Although the recent annual growth rate in the US paramedic field has been 4%, Latino and African American men have been significantly underrepresented in the field compared to their proportion in the US population at large. This problem threatens both the quality and quantity of available emergency health care. The purpose of this study was to describe how men of color (MOC) in community college paramedical programs experienced their awareness, interest, and proactive choice of paramedicine as a course of study. Using a qualitative phenomenological approach and social cognitive career theory as a theoretical framework, I interviewed 23 MOC enrolled during one semester across three community college paramedical programs in the southwestern US: 9 Latino and 14 African American, aged 18-29 with mean age 22 years. The focus of the interviews was the participants' lived experiences at various career points, as well as the enablers and disablers they had encountered. I identified three primary themes for possible use in enhancing recruitment of MOC to the paramedic field: strategic use of new digital media, promotion of the vocation's quasi-familial characteristics, and augmentation of neighborhood-based outreach. Identified areas for further research included recruitment dynamics of female paramedics, MOC persistence issues, and MOC job satisfaction assessments.

This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.

Thesis (Ph. D.)--University of Missouri-Columbia, 1999. / Typescript. Vita. Includes bibliographical references (leaves 215-228). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1999. / Typescript. Vita. Includes bibliographical references (leaves 215-228). Also available on the Internet.

Magister Public Health - MPH / Introduction: The Universal Safety Precautions (USP) are a set of principles including practices and protocols, which is meant to reduce or prevent occupational exposures to blood borne pathogens among health care workers (HCWs), during the course of their duties in health care settings. Globally and in Nigeria, significant number of HCWs are currently being exposed to blood and other body fluids while working in the hospital setting (Amoran, 2013; Samuel et al., 2008; Akinboro et al., 2012; Ajibola et al., 1994; Okechukwu et al., 2012). These exposures contribute annually to about 16,000 HCV infections and 66,000 HBV infections among HCWs worldwide (Prüss-Üstün et al., 2003) and about 1000 cases of HIV per annum in Nigeria since the first recorded case in 1984 (Okechukwu et al., 2012; Patricia et al., 2007). The objectives of the study were to describe the awareness of the USP among HCWs in Kogi State Specialist Hospital (KSSH), Lokoja and to describe the adherence to the USP among HCWs at KSSH. Methods: A descriptive cross-sectional study was conducted among HCWs working in departments where contacts with patients' blood and other body fluids are possible in KSSH. An anonymous self-administered questionnaire was used for data collection. Analysis of the data collected was with Software Package for Social Sciences (SPSS) V23.0.0 for Mac. Results: Of the 125 participants that returned their questionnaires, 37.6% were nurses, 17.6% were doctors and the remainder were laboratory staff, dentists and hospital attendants. Sixty four percent (64%) of them were females, 49.6% had tertiary education while their average age was 38.5 years. Awareness of and adherence to the USP were observed to be 5.6% and 2.4% respectively. Statistically, complete awareness of the USP was not significantly associated with complete adherence to the USP. More so, 3% and 2.2% of the participants with the number of years in services within the ranges of 5-9 years and 1-4 years respectively had complete adherence to the USP. Statistically significant association was only noted between participants' age and complete adherence to the USP. Post-exposure prophylaxis (PEP) and use of personal protective equipment (PPE) were the two USP principles with the lowest levels of awareness and adherence, with 46% and 47.6% on awareness respectively and, 43.8% and 44.6% on adherence respectively. Conclusion: The levels of awareness of and adherence to the USP among the HCWs in KSSH were observed to be very low. There is an urgent need for capacity building of the HCWs on the USP in the form of trainings, and in the long term, there is need to conduct a study to assess possible reasons for the observed outcome.

Trata-se de um estudo exploratório, do tipo intervenção pedagógica, cujo objetivo foi o de reformular o plano de ensino de uma das disciplinas que compõem um Curso de Especialização em Instrumentação Cirúrgica, incorporando mudanças nos processos de ensino-aprendizagem. O referencial teórico para a intervenção propriamente dita se pautou em autores que estimulam um processo de ensino-aprendizagem que instigue a participação dos estudantes, com o uso de metodologias ativas. Com o apoio da instituição, foram incorporadas estratégias pedagógicas diversificadas ao longo das 12 aulas da disciplina, para os 22 estudantes matriculados no primeiro semestre de 2018. Quanto ao método de avaliação da intervenção, ao final da disciplina os estudantes refletiram e escreveram sobre a própria evolução ao longo do percurso, de que forma as estratégias interferiram nesse processo e quais as estratégias mais marcantes. Recordaram os temas e detalhes apresentados no decorrer da mesma, fato que pode inferir que o uso de diferentes estratégias contribuiu para a fixação e construção de conhecimento. As aulas mais marcantes foram as que os aproximaram dos cenários de prática. Quando se auto-avaliaram nesse processo, se perceberam como corresponsáveis pelo ensino-aprendizagem, elemento fundamental nas metodologias ativas. Corpo docente e coordenação sentiram-se instigados com a intervenção pedagógica e pretendem investir mais no desenvolvimento de estratégias que qualifiquem cada vez mais o curso, para o desenvolvimento de um perfil profissional único, para o exigente mercado de trabalho atual. / It is an exploratory study, of the type pedagogical intervention, whose objective was to reformulate the teaching plan of one of the disciplines that make up a Specialization Course in Surgical Instrumentation, incorporating changes in the teaching-learning processes. The theoretical reference for the intervention itself was based on authors who stimulate a teaching-learning process that instigates student participation, using active methodologies. With the support of the institution, diverse pedagogical strategies were incorporated throughout the 12 classes of the discipline, for the 22 students enrolled in the first semester of 2018. As for the method of evaluation of the intervention, at the end of the course the students reflected and wrote about the own along the way, how the strategies interfered in this process and which strategies were the most striking. They recalled the themes and details presented during the course, which may infer that the use of different strategies contributed to the fixation and construction of knowledge. The most remarkable classes were those that brought them closer to the practice scenarios. When they self-evaluated in this process, they perceived themselves as co-responsible for teaching-learning, a fundamental element in active methodologies. Teaching staff and coordination have felt instigated by the pedagogical intervention and intend to invest more in the development of strategies that increasingly qualify the course, for the development of a unique professional profile, for the current demanding job market.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-03-03T14:50:38Z No. of bitstreams: 2 Dissertação - Fernanda Rosiak Gonzaga Faleiro - 2015.pdf: 5911837 bytes, checksum: 1ea9a6cba3828da4bee2da6205d2e19f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-03-03T14:54:11Z (GMT) No. of bitstreams: 2 Dissertação - Fernanda Rosiak Gonzaga Faleiro - 2015.pdf: 5911837 bytes, checksum: 1ea9a6cba3828da4bee2da6205d2e19f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-03-03T14:54:11Z (GMT). No. of bitstreams: 2 Dissertação - Fernanda Rosiak Gonzaga Faleiro - 2015.pdf: 5911837 bytes, checksum: 1ea9a6cba3828da4bee2da6205d2e19f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-10-21 / In Brazil, Unified Health System’s Technical Schools (UHSTS) are reference to the qualification and training of allied health personnel in the health system. With the extensive development of information and communication technologies, distance education (DE) is presented as an alternative to train workers face to face method of teaching. This study aimed to analyze the perceptions of directors of UHSTS on the DE in training of allied health personnel for the UHS in 2013. An exploratory-descriptive study with quantitative and qualitative approach was carried out using an electronic questionnaire to collect data. The response rate was 80,5%. The results showed that the majority of respondents were female (72.4%); aged over 50 years (55.2%) and postgraduate (93,1%). The majority (86.2%) has participated in distance learning courses; 42% of the courses were specialization. With respect to courses/activities in distance education in UHSTS, they were developed in only 31% of schools; most were technical courses (42.2%), followed by training/improvement (26.3%) and specialization courses of higher level (21%); 89.4% were conducted in partnership with other institutions and among technicians, none was financed by the Ministry of Health (MOH). The positive points of DE in the training of allied health personnel in health highlighted by the directors surveyed in subcategories of analysis were: accessibility to courses; reduction absence from workplace; flexible schedules for the study; post-technical courses and theoretical subject. The difficulties identified in subcategories were: lack of technological infrastructure in the municipal districts; students' difficulties in accessing technological resources; unsuitability to all kinds of people; distance physics tutor/student; technical courses in health; financing installations and acquisition of equipment; training of qualified technical staff. It can be concluded that despite the distance education be regarded as an option to the decentralization of the courses of UHSTS, the perception of the directors on this modality qualification and training for allied health personnel was permeated with more hindering aspects than favorable points. The challenges mentioned could be better addressed through a distance education’s politics of MOH which embraced these workers. / As Escolas Técnicas do Sistema Único de Saúde (ETSUS) são referência no Brasil para a qualificação e formação de técnicos de nível médio em saúde para o SUS. Com o amplo desenvolvimento das tecnologias de informação e comunicação, a educação a distância (EaD) apresenta-se como alternativa para a capacitação de trabalhadores face à metodologia presencial de ensino. Este trabalho teve como objetivo analisar a percepção dos diretores das ETSUS sobre a EaD na formação dos técnicos de nível médio em saúde no ano de 2013. Foi realizado um estudo exploratório-descritivo com abordagem quanti-qualitativa, utilizando um questionário eletrônico para a coleta de dados. A taxa de resposta alcançada foi de 80,5%. Os resultados mostraram que a maioria dos pesquisados era do sexo feminino (72,4%), na faixa etária acima de 50 anos (55,2%) e com pós-graduação (93,1%). A maioria (86,2%) já havia participado de cursos a distância, sendo 67,6% como aluno e 42,2% dos cursos feitos foram de especialização. Apenas 31% das Escolas realizavam cursos a distância, sendo que 42,2% eram cursos de nível técnico, 26,3% de capacitação/aperfeiçoamento e 21% de especialização de nível superior; 89,4% foram realizados em parcerias com outras instituições e, dentre os técnicos, nenhum era financiado pelo Ministério da Saúde (MS). Os pontos favoráveis da EaD na formação dos técnicos de nível médio em saúde destacados pelos diretores pesquisados em subcategorias de análise foram: acessibilidade aos cursos; redução da ausência no local de trabalho; flexibilidade de horários para o estudo; cursos pós-técnicos e conteúdos teóricos. Já as dificuldades apontadas em subcategorias foram: falta de infraestrutura tecnológica nos municípios; dificuldades dos alunos em acessar recursos tecnológicos; não adequação a todo tipo de público; distância física tutor/aluno; cursos técnicos em saúde; financiamento das instalações e aquisição de equipamentos; formação de equipe técnica capacitada. Pode-se concluir que apesar de a EaD ser vista como uma opção à descentralização dos cursos nas ETSUS, a percepção dos diretores sobre esta modalidade na formação dos técnicos de nível médio em saúde para o SUS foi permeada de mais aspectos dificultadores do que de pontos favoráveis. Os desafios apontados poderiam ser melhor enfrentados por meio de uma política do MS na área de educação a distância que contemplasse esse público.

This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.

In New Zealand Māori are under-represented in the workforce across multiple sectors. This thesis explores this incongruity with regard to Māori health. A Māori perspective and philosophical foundation formed the basis of the methodological approach, utilising a case study research design to inform the study. This provided the opportunity to explore Māori health workforce development initiatives and their potential to contribute to improvements and gains in Māori health. It was important that this work take into account social and economic factors and their impact on health, as well as the varying political climates of market oriented reform and a fiscal policy focus, because it has not only challenged Māori health development but also provided opportunities for increased Māori involvement and participation in health and New Zealand society. Therefore the thesis, while focused on health takes cognisance of and, coincides with the capacity and capability building efforts that have been a feature of overall Māori development, progress and advancement. In the context of this thesis Māori health workers are seen as leaders within their whānau, hapū, iwi, and Māori communities. Consequently a potential workforce that is strong and powerful can lead to anticipated gains in Māori health alongside other Māori movements for advancement. The potential cannot be under-estimated. This thesis argues that there are critical success factors, specific determinants, influencing Māori health workforce potential, and that these success factors have wider application. Therefore, as this thesis suggests Māori workforce development, especially in relationship to the health workforce, is dependent on effective Māori leadership, the application of Māori values to workplace practices, levels of resourcing that are compatible with training and development, critical mass, and targeted policies and programmes.

Thesis (M.S.)--State University of New York at Binghamton, Thomas J. Watson School of Engineering and Applied Science, Department of Systems Science and Industrial Engineering, 2009. / Includes bibliographical references.