Дисертації з теми "Healthcare programmes"
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Evans, Amanda. "Interprofessional collaborative practice in healthcare : perceptions and experiences of healthcare students undertaking accelerated pre-registration programmes in the practice placement setting." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/interprofessional-collaborative-practice-in-healthcare(a159fb2d-29bd-4364-b0e5-c7eb6ab7ed9d).html.
Повний текст джерелаLehl, S. "Healthcare practitioners' and patients' perspectives of a weight management service and the place of psychological support within this." Thesis, University of Wolverhampton, 2016. http://hdl.handle.net/2436/617877.
Повний текст джерелаNeves, Ana Margarida Lopes das. "Efeitos da formação na prevenção de lesões músculo-esqueléticas da coluna lombar nos profissionais de saúde : revisão sistemática." Master's thesis, Universidade Nova de Lisboa. Escola Nacional de Saúde Pública, 2012. http://hdl.handle.net/10362/9708.
Повний текст джерелаABSTRACT - Morbidity from lumbar spine musculoskeletal disorders is estimated to be around 0.8 million DALYS worldwide and is the main cause of absenteeism from work, causing high economic and social losses. Healthcare professionals are one of the most vulnerable groups to work-related musculoskeletal disorders (WRMSD), namely those moving and handling patients everyday. Facing the frequent perspective of unchanging working conditions, organisational pressure on healthcare and the lack of human resources, programmes focused on training healthcare professionals in patient mobilisation techniques are implemented in order to prevent WRMSD associated with this activity. The aim of this study was to focus on the main interventions described in the bibliography concerning the impact of healthcare professional training on patient handling, more specifically nurses, with regard to helping to prevent WRMSD of the lumbar spine. A systematic review was conducted according to the Prisma Statement® method based on data from PubMed, Web of Science, B-On, JSTOR, Science, Nature, Scielo and IndeX, between 1998 and 2011, in Portuguese, English and French. 79 articles were found and after screening and assessing the quality of the studies, 11 were selected and analysed. There is no scientific evidence to warrant investment in programmes focused on healthcare professional training/information on patient mobilization techniques to prevent musculoskeletal disorders of the lumbar spine. Multifactorial intervention programmes based on systemic and integrative components allow us to understand the relationship between workers, their work and health-related issues and how to implement efficient WRMSD prevention measures.
Arrighi, Yves. "Essays in the economics of health policies." Thesis, Aix-Marseille, 2013. http://www.theses.fr/2013AIXM1094.
Повний текст джерелаThis dissertation aims at improving our understanding of the links between health and wealth, and between health programs and macroeconomic outcomes. Because the former might be bi-directional, it seemed sensible to tackle this issue for each direction of the causality. In the 1st paper, I examine using microsimulation the financial solvability of alternative policies against HIV. Health improvements at the individual level generate productivity gains which translate into an economic surplus that outweighs programs’ costs. In the 4th paper, I examine the relationship between child health and social background using an international survey. Analysis reveals a substantial gradient in health: across the globe, poorer children have worse health. Yet, the effect of wealth is moderated by country-level income and health-supply variables. The two other papers focus on rather methodological issues raised by the fact that curative programs save lives but increase the prevalence of the disease. One study highlights that average income could fall if treatments cannot guarantee a sufficient level of productivity among sick workers. Despite this adverse effect, the microsimulation model demonstrates that treatment policies can raise per capita income in the context of HIV. The 3rd paper of the thesis extends this message to welfare measurement. By restricting attention to the living population, standard indicators of welfare ignore the fact that individuals who would otherwise be dead can be kept alive through treatment, but with a lower than average welfare. Cross-country comparisons based on indicators that are made invariant to the population size may therefore be biased
Patel, Deepak N. "Participation in a health promotion programme and healthcare costs : cross-sectional research of the Discovery Vitality programme." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/11687.
Повний текст джерелаIncludes bibliographical references (leaves 55-61).
To examine the association between 1) the levels of participation in an incentive based health promotion program (study1), 2) the level of engagement with the fitness related activities (Study2) and medical claims and hospital admission amongst adult members of a major health insurer.
Bradley, Dominique K. F. "The 'Productive Community Services' programme : implementing change in a community healthcare organisation." Thesis, University of Essex, 2015. http://repository.essex.ac.uk/15475/.
Повний текст джерелаJaafaripooyan, Ebrahim. "Contextual approach to the performance analysis of Iran's national accreditation programme for healthcare organisations." Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/210549/.
Повний текст джерелаMa, Y. "The development and evaluation of a breastfeeding training programme for healthcare professionals in China." Thesis, Coventry University, 2015. http://curve.coventry.ac.uk/open/items/53d0027f-3864-4a21-9ef9-3a1e48879927/1.
Повний текст джерелаOnate, Öberg Bernard. "Jämförelse av bildkvalité mellan standardsskelettscintigrafi och programmet Evolution for Bone TM i GE-healthcare gammakamera." Thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-68429.
Повний текст джерелаHale, Rachel. "An actor-network analysis of the healthcare worker influenza immunisation programme in Wales, 2009-2011." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/33126/.
Повний текст джерелаOlsson, Jesper. "Factors for successful improvement of Swedish healthcare /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-391-4/.
Повний текст джерелаMeakin, Stephanie. "Exploring the potential of the pre-registration programme for developing student nurses as future clinical leaders within contemporary healthcare." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/366261/.
Повний текст джерелаLindsay, Claire Frances. "Lean in healthcare : an evaluation of Lean implementation in NHS Lothian." Thesis, Edinburgh Napier University, 2016. http://researchrepository.napier.ac.uk/Output/455610.
Повний текст джерелаWang, Chen. "Intercultural competence and short-term overseas study programs: An investigation with healthcare students." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/134412/1/Chen_Wang_Thesis.pdf.
Повний текст джерелаDolatabadi, Mjid Davari. "Does the Iranian health system need a health technology assessment programme to improve effectiveness, efficiency and equity of its healthcare services?" Thesis, University of Liverpool, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.501580.
Повний текст джерелаTucker, Faye Bronwyn. "An assessment of the Isoniazid preventative therapy programme for children in a busy primary healthcare clinic in Nelson Mandela Bay, Eastern Cape Province." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15737.
Повний текст джерелаSingh, Jitendra, and Tracy Eisenschenk. "A Thematic Analysis of the Attitudes and Perceptions of Faculty Towards Inclusion of Interprofessional Education in Healthcare Curriculum." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/ijhse/vol8/iss1/1.
Повний текст джерелаGajaria, Asha. "Alignment of Patient and Provider Views in Health Care Intervention Programs: A Study of the Centre for Healthy Active Living at the Children’s Hospital of Eastern Ontario." Thèse, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/30386.
Повний текст джерелаEnsley, Tucker, KariLynn Dowling-McClay, Jeffrey Gray, Susie Crowe, and Katelyn Alexander. "Preceptor Perceptions of Contemporary Practice Skills Amongst New Graduates Amid Community Pharmacy Transformation." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/1.
Повний текст джерелаPougheon, Bertrand Dominique. "Partenariat patient dans une démarche d’amélioration de la qualite des soins : l’expérience du programme qualité en mucoviscidose." Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCD067/document.
Повний текст джерелаBackground: A quality improvement program (QIP) has been implemented since 2011 inthe CF care network in France adapting the Learning and Leadership Collaborative programdeveloped in the US by the CF Foundation and the Dartmouth Institute for the American CFCentre network.Objective: Assess the contribution of patients and parents of children with CF engaged inthe CF center quality improvement teams, besides their care team, to improve care in theircenter.Method: Mixed design research including a quantitative study focusing on patient outcomesevolution and a qualitative study according to a realist approach using a questionnaire andfocus groups to patients, parents and professionals engaged in the QIP.Results: Participants attested of the good conditions implemented by the QIP to allowpatient and parent engagement, a consensus about the appropriation of the quality methodand tools, the usefulness of the program to improve the quality of care; in the end, patientand parent engagement in the QIP was found to be a given and an asset.Discussion: The QIP has developed collaborative practice in multidisciplinary teams andwith patients and parents. Organizational improvements were concurrent with a cultural shifttowards a culture of quality improvement. Patient and parent engagement in a QIP within theclinical microsystem is a major development for the improvement of the health care system
Vilar, Bruno Siqueira Campos Mendonça 1982. "Context driven workflow adaptation applied to healthcare planning = Adaptação de workflows dirigida por contexto aplicada ao planejamento de saúde." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/275505.
Повний текст джерелаTese (doutorado) - Universidade Estadual de Campinas, Instituto de Computação
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Resumo: Sistemas de Gerenciamento de Workflows (WfMS -- em inglês) são usados para gerenciar a execução de processos, melhorando eficiência e eficácia de procedimentos em uso. As forças motrizes por trás da adoção e do desenvolvimento de um WfMS são aplicações científicas e de negócios. Esforços conjuntos de ambos resultaram em mecanismos consolidados, além de padrões e protocolos consensuais. Em particular, um WfMS científico (SWfMS -- \textit{Scientific WfMS}) auxilia cientistas a especificar e executar experimentos distribuídos. Ele fornece diferentes recursos que suportam atividades em um ambiente experimental, como prover flexibilidade para mudar o projeto de workflow, manter a proveniência e suportar reproducibilidade de experimentos. Por outro lado, apesar de poucas iniciativas de pesquisa, WfMSs não fornecem suporte apropriado à personalização dinâmica e baseada em contexto durante a execução; adaptações em tempo de execução normalmente requerem intervenção do usuário. Esta tese se concentra em superar essa deficiência, fornecendo a WfMSs um mecanismo de ciente do contexto para personalizar a execução de workflows. Como resultado, foi projetado e desenvolvido o DynFlow -- uma arquitetura de software que permite tal personalização aplicada a um domínio: planejamento de saúde. Este domínio foi escolhido por ser um ótimo exemplo de personalização sensível ao contexto. Procedimentos de saúde constantemente sofrem mudanças que podem ocorrer durante um tratamento, como a reação de um paciente a um medicamento. Para suprir a demanda, a pesquisa em planejamento de saúde desenvolveu técnicas semi-automáticas para suportar mudanças rápidas dos passos de fluxos de tratamento, de acordo com o estado e a evolução do paciente. Uma dessas técnicas é \textit{Computer-Interpretable Guidelines} (CIG), cujo membro mais proeminente é \textit{Task-Network Model} (TNM) -- uma abordagem baseada em regras capaz de construir um plano em tempo de execução. Nossa pesquisa nos levou a concluir que CIGs não suportam características necessárias por profissionais de saúde, como proveniência e extensibilidade, disponíveis em WfMSs. Em outras palavras, CIGs e WfMSs têm características complementares e são direcionadas à execução de atividades. Considerando os fatos citados, as principais contribuições desta tese são: (a) especificação e desenvolvimento do DynFlow, cujo modelo associa características de TNMs e WfMS; (b) caracterização das principais vantagens e desvantagens de modelos CIGs e WfMSs; (c) implementação de um protótipo, baseado em ontologias e aplicadas ao domínio da saúde e enfermagem
Abstract: Workflow Management Systems (WfMS) are used to manage the execution of processes, improving efficiency and efficacy of the procedure in use. The driving forces behind the adoption and development of WfMSs are business and scientific applications. Associated research efforts resulted in consolidated mechanisms, consensual protocols and standards. In particular, a scientific WfMS helps scientists to specify and run distributed experiments. It provides several features that support activities within an experimental environment, such as providing flexibility to change workflow design and keeping provenance (and thus reproducibility) of experiments. On the other hand, barring a few research initiatives, WfMSs do not provide appropriate support to dynamic, context-based customization during run-time; on-the-fly adaptations usually require user intervention. This thesis is concerned with mending this gap, providing WfMSs with a context-aware mechanism to dynamically customize workflow execution. As a result, we designed and developed DynFlow ¿ a software architecture that allows such a customization, applied to a specific domain: healthcare planning. This application domain was chosen because it is a very good example of context-sensitive customization. Indeed, healthcare procedures constantly undergo unexpected changes that may occur during a treatment, such as a patient¿s reaction to a medicine. To meet dynamic customization demands, healthcare planning research has developed semi-automated techniques to support fast changes of the careflow steps according to a patient¿s state and evolution. One such technique is Computer-Interpretable Guidelines (CIG), whose most prominent member is the Task-Network Model (TNM) -- a rule based approach able to build on the fly a plan according to the context. Our research led us to conclude that CIGs do not support features required by health professionals, such as distributed execution, provenance and extensibility, which are available from WfMSs. In other words, CIGs and WfMSs have complementary characteristics, and both are directed towards execution of activities. Given the above facts, the main contributions of the thesis are the following: (a) the design and development of DynFlow, whose underlying model blends TNM characteristics with WfMS; (b) the characterization of the main advantages and disadvantages of CIG models and workflow models; and (c) the implementation of a prototype, based on ontologies, applied to nursing care. Ontologies are used as a solution to enable interoperability across distinct SWfMS internal representations, as well as to support distinct healthcare vocabularies and procedures
Doutorado
Ciência da Computação
Doutor em Ciência da Computação
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.
Повний текст джерелаRESUMO - 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.
Roepke, William B., Charles A. Edwards, and Nicholas I. McIntire. "Combating the physician shortage in rural America by increasing early exposure to the medical field through the use of summer medical camps." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/190.
Повний текст джерелаVan, Dyk D. L., and H. Bezuidenhout. "Learning experiences of students during integrated management of childhood illness (IMCI) training." Journal for New Generation Sciences, Vol 11, Issue 2: Central University of Technology, Free State, Bloemfontein, 2013. http://hdl.handle.net/11462/641.
Повний текст джерелаThe aim of the study on which this article is based was to reflect on the learning experiences of students during integrated management of childhood illness (IMCI) training in an undergraduate programme. IMCI is a set of guidelines that was established by the World Health Organisation (WHO) for cost-effective quality care for children younger than five to prevent diseases and death (WHO, 2004). Skilled primary healthcare workers are required to provide quality care at first contact with these children. The IMCI package was presented as an integral part of the second-year module that focuses on primary healthcare. In order to improve the quality of health services and refocus the health system on primary health-care (South Africa Department of Health, 2010), students have to demonstrate that they have achieved competence. According to Killen (2000:188), competence is a holistic term and focuses on knowledge, skills and values instead of competencies, which refer to specific capabilities. Primary health-care workers who act competently will integrate foundational IMCI knowledge with skills and values as well as with the ability to verify their decisions (Killen, 2000:188). Aqualitative, exploratory and descriptive research design was used to investigate the IMCI learning experiences. Such experiences are one of the indications whether training has been successful and how it can be improved (Suski, 2004:222). Data was collected by means of nominal-group technique (NGT) interviews with second-year nursing students of the training school who complied with the criteria for inclusion. NGT interviews were used effectively to evaluate clinical interaction, education and training.The findings reflected the different emotions experienced during teaching and learning as having been positive, negative or neutral. The consideration of negative emotions will assist with the improvement of IMCI teaching and learning, but all these findings can be useful for other higher-education institutions that present or plan to present IMCI training.
Silva, Cristiane Pavanello Rodrigues. "Proposta de avaliação de programas de controle de infecção hospitalar: validação das propriedades de medidas e diagnóstico parcial de conformidade em serviços de saúde do município de São Paulo." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-29042010-112347/.
Повний текст джерелаThe objective of this study was to develop methodology that could ultimately be made available as a system for assessing Hospital Infection Control and Prevention Programs (HICPP), after validation of its measurement properties, which enable practical application in situational diagnoses, whose results provide both improvements in the area and reliable information about the quality of these HICPPs in each healthcare institution. To do so, the content of four indicators was constructed and validated beforehand: 1- (PCET) Technical-operational structure of the HICPP; 2- (PCDO) Operating Guidelines for Control and Prevention of HI; 3- (PCVE) Epidemiological Surveillance System for HI; 4- (PCCP) HI Prevention and Control Activities. The specific objectives were: fully validate (construct and discriminant) and test the reliability (internal consistency) of measurement properties; carry out a partial diagnosis of conformity of the HICPPs in São Paulo Municipal Healthcare Facilities. The HICPP indicators were applied in 50 healthcare institutions, which participated voluntarily in the study. The hospital profile characteristics and the scores of the indicators were described using descriptive statistics. Internal consistency was analyzed using the Cronbach coeficient; the analysis of discriminant validity was carried out by comparing the scores of the indicators between the two groups of hospitals, (those which had some type of quality certification versus those which did not) and exploratory factor analysis with a tetrachoric correlation matrix was used to analyze the validity of the construct. The indicators 1-PCET and 3-PCVE varied little, with almost 100% conformity throughout the sample, whereas the indicators 2-PCDO and 4- PCCP presented good internal consistency with a variation of 0.67 to 0.80; discriminant validity of these indicators showed higher average scores of conformity and were statistically significant in the group of institutions with certification or accreditation; in the validation of the construct it was possible to differentiate and determine 2 dimensions for PCDO (factor 1- recommendations for prevention of HI and factor 2 recommendations for the standardization of prophylaxis procedures), with good correlation of the units of analysis that composed it. The same occurred for PCCP (factor 1 interface with treatment units and factor 2 interface with support units). All of the indicators, with the exception of 4- PCCP, which ranged from 9.5% to 100%, presented scores of > 90%, which show that the HICPPs of participating hospitals have a good standard of quality, with higher average scores in the institutions with certification or accreditation. This study enabled the validation of the measurement properties of the HICPP indicators and produced a practicable HICPP assessment tool in an ethical and scientific manner for diagnosis of quality in this area.
Staines, Anthony. "La relation "programme qualité" / "résultats cliniques" : du concept à sa mise en oeuvre dans trois systèmes hospitaliers : le Conseil de Comté de Jönköping (Suède), Intermountain Healthcare (Etats-Unis) et le groupe Reinier de Graaf (Pays-Bas)." Lyon 3, 2007. https://scd-resnum.univ-lyon3.fr/in/theses/2007_in_staines_a.pdf.
Повний текст джерелаQuality methods of many different types have been used in hospitals. Some specific projects have shown improved results, but there is no strong evidence of the effectiveness of institutionwide quality improvement (QI) programs. This research deals with a specific category of QI programs: those recognised by experts as world class. Three such programs are examined in a case study, investigating their content, implementation, perception and results. The study shows that QI programs can lead to improved clinical results. It documents improvements measured on process indicators for each of the cases and one or a few improved clinical outcomes in two of the cases. The concept of an investment threshold is proposed and explained, a zone of noise delaying evidence of improved results to show, as well as a set of factors increasing or decreasing the effectiveness of QI programs
Nascimento, Fabiana Alves do. "A Vigilância Alimentar e Nutricional brasileira na produção científica e nos serviços de saúde." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/6/6138/tde-21122016-104756/.
Повний текст джерелаIntroduction: The Food and Nutrition Surveillance (FNS) is a set of surveillance strategies within the Health Surveillance, which includes the National Food and Nutrition Surveillance System (Sistema Nacional de Vigilância Alimentar e Nutricional - SISVAN), that aims at continuously monitoring and analyzing the food and nutritional status of the population attended by the Brazilian National Health System (Sistema Único de Saúde - SUS) and supporting actions, programs and policies. Objectives: to describe the Brazilian scientific literature on FNS and analyze to what extent the studies approach is linked/associated to the concept of the National Food and Nutrition Policy (2012); to analyze the coverage of the assessment of the nutritional status and the food intake of the users of the public health services registered on the Web SISVAN between 2008 and 2013. Methods: This study is organized in two methodological axes: a literature review on the concept of FNS present in recent Brazilian scientific production and two original ecological studies describing the assessment of the coverage of the nutritional status and food intake from the Web SISVAN data. Results: In the literature review, we found that the papers were mainly focused on the analysis of population surveys with smaller contribution of studies on health information systems and evaluation of health services. In the original studies, the average full coverage in Brazil ranged from 9.78 per cent to 14.92 per cent for the nutritional status and from 0.13 per cent to 0.41 per cent for the food intake. Both showed statistically significant trends of increase and differences between the Brazilian Federal Units and macro-regions. The FNS was prioritized for mother-child pairs, priority public of the Bolsa Familia Program, in the case of nutrition status data, and related to the presence of nutritionists in the primary healthcare services, in the case of food intake data. Conclusion: We presented an overview of recent scientific literature on FNS and of the monitoring of nutritional status and food intake in the Brazilian health services, revealing contexts where resources need to be mobilized to improve the FNS.
Adão, Izaltina. "Aplicação do instrumento worksite health scorecard para avaliar programas de promoção da saúde no ambiente de trabalho de indústrias catarinenses." reponame:Repositório Institucional do FGV, 2018. http://hdl.handle.net/10438/24192.
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As doenças crônicas não transmissíveis são um problema crescente nos países. Os custos econômicos relacionados ao adoecimento e afastamentos do trabalho não param de aumentar. Empregadores estão implementando programas de promoção da saúde no local de trabalho para melhorar a saúde dos trabalhadores, a produtividade e reduzir os custos com os adoecimentos. Neste sentido, o objetivo principal deste Trabalho Aplicado foi avaliar os programas de promoção da saúde no ambiente de trabalho, oferecidos em uma amostra composta por 114 indústrias do Estado de Santa Catarina. Para isso, aplicou-se o instrumento Worksite Health ScoreCard (HSC) para avaliar o resultado dos programas de promoção da saúde. Foi possível identificar na revisão da literatura que a avaliação dos programas deve se concentrar em questões relevantes e úteis, promover um ciclo contínuo de melhorias de qualidade, eficiência e eficácia dos investimentos, além de identificar lacunas potenciais nas atuais ofertas. O resultado da pesquisa permitiu analisar que, a amostra de 114 indústrias atingiu 23,58% da pontuação máxima possível entre as estratégias e intervenções promotoras de saúde no ambiente de trabalho avaliadas com o HSC. Sobretudo, a pesquisa evidenciou que, os programas de saúde ofertados pelas indústrias participantes, em sua maioria, não correspondem aos conceitos de programas abrangentes, com estratégias e intervenções integradas às principais necessidades de saúde populacional. Notou-se que as estratégias e intervenções promotoras de saúde, aconteceram de forma isolada e não foram priorizadas de acordo com aquelas que são capazes de contribuir com melhores resultados organizacionais e nos comportamentos de saúde, e que refletem nas principais causas de adoecimentos e afastamentos do trabalho.
Chronic non-communicable diseases are a growing problem in many countries. Economic costs related to worker illness and absences continue to rise. Employers are implementing health promotion programs at the workplace to improve worker health, productivity and reduce costs related to illness. In this context, the main objective of this Applied Study was to evaluate health promotion programs at the workplace, offered in a sample composed of 114 industrial sectors in Santa Catarina state. To do so, the Worksite Health ScoreCard (HSC) was used to evaluate the results of health promotion programs. A review of the literature indicated that the evaluation of programs should be focused on relevant and useful issues, promote a continuous cycle of improvements in quality, efficiency and effectiveness of investments, and identify potential gaps in currently offered measures. The study revealed that the sample of 114 industrial sectors attained 23.58% of the maximum possible score for the strategies and interventions they use to promote health at the workplace that were evaluated with the HSC. Above all, the study revealed that most of the healthcare programs offered by participating companies do not correspond to the concepts found in broad programs with strategies and interventions that are integrated to the population’s main health needs. It was found that strategies and interventions that promote health are implemented in an isolated manner and were not given priority by those who are capable of contributing to better results at a company and in health-related behavior. This is reflected in the main causes of illness and work absence.
Muller, Allison. "Bon usage des antibiotiques : résultats d'actions dans différents types d'établissements de santé." Thesis, Bourgogne Franche-Comté, 2017. http://www.theses.fr/2017UBFCE021/document.
Повний текст джерелаBacterial resistance to antibiotics is a worldwide public health issue which is mainly linked to antibiotic misuse (overconsumption and inappropriate prescription).To fight this threat, recommendations from learned societies and national action plans have been set up. Even if they are necessary, they are not sufficient to provide a significant improvement in the antibiotic use. A high rate of non-compliance with the recommendations is observed among healthcare facilities (HCFs). The setting up of proactive antimicrobial stewardship programs (ASP) among every HCF is essential to improve antibiotic use: an action on prescribers’ behavior is necessary, by using various strategies. These strategies, however persuasive or restrictive, have been shown to be effective, with no clinical negative effects for the patients (no increase in mortality and in length of stay), while reducing anti-infective costs.With this work, we aimed to study the appropriateness of antibiotic use in hospitals, at different HCFs levels (local hospital, university hospital, 259 French HCFs cohort), by assessing the impact of national recommendations or local ASP and guidelines. These studies showed that national recommendations could lead to a reduction in carbapenem consumptions, and that an ASP conducted in a local hospital could be very effective to reduce fluoroquinolones consumptions, and bacterial resistance at a longer term. Targeted audits on aminoglycosides prescription and on surgical antibioprophylaxis have permitted to highlight recurrent non-compliances, guiding improvement measures to set up.In conclusion, this work supports the weight of ASPs among each HCF, whatever type and size. Indeed, these ASPs, set up in support of the national recommendations, have demonstrated their effectiveness in reducing antibiotic consumptions and improving prescription appropriateness, by their positive impact on prescribers’ behaviors
Panchalingam, Thadchaigeni. "Three Essays on the Economics of Food, Health, and Consumer Behavior." The Ohio State University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=osu1618834416383345.
Повний текст джерелаDaldon, Maria Teresa Bruni. "Processo de trabalho dos profissionais de saúde em vigilância em saúde do trabalhador." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5163/tde-18012013-104545/.
Повний текст джерелаThis qualitative research is an attempt to understand working process of public healthcare providers who work in Surveillance of Workers\' Health of the Health Surveillance Coordination and of the Reference Center for Workers\' Health within the city of São Paulo. It has sought to understood the strategies, resources, and tools used by these professionals, in addition to identifying the real actions and the meanings assigned by them for their practice. It Intended to also give visibility to their \"intelligence at work\", believing that their experience and knowledge can contribute to the improvement and development of public health policies/work and their own actions in Surveillance of Workers\' Health. It was developed based on theoretical references of work psychodynamics and those of the French-Belgian school of ergonomics. The methodology used was the \"case study\". Government documents, laws and acts of federal, State and local conferences, relating to Public Health at the Brazilian Unified Healthcare System, and those in the area of Workers\' Health, in particular at the VST, were consulted. A study was made of the relevant bibliography to the area, produced between 1980 and 2011. This material was used as a simple data source, and how to information for the understanding of theoretical references, policies and guidelines that governs the work of professionals in Surveillance of Workers\' Health. The fieldwork started with a questionnaire answered by professionals of services in focus, in order to characterize those multi professional teams. The data allowed making a diagnosis of the universe studied and worked to orient to the choice, by representativeness criteria, of 13 professionals who would be invited to participate in semi-structured interviews. Data from the interviews were treated by the method of \"content analysis\", with focus on work process, in dynamics of planning, development and evaluation of the actions of Surveillance of Workers\' Health, from the perception of professionals that perform. Among the results, we see that the Surveillance of Workers\' Health is not a linear process, is subject to tensions and conflicts of various natures that should be considered in the establishment of the criteria adopted for its evaluation, in the pursuit of advances in reach of these actions. Considering the insufficient recognition processes and lack of exchange of experience, and adding to that, the approaching retirement of most professionals working in Surveillance of Workers\' Health in the municipality, highlighted the possibility that the \' know-how \' built up could be lost. The lack of human and material resources and of training processes can bring harm to work. The disorderly manner as has being accepted the demand of work-related accidents in the municipality and the insufficient number of health authorities to meet this demand may be compromising the quality and the effective capacity of Surveillance of Workers\' Health. We found that the lack of clarity about the actions of workers health developing by the Reference Center for Workers\' Health and by Health Surveillance Coordination, in times of National Network of Integral Attention to the Health of the Worker, and the lag between prescribed and real work, may be making it difficult to build up effective a Surveillance of Workers\' Health. With the precariousness of planning, evaluation and systematization, the \"Surveillance of Workers\' Health\" actions may be moving away from its goal of prevention and health promotion.
Pinaire, Jessica. "Explorer les trajectoires de patients via les bases médico-économiques : application à l'infarctus du myocarde." Thesis, Montpellier, 2017. http://www.theses.fr/2017MONTS020/document.
Повний текст джерелаWith approximately 120,000 people affected each year, 12,000 deaths from the first crisis and 18,000 deaths after one year, myocardial infarction is a major public health issue. This pathology requires hospitalization and management in an intensive care cardiology unit. We study this pathology using the French national Prospective Paiement System (PPS) databases.The collection of national hospital data within the framework of the PPS generates about 25 million records per year.These data, which are initially collected for medico-economic purposes, contain information that may have other purposes: improving patient care, predicting the evolution of care, planning their costs, etc.Another emerging issue is that of providing tools for exploring patients' hospital trajectories using data from the PPS. Through several objectives, this thesis aims to suggest tools combining methods from three disciplines: medical computing, data mining and biostatistics.We make four contributions.The first contribution concerns the constitution of a quality database to analyze patient trajectories. The second contribution is a semi-automatic method for the systematic review of the literature. This part of the work delineates the contours of the trajectory concept in the biomedical field. The third contribution is the identification of care trajectories in the prediction of intra-hospital death. Our research strategy is divided into two phases: 1) Identification of typical patient trajectories using data mining tools; 2) Construction of a prediction model from these trajectories to predict death. Finally, the last contribution is the characterization of patient flows through the various hospital events, also considering of delays and costs. In this contribution, we propose a combined-data mining and a longitudinal data clustering technique
Bressan, Aparecida Isabel. "A disponibilidade de aceleradores lineares para o tratamento do câncer no Brasil e as teses de focalização e simplificação do SUS." reponame:Repositório Institucional da FIOCRUZ, 2010. https://www.arca.fiocruz.br/handle/icict/2344.
Повний текст джерелаEsse trabalho analisa a disponibilidade de aceleradores lineares para o tratamento do câncer no Brasil na década de 2.000 a partir dos dados provenientes das pesquisas de Assistência Medição-Sanitária AMS/IBGE e do Cadastro Nacional de Estabelecimentos de Saúde CNES e da Comissão Nacional de Energia Nuclear CNEN. Descreve-se a localização geográfica dos equipamentos, especialmente nas grandes regiões, a disponibilidade ao SUS e aos planos privados de saúde e a natureza institucional dos estabelecimentos de saúde onde estão instalados e aplicados parâmetros oficiais de suficiência. As bases técnicas de sua utilização são descritas para mostrar a importância desses equipamentos de alta complexidade no controle do câncer,mostrado aqui como problema de saúde pública no Brasil. São também expostas as principais iniciativas públicas para a alocação de aceleradores lineares a partir dos anos de 1990: o Projeto REFORSUS, O Programa de Reequipamento da Rede Assistencial Privada do SUS e o Projeto Expande. São identificados os fundamentos e os elementos que nortearam a execução dessas iniciativas. Os achados são utilizados para analisar se a política pública de saúde brasileira, a partir dos anos de 1990 atendeu às teses de focalização e simplificação assistencial contidas nas propostas do Banco Mundial de 1993. Essas teses incluíam a focalização das ações de saúde nos grupos sociais mais necessitados, a simplificação da assistência, com base numa cesta básica de serviços,e a busca da promoção do setor privado por meio da expansão dos seguros de saúde, num contexto em que a dívida externa brasileira levaria o país a submeter-se a fórmulas de ajuste fiscal impostas por organismos internacionais.
The availability of linear accelerator for cancer treatment in Brazil and the focalization and simplification thesis for the public system (called SUS). (Dissertation). Rio de Janeiro: Escola Nacional de Saúde Pública Sergio Arouca - Fundação Oswaldo Cruz, 2010. This work analyze the availability of linear accelerator for cancer treatment in Brazil from 2000 decade considered date from brazilian date bureau survey AMS/IBGE, from Brazilian Ministry of Health survey - CNES and brazilian nuclear energy bureau - CNEN. The geographical location of the equipment is described, especially on the major regions, availability to SUS and private health plans and the institutional nature of health establishments where they are installed and applied official sufficiency parameters. The technical bases for their use are described to show the importance of such equipment high complexity in cancer control, shown here as a public health problem in Brazil. They are also exposed the major public initiatives for the allocation of linear accelerators from years 1990: the Health Sector Reform Project - REFORSUS, the program Reequipamento da Rede Assistencial Privada do SUS and the program Expande, identified their fundamental principles and the elements that have guided its implementation. The findings are used for analyzing whether the Brazilian health policy from the years 1990 attend the focalization and assistive simplification, contained in the proposals of the World Bank in 1993. These theses included the focus of health assistance in the poorest social groups, and simplification of assistance, on the basis of a "basic" basket of services, and promotion of the private sector through the expansion of health insurance, in a context in which the brazilian external debt would lead the country to fiscal adjustment formulas.
Pathak, Amit. "Forecasting Models to Predict EQ-5D Model Indicators for Population Health Improvement." Ohio University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1480959312370497.
Повний текст джерелаSantos, Manuel Taveira da Fonseca Ferreira dos. "Analysis, investment and innovation programme in imaging equipment to improve healthcare diagnosis." Master's thesis, 2021. https://hdl.handle.net/10216/134295.
Повний текст джерелаSantos, Manuel Taveira da Fonseca Ferreira dos. "Analysis, investment and innovation programme in imaging equipment to improve healthcare diagnosis." Dissertação, 2021. https://hdl.handle.net/10216/134295.
Повний текст джерелаVan, Wyk Heila. "Interprofessional education programme to develop teamwork among undergraduate healthcare students during community fieldwork." Diss., 2016. http://hdl.handle.net/2263/53052.
Повний текст джерелаDissertation (MOccTher)--University of Pretoria, 2016.
Occupational Therapy
MOccTher
Unrestricted
Ibarra, Kimberley. "Exploring Ethicists' Perspectives of Healthcare Ethics Program Effectiveness." Thesis, 2013. http://hdl.handle.net/1807/42964.
Повний текст джерелаReilly, Siobhan, C. McCabe, N. Marchevsky, M. Green, L. Davies, N. Ives, H. Plappert, et al. "Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme." 2001. http://hdl.handle.net/10454/18576.
Повний текст джерелаThere is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012-2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14-68) and 24% were from primary care (median, 10; IQR, 5-20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.
This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (grant reference no. RP-PG-0611-20004). Professors Siobhan Reilly, Richard Byng and Max Birchwood are partially supported by the NIHR Applied Research Collaboration (ARC) for North West Coast, Care South West Peninsula and West Midlands, respectively.
Reilly, Siobhan T., C. McCabe, N. Marchevsky, M. Green, L. Davies, N. Ives, H. Plappert, et al. "Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme." 2021. http://hdl.handle.net/10454/18576.
Повний текст джерелаThere is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012-2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14-68) and 24% were from primary care (median, 10; IQR, 5-20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.
This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (grant reference no. RP-PG-0611-20004). Professors Siobhan Reilly, Richard Byng and Max Birchwood are partially supported by the NIHR Applied Research Collaboration (ARC) for North West Coast, Care South West Peninsula and West Midlands, respectively.
Williams, Adri. "The 2010 PMTCT programme as implemented at community healthcare centres in the Limpopo province: a nursing perspective." Thesis, 2016. http://hdl.handle.net/10539/23165.
Повний текст джерелаMT2017
Sykes, Chris. "Being a student nurse: role duality issues for healthcare assistants undertaking a work-based learning pre-registration nursing programme." Thesis, 2019. https://arro.anglia.ac.uk/id/eprint/705287/1/Sykes_2019.pdf.
Повний текст джерелаLawal, Afeez Folorunsho. "Between policy and reality: a study of a community based health insurance programme in Kwara State Nigeria." Thesis, 2020. http://hdl.handle.net/10500/27847.
Повний текст джерелаThe challenge of accessing affordable healthcare services in the developing countries prompted the promotion of community-based health insurance (CBHI) as an effective alternative. CBHI has been implemented in many countries of the South over the last three decades for the purpose of improving access and attaining universal health coverage. However, the sudden stoppage of a CBHI programme in rural Nigeria raised a lot of concerns about the suitability of the health financing scheme. Thus, this thesis examines the stoppage of the CBHI programme in rural Kwara, Nigeria. Premised on the health policy triangle as a conceptual framework, mixed methods approach was adopted for data collection. This involved 12 focus group discussions, 22 in-depth interviews, 32 key informant interviews and 1,583 questionaires. The study participants were community members, community leaders, healthcare providers, policymakers, international partner, health maintenance organisation officials and a researcher. Findings revealed that transnational actors relied on various resources (e.g. fund and ‘expertise’) and formed alliances with local actors to drive the introduction of the programme. As such, the design and implementation of the policy were dominated by international actors. Despite the sustainability challenges faced by the programme, the study found that it benefitted some of the enrolled community members. Though, even at the subsidised amount, enrolment premium was still a challenge for many. The main reasons for the stoppage of the programme are a paucity of fund and poor management. The stoppage of the programme, however, signified a point of reversal in the relative achievements recorded by the CBHI scheme because community members have deserted the healthcare facilities due to high costs of care. In view of these, the thesis notes that short-term policies often lead to temporary outcomes and suggests the need to repurpose the role of the state by introducing a long-term comprehensive healthcare policy – based on the reality of the nation – to provide equitable healthcare services for the citizenry irrespective of their capacity to pay.
Sociology
D. Phil. (Sociology)
Sousa, Oloiva Maria Tavira da Silva e. "Impacto da implementação do sistema de gestão da qualidade em unidades de saúde – estudo de caso numa unidade de saúde." Master's thesis, 2018. http://hdl.handle.net/10348/9143.
Повний текст джерелаOs serviços de saúde e os profissionais de saúde, para melhorar e garantir a qualidade dos serviços, precisam de ferramentas de gestão para atingir resultados satisfatórios. Assim, o presente trabalho teve como finalidade estudar a Impacto da Implementação do Sistema de Gestão da Qualidade (SGQ) na Unidade Local de Saúde do Nordeste (ULSNE), EPE, unidades hospitalares de Mirandela, Macedo de Cavaleiros e Bragança. A razão da escolha destas unidades teve como base o SGQ e no modelo de acreditação, i.e., o Caspe Healthcare Knowledge Systems (CHKS), implementado nas unidades de Mirandela no ano de 2003 até 2015 e nas unidades de Bragança e Macedo de Cavaleiros do ano de 2006 até ao ano de 2015. Também se escolheu este tema por ser atual e muito importante para o crescimento das organizações e profissionais de saúde. O estudo foi feito através de uma pesquisa exploratória, recorrendo a uma revisão de literatura e à aplicação de questionários adaptado à estrutura organizacional da ULSNE, EPE. E para entender o Impacto da Implementação do SGQ na ULSNE, aplicou-se a metodologia quantitativa e o software Statistical Package for the Social Science (SPSS) para tratamento dos dados. O estudo teve uma amostra de 100 questionários respondidos, representando 7,98% do total de colaboradores da ULSNE, EPE, i.e., 1 252 colaboradores. A falta de disponibilidade dos colaboradores é indicada como motivo da reduzida amostra. A amostra reduzida e o longo tempo de resposta aos questionários (cinco meses), são apontadas como limitações do estudo. Como proposta aos próximos estudos, sugere-se: i) a continuação da pesquisa deste tema com uma amostra maior; ii) estudar o mesmo tema com questionários direcionados aos clientes e não aos colaboradores; iii) o uso da pesquisa mista como futuras investigações; e iv) uso do tema para complemento de outros trabalhos científicos. Este trabalho contribui para o corpo de conhecimento da Gestão de Serviços de Saúde porque mostra, através da investigação científica, como a atitude dos profissionais contribui para o impacto da implementação do SGQ baseado no modelo de acreditação CHKS e como, na perspetiva dos colaboradores, o SGQ contribui para o reconhecimento social e político da organização, para os trabalhos dos profissionais de saúde, para o melhor cuidado aos doentes e para a satisfação do doente/cliente. E como principais resultados destacamos os seguintes: i) O impacto da implementação do SGQ na unidade de saúde; ii) a perspetiva e atitude face à qualidade e acreditação por parte dos colaboradores é positiva; iii) relativamente à relação entre a idade dos participantes e a Perspetiva e atitude face à qualidade e acreditação, verificou-se uma correlação mais positiva e significativa (r= .296 ; p≤.05); e iv) quando comparados os colaboradores do sexo feminino e do sexo masculino, relativamente à perspetiva e atitude face à qualidade e acreditação, verifica-se que não existem diferenças significativas em função do sexo. Desta forma, podemos concluir que a implementação do SGQ na ULSNE, EPE, resultou numa atitude e perspetiva positiva dos profissionais de saúde que trabalham nas organizações estudadas.
Health services and health professionals, to improve and ensure the quality of services, need management tools to achieve satisfactory results. Thus, the present study aimed to study the Impact of the Implementation of the Quality Management System (QMS) at the Local Health Unit of the Northeast (ULSNE), EPE, hospitals of Mirandela, Macedo de Cavaleiros and Bragança. The reason for choosing these units was based on the QMS and the accreditation model, ie, Caspe Healthcare Knowledge Systems (CHKS), implemented in the units of Mirandela in the year 2003 to 2015 and in the units of Bragança and Macedo de Cavaleiros of the year from 2006 to the year 2015. We also chose this theme as it is current and very important for the growth of health organizations and professionals. The study was done through an exploratory research, using a literature review and the application of questionnaires adapted to the organizational structure of ULSNE, EPE. And to understand the Impact of QMS Implementation at ULSNE, we applied the quantitative methodology and the Statistical Package for Social Science (SPSS) software for data processing. The study had a sample of 100 questionnaires answered, representing 7.98% of the total employees of ULSNE, EPE, i.e., 1,252 employees. The lack of availability of employees is indicated as the reason for the reduced sample. The reduced sample and the long questionnaire response time (five months) are indicated as limitations of the study. As proposed to the next studies, it is suggested: i) the continuation of the research of this theme with a larger sample; ii) to study the same subject with questionnaires addressed to customers and not to employees; iii) the use of mixed research as future research; and iv) use of the theme to complement other scientific works. This work contributes to Health Service Management's body of knowledge because it shows through scientific research how the attitude of professionals contributes to the impact of the implementation of the QMS based on the CHKS accreditation model and how, from the perspective of employees, the SGQ contributes to the social and political recognition of the organization, to the work of health professionals, to better patient care and patient / client satisfaction. The main results are: i) The impact of the implementation of the QMS in the health unit; ii) the perspective and attitude towards quality and accreditation by employees is positive; iii) with respect to the relationship between the participants' age and the Perspective and attitude towards quality and accreditation, a more positive and significant correlation was verified (r = .296; p≤.05); and (iv) when female and male employees are compared, with regard to the attitude and attitude towards quality and accreditation, it is verified that there are no significant differences according to sex. In this way, we can conclude that the implementation of the QMS in ULSNE, EPE, resulted in a positive attitude and perspective of health professionals working in the organizations studied.
Duquette, Julie R. "Évaluation de l’impact des services en téléobstétrique du RUIS McGill offerts à une population de femmes inuites avec grossesse à risque élevé habitant sur la côte de la baie d’Hudson au Nunavik." Thèse, 2016. http://hdl.handle.net/1866/16285.
Повний текст джерелаHealth care accessibility to the population located in a remote region of Quebec represents a challenge for the Ministère de la santé et des services sociaux. Solution such as telemedicine has been used to mitigate this issue. Therefore RUIS McGill has developed a teleobstetric program helping Inuit women in Nunavik with their risky pregnancy. This thesis’s objective is to understand the impact of the RUIS McGill teleobstetric program on the mother and her new born health plus the cost and utilization of health services following its implementation in the Inuulitsivik Health & and Social Services Centre located on Hudson Bay Shore. Inuit women at high risk pregnancy and their children in the region of Nunavik's Hudson Bay, who are far away from specialist in obstetric, are targeted. The teleobstetric program provides access to the RUIS McGill obstetricians located in Montreal. A quasi- experimental design was used to examine three hypotheses about the mothers and their children health, the use of health services and their costs. The teleobstetric program became operational in 2006, providing the ability to be a before-after study with two groups of women, those who delivered before 2012 (pre-test) and those who delivered after 2006 (post-test). The data collection took place, in its entirety, through paper medical records of the participants allowing the analysis of 47 cases for the pre-test and 81 cases for the post-test. Variance and covariance’s analysis, logistical regression and the non-parametric Mann-Witney test has allowed to conclude that the pre-test and post-test are different for only two variables which is the weight at birth, lower in the post-test and for the blood pressure of the mother at birth, higher in the post-test. For all other variables based on the three hypothesis of this thesis, results show no significate difference between pre-test and post-test, illustrating that the same level of quality has been conserved after the implementation of the teleobstetric program. Based on results, this thesis recommends reviewing and modifying the program’s objectives; sharing telehealth communication terminals with other specialties; undertaking an assessment of the cost-based program; strictly monitor the use of the program to maximize efficiency and potential; establishing a dashboard; and undertaking a comparative evaluation study in a comparable teleobstetric service.
Pereira, Cláudia Raquel Prata. "A importância da intervenção precoce em oncologia oral." Master's thesis, 2017. http://hdl.handle.net/10284/6522.
Повний текст джерелаOral and oropharyngeal cancers are the sixth most common cancers in the world, with a high incidence and mortality rate, especially in countries where populations live on low incomes. Dentists play an important role in the prevention of oral cancer, either by the goal of changing lifestyles or by identifying lesions of the oral mucosa through a thorough examination of the oral cavity. Screening at the population level has not been encouraged, but rather the “opportunistic screening”, where patients receive an examination for signs of Oral Cancer or Potentially Malignant Injuries, even if they have not sought the consultation for this purpose. The aim of this bibliographic revision was to study the strategies and programs of early intervention of oral cancer through the consultation of articles published in the last 5 years.