The focus of the diploma thesis is to evaluate the implementation of Jindřichův Hradec Hospital's Emergency department taking into consideration mainly fulfilling the aims targeted when decision about foundation of this department had been made. There are determined four goals that are crucial for the management of the healthcare institution. Based on that, the hypotheses are built. This thesis provides information which could be used by the Jindřichův Hradec Hospital's management in the terms of deciding about quality monitoring or patients satisfaction assessment.

Hintergrund. Die zahnmedizinische Versorgung und Oralhygiene bei Menschen mit Demenz (MmD) ist auch unter Berücksichtigung der zunehmenden Anzahl der erhaltenen Zähne schwierig. Ziel der Arbeit. Es soll geklärt werden,ob das Angebot einer Beratungsstelle zum Thema Mundgesundheit und Demenz genutzt wird. Material und Methoden. Die Beratungsstelle wurde mit 3 zahnmedizinischen Spezialisten aufgebaut, und ein Jahr lang wurden die telefonischen Anfragen gesammelt sowie ausgewertet. Ergebnisse. Die zahnmedizinische Beratung wurde von 355 Anrufern (180 medizinisch-pflegerisch tätig; 175 Angehörige) im Zeitraum vom 01.06.2012 bis 31.05.2013 genutzt. Von den Anrufern wurden in den ca. 21 min dauernden Gesprächen 2535 Probleme angesprochen. Fast ein Viertel der Anrufer fragte nach einer mobilen Behandlung, und 14,4% suchten einen Zahnarzt, der auf die Behandlung der MmD spezialisiert ist. Orale Erkrankungen, die Mundhygiene und die interpersonellen Schwierigkeiten, die zwischen allen Beteiligten zur oralen Situation auftraten, wurden thematisiert. Drei Viertel des medizinisch-pflegerischen Personals fragten nach Schulungen, um die Mundgesundheit und Oralhygiene bei MmD zu verbessern. Schlussfolgerung. Die Nachfrage bei den Spezialisten zeigte, dass es großen Wissensbedarf sowohl beim Fachpersonal als auch bei den Angehörigen gibt. Die Studie belegt, dass die Probleme in der Mundhöhle von MmD breit gefächert sind. Wissen zu Mund- und Prothesenhygiene sowie den Krankheitsbildern der Mundhöhle könnte strukturiert in die Aus- und Fortbildung eingebracht werden. Neben dem Wissensdefizit wird auch deutlich,dass die zahnmedizinische Versorgungsstruktur nicht für die MmD gesichert ist. Hier sind die Politiker und die Akteure im Gesundheitswesen aufgefordert, die zahnmedizinische Versorgung in den Demenznetzwerken und -strategien zu verankern. / Background. The complexity of dental care and oral hygiene for people with dementia increases with increasing numbers of residual teeth. Aim. This study was carried out to determine whether the offer of a telephone helpline on oral health and dementia would be utilized. Material and methods. Over a period of 1 year contacts received by a telephone helpline manned by three oral healthcare staff were collected and analyzed. Results. From 01 June 2012 to 31 May 2013 a total of 355 callers (180 healthcare staff and 175 relatives) presented and discussed 2535 problems. The average duration of a call was 21 min. Almost one quarter of the callers were looking for mobile dental care services and 14,4% were looking for a dentist specializedin caring for patients with dementia. Oral disease, oral care and conflicts between stakeholders on aspects of oral health were discussed. Of the healthcare staff three quarters asked about training to improve the oral health of people with dementia. Conclusion. The demand on the specialists of the helpline showed a substantial knowledge deficit of healthcare staff and relatives. The study confirmed a wide range of oral health issues of people with dementia. Knowledge on oral and denture hygiene and on oral disease could be introduced into primary training and continued professional education. In addition to the lack of knowledge, deficits also exist in the oral healthcare system for people with dementia. Poliicians and healthcare stakeholders are encouraged to incorporate oral healthcare for people with dementia into strategies and dementia networks.

Throughout the existence of the United States there have been multiple ways to seek healthcare insurance, and healthcare services and treatment. As the country developed a system in which healthcare was distributed was created. As such, this system has created societal divisions and has caused certain people to be excluded from gaining access to healthcare insurance and treatment. From these divisions, certain stigmas and stereotypes have been created about the type of person that does not have access to healthcare. With certain historical reforms in the U.S. healthcare system being currently implemented, the healthcare system is to change dramatically. However, certain people are still being excluded from gaining access to healthcare insurance and healthcare services. The following thesis, based on research which was conducted from April to July 2014 in the Brooklyn borough of New York City, explores the manner in which recent developments and changes within the healthcare system of the United States inhibits the city’s residents from obtaining basic health care. By focusing on medical encounters, this thesis focuses on how agencies of power retain control of the body, and those that seek access to healthcare. This thesis also explores the opinion of the uninsured patients by those who volunteer at The Coalition of Concerned Medical Professionals, which is an organization that offers free healthcare services while acting as political advocates.

This thesis is a case study conducted at the Torsby hospital, medicine department in Torsby, Sweden. The hospital has some financial, communication, and process standardizing problems and was aiming to solve them by implementing lean strategies. The data for this study were collected through structured interviews and observations in the hospital. A thorough discussion of the information gathered from the interviews and the observations made are presented related to the theoretical frame of the study. The findings of this study showed that the lean concept is actually applicable to the healthcare system except for some problems that may affect the success of the lean implementation process in the hospital. By removing or fixing these problems, the hospital can reap the benefits of the implementation process. This study presents and discusses problems in question and suggests some relevant solutions.

The walker is regarded as a promising solution to provide additional support to maintain balance or stability while walking for elderly people. Significant assistance in improving mobility technology have been observed from literature review. However, the walkers available in the market is possible to optimize in design and include additional functionality, including getting out of the seat at home with caregiver aid, emergency care aided system. Considering falling down is a public healthcare problem, we designed the emergency aided system to rescue them [1].   In this paper, we proposed a multiple function elderly mobility and emergency aid system, was developed and modelled by Inventor 2015, and finite element analysis. Simulation was then created to get the value of safety factor, and make comparison base on the results from structural calculation. Finally, the application of few features of the improved walker was illustrated.

The republic of South Africa has a “health for all” policy, regardless of nationality and residence status. However, challenges still exist for non-nationals and little is known regarding migrants’ maternal healthcare experiences. This study explores the maternal healthcare experiences of migrant Zimbabwean women living in Johannesburg, South Africa. It focuses on the lived experiences of women aged 18years and above, who engaged with the public healthcare system in Johannesburg during pregnancy and childbirth. A desk review of the literature was undertaken. The theoretical framework in this study draws from three concepts (1) the Social determinants of health framework (WHO 2010), (2) the Access to healthcare framework (McIntyre, Thiede and Brich 2009) and (3) the “three-delays (Nour 2008). Primary data was collected through the use of open-ended semi-structured interviews with a sample of 15 migrant Zimbabwean women who have been in Johannesburg for a minimum of 2 years, and have attended and given birth or are currently attending antenatal care in inner city Johannesburg. Thematic content analysis was used to analyse data since it helps to extract descriptive information concerning the experiences of Zimbabwean women in Johannesburg and to construct meaning in order to understand their perceptions and opinions about the healthcare system in the city. Although the findings indicate that documentation status is not a key issue affecting access to healthcare during pregnancy and delivery, a range of other healthcare barriers were found to dominate, including the nature of their employment, power relations, language, and discrimination(generally) among others. Language was singled out as the major challenge that runs throughout the other barriers. More interestingly the participants raised their desire of returning home or changing facilities within the Public sector or to private institutions in case of any further pregnancy. This study concludes that the bone of contention is on belongingness, deservingness and not being able to speak any local language, that runs through the public health care institutions and this impact on professionalism and discharge of duties.

Abstract The purpose of this study is to investigate how big data solutions in the Swedish healthcare system can generate a revenue. As technology continues to evolve, the use of big data is beginning to transform processes in many different industries, making them more efficient and effective. The opportunities presented by big data have been researched to a large extent in commercial fields, however, research in the use of big data in healthcare is scarce and this is particularly true in the case of Sweden. Furthermore, there is a lack in research that explores the interface between big data, healthcare and revenue models. The interface between these three fields of research is important as innovation and the integration of big data in healthcare could be affected by the ability of companies to generate a revenue from developing such innovations or solutions. Thus, this thesis aims to fill this gap in research and contribute to the limited body of knowledge that exists on this topic. The study conducted in this thesis was done via qualitative methods, in which a literature search was done and interviews were conducted with individuals who hold managerial positions at Region Västerbotten. The purpose of conducting these interviews was to establish a better understanding of the Swedish healthcare system and how its structure has influenced the use, or lack thereof, of big data in the healthcare delivery process, as well as, how this structure enables the generation of revenue through big data solutions. The data collected was analysed using the grounded theory approach which includes the coding and thematising of the empirical data in order to identify the key areas of discussion. The findings revealed that the current state of the Swedish healthcare system does not present an environment in which big data solutions that have been developed for the system can thrive and generate a revenue. However, if action is taken to make some changes to the current state of the system, then revenue generation may be possible in the future. The findings from the data also identified key barriers that need to be overcome in order to increase the integration of big data into the healthcare system. These barriers included the (i) lack of big data knowledge and expertise, (ii) data protection regulations, (iii) national budget allocation and the (iv) lack of structured data. Through collaborative work between actors in both the public and private sectors, these barriers can be overcome and Sweden could be on its way to transforming its healthcare system with the use of big data solutions, thus, improving the quality of care provided to its citizens. Key words: big data, healthcare, Swedish healthcare system, AI, revenue models, data-driven revenue models

Infraestruturas de Informação foram inicialmente conceituadas como objetos técnicos por autores que identificaram atributos necessários para a evolução de uma II. Entretanto, além dos seus condicionantes técnicos, infraestruturas de informação, evoluem também como resultado da ação gerencial e como tais, precisam ser vistas no contexto da sua contribuição aos objetivos das organizações ou mercados, dos arranjos organizacionais entre os parceiros-usuários e a governança do processo. No intuito de contribuir para os conceitos de II, este trabalho de pesquisa buscou aplicar os conceitos da Kernel Theory, com outras teorias já consagradas, em uma instituição de alta complexidade inserida no ambiente complexo da Saúde: um hospital. O estudo foi feito no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), centro de excelência e referência no campo de assistência, ensino e pesquisa e considerado um dos pólos brasileiros mais importantes de disseminação de informações técnico-científicas.A metodologia adotada foi a do estudo de caso único longitudinal, com abordagem qualitativa, tendo como base de análise a Kernel Theory, comparando seus critérios de evolução de IIs com critérios da Governança de TI, Teoria de Redes Interorganizacionais, Teoria Institucional e RBV (Resource Based View). Para a coleta de dados foi feita a análise documental e as entrevistas semi-estruturadas. Este estudo, além de oferecer a possibilidade de extensão da Kernel Theory, poderá fornecer orientação para a prática da gestão, oferecendo critérios de natureza organizacional e institucional que favorecem a evolução de IIs em ambientes organizacionais complexos. / Information Infrastructures (II) were initially conceptualized as technical objects by authors that identified attributes required for the evolution of an II. However, beyond its technical limitations information infrastructures may also evolve as a result of managerial actions and as such, must be considered in the context of its contribution to the goals of organizations and markets, the organizational arrangement between partners, users and the governance process. In order to contribute to the concepts of II, this research sought to apply the concepts of Kernel Theory with other already established theories at an institution of high complexity in the health sector: a hospital. The study was conducted at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) , a center of excellence and reference in the field of assistance, education and research and considered one of Brazil´s most important centers for the dissemination of technical-scientific information. Single case longitudinal study was the adopted research methodology, with a qualitative approach, using criteria from Kernel Theory compared to criteria from IT Governance, Theory of Interorganizational Networks, Institutional Theory and RBV (Resource Based View). Data collection was based on document analysis, structured and semi-structured interviews. This study, not only offers the possibility of extending the Kernel Theory, but can also provide guidance for management, providing criteria of organizational and institutional nature that can stimulate the evolution of IIs in complex organizational environments.

Infraestruturas de Informação foram inicialmente conceituadas como objetos técnicos por autores que identificaram atributos necessários para a evolução de uma II. Entretanto, além dos seus condicionantes técnicos, infraestruturas de informação, evoluem também como resultado da ação gerencial e como tais, precisam ser vistas no contexto da sua contribuição aos objetivos das organizações ou mercados, dos arranjos organizacionais entre os parceiros-usuários e a governança do processo. No intuito de contribuir para os conceitos de II, este trabalho de pesquisa buscou aplicar os conceitos da Kernel Theory, com outras teorias já consagradas, em uma instituição de alta complexidade inserida no ambiente complexo da Saúde: um hospital. O estudo foi feito no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), centro de excelência e referência no campo de assistência, ensino e pesquisa e considerado um dos pólos brasileiros mais importantes de disseminação de informações técnico-científicas.A metodologia adotada foi a do estudo de caso único longitudinal, com abordagem qualitativa, tendo como base de análise a Kernel Theory, comparando seus critérios de evolução de IIs com critérios da Governança de TI, Teoria de Redes Interorganizacionais, Teoria Institucional e RBV (Resource Based View). Para a coleta de dados foi feita a análise documental e as entrevistas semi-estruturadas. Este estudo, além de oferecer a possibilidade de extensão da Kernel Theory, poderá fornecer orientação para a prática da gestão, oferecendo critérios de natureza organizacional e institucional que favorecem a evolução de IIs em ambientes organizacionais complexos. / Information Infrastructures (II) were initially conceptualized as technical objects by authors that identified attributes required for the evolution of an II. However, beyond its technical limitations information infrastructures may also evolve as a result of managerial actions and as such, must be considered in the context of its contribution to the goals of organizations and markets, the organizational arrangement between partners, users and the governance process. In order to contribute to the concepts of II, this research sought to apply the concepts of Kernel Theory with other already established theories at an institution of high complexity in the health sector: a hospital. The study was conducted at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) , a center of excellence and reference in the field of assistance, education and research and considered one of Brazil´s most important centers for the dissemination of technical-scientific information. Single case longitudinal study was the adopted research methodology, with a qualitative approach, using criteria from Kernel Theory compared to criteria from IT Governance, Theory of Interorganizational Networks, Institutional Theory and RBV (Resource Based View). Data collection was based on document analysis, structured and semi-structured interviews. This study, not only offers the possibility of extending the Kernel Theory, but can also provide guidance for management, providing criteria of organizational and institutional nature that can stimulate the evolution of IIs in complex organizational environments.

Clinical nursing practice is on the cusp of significant and unrelenting change amid globalization, austerity measures and technological advancements as the world moves out of the industrial age into the knowledge age. With advances in technology, theory and research, the potential changes to future nursing practice are unlimited. Understanding the process nurses undertake to change their practice in light of these predicted trends is critical if outcomes for patients are to be safe and effective. Yet, there was a paucity of published research that investigate the process of nursing practice change. Thus, the purpose of this study was to describe the process registered nurses undertake to change their clinical practice. The study used an interpretive description methodology and involved interviewing 15 registered nurses with various backgrounds and experience in Doha, Qatar. Data were analyzed using constant comparison methods, simultaneous data collection and analysis, and intensive memoing. The findings revealed an overall theme of asing the dis-ease’, in addition to three sub-themes: disruption, actioning and stabilizing. The study provide simportant insights into how nurses change their clinical practice. A significant contribution of this study is the role of the individual in changing nursing practice. / Graduate / 2020-06-03