Rozprawy doktorskie na temat „Unplanned”
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Barrett, Geraldine. "Developing a measure of unplanned pregnancy". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2002. http://researchonline.lshtm.ac.uk/768479/.
Pełny tekst źródłaRussell, Sarah, Randi G. Bastian, Tifani A. Fletcher, Lana McGrady, Andrea D. Clements i Beth Bailey. "Inattention and Risk Factors for Unplanned Pregnancy". Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/7257.
Pełny tekst źródłaBleeker, Jate. "An Impossible Profession: How To Plan the Unplanned?" Thesis, KTH, Urbana och regionala studier, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-200830.
Pełny tekst źródłaStory, Wendi A. "The Effects of Unplanned Pregnancy Among College Women". Thesis, Virginia Tech, 1999. http://hdl.handle.net/10919/31856.
Pełny tekst źródłaMaster of Arts
Cecil, Elizabeth. "Determinants of unplanned admissions in children : investigating the relationship between primary care quality and health service use with unplanned admissions in children". Thesis, Imperial College London, 2016. http://hdl.handle.net/10044/1/63859.
Pełny tekst źródłaTörnquist, Martin. "A personal city : A city planned for the unplanned". Thesis, Umeå universitet, Arkitekthögskolan vid Umeå universitet, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-171845.
Pełny tekst źródłaSharp, Jonathan. "'Unplanned but not unwanted' : a developmental perspective of teenage pregnancy". Thesis, University of East Anglia, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396729.
Pełny tekst źródłaWeatherspoon, Kathleen Janet. "Reducing Unplanned Hospital Readmissions| A Qualitative Exploratory Multiple-Case Study". Thesis, University of Phoenix, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13425878.
Pełny tekst źródłaHealthcare quality measurement and care reimbursement have become a central focus for leaders and administrators of healthcare organizations. The provision of high-quality healthcare is contingent on the skills and abilities of leaders and clinical staff who support evidence-based clinical practice through implementation strategies. The problem defined in this qualitative exploratory multiple-case study was concerned with the frequency of unplanned hospital readmissions occurring in the state of Florida specifically, in healthcare facilities located in Broward, Miami-Dade, and Monroe Counties (tri-county area). Healthcare stakeholders working in organizations located in the tri-county area report hospital readmission rates of 23%, that resulted in higher financial penalties. The purpose of this qualitative exploratory multiple-case study was to explore the reasons for higher than expected unplanned hospital readmissions in healthcare facilities located in the tri-county area of south Florida to help hospital administrators to improve healthcare quality through reducing unplanned rehospitalizations. Thirteen participants contributed to this study: 4 (31%) healthcare leaders, 4 (31%) clinicians, and 5 (38%) registered nurses. Through the collective experiences of healthcare stakeholders, two primary and two secondary themes emerged to provide a clearer understanding of the contributing factors related to unplanned hospital readmissions. Four themes namely, education, population, and cultures and resources supported existing literature and provided new knowledge related to the importance of executive leader knowledge, nurse educational and skill levels, patient literacy and language, and cultural elements when applying evidence-based clinical practices in complex healthcare environments.
Warren, Keith Clements. "Family Environment, Affect, Ambivalence and Decisions About Unplanned Adolescent Pregnancy". Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331841/.
Pełny tekst źródłaStallings, Jamie M. "INFORMED: THE IMPACT ON DECESION MAKING DURING AN UNPLANNED PREGNANCY". CSUSB ScholarWorks, 2014. https://scholarworks.lib.csusb.edu/etd/73.
Pełny tekst źródłaKhethiwe, Thandokazi Theo. "Factors contributing towards and support groups for young women who are experiencing unwanted pregnancies". Thesis, University of Zululand, 2012. http://hdl.handle.net/10530/1274.
Pełny tekst źródłaUnwanted pregnancy among young unmarried South African women still remains a challenge. It has been identified that young unmarried women who are living in rural areas are more vulnerable to unwanted pregnancy. Bronfenbrenner.s theory of systems has been used in the study. The participants were sourced from eMbobeni location, a rural area in Bizana in the Eastern Cape Province. The data was collected through focus group interviews and analysed through content analysis. Group interviews were tape recorded and transcribed. Group support was provided for the participants in the focus group. Through the study it has emerged that lack of knowledge about sexuality and the protection of oneself still remains a challenge. Factors contributing towards unwanted pregnancy among young unmarried women were identified as being lack of parental support; lack of knowledge and the stigma towards contraception; pressures from the partner; ignorance, carelessness and restrictions; and shift of responsibility.
National Research Foundation (NRF)
Henning, John Gordon. "Evaluation of long-hole mine design influences on unplanned ore dilution". Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102985.
Pełny tekst źródłaThe primary objective of the research undertaken is to establish new models for stope and orezone design, with respect to anticipated stope overbreak, focusing on the position and type of stope within the orezone extraction sequence. Identified factors influencing unplanned dilution, such as: induced stress environment, stope geometry, and the setting of individual stopes are considered.
The research undertaken incorporates a variety of components, including (i) parametric 3-D numerical modelling to examine influences of individual factors on hanging-wall overbreak, (ii) case example analysis, and (iii) orezone extraction sequence simulation, using 3-D elastic numerical modelling. Design criteria, developed from the parametric modelling, was applied to the orezone sequence modelling to develop trends for stope dilution, as functions of stope design and construction.
It was found that hanging-wall overbreak is not significantly influenced by depth alone, and that stopes with large vertical and short horizontal dimensions or stopes having long horizontal and short vertical dimensions are more stable than large square-like stopes. Also, through parametric and case studies, it was demonstrated that, in addition to stope dimension, the amount of unplanned dilution differed according to stope type. Five stope types were identified, based on their position within a tabular blasthole mining sequence. Measured overbreak varies with stope type, with secondary stopes generating a greater volume of hanging-wall dilution than do primary stopes. A pillarless mining sequence will generate less overall dilution than a primary stope: secondary pillar mining sequence.
Pierce, Tamarha. "Experimental priming of interpersonal expectations and coping with an unplanned pregnancy". Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23286.
Pełny tekst źródłaHigham, Sue. "Protecting, providing and participating : fathers and their children's unplanned hospital admission". Thesis, Swansea University, 2011. https://cronfa.swan.ac.uk/Record/cronfa42988.
Pełny tekst źródłaGotts, N. M. "Unplanned wayfinding in path-networks : a theoretical study of human problem solving". Thesis, University of Sussex, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.233103.
Pełny tekst źródłaMackenzie, Matthew Robert. "Understanding anesthesia's role in the unplanned admission of pediatric ambulatory surgical patients". Thesis, Boston University, 2012. https://hdl.handle.net/2144/12496.
Pełny tekst źródłaIntroduction: Pediatric ambulatory surgery has experienced a surge in popularity as new surgical and anesthetic techniques have made it a more viable option for a host of surgical procedures. While the vast majority of patients are successfully discharged upon recovery from anesthesia, a small proportion 1-2.5% in previous studies must be admitted to the hospital's inpatient unit. Many of these patients present with conditions such as uncontrollable post-operative pain and nausea and vomiting associated with anesthesia. As such we sought to characterize the unplanned admissions population at Children's Hospital Boston, a tertiary care pediatric hospital and investigate Anesthesia's role in their care. Methods: Patients were identified as possible candidates for inclusion into this study if they experienced a status change in the Children's Hospital Boston records system from "Day Surgery Unit" to "Inpatient Unit". Data from these patients was gathered using Anesthesia records, medical record number summaries, growth charts, and other electronic medical records. Results: The unplanned admission rate at Children's Hospital Boston was 1.29% from January 2010 through June 2011, representing 347 patients from a day surgery population of 26,951. No statistically significant differences were observed in regards to patient fitness, as measured by American Association of Anesthesiologist classification, when compared to patients successfully discharged. The leading causes of admission were uncontrollable postoperative pain (n=117, 39.8%) and post-operative nausea and vomiting (n=94, 32.0%). When compared to the successfully discharged patient population; orthopedic surgery experienced a statistically significant increase in its contribution rate while genitourinary surgery experienced a statistically significant decrease. Pre-operative acetaminophen usage was only 19%, while midazolam pre-medication was 51.4%. Regional anesthesia was utilized in only 11.5% of cases overall and 27.3% of orthopedic patients. Patients experiencing post-operative nausea and vomiting were primarily treated with ondansetron and dexamethasone as prophylaxis while overwhelmingly receiving a re-dosing of ondansetron post operatively. Post-operative utilization of metaclopramide in these patients was 3.7%. Conclusion: At Children's Hospital Boston 71.8% of unplanned admissions are either for pain or nausea and vomiting, two conditions that are intimately related. It is reasonable to presume that an increased emphasis on prophylaxis analgesia in the form of pre-operative acetaminophen and regional anesthesia would help alleviate a portion of these cases directly related to uncontrollable pain. It is also not unreasonable to assume that these options may decrease post-operative opioid usage, a significant risk factor for post-operative nausea and vomiting. In cases where nausea and vomiting is still present and patients have received ondansetron and dexamethasone intraoperatively, there seems to be a reliance on re-dosing with ondansetron, whereas based on physiological pathways of nausea patients, a third drug-class may be a better option. Improvements in these areas could decrease the unplanned admission rate at Children's Hospital Boston.
Britton, Donna Marie. "Modified Interdisciplinary Rounds/Progression of Care Rounds| Decreasing 30-day Unplanned Readmissions". Thesis, Grand Canyon University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10837264.
Pełny tekst źródłaThe continuously growing readmission rates within 30-days of discharge point toward compromising quality outcomes such as fragmented health care. The purpose of this project was to compare the effectiveness of pre-intervention traditional interdisciplinary rounds (IR)/ progression of care rounds (POCR) members, in comparison to the intervention of modified IR/POCR members, by adding a disease-specific educator (DSE) member to the team, as measured by the 30-day unplanned readmissions rate in patients discharged from a single cardiology unit in Galveston, Texas. A comparison of 30-day unplanned readmissions during two different timeframes was performed using the planned readmission tool. The Iowa model of evidence-based practice and the model of collaborative care supported the project. A comparative quantitative methodology was used to analyze the data. The final sample consisted of 50 (N = 50) patients discharged during the pre-intervention and 53 (N = 53) during post-intervention. The data was analyzed using descriptive statistics and an unpaired t-test. The pre-intervention IR/POCR team members period 30-day readmissions were 7 compared to 3 during the post-intervention IR/POCR team members. The standard deviation of pre-intervention IR/POCR and post-intervention was 3.95980 and 2.12132 respectively. The results show a significant value of 0.106 (95% CI, -1.04243 to 5.04243). The implementation of the DSE to the IR/POCR team assisted in identifying and closing the gap associated with quality patient outcomes and reduced 30-day unplanned readmission rates. Further research is needed due to a limited practice site.
Prudencio, Denise Angelo Moreno. "Discharge Phone Call on Unplanned Readmission Due to Chemotherapy Among Cancer Patients". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7060.
Pełny tekst źródłaKaranja, Faith Njoki. "Use of knowledge based systems for the detection and monitoring of unplanned developments". [S.l.] : [s.n.], 2002. http://deposit.ddb.de/cgi-bin/dokserv?idn=966084659.
Pełny tekst źródłaHoskins, R. "Why do patients seek unplanned follow up after treatment in the emergency department?" Thesis, University of the West of England, Bristol, 2014. http://eprints.uwe.ac.uk/22758/.
Pełny tekst źródłaKohtz, Cindy Rhodes Dent Crumpler Thomas P. "Alternative pedagogies and non-conventional teaching methods in nursing education unplanned and limited change /". Normal, Ill. : Illinois State University, 2006. http://proquest.umi.com/pqdweb?index=0&did=1251836291&SrchMode=1&sid=3&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1178889759&clientId=43838.
Pełny tekst źródłaTitle from title page screen, viewed on May 11, 2007. Dissertation Committee: Dent Rhodes, Thomas Crumpler (co-chairs), Sara L. Campbell. Includes bibliographical references (leaves 182-191) and abstract. Also available in print.
Williams, Peter Alan. "Exploratory study of mapping outcomes of executive coaching with specific focus on unplanned outcomes". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/97433.
Pełny tekst źródłaENGLISH ABSTRACT:This research assignment is an exploratory qualitative study into mapping unplanned outcomes of executive coaching. The research purpose was twofold: to address the lack of a common and comprehensive framework for the mapping of outcomes of executive coaching, and to add to the body of knowledge regarding unplanned outcomes of executive coaching. In developing the mapping framework, the available literature was reviewed and, through an inductive process, a framework, model, taxonomy and mapping tool were developed. Based on core concepts attributable to Kirkpatrick, Wilber and Jaques, the mapping tool developed was then tested, using data obtained from a purposive sample of seven semi-structured interviews with Gauteng based coachees. The sample excluded any individuals who had been coached by the researcher. During the data analysis, the planned outcomes were mapped using the mapping tool and related processes. Thereafter the actual outcomes were mapped, identifying those outcomes that matched planned outcomes and those that supported the planned outcomes. A technique named ‘outcome chains’ was developed and used for this process. The unplanned outcomes were identified by a process of elimination, being those that remained unallocated in the planned chain process. It was found that outcomes of executive coaching can be mapped using a framework based on the principles of Kirkpatrick, Wilber and Jaques, with all identified outcomes being mapped successfully. Four categories of unplanned outcomes were identified, namely those that hinder the attainment of planned outcomes, insufficient evidence of achieving planned outcomes, actual outcomes related to planned outcomes but with scope different to planned and, fourthly, actual outcomes unrelated to planned outcomes. Additionally, three themes of unplanned outcomes, each with two sub-themes, were identified, namely personal (sub-themes: physical and spiritual), family (sub-themes: immediate and extended) and work (sub-themes: positive and negative). The most surprising finding was that all seven coachees experienced unplanned outcomes, which is markedly different to previous research findings and may be due to the inclusion of non-work related outcomes. The key recommendations arising from this research assignment embrace the research into, and practice of, executive coaching. Regarding the research elements, it is recommended that the mapping framework developed in this research be further refined and tested as a holistic standard for evaluating the outcomes of executive coaching, including those outcomes that impact the coachee as an individual. For the executive coaching fraternity, it is recommended that coaches challenge themselves and their practices regarding the probability, categories and impact of unplanned outcomes, and introduce measures to maximise the upside and minimise the risks of unplanned outcomes. Finally, the regular testing and recording of the coachee’s reaction to executive coaching is recommended as a predictor of coaching efficacy.
Dennis-Brinson, Alisha. "A Discovery of How Women with Unplanned PregnancyExperience Spiritual Community at Akron Pregnancy Services". Ashland Theological Seminary / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=atssem1581156517405563.
Pełny tekst źródłaBusby, John. "Preventing unnecessary unplanned hospital admissions and achieving timely discharge; an analysis of geographic variation". Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702487.
Pełny tekst źródłaJang, Hyong Doo. "Unplanned dilution and ore-loss optimisation in underground mines via cooperative neuro-fuzzy network". Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/997.
Pełny tekst źródłaAtkinson, Thomas. "The end of the line: Managing unplanned changes in an urban stormwater treatment wetland". Thesis, Atkinson, Thomas (2015) The end of the line: Managing unplanned changes in an urban stormwater treatment wetland. Masters by Research thesis, Murdoch University, 2015. https://researchrepository.murdoch.edu.au/id/eprint/25675/.
Pełny tekst źródłaMacPherson, C. "A study to examine the risk factors and consequences associated with unplanned and unwanted pregnancy". Thesis, Queen's University Belfast, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273056.
Pełny tekst źródłaSpencer, Carolyn R., i n/a. "Cognitive Schemata and Project Manager Regulation of Unplanned Change: Categorical Analysis of Structured Interview Reports". Griffith University. School of Applied Psychology, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040721.092038.
Pełny tekst źródłaSpencer, Carolyn R. "Cognitive Schemata and Project Manager Regulation of Unplanned Change: Categorical Analysis of Structured Interview Reports". Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366716.
Pełny tekst źródłaThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology (Health)
Full Text
Heller, Rebecca Lily. "No missed opportunity : expanding sexual healthcare provision beyond current service delivery models". Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/28997.
Pełny tekst źródłaGlenn, Nadia Arrella. "THE MEANING AND UNDERSTANDING OF UNINTENDED PREGNANCY: A QUALITATIVE STUDY OF PREGNANCY AMONG AFRICAN AMERICAN WOMEN LIVING WITH HIV". Diss., Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/555618.
Pełny tekst źródłaPh.D.
Few studies explore the phenomenon of unintended pregnancy among women living with the Human Immunodeficiency Virus (HIV). To decrease mother-to-child transmission and transmission to a sexual partner, contraceptive methods, cultural beliefs, in addition to protocols pertaining to preconception, pregnancy, labor, delivery and the postpartum period among persons living with HIV must be considered. Half of the pregnancies that occur among HIV-positive women are unintended and requires monitoring and additional prenatal care to reduce adverse health outcomes. This qualitative study sought to increase knowledge of the meaning and understanding of unintended pregnancy among a sample of twelve urban HIV-seropositive African American women. Women shared their experiences related to pregnancy, risk and living with HIV. The majority of participants reported they experienced an unintended pregnancy, discussed lapses in contraception use, knowledge of pregnancy and antiretrovirals, vertical transmission of the virus, sexual risk, and differences in adherence to antiretrovirals during and after pregnancy. Guided by grounded theory the major themes that emerged were used to develop a model that explained unintended pregnancy among the participants. The major themes included resilience, disclosure, and an instinct to protect. Additionally, culture, stigma, social support, contraception, and partner safety were secondary themes. Our review suggests that a model of unintended pregnancy containing social-ecological aspects can describe predictors of pregnancy and potential prevention strategies. Furthermore, the future exploration of the challenges that African American women living with HIV experience with unintended pregnancies, efforts to manage their condition and prepare for a pregnancy are needed.
Temple University--Theses
Zhao, Jing Mechanical & Manufacturing Engineering Faculty of Engineering UNSW. "A decision support tool for unplanned maintenance at ramp time including aviation regulations and scheduling disruption". Awarded by:University of New South Wales. School of Mechanical and Manufacturing Engineering, 2007. http://handle.unsw.edu.au/1959.4/27449.
Pełny tekst źródłaLei, Ming. "Entertainment education and gender how do they contribute to the prevention of teen and unplanned pregnancy? /". Online access for everyone, 2008. http://www.dissertations.wsu.edu/Thesis/Summer2008/m_lei_072108.pdf.
Pełny tekst źródłaMacNeill, Virginia Margaret. "The effectiveness of services intended to prevent young people from leaving home in an unplanned way". Thesis, Royal Holloway, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249753.
Pełny tekst źródłaXie, Jingying, i 谢静颖. "A cross-sectional knowledge, attitude and practice study among women with unplanned pregnancy in Guangzhou, China". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46943729.
Pełny tekst źródłaRoux, Samantha Lynne. "An exploratory study of mothers perceptions and experiences of an unplanned Caesarean section / Samantha Lynne Roux". Thesis, North-West University, 2010. http://hdl.handle.net/10394/4943.
Pełny tekst źródłaThesis (M.Sc. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.
RANGEL, FABIO DE BARROS. "IMPULSIVE BUYING IN TRAVEL RETAIL ENVIRONMENT: THE INFLUENCE OF THE ENVIRONMENT ON UNPLANNED PURCHASES AT AIRPORTS". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2014. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=24715@1.
Pełny tekst źródłaThis study analyzes the effect of airport retail environment on consumer behavior in unplanned purchases. The conceptual model of Mohan (2013) was used for the purpose we test both the both the positive elements inherent to the store (music, lighting, lay out and attendants) and the individual characteristics of consumers regarding the affective side as negative, as well as the need to purchase a particular product. Was sent by e-mail a survey to customers who bought in Duty Free in arrival from Sao Paulo to store at least 1 month. The study results show how this set of elements within the dynamic purchasing influence consumption.
Ng, Cheong Tin Marie Melina. "ERP projects : an examination of the factors influencing additional unplanned effort in the project life-cycle". Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/11348.
Pełny tekst źródłaFor over a decade, ERP systems have been the target of significant amounts of investment in organisations. Some have reaped the benefits anticipated while others struggle to achieve the required level of success. In fact, based on available statistics, numerous organisations have faced problems in keeping their allocated budget and time schedules on track often facing the threat of failure, escalation or significant redirection in their projects. As a result, organisations are seen to spend what can be termed as additional unplanned effort (AUE) in order to try and achieve a certain level of success given budget and time constraints. Using the concept called AUE, derived from topics such as ERP project success and failure, the ERP life-cycle framework and critical success factors (CSFs) relevant to the life-cycle phases, this study attempted to investigate the factors that influence AUE in the phases ofthe ERP life-cycle which in this study consist of the pre-implementation and implementation phases specifically. A sub-objective was also to investigate the possible influence that the presence of factors, responsible for escalation of commitment (EoC) in IT projects, have on AUE in ERP projects. Based on a qualitative mUltiple case-study of 5 ERP projects at different organisations, results showed that there are several factors that influence AUE in satisfying CSFs in each phase of the life-cycle. Particularly, in the pre-implementation phase, factors such as the justification for ERP adoption, the formalisation of an ERP vision, the finalisation of an ERP package choice, the stability of organisational structure, the organisation and flow of the acquisition process, the nature of market conditions and the type of internal and external partnership were found important in influencing AUE in that phase. In the implementation phase factors such as the formalisation of an implementation strategy, the management of organisational momentum and resistance to change, the maintenance of external partnership relationships, conditions external to the organisation, the nature of the organisation and the management of project factors were found important.
Chapman, Steven Edward. "The impact of unintended and unplanned pregnancy on maternal health care a panel study of Morocco /". Available to US Hopkins community, 2002. http://wwwlib.umi.com/dissertations/dlnow/3068130.
Pełny tekst źródłaLubensky, Micah Elan. "An unplanned trade-off? : the potential conflict between reducing prejudice and supporting engagement in collective action /". Diss., Digital Dissertations Database. Restricted to UC campuses, 2004. http://uclibs.org/PID/11984.
Pełny tekst źródłaSkogstad, Shannon Nancy. "Deinstitutionalization : the unplanned parenting paradigm". 2003. http://hdl.handle.net/1993/17904.
Pełny tekst źródłaHuang, Jhih-Siou, i 黃智琇. "Predicator of Unplanned Readmission of Pneumonia Patient". Thesis, 2015. http://ndltd.ncl.edu.tw/handle/54101225042235566820.
Pełny tekst źródła中臺科技大學
醫療暨健康產業管理系碩士班
103
Background: Readmission denotes the event that a patient has been hospitalized again after being discharged in a certain period. Readmission is caused by failed treatment or a new or worsening comorbid illness. and manifests two significant problems: deteriorated health care quality and increased health care cost. Hence, readmission is treated as an indicator for evaluating the overall health care quality. Decrease in pneumonia-related readmission has been recognized as a benchmark of quality care. Objectives: This study aims to find the demographic factors, readmission rate, disease factors, treatment factors, comorbidities, and the other risk factors to predict readmissions and to design a model to predicting readmission for pneumonia patients within 30 days after discharge. Methods: The patients with age greater than 18 years old, who had been hospitalized from January 2013 to December 2013, were recruited for this study. The patients were divided into 2 groups. The study group included patients who had been readmitted within 30days after discharge, while patient who hadn’t been readmitted within 30days after discharge were assigned in the control group. Data contain a total of 66 variables, including demographic information, disease factors, treatment factors, and comorbidities, were retrieved from the hospital information system of a regional teaching hospital. After single-variate inferential analyses (Student’s t-test and Pearson χ2) and logistic regression analysis, significant variables which reached significant level (p<0.05) were selected for construct the predictive model. The performance was evaluated with predictive accuracy (or misclassification rate) and receiver operating characteristic (ROC) curve. Result: It was observed that a total of 17,222 patients were discharged from the hospital during the study period; among them, 781 patients with principal diagnosis of pneumonia and age greater 18 years old. After excluding patients who died before discharge (n=15), transferred to other hospitals (n=21), and discharged against medical advice (n=22), data of 723 cases were used for analysis. Of these patients, men accounted for 66.9% with mean age of 72.2 (SD 16.5), and 82 cases were followed by a 30-day readmission (readmission rate 11.3%). The top five primary diagnoses were pneumonia, urinary tract infection, pneumonitis due to inhalation of food or vomitus, chronic airway obstruction, acute respiratory failure, and heart failure. The age (P<0.001), age group (χ2=31.314, P<0.001), length of admission (P<0.05), BUN (P<0.05), Neutrophil (P<0.05), number of medication (P<0.01), number of treatment process (P<0.001), oxygen use (χ2=4.584, P<0.05), inhalation treatment (χ2=2.974, P<0.05), airway suction (χ2=13.973, P<0.001), nasal gastric tube feeding (χ2= 14.604, P<0.001), use of indwelling catheters (χ2=19.961, P<0.001), congestive heart failure (χ2=3.424, P<0.05), and cardiac arrhythmia (χ2 = 8.121, P<0.05) were found to be significantly different between 2 groups. After logistic regression analysis, only 10 variables, including age, length of admission, number of medication, number of treatment procedure, oxygen use, use of indwelling catheter, nasal gastric tube feeding, BUN, cardiac arrhythmia, and valvular disease were significant and selected for constructing the prediction model with a Cox-Snell R2 of 0.75, a predictive accuracy of 87.7%, and an area under ROC curve (AUC) of 0.747. Conclusions: The model constructed using 10 variables for predicting readmission achieved an accuracy of 87.7%. Among these 10 variables, age, indwelling catheters use, and cardiac arrhythmia were the most important predictive factors for readmission prediction. These 3 factors can be evaluated at the time of discharge and are can be used to predict patients who have higher probability to be readmitted. A post-discharge heath care plan can be conducted to prevent patient readmission, thereby increasing the patient safety and reducing the healthcare cost.
Hosford, Helen Cristin Farah. "Psychosocial factors affecting choices in unplanned pregnancy". Thesis, 2012. http://hdl.handle.net/10210/4290.
Pełny tekst źródłaThe aim of this study was to ascertain which variables affect and influence women when making choices in unplanned pregnancy. In addition, to determine if there were any significant differences between the pregnancy and termination of pregnancy (TOP) group, indicating a specific profile for the respective group. Comparatively little research has been conducted on unplanned pregnancy and abortion within South Africa, as compared with international studies. Future longterm studies are recommended. The research conducted was of a quantitative quasi-experimental research design, wherein the researcher compared the following variables between the two groups: Biographic/demographic data, Personality Styles, perceived Family Environments and Coping Resources. Subjects were not randomly assigned, but selected by the nursing staff and researcher. Statistical analysis reflected that the two groups differed significantly on four variables. The majority of women in the TOP group were found to be the sole earners within their families. Conversely, women in the pregnancy group had more financial resources and lower levels of employment. A lack of sufficient finances was shown to be the strongest determining factor for those electing abortions. A compounding factor, were the nature of the relationships from where conception arose, 71% of the women who elected abortion described difficulties with the partnerin- conception. These included poor relationships due to excessive drinking, extramarital affairs, disinterest in the pregnancy, subsequent abandonment and divorce. Although the two groups had similar profiles in terms of the religious variable, many of the women who elected to remain pregnant, cited religion and/or their beliefs as the primary reason for continuing their pregnancies. In contrast, the TOP group reported a higher level of conflict within their family of origin, compared to the pregnancy group. IV No underlying pathology was found to exist in the group electing terminations, with both groups presenting similar personality styles. The two groups were also found to use comparable coping skills and resources. This research indicates, that most of the women experiencing an unplanned pregnancy based their decisions to abort on external variables; such as their relationships, financial position and religious beliefs. Studies indicate that these women are more likely to experience deleterious consequences, than those who make this decision based on their own personal needs. Many of these women made their decisions based on limitations not preference. This study may be considered to show important findings, as it reflects the need for effective pre- and post-abortion intervention/counselling services, which should be easily accessible to the public. The psychological well-being of the individual is critical for the overall well-being of the community, and ultimately therefore, society.
Chang, Ting-Yu, i 張廷宇. "Is In-App Purchases an Unplanned Behavior?" Thesis, 2012. http://ndltd.ncl.edu.tw/handle/63682244171001919505.
Pełny tekst źródła國立中央大學
資訊管理研究所
100
In recent years, smart phones have gradually replaced feature phones in the mobile market. Along with the rapid growth of smart phones, mobile phone’s application (app) also receive public acceptance. By the end of 2011, the number of apps available on both the Apple App Store and the Google Play all surpassed 50,000. In addition, Apple App Store has reached 25 billion in app download count by March 2012. With the growth of App’s market, the App revenue model has gradually transformed from “one-time purchases” to “in-app purchases.” Of all App categories, Games have netted the most revenue. This study attempts to look into the phenomenon of “in-app purchases,” trying to explain the seemingly impulsive behavior. We extended the “Theory of Planned Behavior (TPB)” with “Flow theory.” In this study, data was collected from 326 valid respondents through web-based questionnaires distributed through relevant discussion groups. PLS and SPSS were employed as data analysis tools. Result revealed that: (1) the extended TPB model is effective in explaining the respondent’s in-app purchases behavior; (2) “flow experience” has a directly effect on respondent’s actual behavior; and (3) descriptive norm is more likely to influence the respondents than injunctive norm in in-app purchase behavior.
Gama, Nothando Nokuthula. "The effects of unplanned pregnancy on female students of the University of Zululand". Thesis, 2008. http://hdl.handle.net/10530/132.
Pełny tekst źródłaThe study investigated the effects of unplanned pregnancy on female students at the University of Zululand. The sample consisted of 22 female students whose ages range from 15-26+. Female students who are sexually active were more likely to use no contraceptives, which puts them at a high risk of unplanned pregnancy. Some are influenced by their partners regarding birth control or they forget to use contraceptives altogether. University students engage in sexual intercourse, generally with multiple partners. The University of Zululand female students are faced with the problem of unplanned pregnancies, which is very high. It has become imperative, therefore, to get some answers to the questions as to why some fall pregnant and say it was unplanned and some do not know who impregnated them. The researcher wanted to examine perceptions of the effects of unplanned pregnancy on female students; to examine long term or on-going effects that female students might experience after termination of pregnancy or miscarriage, and to investigate the level of knowledge related to contraceptives and other means of preventing unplanned pregnancy. The findings show that it is the young adults (15-19) years of age that are mostly affected by unplanned pregnancies. Racial group are the blacks, those who are not married, are mostly experiencing unplanned pregnancy. There are a few people who are using contraceptives; this also indicates that there is lot that needs to be done in educating people about the use of contraceptives.
Williamson, Micheal. "unplanned wanderings: and the discovery of a pier". 2008. http://hdl.handle.net/1993/3089.
Pełny tekst źródłaOctober 2008
Tsai, I.-Ying, i 蔡易穎. "The Impact of Unplanned Hemodialysis on Healthcare Costs". Thesis, 2013. http://ndltd.ncl.edu.tw/handle/93564326464465902919.
Pełny tekst źródła國立陽明大學
醫務管理研究所
101
Background: The clinical and socioeconomic impact of unplanned dialysis is significant. Access to nephrology care before initiation of chronic dialysis is associated with improved outcomes. There have been no reports of unplanned hemodialysis (HD) initiation in Taiwan. The aim of this study is to evaluate the impact of healthcare utilization and healthcare cost, and to analyze whether the healthcare utilization in the predialysis period correlates with the planned start among incident hemodialysis patients. Study design: retrospective cohort study. Setting &; Participants: We conducted the study of adult patients, who initiated first long-term hemodialysis therapy between January 1, 2005 and December 31, 2007. We used the sampling file of one million people in 2005, in Taiwan National Health Insurance Research Database (NHIRD). The study period for each patient extended from 2 years before to 90 days after the initiation of HD therapy. Predictors: Patient characteristics (sex, age, diabetes, hypertension, peripheral vascular disease, congestive heart failure, myocardial infarction) and healthcare utilization (nephrology care, western medicine outpatient department (OPD) visits, and emergency department (ED) visits) in the predialysis period. Predictors of the planned starts were evaluated with logistic regression. Outcome and measurements: ED visits hospitalization rates, cause-specific hospitalizations, length of hospitalization and total hospitalization costs per patient in the postdialysis period. Results: A total 927 patients were included (mean age, 63 years old; 53% male; 67% unplanned dialysis initiation). In the postdialysis period, the proportion of hospitalization (17.6% vs. 48.5%, p < 0.001) and ED visits (26.7% vs. 37.8%, p = 0.006) were significantly higher in the unplanned group. In all hospitalized patients, the median length of hospitalization (7 days vs. 13 days, p = 0.009) was significantly higher in the unplanned group. For all cardiovascular hospital admissions, the median length of hospitalization (4 days vs. 14 days, p = 0.036), and the median unadjusted total hospitalization costs per patient ($1492 vs. $2711, p = 0.046) were significantly higher in the unplanned group. For all infectious hospital admissions, the median length of hospitalization (8 days vs. 16.5 days, p = 0.003), unadjusted median total hospitalization cost per patient ($1651 vs. $2884, p = 0.033) were also significantly higher in the unplanned group. Total annualized hospital costs related to unplanned dialysis was $ 350,000 (about $10.5 million TWD). Reducing the rate of unplanned dialysis by one-half yielded savings about $208,000 (about 6.2 million TWD), when we used the total number of new ESRD in 2005 as the estimation. In a model using only patients’ characteristics as the risk factor, logistic regression showed lower ORs for advancing age 0.99 (95% CI, 0.99-1.00), diabetes 0.52 (95% CI , 0.38-0.71), and myocardial infarction 0.36 (95% CI, 0.14-0.94), and higher ORs for hypertension 1.72 (95% CI, 1.17-2.63). In the expanded model II, odds were lower for advancing age 0.95 (95% CI, 0.97-1.00), diabetes 0.51 (95% CI, 0.37-0.73), and the number of ED visits 0.73 (95% CI, 0.62-0.87). Odds were higher for predialysis nephrology care for over 90 days before HD 1.97 (95% CI, 1.31-2.96), the number of nephrology care 1.28 (95% CI, 1.21-1.37) and the number of western medical OPD visits, except nephrology care 1.05 (95% CI, 1.03-1.08). Limitations: Clinical outcomes, laboratory data, and social-economic status were not feasible due to the nature of the database. Conclusions: Between 2005 and 2007, the proportion of unplanned starts of HD was high in Taiwan. Unplanned starts are linked to more ED visits and more hospitalizations in the postdialysis period. All infection and all cardiovascular causes related hospitalizations play a major part of the total hospitalization costs, especially in the unplanned group. Increasing predialysis nephrology care, increasing OPD visits and decreasing ED visits were associated with increased odds of planned starts. That said the impact of unplanned dialysis is significant in the healthcare cost and utilization. Further research and the implementation of initiatives are needed to reduce the rate of unplanned HD starts and the significant reduction of related healthcare costs. Key words: unplanned start, hemodialysis, healthcare costs, utilization, hospitalization
Yeh, Nai-Chi, i 葉乃綺. "The Effect of Cash Rewards on Unplanned Buying". Thesis, 2004. http://ndltd.ncl.edu.tw/handle/10683116317083266187.
Pełny tekst źródła國立成功大學
國際企業研究所碩博士班
92
As globalization became a trend, competence of businesses is more and more severe. In order to making profit and existing, many companies raise marketing budget and use various new type promotion activities to attract consumers. Cash Rewards, a new type promotion tool, which was applied on many famous department stores, apparel retailing chain and grocery stores etc., for it could stimulate consumption and bring short-term performance rising. What effect the new type promotion tool has to attract consumers and let them be willing to buy more goods? In this article, author through cash rewards to discuss how promotion usage influences on final purchase behaviors? What will affect artificial buying desire? And how unplanned purchases happened? The main purposes of this article are: (1) Using consumer motivation, expected benefit and expected regret to develop dimension of artificial buying desire.(2)To discuss different cash rewards programs have influence on artificial buying desire.(3)To discuss effects of the amount of paid money may influence artificial buying desire.(4)To discuss effects of the artificial buying desire may influence unplanned purchase.(5)To discuss mediator effects of add –purchase goods’ price, preference of goods alternatives. (6)To provide suggestions of pricing cash rewards promotion tool. The main results are as follows: (1)When a company use the same discount to provide different cash rewards programs, there are no different degree of artificial buying desire of consumers. (2)The more amounts of paid money, the higher degree of consumer’s artificial buying desire. (3)When a company use cash reward promotion, higher artificial buying desire will bring higher rate of unplanned purchase. (4)Add-purchase goods price has no influence on final unplanned purchase. (5)Preference factors have influence on final unplanned purchase.
Shen, Li-Pen, i 沈麗盆. "Correlates of the unplanned replacement of peripheral intravenous catheters". Thesis, 2010. http://ndltd.ncl.edu.tw/handle/08897421872663197664.
Pełny tekst źródła高雄醫學大學
護理學研究所
98
The purpose of this study was to explore predictors for the medical patients̛unplanned replacement of peripheral intravenous catheters. An observational and propctive study, Since June 1, 2009 to November 10, 2009, with a purposive sampling, a total of 210 patients and 105 nurses, in a medical center involving nine medical wards was recruited in southern Taiwan. The results showed that unplanned replacement rate of peripheral intravenous catheters accounted for 43.8%; whether unplanned replacement peripheral intravenous catheter or not was significantly different with either injection of a large volume of solution or not, or either application of alcohol povidone-iodine solution for the sterilizing puncture of the skin or not. with multivariate logistic regression analysis, it showed that injection of a large volume of solution was the determinant for unplanned replacement of peripheral intravenous catheters. The odds ratio (odds ratio, OR) was 1.97. The results of this study could provide an indicator for unplanned replacement of peripheral intravenous catheters in order to enhance the quality of nursing care for the peripheral intravenous catheter.
Hu, Hsiao-Chen, i 胡曉珍. "The unplanned readmission and relative factors in cancer patient". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/72163645598050626464.
Pełny tekst źródła國立臺北護理健康大學
護理研究所
99
The purpose of this study was to explore the association between unplanned readmission within 31 days and demography, disease characteristics, activities of daily living, nutritional status, nursing direction, and discharge planning need. This is a chart review study. We linked cancer registry database and patients information system to select patients who hospitalized in general ward from Jan. 2008 to Jun. 2009 and newly diagnosed with lung, liver, colorectal and breast cancer in a medical centers of northern Taiwan. In these patients, there were 60 patients unplanned readmission within 31 days. We randomized another 60 patients according to cancer diagnosis from these patients. Information of patients’ nutrition data, activities of daily living, nursing direction and discharge planning needs were collected form medical chart and discharge planning system. The SPSS Version 17.0 statistical analysis program was used for data management and analysis. The mean age of 120 patients was 61.2 years (SD = 13.9). Most patients were male(55%), married(87.5%), living with their families(95%). The average length of stay was 9.9 days(SD = 11.0). The majority patients had chronic diseases (60.8%), cancer stage III(37.5%), hemoglobin below than 12 g / dl (60.8%), and BMI range from 18.5 to 23.9 (47.5%). About 26.7% patients were unplanned readmission within 31 days due to disease symptoms related to cancer. The logistic regression model indicated that age, cancer metastasis, activities of daily living, and needs of discharge planning related to unplanned readmission significantly. Patients with discharge planning need had higher risk of unplanned readmission than those without need (OR=4.01, CI=1.25-12.85 ). Patients with metastasis also had higher unplanned readmission risk than those without (OR= 3.79, CI=1.44-9.98). The total explanation variance accounted for 25.3%. However, hemoglobin, BMI and nursing direction couldn’t predict unplanned readmission in our study. This study proves that discharge planning is the risk factor of unplanned readmission. We should discuss the function and features of discharge plan to build up complete discharge service that meets cancer patients’ needs. The relationships between nutrition status, nursing direction and unplanned readmission need more research to be verified.