-determination. The competent patient should be in a position to make informed decisions about his/her care. In practice, this is often not the case. Paternalism, the approach to medical practice that left decision-making in the hands of the doctor, is waning and it is increasingly recognised in both the legal and medical arenas that there are values other than medical factors which determine the choices that patients make. Unfortunately, these developments have not resulted in huge advances for patient self-determination. This is largely because the mechanism by which the law purports to protect self-determination – the consent model – has fundamental flaws that constrain its effectiveness. In the last three decades, various attempts have been made to reconceptualise consent on order to make it fit for purpose, but these have achieved only limited success. This thesis starts with the premise that it is often more productive to consider what an alternative model has to offer, than to persist with amelioration of a model that is fundamentally flawed. The limitations of the consent model are discussed and a novel model, the property model, is advocated. The theoretical underpinnings of this model and its structure are presented. Essentially, the patient’s bodily integrity is protected from unauthorised invasion, and his/her legitimate expectation to be provided with the relevant information and opportunity to enable him/her make an informed decision regarding treatment is taken to be a proprietary right. It is argued that the property model potentially overcomes the limitations of the consent model, including the obstacle caused by the requirement to prove causation in consent cases. The property model provides a means by which the patient’s right to self-determination can be recognised as a distinct legal right. The model does not create new rights, only seeking to afford stronger protection of an existing right. No constitutional, professional, or other conflict is generated by applying property analysis to patient self-determination. The model fits with the rights-based approach that the courts have evolved in UK consent cases, and is consistent with modern medical professionalism.
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Namukasa, Aishah [Verfasser]. "Law and Labour Migration Struggles: Legal Consciousness of East African Healthcare Professionals in Britain / Aishah Namukasa". Kassel : kassel university press c/o Universität Kassel - Universitätsbibliothek, 2020. http://d-nb.info/1220230049/34.
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Neuhaus, Christian, Andreas Polze i Mohammad M. R. Chowdhuryy. "Survey on healthcare IT systems : standards, regulations and security". Universität Potsdam, 2011. http://opus.kobv.de/ubp/volltexte/2011/5146/.
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IT systems for healthcare are a complex and exciting field. One the one hand, there is a vast number of improvements and work alleviations that computers can bring to everyday healthcare. Some ways of treatment, diagnoses and organisational tasks were even made possible by computer usage in the first place. On the other hand, there are many factors that encumber computer usage and make development of IT systems for healthcare a challenging, sometimes even frustrating task. These factors are not solely technology-related, but just as well social or economical conditions. This report describes some of the idiosyncrasies of IT systems in the healthcare domain, with a special focus on legal regulations, standards and security.IT Systeme für Medizin und Gesundheitswesen sind ein komplexes und spannendes Feld. Auf der einen Seite stehen eine Vielzahl an Verbesserungen und Arbeitserleichterungen, die Computer zum medizinischen Alltag beitragen können. Einige Behandlungen, Diagnoseverfahren und organisatorische Aufgaben wurden durch Computer überhaupt erst möglich. Auf der anderen Seite gibt es eine Vielzahl an Fakturen, die Computerbenutzung im Gesundheitswesen erschweren und ihre Entwicklung zu einer herausfordernden, sogar frustrierenden Aufgabe machen können. Diese Faktoren sind nicht ausschließlich technischer Natur, sondern auch auf soziale und ökonomische Gegebenheiten zurückzuführen. Dieser Report beschreibt einige Besondenderheiten von IT Systemen im Gesundheitswesen, mit speziellem Fokus auf gesetzliche Rahmenbedingungen, Standards und Sicherheit.
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McElroy, Adlene Jones. "Antibullying Definition, Policy, Surveillance, Education, and Training in the Healthcare Field". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6618.
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Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These interview data were transcribed, and then subjected to a coding and analysis procedure inspired by Stevick, Colaizzi, & Keen. Findings indicate that many participants have either experienced or witnessed organizational bullying, and that occurrences of bullying are more prevalent among staff. Findings also indicate that leaders consistently understand policies and law and organizational procedures related to bullying, but staff and nurses do not share this experience. Last, staff and nurses perceive that leaders fail to follow through with enforcing organizational policies related to bullying. Positive social change implications stemming from this study include recommendations to organizational leadership and regulatory boards to develop organizational and public policies that more clearly identify the liabilities and risks of non-compliance, as well as promoting an annual training protocol that better supports public and organizational policies related to anti-bullying measures. These recommendations may result in reduced incidents of bullying, and therefore improved care to patients.
Antibullying Definition, Policy, Surveillance, Education, and Training in the Healthca
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Krishnakumar, Sukumarakurup. "The Role of Emotional Intelligence and Job Emotional Requirements in Job Attitudes and Behavior". Diss., Virginia Tech, 2008. http://hdl.handle.net/10919/27849.
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A recent focus on understanding emotions in organizations has resulted in increased attention to the role of Emotional Intelligence (EI). Emotional Intelligence (EI) is a type of intelligence that helps individuals to perceive, assimilate, understand, and manage emotions (Mayer & Salovey, 1997). The aim of this study is to understand the role of EI on individual attitudinal and performance outcomes. Specifically, this paper argues that EI may be an important determinant of employee job satisfaction, turnover intention, and performance. Further, these effects are expected to be most pronounced in job functions with higher emotional requirements. Data collected from 278 law enforcement and healthcare employees provide no support for these propositions. These findings, their implications, and potential future studies are discussed.Ph. D.
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Kazarian, Melinee. "The role of the criminal law and the criminal process in healthcare malpractice in France and England". Thesis, University of Manchester, 2013. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:198260.
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This thesis seeks to contribute to the debate about the role of the criminal law in holding health professionals and health institutions to account for malpractice. The research attempts a critical comparison of the role of the criminal law and the criminal process in healthcare malpractice in France, a civil law jurisdiction, and England, a common law jurisdiction. In France, the criminal process is more readily invoked to address failings and malpractice in healthcare. The aim of this research is to see how the comparison of the two jurisdictions sheds light on the now much debated question of how the criminal process should relate to healthcare malpractice. The purpose of the comparative examination of law and process is twofold: (1) to highlight what might be seen as failings within each legal system and identify lessons that might be learned from each other and (2) to locate these differences in an analysis of how (if at all) the criminal process can best engage with healthcare malpractice. The much publicised HIV-contaminated blood episode in France and England is studied as an illustration of a case of systemic healthcare failure and the use of the criminal process in France. It is used to illustrate and explore more fully the questions above and shed light on the overall aim of the thesis, which is to assess what the role of the criminal law should be in the context of healthcare malpractice. The research reveals that particular features of the general substantive criminal law and criminal process go a long way toward explaining differences in the criminalisation of healthcare malpractice as between France and England. The criminalisation of ‘simple’ direct negligence which may result in death or injury in France provides the possibility to criminalise healthcare malpractice more readily than in England, where only gross negligence resulting in death is generally criminalised in the healthcare malpractice context. Features of the French inquisitorial criminal process (notably juges d’instruction and parties civiles) play a central role in providing a greater platform for the criminalisation of healthcare malpractice in France, whereas features of the English adversarial system (in particular the role of the Crown Prosecution Service and the jury) tend to minimise the possibility for a wider criminalisation of healthcare malpractice in England. However, I do not argue that England should follow France in adopting more extensive use of the criminal process in the context of healthcare malpractice. Key lessons drawn from the present study are that the criminal process is not usually an appropriate means to respond to many instances of healthcare malpractice. This is not to say that the criminal process has no role to play where the conduct of the professional has shown no regard for the safety of patients. Features of French criminal law and criminal procedure might be useful to counteract healthcare malpractice using alternative non-criminal proceedings. For instance, it will be argued that the model of thorough investigations conducted by juges d’instruction in the French criminal process could be better achieved outside the criminal law to provide transparency in the healthcare context. The study will point out the limitations of the criminal process in preserving health and safety and will thus highlight the importance of alternatives to the criminal process such as prevention in the healthcare setting and support to victims of healthcare malpractice.
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Wei, Liang Wang Daniel. "Can litigation promote fairness in healthcare? : the judicial review of rationing decisions in Brazil and England". Thesis, London School of Economics and Political Science (University of London), 2013. http://etheses.lse.ac.uk/739/.
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This thesis analyses “health care litigation” in Brazil and England. By health care litigation I mean those lawsuits in which claimants demand from the State the provision of a certain health treatment based on their entitlement to receive health care from the public health system or funded by it. The question that guides this thesis is whether courts intervening in rationing decisions make the public health system more or less fair. The concept of fairness I use in this thesis draws on the idea of “accountability for reasonableness” developed by Norman Daniel and Charles Sabin. This research will analyse the case-law of courts in Brazil and England, and the impact of litigation on the public health system. Based on this research, I argue that health care litigation in Brazil, where courts interpret the right to health as an individual trump against rationing decisions, is making the public health system less fair. Conversely, in England, where courts mainly control the procedure rather than the substance of the rationing decisions, litigation contributed to make health authorities more accountable and rationing decisions more public and based on better reasons, robust evidence and fair principles. Interestingly, even though courts in both countries have judged their cases in different ways, in the long term, litigation was one of the reasons for the creation of health technology assessment systems that try to legitimate rationing decisions through more public and better reasoned decisions: CONITEC in Brazil and NICE in England. The analysis of healthcare litigation in Brazil and England also contributes to the broader debate about social rights adjudication. These cases provide empirical and nuanced evidence that can be compared with the experience of other jurisdictions to shed light on the potential, risks and limits of courts controlling the allocation of resources in social policies using the language of social rights.
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O'Neill, Clayton Bernard. "Is there appropriate weight given to the Abrahamic religious beliefs of patients and healthcare professionals in English medical law?" Thesis, Durham University, 2017. http://etheses.dur.ac.uk/12050/.
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Is the legal protection that is given to the expression of Abrahamic religious belief adequate or appropriate in the context of English medical law? This is the central question that is explored in the thesis. A framework to support judges in the resolution of contentious cases that involve dissension between religious belief and medical law is developed from Alan Gewirth’s Principle of Generic Consistency (PGC). This framework is applied to a number of medical law cases studies: the principle of double effect, ritual male circumcision, female genital mutilation, Jehovah’s Witnesses (adults and children) who refuse blood transfusions, and conscientious objection of healthcare professionals to abortion. The thesis also examines the legal and religious contexts in which these contentious cases are arbitrated. It demonstrates how human rights law and the proposed framework can provide a gauge to measure competing rights and apply legitimate limits to the expression of religious belief, where appropriate. Thus, the original and significant contribution to knowledge is the development of an evaluative framework and its application to distinct case studies. This leads to the conclusion, based upon a stance of principled pragmatism, that some aspects of current legal protections in English medical law require amendment.
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Kopp, Thomas, i Valentin Pfisterer. "Between a rock and a hard place - legal pitfalls of voluntary cooperation of German companies with German and foreign regulatory and law enforcement authorities". Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-208934.
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German companies or German-based subsidiaries of international businesses may become subject of, or otherwise involved in, investigations by German or foreign regulatory or law enforcement authorities. In the context of such investigations, it is not unusual for the concerned company to face informal requests from German or foreign regulatory and law enforcement authorities for voluntary cooperation. Oftentimes, such requests focus on the transfer of electronic data for investigatory purposes, and such data typically relate, in whole or in part, to individuals (e.g. employees, suppliers and customers). In these and other cases, compliance of German companies or German-based subsidiaries with informal requests from regulatory and law enforcement authorities may itself entail a compliance risk or even constitute a breach by the corporate entity of the German data protection laws resulting in criminal prosecution, administrative sanctions, or damage claims and other actions by third party individuals. This article outlines the scope of application of the German Federal Data Protection Act, introduces the applicable statutory provisions, and discusses the relevant considerations in the context of an informal request by a regulatory or law enforcement authority for voluntary cooperation in the context of global investigations, in particular where a German-based entity faces requests from authorities abroad.
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Bortfeldt, Alexander. "Disparities in EU legal instruments regarding crossborder healthcare : A comparative study of Regulation 883/2004 and Directive 2011/24/EU and their potential effect on Union goals; especially the free movement provisions". Thesis, Stockholms universitet, Juridiska institutionen, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-185270.
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The statutory health care systems of EU member states show a lot of differences, e.g. in financing, reimbursing, availability, form of membership, etc. The European health insurance card gives EU citizens the possibility to see a doctor while abroad, extending their right from receiving emergency treatment to receiving full necessary treatment under the laws of the member state. The scope of the insurance claim abroad is governed by the respective national law. This can result in a significantly higher cost sharing compared to the domestic situation. Depending on the country, this can include both fixed amounts (additional payments) and percentage shares of up to more than half of the costs.[1] While exercising the right to free movement EU citizens might need way more than emergency care, especially in relation to the rise of chronic diseases like diabetes etc. But quality treatment of patients residing abroad requires a seamless coordination of the member states’ health insurance systems. The access to member states health care systems is not seldomly tricky, in some cases it is even denied to nationals of the state. This thesis seeks to spot access difficulties in different member states asking for the question whether or not this might impede the EU’s free movement provisions.
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More, Alexander Frederick Medico. "At the Origins of Welfare Policy: Law and the Economy in the Pre-Modern Mediterranean (1150-1350)". Thesis, Harvard University, 2014. http://nrs.harvard.edu/urn-3:HUL.InstRepos:13068537.
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This dissertation is an economic and institutional history of the first comprehensive public health and welfare system in the Western world. Based on previously unexamined archival and archaeological evidence from several European repositories, it argues that the Republic of Venice, at the beginning of the second millennium, implemented legislation of unprecedented scale, intended to regulate and improve the health and standards of living of its population. The Venetian empire, in this period, was unrivaled in its dominance of Mediterranean trade. Economic success and the densifying networks of communications brought new challenges, and new health stresses, including communicable disease, to key commercial hubs under Venetian control, on the Dalmatian coast and islands in the eastern Mediterranean.
At this time, a period commonly known as the Commercial Revolution, Venice itself became one of the most populous and wealthiest European cities. The government of the Republic allocated a substantial portion of its surplus revenues to the establishment and funding of new welfare legislation, influenced by Roman and Byzantine legal precedents. The nature of the Venetian parliamentary system gave rise to a host of detailed norms aimed at subsidizing the import of food and primary necessities. In addition, the Republic created and funded the first and largest state-sponsored staff of medical practitioners in Europe, intended to preserve the public's health in the expansive territories under its control. These practitioners were chosen, by and large, on the basis of testimonies of magistrates and patients who vouched for their expertise and reputation.
Through a detailed analysis of archival, archaeological and narrative evidence, this dissertation alters our understanding of the development of pre-modern states and their contribution to the creation of what historians have broadly defined "welfare policies." Comparisons between the prices of primary necessities among multiple cities of the Mediterranean test the effects of such policies on the standards of living of European populations. A comprehensive list of all public health infrastructures in Venetian territories outlines the long-term role of the state in the creation and funding of hospitals, hospices and orphanages. By contextualizing new and old evidence, this dissertation argues that, in crafting these new policies, Venetian legislators yielded to economic and political considerations, as well as popular expectations and traditions of evergetism.History
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Meyer, Patti A. "The Health Consequences and Healthcare-Seeking Strategies for South American Immigrant Careworkers in Genoa, Italy". UKnowledge, 2013. http://uknowledge.uky.edu/anthro_etds/6.
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This research on healthcare strategies of home-based, low-wage, immigrant careworkers contributes to the ways medical anthropology, migration studies and social science understand human-economy-family care relationships and health and carework as commodities in today's global economy. It reveals the consequences for workers as they defray the costs of care for the Italian government and contribute to their home economies. This research was conducted in Genoa, Italy, which has the largest percentage of people over the age of 70 in any city of its size in the world and a tradition of sending and receiving immigrant workers. The main question was: Under the circumstances of providing labor-intensive, in-home supportive services, how do immigrant workers respond to their own health needs?
The researcher collected data from interviews with 50 careworkers, 25 professionals who provide services to the careworkers, and 23 administrators in the health system, government agencies, labor unions, and the Catholic Church. The careworkers interviewed were women from South America, as they do most of the carework jobs in this city. Long-term participant observation and interview data were analyzed to: 1) produce empirical data on health concerns of and healthcare resource use by migrant careworkers; and 2) investigate the relationships between health concerns, living/working conditions, and healthcare resource use of transnational immigrants in the informal economy. The data showed that the Catholic Church promoted immigrants as able workers, aided their elderly parishioners, and provided necessary mental health support to careworkers who experienced stress. The data also revealed that the health care system of Italy functioned well to address the physical health concerns of immigrant careworkers. The relationship between the client and the worker was important for the general well-being of the worker and her ability to maintain her general health, have time for medical appointments, socialize outside of the workplace, and attend community events. This study examined: strategies for using health resources; responses of the Italian medical system personnel to anti-immigrant legislation; use of non-State resources to meet health needs; the health consequences of caring for an elderly person in the private home; and ways to address these health consequences.
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Medling, Nicholas. "The Individual Mandate, Commerce Clause, and Supreme Court: Predicting the Court's Ruling in HHS v. Florida". Scholarship @ Claremont, 2012. http://scholarship.claremont.edu/cmc_theses/345.
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An analysis of the evolution of the Commerce Clause, the Justices on the Supreme Court, and the arguments presented in this case indicate that the minimum coverage provision of the Patient Protection and Affordable Care Act will be struck down. Although the Court will likely be split 5 to 4 along ideological lines, each of the justices will have a unique rationale behind their decision. Chief Justice Roberts, Justice Scalia, and Justice Kennedy were heavily targeted by both parties’ oral and written arguments because there was speculation that any one of these traditionally conservative justices could be the fifth vote to uphold the individual mandate. However, it does not appear likely that the federal government supported their claims well enough to yield such a result. Instead, the Court will respond in the negative to the issue of "Whether Congress had the power under Article I of the Constitution to enact the minimum coverage provision." The Court’s interpretation of the Congress' commerce power has undergone two major expansions since the Constitution was ratified, and both of these expansions were met with a contractionary response to prevent the commerce clause’s growth into an unchecked power. This Court will not open a new frontier of power for the Congress, but rather it will respect the limits on Congressional power established by the Rehnquist Court.
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Schönborn, Elias. "Anti-corruption compliance in times of the Covid-19 pandemic: Criminal law risks and incentives for compliance-management-systems in the healthcare sector". Universität Leipzig, 2021. https://ul.qucosa.de/id/qucosa%3A74480.
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In addition to a global endurance test for the health system, the Corona pandemic
triggered a tremendous social and economic crisis. Health professionals as well as
politicians and business managers have to make decisions with considerable consequences
under great time pressure. In this context, numerous international organizations
- including Transparency International, GRECO and IACA - point out
that the Corona crisis can be a breeding ground not only for conflicts of interest,
but also for corruption. Even though quick decisions have to be made at present, it is clear that the strict prohibitions on corruption must be fully observed also in
times of the Corona crisis. In order to avoid violations from the outset, existing compliance
systems should continuously be updated and adapted to the current situation.
This article begins with a description of possible forms of corruption in the
health care sector that are particularly relevant in the current times of crisis. Finally,
the article offers ideas for updates on the company's internal healthcare compliance
system with regard to anti-corruption.
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Mauck, Erin. "A Qualitative Analysis of End-of-Life Healthcare in Tennessee: Politics, Principles, and Perceptions". Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3846.
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The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.
For this study, data were collected using semi-structured, in-depth interviews with an open interview guide. These interviews were conducted in a two-tiered format. Tier 1 included ten leading experts in various areas of end-of-life healthcare and aging in Tennessee. Tier 2 included nine legislators who were members of the health committees of either the Tennessee House of Representatives or the Tennessee Senate. Qualitative data were organized into numerous categories, and an initial phase of open coding was completed. From this phase of coding, emergent themes and focuses were discovered. This was followed by focused coding on all nineteen interviews using coding software to organize subtleties.
Findings of the Tier 1 interviews indicated that there are many areas of end-of-life healthcare that need improvement including increased funding, expanded caregiver support, improved doctor-patient communication, and increased use of advance directives. Emergent themes included the influence of money, having difficult conversations, the stigma of death and dying, and supporting the caregiver. Tier 2 findings highlighted the motivations behind voting decisions and the level of awareness legislators have in areas of end-of-life healthcare policy. Both tiers also explored the support and opposition of physician-assisted death.
The findings of this dissertation are intended to inform health professionals and state legislators. The data gathered through this exploratory research and the knowledge gained will lead to a greater understanding of end-of-life healthcare in Tennessee, and what needs to be done to improve its quality. This will allow individuals and families faced with end-of-life decisions to navigate the process with expanded options, access, and support.
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Rudhe, Julia. "Mechanical restraint in psychiatric healthcare facilities : A helpful tool, or torture or other cruel, inhuman or degrading treatment or punishment in disguise?" Thesis, Stockholms universitet, Juridiska institutionen, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-195116.
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The use of mechanical restraint is a common practice in psychiatric care, often defended by medical necessity but seldom questioned from a human rights perspective. The purpose of this thesis has been to investigate under which circumstances mechanical restraint by bed through belt fixation could amount to torture and other cruel, inhuman or degrading treatment or punishment. Persons with psychosocial disabilities are in a particularly vulnerable situation and as the International Convention on the Rights of Persons with Disabilities (CRPD) is the most comprehensive rights framework for this group, it has been discussed whether the CRPD sets out additional safeguards in relation to restraint. A legal doctrinal approach is the basic methodology used in order to outline the current international and European legal framework on torture and other ill-treatment and disability rights. A survivor-controlled research methodology has been applied and to amplify other voices of persons with firsthand experience of being mechanically restrained, interviews have been conducted with persons from Sweden and Spain. Healthcare professionals have also been interviewed. A feminist perspective on the law is applied. Different international conventions and bodies of the United Nations have diverse interpretations on what acts or omissions that amount to torture and other cruel, inhuman or degrading treatment or punishment, although there is an aim and will to streamline the conventions. It is clear that the use of mechanical restraint can create such intense mental or physical suffering required to reach the common criterion of seriousness. However, some people do not experience the required levels of suffering for it to be considered torture, meaning that it might not amount to torture but rather other ill-treatment. The threshold for being considered torture according to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (UNCAT) seems to be somewhat higher than that of the International Covenant on Civil and Political Rights (ICCPR) and the European Convention of Human Rights (ECHR). In this thesis it was found that the most critical element for this is the requirement of intent. Intent can however be implied under certain circumstances if the practice is of discriminatory nature. If a person has a psychosocial disability, intent might be presumed if States do not provide appropriate health care. In the case of girls and women, intent might also be presumed since they seem to have a higher risk of getting restrained for unlawful reasons. The main conclusion in this thesis is that mechanical restraint by bed through belt fixation could amount to torture or other cruel, inhuman or degrading treatment or punishment according to the UNCAT, ICCPR and ECHR.
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Oscarsson, Victoria. "The Relationship between Paternalism and Autonomy in Medicine from an Ethical and Legal Viewpoint". Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-87104.
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Introduction: The terms autonomy and paternalism can be conceptualized and analyzed from different perspectives. The most relevant for physicians in this study are the ethical and legal viewpoints. In order to conceptualize anything a definition to depart from is needed, in this case from Oxford’s dictionaries. The importance to reflect on ethical and legal matters as a physician is due to the power over the patient one has, and it must be respected and grounded in a motivated ethical principle, since all our actions arise from ethics, consciously and subconsciously. Aim: The aim is to analyze and discuss the relationship between paternalism and autonomy from a medical ethical perspective, in relevant Swedish laws and with regards to the ethical principles. Methods: This is a qualitative study on hermeneutic ground that used two different databases and libraries and sorted material according to relevance. Inevitably this leads to a bias due to the author’s previous knowledge and selected sources. Results, Discussion and Conclusion: Physicians tend to prioritize ethical arguments depending on the situation. Autonomy is one of the four ethical principles, and this is not always the most prioritized, but beneficence may be seen as a stronger argument for action. Also, there are more regulations to secure the patient’s autonomy than the physician’s paternalism, leading to only indirect regulations towards paternalism. The conceptualization of paternalism and autonomy can be seen in many different ways, and are not always opposites as it can initially seem, but in some scenarios aline.
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Kirschbaum, Lisa Christina. "The illegal targeting of healthcare in the Yemen armed conflict: A quantitative and qualitative content analysis of the experiences of humanitarian actors and the Yemeni population". Thesis, Uppsala universitet, Teologiska institutionen, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-388911.
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The illegal targeting of healthcare in armed conflict is nothing new but its continuance and impunity at a time when the protection of it has formally never been higher, for instance through the UNSC Resolution 2286, motivated this study. Therefore, the thesis analyses how the illegal targeting of healthcare affect humanitarian actors operating in Yemen as well as the local population. How the population and humanitarian actors perceive and interpret the violent targeting of healthcare was explored as well. This study is based on a quantitative and qualitative content analysis of 11 media outlets and 25 documents provided by humanitarian actors. As a theoretical framework the humanitarian principles, international humanitarian law and the politicisation of humanitarian aid were addressed. Moreover, securitization theory was used in order to explain how humanitarian actors securitize the targeting through language. The results show that consequences of the illegal targeting for humanitarian organisations are limited access to the field as well as the closing of facilities and withdrawal of staff due to security issues. For the Yemeni population consequences are a limited access to healthcare as well as a loss of trust in the safety of medical facilities and therefore they often take the decision to not seek medical care. The analysis shows that humanitarian actors present the illegal targeting as a threat to the survival of beneficiaries and connect this to their own organisational survival and through that securitize the illegal targeting.
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King-Moore, Dorothy. "Researchers', Stakeholders', and Investors' Perceptions of U.S. Stem Cell Research Policy". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3947.
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Federal support and funding for human embryonic stem cell (hESC) research in the United States lags behind stem cell programs in many countries because of the divisive debate over hESC research and the continually evolving federal policies that have hindered research efforts. The purpose of this phenomenological study was to explore the perceptions of stem cell researchers, stakeholders, and investors in the United States about the effects of the current federal stem cell policy on stem cell research in the United States, the moral disagreement with stem cell research, and their recommendations to improve stem cell research policy in the United States. Rogers's diffusion of innovation theory and Kingdon's agenda-setting theory served as the theoretical frameworks for this study. Data were collected through telephonic semistructured interviews with a snowball sample of 21 participants. Data were analyzed using Attride-Stirling's 6 steps of thematic coding. Findings indicated the need to educate laypersons and legislators, involve the public in the stem cell research policy debate, increase federal funding, and exclude religious considerations from political discussions. The implications for positive social change are directed at stem cell policymakers to focus attention and resources on creating a cohesive federal hESC funding policy to ensure that stem cell research improves in the United States with the goal of developing treatments for conditions that are currently untreatable.
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Danovska, Ketija. "Vaccination Hesitancy Among Parents in Stockholm, Sweden : A qualitative study examining the effect of the incorporation of the “United Nations Convention on the Rights of the Child” into Swedish Law in 2020". Thesis, Södertörns högskola, Miljövetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-43153.
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Background: On 1 January 2020, the UNCRC was incorporated into the Swedish national law. The Convention argues that all children have the right to health, life, survival and development. The Articles of the UNCRC require higher authorities, health facilities and parents to act in the best interest of children, and to do everything to secure children’s rights. Interpreting the Convention, it is possible to conclude that all children have the right to safe and effective vaccines. Even though vaccines are accessible and free of charge to all children in Sweden, vaccination coverage for multiple vaccine-preventable diseases in Sweden has dropped. As one of the reasons for this drop in vaccination coverage is proposed vaccination hesitancy. To fulfil children’s rights as proposed in the UNCRC, vaccination hesitancy needs to be understood and addressed. Aim: The objective of the study is to understand causes of vaccination hesitancy among parents living in Stockholm, Sweden and to examine how healthcare professionals in Stockholm County are working to eliminate vaccination hesitancy, in goal to promote children’s rights to health, life, survival and development after the UNCRC became a Swedish law on 1 January 2020. Additionally, to analyze if strategies applied by Stockholm County are truly addressing identified causes of vaccination hesitancy among parents living in Stockholm, Sweden and in that way increasing vaccination rates this year. Method: This study used a qualitative research strategy. Vaccination hesitancy in Sweden was studied using 20 semi-structured interviews with parents living in Stockholm, while effect of the UNCRC incorporation into Swedish law on vaccination hesitancy was studied using a semi-structured interview with one health professional working in Stockholm County. The gathered data was summarized, categorized and analyzed according to the proposed themes of two theories. The theoretical framework consisted of the Health Belief Model and Social-Ecological Model. Conclusion: It was possible to conclude that the choice of immunization among parents is shaped by; 1) sources and type of the received information on vaccines, vaccination and vaccine-preventable diseases included in the general Swedish child vaccination program, 2) their views on vaccine quality, safety, effectiveness and necessity for satisfying children’s rights to health, life, survival and development, 3) the level of knowledge of epidemiological concepts, mechanisms, infectious diseases and vaccines included in the vaccination program, and 4) the level of trust in the Swedish Government and healthcare, and belief if they are acting in the best interest of children. After the UNCRC incorporation into Swedish law, there have not been observed any changes in the strategic work of Stockholm County against vaccination hesitancy. For the past ten years, they are applying methods at the individual- and interpersonal level, which are not quite reaching vaccine hesitant parents living in Stockholm. Other methods at the community- and public policy level are needed. Due to unclear implications of the UNCRC entrance as a national law and COVID-19 pandemic, it is not possible to estimate if there are any changes in the vaccination rates this year.
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Canto, Diego Eidelvein do. "A vulnerabilidade agravada do consumidor-idoso nos planos privados de assistência à saúde". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/170635.
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O presente trabalho analisa as relações de consumo nos planos privados de assistência à saúde a partir dos princípios da vulnerabilidade e da confiança. Aborda o contexto pós-moderno no qual este pacto está inserido e os reflexos que o avançar da idade podem trazer aos serviços médico-ambulatoriais. Analisa o tema a partir da doutrina, legislação e jurisprudência, investigando qual a resposta dada pelos operadores do direito para enfrentar os desafios que o agravamento da vulnerabilidade do consumidor-idoso traz aos planos e seguros de saúde. Busca verificar quais os instrumentos necessários para a tutela da saúde do idoso e de sua confiança, permitindo que ingressem nestes pactos com padrões mínimos e inderrogáveis de proteção, para que haja um desenvolvimento social harmônico e um crescimento econômico equilibrado desta importante parcela do mercado de consumo. Aborda a vulnerabilidade inerente à relação de consumo e a imprescindibilidade de uma hermenêutica jurídica adequada à proteção dos idosos nos contratos de planos e seguros de assistência à saúde, bem como a importância do diálogo das fontes para reconstruir a confiança dos consumidores-idosos. Examina o fenômeno crescente da judicialização da saúde suplementar no Brasil para o controle de cláusulas e práticas abusivas neste importante setor do mercado de consumo. Por fim, ressalta a necessidade de ações afirmativas no campo dos serviços privados médico-assistenciais através do diálogo das instituições como forma de reconstruir e reforçar a confiança do consumidor.The present work analyzes consumer relations in the healthcare plans and in the health insurance based on the principles of vulnerability and trust. It addresses the postmodern context in which this pact is inserted and the reflexes that advancing age can bring to the medical outpatient services. It analyzes this issue from the doctrine, legislation and jurisprudence, investigating the response given by legal operators to the challenges that the aggravation of the vulnerability of the elderly consumer can bring to health insurance and healthcare plans. It seeks to verify the necessary mechanisms to protect the health of the elderly and their confidence, allowing them to enter in these contracts with minimum and non-derogable standards of protection, so it can be had a harmonious social development and balanced economic growth of this important part of the consumer market. It discourses the vulnerability inherent in the relationship of consumption and the indispensability of proper legal interpretation to the protection of the elderly in healthcare plans and health insurance, and the importance of the dialogue of the sources to rebuild elderly consumer confidence. Examines the growing phenomenon of the development of the number of claims at the Judiciary, associated to matters related to health insurance and healthcare plans in Brazil and to the control of clauses and abusive practices in this important sector of the consumer market. Finally, it emphasizes the need for affirmative action in the field of private medical care services through institutional dialogue to rebuild consumer confidence and strengthen the principle of trust, contributing to a harmonious social development and balanced economic growth. Finally, it emphasizes the need for affirmative action in the field of private medical care services through institutional dialogue to rebuild consumer confidence and strengthen the principle of trust.
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Mora, Cole. "A Tough Pill to Swallow: PhRMA and Pharmaceutical Lobbying in the Context of the Affordable Care Act". Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/cmc_theses/1544.
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What is lobbying, properly understood, in the United States, and what strategies and tactics—including and especially those determined by contextual factors, as well as firm characteristics—are commonly employed by corporate lobbies as they operate in our American political environments? Considering this, what are the main strategies and tactics employed by the pharmaceutical lobby, with a particular focus on the Pharmaceutical Manufacturers and Researchers of America, or PhRMA? Finally, what roles did PhRMA play in the development and passage of the Obama administration’s Affordable Care Act, and what can this tell us about the lobbying strategies and tactics utilized by one of the most effective lobbies in modern times, as well as about how their strategies and tactics align, or not, with conventional conceptions of lobbying?
Through effective use of key lobbying tactics such as direct lobbying and use of public awareness, PhRMA completed one of the more successful lobbying campaigns in recent history. When the White House came calling, they were first to the table, for they knew that with that seat came a position of leverage. From there, they were able to build both political and public support to complete a deal with the Obama administration that they positioned as necessary to keep the Affordable Care Act alive. This deal would ensure that the pharmaceutical industry would pay a flat rate of support for the act, and was therefore guaranteed protection from future government attempts to set or regulate the prices of their products and medicines. PhRMA played the long game, and they played it well.
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Yücel, Aysun. "Balansgången mellan skydd av personlig integritet och skydd för företagshemligheter : Med särskilt fokus på forskning om AI-teknik inom sjukvård". Thesis, Stockholms universitet, Juridiska institutionen, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-171563.
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Sammanfattning Vi lever i en alltmer digitaliserad värld där utvecklad teknik kan bidra till att lösa flertalet samhällsproblem. Till exempel är intresset av avancerad AI-teknik inom sjukvård alltmer efterfrågat. AI-teknik har stor potential att stödja sjukvårdspersonal och individer, förkorta köer och förbättra vården. Tekniken bygger på insamlandet av stora mängder data som ska programmeras till att härma intelligent beteende. Åtskilliga känsliga personuppgifter behandlas i och med insamlandet av denna data. Inom ramen för den pågående debatten om personlig integritet skapas samtidigt en potentiell konfliktyta där företagshemligheter riskerar att avslöjas när information lämnas ut vid utövandet av enskildas dataskyddsrättigheter. Konfliktytan aktualiseras till exempel om registerutdraget inkluderar delar av företags affärsplaner, arbetsmetodik och teknikens uppbyggnad. Ett annat exempel rör systematiskt utlämnande av personuppgifter efter begäran från en mängd registrerade, där sammanställningen i sig kan betraktas som företagshemligheter. Hur ser gränsdragningen ut för dessa motstående intressen? Hur förhåller man sig till balansgången mellan skydd av personlig integritet och skydd för företagshemligheter? En adekvat intresseavvägning möjliggör för företag att skydda företagshemligheter samtidigt som enskildas personliga integritet inte äventyras. Hur denna intresseavvägning ska se ut är dock fortfarande oklart, vilket ligger till grund för denna uppsats.Abstract We live in an increasingly digitized world where technology can help solve many societal challenges. For example, the interest in advanced AI technology in healthcare is increasingly in demand. AI technology has great potential to support healthcare professionals as well as individuals, shorten queues and improve healthcare. The technology is based on the collection of large amounts of data to be programmed to mimic intelligent behaviour. A great number of sensitive personal data are processed when such data is collected. Within the framework of the ongoing debate on personal integrity, a potential conflict area arises at the same time, where trade secrets risk being disclosed while information is provided as individual data protection rights are exercised. The conflict area is raised, for instance, in cases where the register extract includes parts of the company’s business plans, work methodology and the structure of the technology. Another example concerns systematic disclosure of personal data upon request from a great number of registered persons, where the compilation itself can be regarded as trade secrets. What will the boundaries of these opposing interests be like? How does one relate to the balance between the protection of privacy and the protection of trade secrets? An adequate balance of interests enables companies to protect trade secrets while not compromising individual privacy. However, how this balance of interests should be framed is still unclear, which has given rise to this thesis.
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Vaseigaran, Ajanth, i Gobi Sripathy. "Artificial Intelligence in Healthcare". Thesis, KTH, Industriell ekonomi och organisation (Inst.), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-296643.
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Healthcare systems play a critical role in ensuring people's health. Establishing accurate diagnoses is a vital element of this process. As sources highlight misdiagnoses and missed diagnoses as a common issue, a solution must be sought. Diagnostic errors are common in the emergency departments, which has been recognized as a stressful work environment. Today's industries are forced to deal with rapidly changing technological advances that result in reshaped systems, products, and services. Artificial Intelligence (AI) is one of such technologies that can work as a solution to diagnosis issues but comes with technical, ethical and legal challenges. Hence, the thesis intends to investigate how AI can affect the accuracy of diagnosis as well as how its integration in healthcare relates to the technical, ethical and legal aspects. The thesis begins with a literature review, which serves as a theoretical foundation and allows for a conceptual framework to be formed. The conceptual framework is used to select interviewees, which results in 12 interviews with professors, researchers, doctors and politicians. In addition, a survey is conducted to obtain the general public’s opinion on the matter. The findings present that AI is already mature enough to make more accurate diagnoses than doctors as well as release burden from medical practitioners in the form of administrative tasks. One obstacle is the incomplete data available since laws hinder sharing of patient data. Furthermore, the AI algorithms must be fit for all social minorities and not demonstrate racial discrimination. The European AI Alliance was established in 2018 with the aim to keep the technology in check. Similar initiatives can be created on a national- and regional level to maintain some form of control over its proper use.Sjukvårdssystem utgör en avgörande roll för att säkerställa människors välmående och hälsa. Att fastställa korrekta diagnoser är en viktig del av denna process. Enligt källor är feldiagnoser och uteblivna diagnoser ett vanligt problem och bör därför lösas. Diagnostiska fel är vanligt förekommande på akutmottagningar, vilka karaktäriseras som en stressig arbetsmiljö. Dagens industrier tvingas hantera snabbt föränderliga tekniska framsteg som resulterar i omformade system, produkter och tjänster. Artificiell Intelligens (AI) är en av sådana tekniker som kan fungera som en lösning på diagnosfrågor. Dock kommer den med tekniska, etiska och legala utmaningar. Examensarbetet avser därför att undersöka hur AI kan påverka diagnosens precision samt hur integrationen i vården relaterar till de tekniska, etiska och legala aspekterna. Rapporten inleds med en litteraturstudie, vilket fungerar som en teoretisk grund och bidrar till att skapa ett konceptuellt ramverk. Det konceptuella ramverket används för att välja intervjupersoner, vilket resulterar i 12 intervjuer med professorer, forskare, läkare och politiker. Dessutom genomförs en enkätundersökning för att få allmänhetens åsikt i frågan. Rapportens resultat visar att AI redan är tillräckligt utvecklad för att göra en mer precisionssäker diagnos än en läkare samt kan avlasta läkare i form av administrativa uppgifter. Ett hinder är att den data som finns tillgänglig är ofullständig på grund av lagar som hindrar delning av patientdata. AI-algoritmerna måste dessutom vara lämpliga för alla sociala minoriteter och inte leda till rasdiskriminering. European AI Alliance grundades 2018 med målet att hålla tekniken i schack i förhållande till de etiska och legala aspekterna. Liknande initiativ kan skapas på nationell och regional nivå för att bibehålla någon form av kontroll över dess korrekta användning.
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Nardon, Nichole Diane. "The Low Literate Consumer in the Pharmacy". Thesis, Virginia Tech, 2003. http://hdl.handle.net/10919/36434.
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The best public policy arises out of a need to provide protection to those who cannot protect themselves in the marketplace. This paper suggests that consumers with limited literacy skills are routinely overlooked within the healthcare arena and may be in need of consumer protection policies. Low literacy is generally perceived to be a stigma, and consumers may actively work to hide this fact. Moreover, given they lack literacy skills, low literate consumers employ other coping strategies to get their needs met. Based on the analysis of secondary data, in-depth interviews with adults from literacy educational centers, and observations in pharmacies, I explore the viability of the coping strategies that low literate consumers use when buying and consuming prescription and non-prescription drugs. The results suggest that while some of the strategies are successful, other strategies may lead to harmful consequences.Master of Science
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Adler, David, i Kevin Francis. "A Case-Based Survey Concerning the Judicious Use of Antibiotics of Individuals: Results among subjects with no prior health care experience compared to health care professionals". The University of Arizona, 2005. http://hdl.handle.net/10150/624696.
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Class of 2005 AbstractObjectives: To perform a cross-sectional survey of health care professionals and lay people on the appropriate use of antimicrobial drugs using a case-based approach. Methods: This study used a case-based survey as a tool to assess for proper antibacterial use. The survey included nine case-based scenarios involving common infectious diseases seen in the outpatient setting. Survey participants needed to assess the problem and determine if antibacterial therapy was appropriate now, not appropriate, or if the patient should be observed for 2-3 days before acting. Demographic information was also requested from the participants. Results: Thirty-one lay people and 35 professionals (pediatricians or family practice physicians) returned a completed survey. The mean (sd) cumulative scores for these two groups were 13.4 (4.45) and 21.3 (3.40), respectively. The range of scores for the lay persons was 5 to 23 and the range for the professionals was 15 to 27. The mean score for physicians was significantly greater than the mean score for lay persons. Implications: The survey results indicated that the professionals had a better understanding of the appropriate use of antibiotics versus the lay people.
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Smith, Rhonda J. "Employee Engagement in a Cardiac Catherization Lab". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2044.
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Employee Engagement in a Cardiac Catheterization Lab
by
Rhonda J. Smith
Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice
Walden University
February 2016
This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors inside the workplace have a greater impact on employee work feelings and behaviors than do the employees' own personal tendencies. It was also guided by the Lean model, which aims to transform an organization's culture via a customer-focused method to constantly produce improvement opportunities, remove waste, and create value. This project utilized a descriptive research design. The catheter laboratory staff were e-mailed a link to complete a staff engagement and workplace climate survey. The survey was based off of a prior staff satisfaction survey used by the organization for consistency, but was not validated in the process. This survey provided a means to establish employee attitudes on several aspects analyzed by a 7 point-Likert scale. Of the 19 staff members who received the survey, 11 completed it, yielding a 60% response rate. Overall, the staff indicated that they were satisfied with their job and enjoyed working in their department. The findings from this survey were shared with the catheter laboratory staff and they chose to work on improving teamwork with departments outside of cardiology. The results of this study reinforce existing literature that demonstrates that employees who are engaged in the workplace are happier and more productive. The concept of staff engagement has been linked to higher quality patient outcomes, greater financial viability, increased productivity, and higher employee satisfaction.
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Rushen, Karen. "Ministering in a thin place the spiritual lives and ministerial experience of Catholic lay healthcare chaplains /". Online full text .pdf document, available to Fuller patrons only, 2003. http://www.tren.com.
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Sharma, Abhimanyu Kumar. "Language policies in the European Union and India : a comparative study". Thesis, University of Cambridge, 2019. https://www.repository.cam.ac.uk/handle/1810/287638.
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The thesis offers a comparative analysis of language policies in the EU and India. Specifically, it examines the role of power and ideology in the formulation and implementation of language policies. The need for this thesis emerged in view of the lack of comprehensive comparative analyses of language policies which leads to epistemological gaps, including one-dimensional narratives of language policies, and theories which are lacking in precision. In light of these gaps, the thesis undertakes a comprehensive investigation of policies in eight policy domains (administration, legal safeguards for minority languages, law, education, media, healthcare, business, and social welfare) in the EU and India and in two case studies each from the EU (Luxembourg, Wales), and India (Manipur, Tamil Nadu), chosen on the basis of maximum and minimum deviation from the EU's and Indian policies. The study examines policy texts (statutes on language use in these polities), and contexts which concern the historical and socio-political factors underpinning language policies. The thesis makes three important contributions. First, it marks a break from the prevalent understanding of power in macro-level policymaking. Research to date has tended to view power as a monolithic entity, while this thesis offers evidence that power and ideology are not uniform across policy domains. Second, it bridges the text-context divide of language policy research by conducting an investigation of policy-related legislation, and highlighting the importance of texts in understanding language policies, as they reflect the changes in power structures through time. Third, the thesis proposes a new analytical concept for investigating language policies, Categories of Differentiation (COD). Categories of Differentiation refer to the sets of binaries which underpin language policies in the aforementioned case studies. These binaries include the hills-valley divide (Manipur), the Dravidian-Aryan divide (Tamil Nadu), and the autochthonous-allochthonous divide (EU) among others. Language policies have often been described as 'multilayered', and COD offer a systematic approach to exploring these multiple layers. Overall, the thesis demonstrates how comparative research aids understanding of language policies, and sets out a possible theoretical framework for conducting it.
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Al, Maqbali Fatma. "Navigating antenatal care in Oman : a grounded theory of women's and healthcare professionals' experiences". Thesis, University of Manchester, 2018. https://www.research.manchester.ac.uk/portal/en/theses/navigating-antenatal-care-in-oman-a-grounded-theory-of-womens-and-healthcare-professionals-experiences(498154bf-961f-427d-8b08-89a640bfb270).html.
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Background: In Oman, 33.3% of women attended late for publicly funded antenatal care in 2015 and 24% did not attend for the recommended 4-6 visits during their pregnancy. This low attendance suggests a need to explore attendance for antenatal care for low-risk pregnant women in Oman. Methodology: An exploratory qualitative design informed by constructivist grounded theory methodology was used in this research. Methods: In-depth semi-structured interviews were conducted with an initial purposive sample of nine pregnant women. The initial analysis enabled theoretical sampling of thirteen non-participant observations during women's appointments, interviews with ten care providers, and six women who booked late after 12 weeks of gestation. A constructivist grounded theory analytical framework of initial, focused and theoretical coding was followed to analyse all the data collected. Findings: The core category consists of five interrelated sub-categories: perceived benefits and value of antenatal care; timing of the first antenatal visit; woman-carer interactions during antenatal care; experiences with antenatal care delivery; and supplementary use of private healthcare. The integral categories explain the social processes and issues surrounding antenatal care. The emergent core category, Navigating antenatal care, reflects the views of the women and their care providers. The women were unhappy with the organisation and physical environment of care but attended their appointments to ensure optimal pregnancy outcome and to alleviate their fears of developing complications. Thus, they used both private and public healthcare and sourced online information in response to their feelings of obligation to protect their fetus. Conclusion: The women appeared disempowered and to lack control over the care they received. Thus, they accepted conditions such as long waiting times in an uncomfortable environment and the disrespect they encountered during their visits. There was a discrepancy between what the women expected and needed from their antenatal care and the actual care and information they received, which did not satisfy their needs. This could be due to a lack of woman-centred care and limited involvement in the plan of care. Thus, women sought further reassurance by accessing private clinics, using online information, and networking with others, which also resulted in a late booking for public antenatal care.
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Ghosh, Sthitodhi. "A Mobile Healthcare (mHEALTH) System Using Polymer Lab-On-A-Chip With Chemiluminescence Based High-Sensitive Immunoassay For Clinical Diagnostics". University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592170905649462.
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Moberg, Anne-May. "Från lag till handling : En fallstudie av hur lagkravet om patientsäkerhetsberättelse nyttiggjordes i Stockholms läns landsting". Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-21511.
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Bakgrund: Enligt patientsäkerhetslagen 2010:659 ska vårdgivare årligen skriva en patientsäkerhetsberättelse. Granskning av 76 patientsäkerhetsberättelser i Stockholms läns landsting (SLL) visade bristande kunskap om hur den skrivs och bristfällig förståelse för patientsäkerhet, främst bland mindre vårdgivare. Hälso- och sjukvårdsadministratörer kunde inte besvara vårdgivarnas frågor om patientsäkerhetsberättelsen, varför ett förbättringsprojekt initierades för att skapa stödmaterial samt nyttiggöra patientsäkerhetsberättelsen. Syfte: Att belysa hur ett statligt styrinitiativ hanterades i praktiken i SLL och vilka erfarenheter som kunde knytas till praktikprojektet i hälso-och sjukvårdsadministrationen, hos vårdgivare och i interaktionen dem emellan samt om insatserna bidrog till ökad förståelse för patientsäkerhet. Metod: Studien var en deskriptiv fallstudie. Datainsamlingen bestod av intervjuer med vårdgivare och hälso-och sjukvårdsadministratörer och dokumentanalys. Analyserna var kvalitativ och kvantitativ innehållsanalys. Resultat: I uppföljning av vårdgivare nyttiggjordes patientsäkerhetsberättelsen med stöd av mall och manual. Interaktionen mellan vårdgivare och hälso- och sjukvårdsadministratör gick från kontroll till dialog. Lärande, och i viss mån förståelse för patientsäkerhet, ökade. Slutsats: Genom att vara proaktiv och bereda stöd för vårdgivare att fullfölja sitt åtagande avseende patientsäkerhetsberättelse kunde flera vårdgivare bli varse sitt ansvar och skyldigheter. Förbättringsprojektet genomfördes med stöd av förbättringskunskap och hög delaktighet, ett arbetssätt som rekommenderas. Fortsatt forskning av styrningens effekter föreslås.Background: Caregivers shall according to the patient safety act 2010:659 annually write a patient safety declaration. Review of 76 patient safety declarations in Stockholm County Council (SCC), Sweden, showed a lack of knowledge about how to write and inadequate understanding of patient safety, particularly among smaller caregivers. Healthcare administrators could not answer caregivers’ questions on the patient safety declaration, why an improvement project was initiated to create support and to make the patient safety declaration useful. Aim: To illustrate how a state steering initiative was handled in practice in the SCC and the experiences associated with the improvement project in health care administration, among caregivers and the interaction between them, and whether the efforts contributed to increased understanding of patient safety. Method: The study was a descriptive case study. The data collection was interviews of caregivers and healthcare administrators and document analysis. The analysies performed were qualitative and quantitative content analysis. Results: The patient safety declaration was made useful in the follow up process of caregivers with support of a template and a manual. The interaction between caregivers and healthcare administrators went from monitoring to dialogue. Learning increased and also understanding of patient safety to some degree. Conclusion: By being proactive and prepare support for caregivers to fulfill their commitment on patient safety declarations, several caregivers became aware of their responsibilities and obligations. The improvement project was accomplished with improvement knowledge and high level of participation, an approach that is recommended. Further research on the steering effects is suggested.
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Bernstein, Celia J. "Investigating the role of healthcare in the construction of lay experience of physical disability : a multimethod qualitative study of people living with dystonia". Thesis, University of Warwick, 2018. http://wrap.warwick.ac.uk/111260/.
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The notion of ‘experiential knowledge’, or knowledge that is derived through and from people’s direct or indirect experience of a condition, has been elusively defined, particularly its relationship to biomedicine. While some researchers argue that this episteme exists independently of expert models of disease, others maintain that it develops alongside and/or through the pervasive hegemonic framework of biomedicine. This research makes a novel contribution to the aforementioned debates by analysing the various ways in which the relationship between experiential and medical knowledge can be both synergistic and epistemologically (dis)similar. This argument is developed through an exploration of the everyday experiences and experiences of healthcare of 42 individuals living with, and managing, the hyperkinetic movement disorder known as dystonia. In many cases of this condition, effective treatment options are limited and prognoses uncertain. Qualitative data were gathered through group and individual interviews and thematically analysed for patterns and relationships, as well as deviant cases. It was found that participants interpreted their experiential knowledge of dystonia in confluence with medical knowledge and their everyday realities. The dynamism of this interrelationship fluctuated in intensity according to the extent to which participants felt that biomedicine could provide them with a socially legitimated explanation of their visceral experiences across different contexts. For example, the negotiation of a diagnosis and/or treatment plan were sites where this interrelationship became particularly fraught resulting in varying dynamic synergies between the two forms of knowledge, which I have termed dissonant and resonant synergies. Through these novel concepts, I demonstrate how the relationship between experiential and medical knowledge transforms and shifts across the disease trajectory of a contested and complex condition like dystonia. In addition to these conceptual insights, a consideration of how health professionals could strive to resonate their knowledge with that of their patients’ is presented.
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Nasser, Ali Djambae. "Accès aux soins et gestion des flux migratoires". Thesis, Normandie, 2018. http://www.theses.fr/2018NORMR050.
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Mayotte département d’outre-mer français depuis 2011, fait partie de l’archipel des Comores ; elle est séparée des îles de l’État de l’Union des Comores depuis 1975. L’instauration d’un visa en 1995 et l’ordonnance n° 2002-688 du 12 juillet 2004 entréeen vigueur le 1er avril 2005 relative à l’extension de la sécurité sociale à Mayotte exclut les malades étrangers du système de santé mahorais. Ceci entraine des processus d’évacuation sanitaire par la voie d’une immigration clandestine qui provoque des naufrages et des violations des droits du patient. L’attrait de Mayotte et de la France métropolitaine pour les populations défavorisées occasionne des situations de conflits et de concurrence pour l’accès à la protection sanitaire et sociale. Les populations défavorisées de Mayotte, qui se battent pour combler leur retard par rapport à la métropole, vivent mal cette concurrence ; tandis que les populations immigrées vivant dans la clandestinité et sous la menace d’une expulsion imminente, rencontrent des difficultés pour faire valoir leur droit aux soins et au bénéfice à l’assistance du système social. Les obstacles sont nombreux et souvent considérables, dus notamment à la discrimination, à une disparité de difficultés sociales et économiques et à leurs conditions de vie généralement très difficiles. La maîtrise des flux migratoires et la lutte contre l’immigration irrégulière demeurent des priorités de la politique du gouvernement français en matière d’immigration. Laspécificité de la situation du département de Mayotte ainsi que l’importance des flux migratoires qui y sont constatés ont conduit les autorités sanitaires à gérer les flux migratoires liés aux évacuations sanitaires par la voie illégale. La France mène une politique sanitaire en continuant de soutenir l’Union des Comores dans l’amélioration de l’accessibilité et de laqualité des soins, à travers les programmes d’appui au secteur de la santé. Ces programmes auront pour finalité l’amélioration de la santé des mères et des enfants, notamment la réduction des mortalités maternelle et néonatale. La France à travers son organisme Agence française de développement (AFD) entend appuyer le ministère de la Santé dans l’élaboration et la mise en oeuvre des politiques publiques et contribuer au renforcement du cadre institutionnel et juridique du secteur. Il s’agira notamment d’appuyer l’État comorien dans la mise en place de mécanismes de régulation du service privé dans le secteur public et de réformer la pharmacie nationale. Cette recherche pointe les enjeux liés au droit de la protection sociale et au droit de la santé des étrangers sur le territoire national, aussi bien en France métropolitaine qu’à Mayotte. La diversité des droits nationaux applicables à Mayotte constitue une entrave sérieuse face aux dispositifs locaux relatifs à l'accompagnement sanitaire et social. Il est donc indispensable de chercher des solutions juridiques relatives à l’uniformisation de ce droit sanitaire et social afin d’améliorer le système de santé. Les résultats de cette recherche ont montré que les dispositifs locaux tels que le « bon rose » et le « bon AGD » ne sont pas du tout équivalents aux dispositifs nationaux (l'AME et la CMUc)Mayotte a French overseas department since 2011, is part of the comorian archipelago from which it was separated from the State of Union of the Comoros islands since 1975. The introduction of a visa in 1995 and the order n° 2002-688 delivered on 12 july 2004 and entered into force on April 1st 2005 with regard to the extension of social security in Mayotte exclude the foreign sick from Mayotte's health system. This leads to a process of medical evacuation following an illegal immigration way that causes shipwrecks and the violation of the patient's rights. The attraction of Mayotte and Mainland France for disadvantaged populations lead to conflict situations and competition in the access to health and social protection. Mayotte's disadvantaged populations, who are struggling to catch up with the mainland, do not get along with that competition. At the same time the illegal immigrants living clandestinely and with the threat of expulsion are facing difficulties to assert their right to health care and to benefit from social system assistance. Obstacles are numerous and most of the time considerable, mainly because of discrimination, because of their judicial status, of disparity in their social and economical difficulties and because of their generaly very hard living conditions. The control of migratory flow and the fight against illegal immigrant remain the top priorities of the French government policy as far as immigration is concerned. The singularity of the situation in the department of Mayotte and the huge migratory flows that have been observed led healthcare authorities to handle migratory movements related to illegal medical evacuations. France has a healthcare policy and continues to support the Union of Comoros in the effort to improve healthcare access and quality, through support programs to health sector. These programs aim at improving the health of mothers and children, mainly in reducing maternal mortality. Through its organisation AFD, France aims at supporting health ministry in elaborating and implementing public policies and helping comorian state to put in place regulatory mechanisms of a private service within public sector and to reform the national pharmacy. This work focus on the issues related to the right to social protection and the health law for foreigners on the national territory, in mainland France and in Mayotte as well. Diversity of national laws applicable in Mayotte is a significant barrier to local devices in terms of medical and social assistance. It is necessary to seek legal solutions related to standardization of this health and social law in order to better the healthcare system. During our field research we observed that local devices such as the "pink warrant" and the "good AGD" are not at all equivalent to the national devices (AME and CMUc)
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Owusu, Gertrude Adobea. "Use of Preventive Screening for Cervical Cancer among Low-income Patients in a Safety-net Healthcare Network". Thesis, University of North Texas, 2003. https://digital.library.unt.edu/ark:/67531/metadc4191/.
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This study is a secondary analysis of survey data collected in fall 2000 from patients of a safety-net hospital and its eight community health outreach clinics in Fort Worth, Texas. The study examined three objectives. These include explaining the utilization of Pap smear tests among the sample who were low-income women, by ascertaining the determinants of using these services. Using binary logistic regressions analyses primarily, the study tested 10 hypotheses. The main hypothesis tested the race/ethnicity/immigration status effect on Pap smear screening. The remaining hypotheses examined the effects of other independent/control variables on having a Pap smear. Results from the data provide support for the existence of a race/ethnicity/immigration status effect. Anglos were more likely to have had a Pap smear, followed by African Americans, Hispanic immigrants, and finally, by Hispanic Americans. The persistence of the race/ethnicity/immigration status effect, even when the effects of other independent/control variables are taken into account, may be explained by several factors. These include cultural differences between the different groups studied. The race/ethnicity/immigration status effect on Pap smear screening changed with the introduction of age, usual source of care, check-up for current pregnancy, and having multiple competing needs for food, clothing and housing into the models studied. Other variables, such as marital status, employment status and health insurance coverage had no statistically significant effects on Pap smear screening. The findings of this study are unique, probably due to the hospital-based sample who has regular access to subsidized health insurance from a publicly funded safety-net healthcare network and its healthcare providers. Given the importance of race/ethnicity/immigration status for preventive Pap smear screening, public education efforts to promote appropriate Pap smear tests among vulnerable populations should target specific race/ethnicity/immigration status groups in the U.S. within the cultural context of each group. Furthermore, publicly funded health programs for underserved populations such as the John Peter Smith Connections and Medicaid should be maintained and strengthened.
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Isetta, Valentina. "Advances in the application of information and communication technologies in healthcare at the patient's home". Doctoral thesis, Universitat de Barcelona, 2013. http://hdl.handle.net/10803/121468.
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INTRODUCTION
The pressure to contain health costs, particularly by avoiding hospitalizations and promoting the early discharge of patients, is generating a greater demand for home healthcare at a time when this resource is rapidly becoming less available. Telemedicine has been defined as the use of information and communications technologies (ICT), to deliver health services and transmit health information at distance for the purpose of improving patient’s care and education and to facilitate communication between patients and healthcare professionals. Most of the studies on telemedicine showed a lot of potentialities and possibilities, but did not develop further in the clinical routine because of problems and difficulties involving the use of this technology. Therefore, it seems clear the need of simple and straightforward applications, which can provide useful and widely applicable services to healthcare and as well as reliable data to assess the actual impact of telemedicine on homecare.
2) GENERAL AIM
To design, develop, validate and assess the benefit of new Information and Communication Technology (ICT) applications in healthcare at patient’s home.
3) HYPOTHESES
1. An Internet-based support system for monitoring newborn patients after discharge from nursery would improve care, be well accepted by parents and reduce unplanned healthcare, particularly visits to the emergency department;
2. The development of a specific web-based tool could introduce a new strategy for the continuous positive airway pressure (CPAP) therapy follow-up of patients with obstructive sleep apnea syndrome (OSAS), which could improve the CPAP compliance, reduce face-to-face clinical visits, and be more cost-effective;
3. A new telemedicine system for remote CPAP therapy monitoring could provide valuable and useful data about treatment compliance and efficacy for the follow-up of OSAS patients.
4) STUDY 1
- A new Internet-based monitoring tool for the neonatal home care after discharge was successfully developed;
- This new monitoring approach resulted in a high level of parental satisfaction with the service;
- Using a societal perspective, the cost of the Internet-based follow-up resulted much lower than that of the conventional hospital-based follow-up. Additionally, ED visits in the first month of patients’ life decreased with the use of the Internet-based monitoring system. This telemedicine follow-up strategy proved absolute dominance (both more clinically effective and less costly) over the standard follow-up based on hospital visits;
- This Internet-based tool has been effectively transferred to the health system since it is in routine clinical use at the Hospital de Sant Pau in Barcelona (www.petitsacasa.santpau.cat).
5) STUDY 2
- The opinion of the interviewed patients and medical staff about the helpfulness and satisfaction of the telemedicine monitoring approach indicated that the web-based support tool together with the televisit are potentially useful to support the home follow-up of CPAP treatment in OSAS patients;
- The high patients’ compliance to the remote monitoring through the online questionnaire suggested this strategy to be helpful and practical for the long-period CPAP therapy control;
- The multicenter support system we developed represents a new telemedicine approach to CPAP therapy follow-up for OSAS patients, which seeks enforcing patients’ confidence and improving therapy adherence;
- The developed telemedicine support system has been effectively transferred to the health system since it is in use in a multinational clinical trial currently involving 18 hospitals (www.mi-cpap.com).
6) STUDY 3
- The geometry of the telemonitoring device (NOWAPI) does not influence the CPAP treatment;
- NOWAPI showed good compatibility with the CPAP machines and an excellent performance in estimating the duration of the CPAP treatment and in detecting residual respiratory events in simulated OSAS patients. The results of this study demonstrated that NOWAPI system could be a valuable tool for telemonitoring the treatment of obstructive sleep apnea;
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Cifter, Abdusselam. "An inclusive approach towards designing medical devices for use in the home environment". Thesis, Brunel University, 2011. http://bura.brunel.ac.uk/handle/2438/5515.
Pełny tekst źródłaStreszczenie:
An emerging trend of the healthcare industry is the huge increase in the number of medical devices being used by lay people at home. Home use medical devices range from simple inhalers to very complicated devices such as defibrillators. This research aimed to assist designers in developing home use medical devices by providing information and suggestions regarding lay users and how to address their needs and expectations. For this purpose a qualitative and inductive approach was adopted and several studies were carried out, including: (1) a comprehensive literature review to understand the background of the phenomena; (2) observational studies with 40 lay users (i.e. 10 younger lay users, 10 older lay users, 10 users with mobility and sensory disabilities, and 10 users with cognitive disabilities) in order to identify their characteristics when interacting with products; (3) an online questionnaire survey with 53 designers to understand designers‟ requirements when designing home use medical devices, as well as their expectations for a proposed design support tool; (4) the development of the design support tool; and (5) an evaluation study with 12 professional designers in order to assess the effectiveness of the tool (in a format of a design guidance). This research adopted an inclusive approach which investigated both lay users‟ characteristics and designers‟ perspectives. It has, for the first time, outlined lay user characteristics based on empirical studies with different groups of people. It is also one of few studies focussing on designing home use medical devices; the requirements of professional designers have provided an in-depth insight into the challenges of designing medical devices for use in the home environment. The design guidance, as commended by the designers in the evaluation, was the first comprehensive information source in the UK for the emerging home use medical device field where little support is currently available.
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Espinal, Redondez Luis Ángel, Alvarado Cinthia Mónica Ibáñez i Melo Manuel Alejandro Javier Armando Moyano. "Propuesta de un Modelo Predictivo para Realizar un Control y Supervisión más Eficiente de las Prestaciones de Servicios de Salud en una Aseguradora Pública de Salud". Master's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/652194.
Pełny tekst źródłaStreszczenie:
El acceso a un sistema de salud digno constituye uno de los derechos fundamentales de toda persona, en el Perú se han realizado grandes esfuerzos para mejorar la calidad de los sistemas de salud, es un desafío al bicentenario el brindar un aseguramiento de salud de calidad que pueda alcanzar a todos los peruanos. Este objetivo enfrenta grandes desafíos ya que existen deficiencias en los procesos de las instituciones que brindan servicios de salud, siendo la Aseguradora Pública de Salud uno de los principales actores en el aseguramiento de la salud en el Perú.
Nuestra investigación se ha centrado en el proceso de Evaluación Automática (EA), que tiene como objetivo evaluar la validez de las atenciones brindadas por las Instituciones Prestadoras de Servicios de Salud (IPRESS) afiliadas a la Aseguradora Pública de Salud. Durante los años 2017 y 2018 se detectó que el 3.82% y 1.85% del total de atenciones presentaban irregularidades. Estudios hechos a nivel mundial muestran que el nivel de irregularidades en entidades similares se encuentra entre el 3% y el 10% por lo que existe la posibilidad de elevar la capacidad de detección de irregularidades en la citada aseguradora.
A través de nuestra investigación hemos identificado que mediante el uso de modelos predictivos construidos mediante la analítica de datos en el proceso de Evaluación Automática (EA), específicamente en la etapa llamada Supervisión Médica Electrónica (SME), se puede incrementar el nivel de detección de irregularidades, para ello es necesario aplicar la metodología CRISP-DM y el software WEKA.Access to a decent health system is one of the fundamental rights of every person, in Peru great efforts have been made to improve the quality of health systems, it is a challenge for the bicentennial to provide quality health assurance that can reach all Peruvians. This objective faces great challenges since there are deficiencies in the processes of the institutions that provide health services, with the Public Health Insurer being one of the main actors in health insurance in Peru. Our research has focused on the Automatic Evaluation (EA) process, which aims to assess the validity of the health care provided by the Health Services Provider Institutions (IPRESS) affiliated with the Public Health Insurer. During the years 2017 and 2018 it was detected that 3.82% and 1.85% of the total health care presented irregularities. Studies done worldwide show that the level of irregularities in similar entities is between 3% and 10%, so there is the possibility of increasing the ability to detect irregularities in the aforementioned insurer. Through our research we have identified that by using predictive models constructed through data analytics in the Automatic Evaluation (EA) process, specifically at the stage called Electronic Medical Supervision (SME), it is posible to increase the level of irregularity detection, for this it is necessary to apply the CRISP-DM methodology and the WEKA software.
Trabajo de investigación