Este estudo discute a visita médica domiciliar, com base em pesquisa realizada no município de Florianópolis, Santa Catarina, tendo como cenário o Programa Saúde da Família. O objetivo principal foi compreender a visita médica como espaço de interação e instrumento potencializador da comunicação entre o profissional, o paciente e sua família. Adotaram-se metodologia qualitativa e estudo de caso com triangulação de técnicas, combinando entrevistas, observação participante e leitura de documentos. Realizaram-se entrevistas com roteiros semiestruturados, um para os profissionais e outro para o usuário e familiares. As entrevistas foram gravadas e transcritas com autorização de pacientes e profissionais, e o termo de consentimento livre e informado foi assinado por todos os participantes. Foram entrevistados um médico, seis médicas de família e dez usuários com seus familiares, os quais receberam visitas desses profissionais. Em etapa concomitante às entrevistas, realizou-se observação dos profissionais médicos no período de realização de visitas domiciliares, sendo observadas pela pesquisadora dez visitas domiciliares. A análise dos resultados constatou que a visita permite ao profissional médico refletir sobre sua prática, colocando para ele desafios que envolvem sua capacidade em comunicar-se e interagir fora de um contexto protegido, representado pelo centro de saúde e o consultório, e onde as demandas surgem conforme o modo de vida do paciente e sua família. A percepção dos profissionais em relação à visita é de que se trata de uma atividade que atua positivamente na evolução clínica dos pacientes atendidos, pois foi relatada uma diminuição do número de internações hospitalares depois de iniciado o acompanhamento domiciliar. Para os profissionais, o acompanhamento médico e o tratamento propostos são influenciados pelo vínculo estabelecido entre profissional, paciente e família, que favorece a comunicação e permite uma interação que impacta o tratamento instituído. Os problemas de saúde que motivaram as visitas são em geral doenças crônicas, mas também problemas agudos podem demandar o atendimento. A ausência de um cuidador não impediu que o profissional médico mantivesse o acompanhamento domiciliar. A elegibilidade de critérios para visita médica varia conforme a situação que é vivenciada pelas equipes de saúde, existindo a preocupação de que a assistência aconteça de forma participativa. Os usuários e familiares relataram que a visita médica propicia uma relação mais próxima com o médico e a compreensão do caso. Concluiu-se que a visita domiciliar favorece o estabelecimento de uma comunicação voltada ao entendimento mútuo, ao possibilitar que a hierarquia rigidamente demarcada entre médico e paciente seja questionada, quando aspectos do contexto, das relações do usuário com sua família e comunidade entram em cena. A interação que ocorre suscita que o profissional busque condutas que vão além da eficácia técnica (êxito técnico), na direção do sucesso prático, promovendo maior participação do paciente e família em relação ao cuidado realizado / This study discusses the domiciliary medical visit, with base in research accomplished in the municipal district of Florianópolis, Santa Catarina, in the context of the Family Health Program. The main objective was to understand medical visit as a space for interaction and as a powerful instrument of communication between the professional, the patient and his or her family. Qualitative methodology and case study were adopted along with triangulation techniques, combining interviews, participant observation and the reading of documents. Interviews with semi-structured scripts were performed, one for doctors and another for users and relatives. The interviews were recorded and transcribed with the patients and the professionals permission, and a free consent and informed form were signed by all participants. Seven doctors and ten users and their relatives, who had received visits of these doctors, were interviewed. In step concurrently with the interviews, medical professionals were observed while home visiting ten families who were not interviewed later by the researcher. By analyzing the information it was found that the visit allows the doctor to ponder on his or her professional practice, putting him or her through challenges that involve his or her ability to communicate and interact outside of a protected context, represented by the health center and clinic, and where the demands arising from the way of life of patients and their families shows up. The perception of professionals over the visit is that it is an activity that is effective in the clinical outcome of patients treated, as was reported a decrease in the number of hospital admissions after the start of home care. For professionals, the medical monitoring and proposed treatment adhesion are influenced by the bond established between professional, patient and family, which improves communication and allows an interaction that impacts the treatment. The health problems that motivated the visits were, in general, chronicle diseases, but also acute problems can demand attendance. The absence of a caregiver did not prevent the medical professional to maintain the home care. The eligibility criteria for medical visits vary according to the situation that is experienced by health staff. Care is taken so that the assistance takes place in a participatory manner. The users and their relatives related that the medical visit allows closer relation with the doctor and the comprehension of the case. It was concluded that domiciliary medical visit favors the interaction between those involved by establishing communication geared towards mutual understanding, raising questions about the inflexible hierarchy between doctor and patient when aspects of the context and the relations of users with their families and community emerge. The interaction that occurs gears the professional towards a conduct which seeks to go beyond the technical efficiency (technical success), heading into the practical success and promoting the participation of the patient and family regarding the care provided

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-20T13:36:52Z No. of bitstreams: 1 michellegoncalvesrodrigues.pdf: 524098 bytes, checksum: a921612256e261ca66a856c9b280777e (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:24:19Z (GMT) No. of bitstreams: 1 michellegoncalvesrodrigues.pdf: 524098 bytes, checksum: a921612256e261ca66a856c9b280777e (MD5) / Made available in DSpace on 2016-09-26T20:24:19Z (GMT). No. of bitstreams: 1 michellegoncalvesrodrigues.pdf: 524098 bytes, checksum: a921612256e261ca66a856c9b280777e (MD5) Previous issue date: 2010-03-04 / O presente trabalho tem por objetivo refletir sobre a Estratégia de Saúde da Família (ESF) e a política de saúde intitulada Humaniza SUS. Para isso recorreremos as ditas ―tecnologias leves‖, ou "tecnologias corporais", como formas de cuidado do outro, aliado ao enfoque antropológico sobre o ritual e a ritualização das práticas. Nosso argumento parte do contraponto entre práticas estereotipadas e práticas recriadas pelas constantes possibilidades de afetação que os sujeitos vivenciam na vida ordinária. A maneira como os significados dados por cada agente quando se referem às práticas próprias da ESF, como as visitas domiciliares e os grupos educativos, nos permitem compreender os processos de transformação dos corpos, onde cada ator corporifica suas experiências passadas e recriam os significados para a ação presente. Partimos de casos etnográficos para questionarmos a concepção de um corpo único biomédico, demonstrando a multiplicidade de corpos que envolvem distintos itinerários de vida. / This paper aims to discuss the Family Health Strategy (Estratégia de Saúde da Família - ESF) and health policy entitled Humaniza SUS. To do so will draw the so-called "soft technologies", or "body technologies" as ways of caring for others, coupled with the anthropological focus on ritual and ritualistic practices. Our argument is the opposition between practices and stereotyped practices recreated by the constant possibility of affecting the subjects live in ordinary life. The way the meanings given by each agent when they refer to practices peculiar to the ESF, such as home visits and educational groups, allow us to understand the processes of transformation of bodies, where each actor embodies his past experiences and recreate meanings for this action. We started from ethnographic cases to question the design of a single body biomedical, demonstrating the multiplicity of bodies involving different paths through life.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-11-19T13:56:21Z No. of bitstreams: 1 Fabiana Lopes Joaquim.pdf: 1822430 bytes, checksum: 8a173943a6c0e0ccfccc7788fbb35728 (MD5) / Made available in DSpace on 2015-11-19T13:56:21Z (GMT). No. of bitstreams: 1 Fabiana Lopes Joaquim.pdf: 1822430 bytes, checksum: 8a173943a6c0e0ccfccc7788fbb35728 (MD5) Previous issue date: 2014 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Evidenciando-se a úlcera como um problema epidemiológico que acomete os membros inferiores e provoca impacto na qualidade de vida e produtividade, torna-se necessário avaliar a capacidade funcional de seus portadores, que sofrem com dores, edema e consequentemente dificuldades de locomoção. Frente ao exposto, esta pesquisa teve como objeto a intervenção em saúde realizada por enfermeiros, durante a visita domiciliar a adultos e idosos que vivem com úlceras venosas. Os objetivos foram: identificar a efetividade das intervenções na capacidade funcional de adultos e idosos com úlceras venosas e comparar o efeito da visita domiciliar antes e após orientações na capacidade funcional dessas. Trata-se de um estudo clínico experimental, randomizado não cego e controlado com delineamento do tipo transversal e abordagem quantitativa. O campo de pesquisa foi o Ambulatório de Reparo de Feridas do Hospital Universitário Antônio Pedro (HUAP) localizado em Niterói/RJ e o domicílio de pacientes atendidos no referido ambulatório. Participaram da pesquisa 32 pacientes, que vivem com úlceras venosas e que se encontram em tratamento no referido ambulatório, sendo 16 participantes alocados aleatoriamente por meio do Software Biostat 5.0 no grupo caso e 16 no grupo controle. A coleta de dados ocorreu através dos instrumentos: Protocolo I – Adaptado - Avaliação de clientes com úlceras venosas, utilizado no projeto Cicatrizar da Pró-Reitoria de Pesquisa e Pós-Graduação (PROPP/UFF) e Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq); Escala de Independência em Atividades da Vida Diária (Escala de KATZ - EIAVD); Escala de avaliação de equilíbrio e marcha (Índice de TINETTI); e instrumento com orientações a serem prestadas aos sujeitos da pesquisa que receberam visita domiciliar, sendo este o instrumento de registro da intervenção aplicada no estudo. Os resultados apresentados através da Escala de KATZ-EIAVD e do Índice de TINETTI antes da intervenção demonstram que há semelhança em relação às questões e pontuação nos dois grupos. Após a intervenção, os resultados revelam que o Índice de TINETTI expressa melhor o comprometimento da capacidade funcional de adultos e idosos com úlceras venosas, demonstrando melhora significativa no grupo caso quando comparada ao grupo controle, que se manteve absolutamente estável quando comparado com os resultados apresentados pela Escala de KATZ-EIAVD. Deste modo conclui-se que as intervenções no contexto domiciliar foram benéficas aos participantes do grupo caso / Seeing the ulcer as an epidemiological problem that affects the lower limbs and causes impact on quality of life and productivity, it is necessary to evaluate the functional capacity of patients suffering from this, who experience pain, swelling and, as a consequence, movement difficulties. Based on it, this research aims to assess the health intervention performed by nurses during home visits to adults and elders with venous ulcers. The objectives were to identify the effectiveness of interventions on the functional capacity of adults and elders, and to compare the effects of home medical visits before and after functional capacity advice is provided. This is an experimental, non-randomized blind, with a cross-sectional controlled design and quantitative approach clinical study. The field research was the Outpatient Wound Repair clinic of the Antonio Pedro University Hospital (HUAP) located in Niterói / RJ and the domicile of patients treated at the clinic. 32 venous ulcers patients who are in treatment at the clinic participated; 16 participants were randomly allocated in the control group and 16 in the case group through the software Biostat 5.0. Data collection occurred through the instruments: Protocol I - Adapted - Assessment of patients with venous ulcers used in the Heal Project, of the Pro Dean of Research and Graduate department (PROPP / UFF) and the National Council for Scientific and Technological Development (CNPq); Measure Scale of Independence in Activities of Daily Living (Katz – EIAVD Scale); Scale assessment of balance and gait (Tinetti Index) and the instrument with guidelines to be provided to research subjects who received home visits, which is the recording instrument applied in the study intervention. The results presented by Katz-EIAVD Scale and Tinetti index before intervention shows that there are similarities in the issues and score in both groups. After the intervention, the results reveal that the Tinetti index best expresses the impaired functional capacity of adult and elderly patients with venous ulcers, demonstrating a significant improvement in the case group compared to the control group, which remained absolutely stable when compared to the results presented by KATZ-EIAVD Scale. Thus we conclude that interventions in home environment were beneficial to the participants in the case group

À partir d'une enquête ethnographique sur les réceptions situées d'un tableau de Nicolas Poussin conservé au musée des beaux-arts de Lyon, cette thèse interroge la place de la visite au musée d'art dans les répertoires de loisir des classes moyennes et supérieures. Elle s'appuie sur trois matériaux principaux : environ 50 journées d'observations in situ de l'activité des visiteurs, 45 entretiens de réceptions menées au musée, et 18 entretiens biographiques portant sur les habitudes de visite de visiteurs occasionnels ou réguliers aux profils sociaux similaires à ceux arrêtés au musée. La thèse met en évidence l'importance du statut des œuvres dans l'orientation et dans l'allocation de l'attention des visiteurs. Cet usage pratique de la légitimité culturelle produit un paradoxe : le tableau examiné est considéré comme un chef-d'œuvre, mais il suscite peu d'intérêt esthétique. L'examen lexicométrique d'un corpus d'articles de presse consacrés au tableau confirme que cette réaction s'étend à des publics professionnels comme les journalistes. Le malaise que provoque cette contradiction témoigne de l'importance de la compétence artistique statutaire. La thèse examine alors la place des dispositifs de médiation dans la réduction de cet écart. On peut interpréter la tendance à la déconnexion entre leur usage et la contemplation des œuvres comme un signe de l'importance du discours autorisé de l'institution pour les visiteurs faiblement ou moyennement dotés en ressources spécifiques. Enfin, l'analyse des biographies de visiteurs montre le poids de l'injonction normative à la visite ainsi que l'importance de son inscription dans des routines de loisirs. / Drawing on an ethnographic study of the receptions of a Nicolas Poussin's painting curated at the Fine Arts Museum in Lyon, France, this dissertation analyses the position of museum visiting in the leisure repertoire of the middle and upper-middle classes. Three main data sources are used: about 50 days of observation of the activities of museum visitors, 45 reception interviews carried out inside the museum, and 18 biographical interviews on visiting habits with occasionnal or regular museum visitors. The dissertation sheds light on the central role of the artwork's status in their orientation and the distribution of their attention. This practical use of cultural legitimacy leads to a paradox: the painting is considered a masterpiece, but it has little aesthetic appeal. A lexicometric analysis of a corpus of newspapers articles confirms that this perspective may be extended to professional audiences, such as journalists. The unease this contradiction provokes in the audience is a reminder of the centrality of statutory artistic skill. The dissertation then analyses how mediation devices are used to fill this gap. The disconnection between the use of devices and the contemplation of the painting might be interpreted as the sign of how important the authorized, institutional discourse on the artwork is for visitors with low to average levels of specific resources. Finally, an analysis of visitors' biographies demonstrates that a normative injunction to visit greatly weights in visitors' practices, but that visits mostly occurs when they are embedded into leisure routines.

Master of Science / Department of Hotel, Restaurant, Institution Management & Dietetics / Ki-Joon Back / The objectives of this research were to address the impacts of positive and negative emotions on customers’ satisfaction and customers’ repeat visit intentions, and to investigate the mediating effect of customer satisfaction on the relationship between emotion and customers’ repeat visit intentions. A theoretical model of the formation of repeat visit intentions was proposed through a comprehensive review of the literature. Richins’ Consumption Emotion Set (1997) was modified to make it suitable for application in the lodging industry. The modifications were based on the participants’ responses to each emotion descriptor in the pilot test. Surveys were completed by graduate students and faculty members, undergraduate students at a Midwestern university, and conference attendees. Of 259 surveys returned, 248 responses were used for data analysis. Data were analyzed using factor analysis and a series of regression analysis. Positive and negative consumption emotions were found to have a significant effect on customer satisfaction and repeat visit intentions. Results also provided evidence of a significant association between customer satisfaction and repeat visit intentions. Customer satisfaction was found to be a full mediator in the relationship between customers’ positive and negative consumption emotions and repeat visit intentions. The loss aversion of the prospect theory was empirically supported in the formation of customers’ repeat visit intentions since results indicate that negative emotion has a greater influence on customer satisfaction and customers’ repeat visit intentions. Results support the importance of considering the impact of customers’ emotions on post-purchasing behaviors when developing better marketing and service strategies to achieve higher occupancy rate and retain customers.

La Franche-Comté a connu des changements importants au cours du dix-septième siècle. Pendant la guerre de Dix Ans, version locale de celle de Trente Ans, elle perd la moitié de sa population. Elle se relèvera démographiquement grâce à une immigration française, savoyarde et lorraine. Au début du siècle elle était un état autonome au sein de la monarchie des Habsbourg. Besançon perd en 1654 son statut de ville libre d’Empire et son droit de siéger à la Diète. La Franche-Comté est réunie à la France en 1678 par le traité de Nimègue. La suppression des Etats de la province va déséquilibrer les institutions en favorisant l’absolutisme. Sur le plan ecclésiastique, le chapitre métropolitain perd son droit d’élire l’archevêque ; un indult de nomination est concédé à Louis XIV en 1698. Pendant un siècle et demi après le concile de Trente, la réforme du clergé et des fidèles va se déployer en étant soutenue par un élan religieux. L’année 1665 avec la fondation du séminaire de Besançon constitue un moment décisif. L’année suivante l’archevêque demande qu’une école primaire soit ouverte dans chaque village. Choisis par un concours, les curés deviennent suffisamment instruits pour enseigner leurs ouailles. / Franche-Comte went through significant changes in the seventeenth century. During the “10 Years War”, a local episode which was part of the “30 Years War”, it lost half its population, expanding subsequently through immigration from France, Savoy and Lorraine. At the beginning of the century it was an autonomous State under Hapsburg rule, but in 1654 Besancon lost its status as a “free town” and its right of a seat in Parliament. In 1678 Franche-Comté was re-united with France under the Treaty of Nijmegen. The abolition of the States of the province destabilized the institutions favouring absolutism. The Metropolitan Chapter lost the privilege of electing its Archbishop, this responsibility passing to Louis XIV in 1698. After the Council of Trent, the reform of the clergy and the followers increased and was carried away by a religious impulse. 1665 saw the founding of the Seminary of Besancon, a decisive moment because the following year the Archbishop called for primary schools to be opened in every village. Parish priests, who were to teach their flock, were selected by competition and were to be trained to carry out these duties.

Background:  Existing research shows that both biological and social factors contribute to early language development. Reading out loud and active interplay with infants and toddlers have been highlighted as positive factors for development of understanding and vocabulary. The preschool functions as an equalizing environment, as it provides equal opportunities for children with various life conditions to develop their language skills. However, there are notable differences in language development in children from homes with low and high income and education levels, respectively. The Språkstegen project has therefore been implemented as an intervention. The basic idea of Språkstegen is that the child service nurses, who conduct the home visits at month 8, introduce a book gift, which is read aloud for the child in active interplay. The nurses also provide parents with tools and information to support the activity. Aims: The aim is to understand child service nurses’ experiences of participating in a project that seeks to improve the language development of infants and toddlers. Method: Data collection has been conducted through semi-structured interviews of child service nurses. The collected data have been transcribed and analyzed using conventional qualitative content analysis. The collection was delimited to public and private health care facilities in Blekinge county, Sweden. Results: The respondents are positive towards Språkstegen as intervention. They report that parents and children are satisfied, and that parents are inspired by the possibilities with early reading and the tools available for stimulating interplay during reading. Conclusions: Språkstegen makes it possible to reach more parents and provide knowledge and tips to support early language development through active interplay and reading aloud. / Bakgrund: Tidigare forskning har visat att det finns både biologiska och sociala faktorer som påverkar små barns språkutveckling. Högläsning och aktivt samspel med barn från tidig ålder har lyfts upp som en positiv faktor både för språkförståelse och ordförråd. Förskolan fungerar som en utjämnande verksamhet, då barn från med olika livsvillkor ges lika möjlighet att utveckla sitt språk. Det finns dock tydliga skillnader avseende språkutvecklingen mellan barn från hem med hög respektive låg utbildningsnivå och ekonomisk status. Projektet Språkstegen har därför lanserats som en intervention. Språkstegens grundläggande idé är att BHV-sjuksköterskorna som utför hembesöket och barnets åttamånaderskontroll också introducerar en bok. Under besöket läser BHV-sjuksköterskan bokgåvan högt för barnet och samtalar också med föräldrarna om läsningens och det aktiva samspelets betydelse. Syfte: Syftet med studien är att beskriva BHV-sjuksköterskors erfarenheter av att medverka i ett projekt med avsikten att förbättra språkutvecklingen hos små barn. Metod: Datainsamling har utförts via semistrukturerade intervjuer av BHV-sjuksköterskor. Det insamlade datamaterialet har transkriberats och har därefter analyserats med konventionell kvalitativ innehållsanalys. Datainsamlingen begränsades till offentliga och privata vårdcentraler i Blekinge län. Resultat: Respondenterna är positiva till Språkstegen som intervention och rapporterar att föräldrar och barn är nöjda samt att många blivit inspirerade av möjligheterna med tidig läsning och verktygen för att förbättra samspelet med barnet under läsning. Slutsats: Språkstegen gör det möjligt att nå fler föräldrar och ge dem kunskap och tips för att stötta barnens språkutveckling genom interaktiv högläsning. Projektet bidrar också till att ge föräldrarna en bättre förståelse för vikten av samspel med barnet genom högläsning.

A traditional printed newspaper is being replaced by an online one. This is one of the reasons why I in this thesis focus just on internet journalism. The online journalism servers I present in a relation to other periodicals -- newspapers, broadcast and television. The thesis describes and analyses main development trends in the Czech media market. It puts an emphasis on economic sections of general news and it also compares these sections with specialized economic servers. An important part of the thesis is focused on an analysis of reader's attendance which results in a rank of the most popular news servers. The model of the time series analysis is set up for two websites and it predicts future development trend in the number of real users of online news. The aim of this thesis is to provide a general view on the contemporary situation and also to describe the developmental tendency of online reporting. The result of the dissertation is the prediction of future development trend of online reporting servers.

Maternal mortality is a critical area of concern globally, despite the availability of accessible preventive measures. The role of sociodemographic and service delivery factors in maternal mortality in the Accra Metropolitan Area of Ghana are important to examine. As part of the United Nations (UN) Millennium Campaign, the UN implemented 8 Millennium Development Goals (MDGs); maternal mortality reduction by 75% between 1990 and 2015 was among the fundamental MDGs to be achieved by 2015. The purpose of this case-control study was to use secondary data to assess the relationships between sociodemographic variables, service delivery factors, and maternal mortality among 8,171 women of reproductive age (15-45 years) living in the Greater Accra metropolitan area in Ghana. The health belief model and social cognitive theory provided the theoretical framework to interpret the study findings. Particularly, income (p = .023), primary (p = .035) and secondary (p = .002) education, and health insurance (p = .008) were significantly associated with maternal-related mortality. However, for survival outcome, health insurance (p = .003), prenatal care (p = .001), and presence of a skilled attendant at delivery (p = .020) were significant factors. These study results provide support for the significant effects of sociodemographic and service delivery factors on maternal mortality and survivorship in the Greater Accra metropolitan area in Ghana. The results of this study could enhance educational and outreach programs designed to lower maternal mortality rate. Further research needs to be done to advance knowledge and practice in health delivery services and public health education with respect to the importance of sociodemographic and service delivery characteristics.

The goal of my study is to develop a mobile application to enable all visitors, including blind and low-vision visitors, to autonomously gather and share information about interpretations of art and to have a fully independent museum-going experience. With an application, blind visitors have more access to opportunities and tools in the museum, which empowers their museum experience. My study used a qualitative, mixed-methods approach to research how blind and low vision museum visitors might increase their independence in the museum space and discover ways to equalize their access without relying on museum educators. In carrying out my study, I conducted interviews and collected data based on observations and transcribed and analyzed them using a grounded theory approach. I used Freire's theory of pedagogy of the oppressed and hooks' theory of education as the practice of freedom to frame my study.