Include bibliographical refrences / Aim: The aim of this study is to determine the level of perceived and actual knowledge of Cape Town emergency care personnel when dealing with children who acutely disclose incidents of sexual abuse. Method: Operational EMS personnel and emergency medicine registrars in emergency centres located in the Cape Town metropolitan area were asked to complete a quantitative questionnaire with an optional qualitative portion. Informed consent was obtained and the participants' anonymity was guaranteed. A total of 120 voluntary participants - made up of 30 doctors, 30 Advanced Life Support personnel, 30 Intermediate Life Support personnel and 30 Basic Life Support personnel - took part in the study. Findings: This study reveals that EMS personnel and emergency medicine registrars believe that they are inadequately trained and equipped to deal with situations in which a child discloses abuse. They remain capable of treating physical injuries but feel inadequate, frustrated and helpless when confronted by incidents of child abuse. The current EMS syllabus (with particular reference to its teaching and application in the Western Cape metropolitan area) is limited in the coverage of this subject. The syllabus only addresses types of abuse and how to treat the physical injuries relating to abuse, leaving many gaps in the knowledge of medical personnel. With specific reference to sexual abuse, there is a paucity of information in the syllabus relating to how children who disclose their experiences of abuse should be managed. The current training syllabus does not include any information that could lead to an understanding of disclosure, the manner in which it evolves, why children are not always forthcoming with disclosure and more importantly, what to say to children when they disclose abuse. Conclusion: When EMS personnel are called to a scene of child abuse they are uniquely first person the child encounters directly after the abuse is frequently an EMS member. This person is afforded a unique opportunity to observe the behaviour of the victim as well as that of the child's caregivers. They are also able to corroborate the mechanism of injury and verify aspects of the story as given to them by the caregivers, thus being more easily able to identify situations of suspected child abuse. More comprehensive training is required to enable EMS members to effectively and confidently deal with cases involving suspected or confirmed child abuse as well as disclosures of abuse by the patient.

A significant number of women in the United States (U.S.) are physically, sexually, or emotionally abused by a partner or former partner every year. Young adult females are most likely to experience intimate partner violence (IPV), with prevalence rates for this group double the overall average. Many of these women will experience serious physical and psychological health consequences. Despite this, IPV reporting rates are extremely low, especially among college women. In response, the U.S. Preventive Services Task Force and many health care organizations have recommended universal screening for all women of child-bearing age; however compliance with this recommendation remains low.

The purpose of this study was to uncover the experience of health care providers (HCPs) as they work with fathers of children who are overweight and obese in the outpatient setting. Interpretative phenomenological analysis was used for data collection and analysis in this study. Seven HCPs were interviewed about their experiences. Two major themes emerged from the experiences of these HCPs: "dad in the backseat," and "paternal resistance." The theme of "dad in the backseat" captured to the HCPs' perception of parental roles and related stereotypes with respect to fathers' lack of presence in the health-care setting, family roles that relegate fathers to the backseat in dealing with this issue, and the tendency of fathers to take a passive role and defer to mothers in the management of their child's weight. "Paternal resistance" reflected the perceived tendency of the father to resist the acceptance of their child's weight as a problem, and to resist change and even undermine family efforts to make healthier choices. Health care providers' experiences of fathers as having a minimal role in the management of their child's overweight and obesity may lead them to neglect fathers as agents of change in this important issue.

Studier har visat att dialektisk beteendeterapi (DBT) är en tidskrävande integrerande behandlingsform. DBT beskrivs utifrån fyra hörnstenar: inlärningsteori, kognitiv teori, dialektisk filosofi och zenbuddistisk filosofi. DBT utvecklades för självskadebeteende, senare utvecklades den också för annan beteendeproblematik. Syftet med denna studie var att undersöka hur behandlare och behandlingsassistenter med DBT erfarenheter upplever att klienterna tillgodogör sig DBT-behandlingen och om män respektive kvinnor tillgodogör sig olika. En man och fem kvinnor i Sverige med olika yrkeserfarenheter inom DBT intervjuades mellan 45-60 minuter om hur DBT-behandling av klienter tillgodogörs på LVM-hem utifrån behandlarens perspektiv. Intervjuerna meningskoncentrerade och resulterade i fem teman: a) främja positiv utveckling; b) en ökad kunskap; c) en ökad självkontroll; d) en ökad självkänsla; e) ett ökat välbefinnande. Slutsatsen är att ökad kunskap om sin personlighet främjar positiv utveckling att tillgodogöra sig verktyg för att öka självkontrollen, vilket kan leda till ökad självkänsla som främjar till ett ökat välbefinnande.

The purpose of the study was to examine cultural competence among oncology health care providers. Specifically, the study assessed how career type, presence of previous diversity training, and education affected overall cultural competence of oncology health care providers. The study used a quantitative survey design with self-administered questionnaires. A total of 36 voluntary oncology health care providers completed the cultural competence assessment survey. Participants were asked of their cultural awareness/sensitivity, cultural behaviors, previous experiences of diversity trainings, and some demographics questions. Descriptive (e.g. mean, frequency distributions) and inferential (e.g. t-test, one-way analysis of variance) statistics were used to analyze the data. Findings of the study showed that the levels of cultural competence among oncology health care providers were low to moderate. Oncology health care providers who were social workers and registered nurses tended to report more frequent culturally competent behaviors, compared to other career types of health care providers. The study also found that those who had specific previous diversity training tended to report higher levels of cultural competence compared to those who did not have those diversity trainings. Findings of the study suggest that there be a need for improvement in the cultural competency practice among oncology health care providers. The results of this study could serve as a reference in the initial evaluation of exploring cultural competency health care practice in the specialization of oncology.

<p>The social service care system for the elderly has undergone a number of changes during the last decades. These reforms, especially the purchaser-provider split, have changed the role of the state in this sector somewhat, from being a monolithic provider of tax-financed elderly care to primarily being a purchaser who might choose to purchase elderly care services from private providers. However, the state has still retained a public elderly care service. Needless to say, the reform paved the way for a number of private enterprises in the area, causing competition between public and private providers. Adherents of the reform have argued that private providers can improve efficiency, while opponents have claimed that the chase for profit might affect the quality of the care in a negative way.</p><p>This study focused on the basis for this controversy by examining the relationship between factors such as profit, efficiency, care quality, incentives, motivation and productivity. The study was performed by interviewing thirteen employees and managers in four different care organizations (of which half were public and the other half private). Their answers were analyzed from three theoretical aspects; incentives and motivation, efficiency and productivity, and care quality.</p><p>The findings were that, since the revenue size is beyond their control, private providers can only create profits by reducing costs in a number of ways. Some of these ways, such as cutting down on education, team building activities and salaries, might be detrimental for the company in the long term (and thereby increase costs over time) and have adverse effects on quality. Others, however, such as increasing the efficiency of non-care activities (less administration and optimized scheduling, for example), avoid hiring overqualified staff and instead providing them with enough education for the task at hand, and optimizing work hours, might be more enduring over time and have none or small adverse effects on quality. More dispiritingly, it was also shown that the purchasers do not have any real knowledge about the quality of the work performed, regardless of the provider being private or public, and that in some municipalities users are denied to choose provider for themselves.</p>

The social service care system for the elderly has undergone a number of changes during the last decades. These reforms, especially the purchaser-provider split, have changed the role of the state in this sector somewhat, from being a monolithic provider of tax-financed elderly care to primarily being a purchaser who might choose to purchase elderly care services from private providers. However, the state has still retained a public elderly care service. Needless to say, the reform paved the way for a number of private enterprises in the area, causing competition between public and private providers. Adherents of the reform have argued that private providers can improve efficiency, while opponents have claimed that the chase for profit might affect the quality of the care in a negative way. This study focused on the basis for this controversy by examining the relationship between factors such as profit, efficiency, care quality, incentives, motivation and productivity. The study was performed by interviewing thirteen employees and managers in four different care organizations (of which half were public and the other half private). Their answers were analyzed from three theoretical aspects; incentives and motivation, efficiency and productivity, and care quality. The findings were that, since the revenue size is beyond their control, private providers can only create profits by reducing costs in a number of ways. Some of these ways, such as cutting down on education, team building activities and salaries, might be detrimental for the company in the long term (and thereby increase costs over time) and have adverse effects on quality. Others, however, such as increasing the efficiency of non-care activities (less administration and optimized scheduling, for example), avoid hiring overqualified staff and instead providing them with enough education for the task at hand, and optimizing work hours, might be more enduring over time and have none or small adverse effects on quality. More dispiritingly, it was also shown that the purchasers do not have any real knowledge about the quality of the work performed, regardless of the provider being private or public, and that in some municipalities users are denied to choose provider for themselves.

Every mother and child has the right to survive childbirth which requires skilled birth attendants together with referral and available emergency obstetric care (EmOC). The objective of the study was to describe delivery care routines at different levels in the health care system in Quang Ninh province, Northern Vietnam. The design was cross sectional using a structured questionnaire. Two districts in Quang Ninh province with 40 Community Health Centres (CHC), three district hospitals and one region hospital was included in the study, in total 138 (CHC n=105 and hospitals n=33) health care providers participated. In our study 20% (CHC) of the health care providers assisting deliveries at CHC were midwives and health care provider’s in our study further report to have assisted at less then 10 deliveries/year (81% of respondents at CHC). Findings show that the health care provider’s routines and care for women during labour and delivery vary and that there is a need for re-training and that women in labour should be cared for by health care providers with adequate training like midwifery. In our study CHC had poor resources to provide basic or comprehensive EmOC. Our findings indicate that there is a need for re-training in delivery care among health care providers and since the number of deliveries at CHC is few they should be handled by someone who is a skilled birth attendant. Our findings also show a variation in care routines during labour and delivery among health care providers at CHC and hospital levels and this also show the need for re-training and support from proper authorities in order to improve maternal and newborn health.

Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 63-66).

Made available in DSpace on 2014-06-11T19:28:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-09-02Bitstream added on 2014-06-13T18:32:40Z : No. of bitstreams: 1 cornelio_gf_me_botfm.pdf: 755589 bytes, checksum: f17aa6bdccf67683655e111671c9392b (MD5) / Secretaria de Saúde do Estado de São Paulo / O objetivo deste estudo foi caracterizar a educação em saúde dos cuidadores formais em Instituições de Longa Permanência para Idosos (ILPIs) de Botucatu-SP. Trata-se de um estudo descritivo, quantitativo e transversal realizado em nove ILPIs cadastradas pela Vigilância Sanitária, sendo entrevistados 43 cuidadores, os responsáveis técnicos e coordenadores dessas instituições. Foram aplicadas questões técnicas para analisar o conhecimento dos cuidadores quanto à assistência ao idoso e também a Escala de Katz para avaliar o nível de dependência dos idosos abrigados para a realização das atividades da vida diária. A maioria dos cuidadores possuía o 2º grau completo, mas 34,9% apresentavam 1º grau incompleto. Além disso, 58,1% tinham formação na área da saúde e 9,3% realizaram cursos específicos na área de Saúde do Idoso. As principais dificuldades apontadas pelos cuidadores foram referentes às condições e organização de trabalho, sobretudo, a falta de recursos humanos e à habilidade técnica e/ou psicológica para lidar com o idoso com presença de estresse e deficiência de atividades de lazer. No entanto, a necessidade de capacitação não é percebida como prioridade. Os resultados revelaram desconhecimento de cuidados básicos, principalmente com relação à crença de mitos e estereótipos sobre o idoso e o processo de envelhecimento, sendo importante a expansão de conteúdos gerontológicos nos currículos de cursos especializados bem como o estabelecimento de critérios para a função de cuidador com seleção mais criteriosa no processo de contratação. Dificuldades quanto à referência e contrarreferência de idosos e a falta de rede de apoio social também foram referidas pelos responsáveis e/ou coordenadores, sugerindo a necessidade de melhor integração dos serviços com definição clara das responsabilidades. Problemas nas relações... / This study aimed at characterizing the health education of formal care providers in Long-Stay Institutions for Older Individuals (ILPIs) in Botucatu-SP, Brazil. It is a descriptive cross-sectional study performed in nine ILPIs registered by Health Surveillance, where forty-three care providers, technical supervisors and coordinators were interviewed. Technical questions were applied in order to evaluate the care providers’ knowledge concerning care provision to older individuals, and the Katz scale was used to analyze the older sheltered individuals’ level of dependence to perform activities of daily living. Most care providers were high-school graduates, but 34.9% had not completed elementary-school education. Additionally, 58.1% had health-care qualifications, and 9.3% had attended specific courses on older people’s health. The major difficulties reported by the care providers were related to work conditions and organization, particularly to the lack of human resources and of technical and/or psychological skills to deal with the older individuals in the presence of stress and deficiency of leisure activities. However, the need for training is not perceived as a priority. Results showed lack of knowledge concerning basic care, particularly as regards the belief in myths and stereotypes regarding older persons and the ageing process, which shows the importance of the expansion of gerontological content in the curricula of specialized programs as well as the establishment of criteria for health care provider jobs with more strict criteria in hiring processes. Difficulties concerning the referral and counter-referral of older individuals and the lack of a social-support network were also reported by the professionals in charge or coordinators, suggesting the need for better integration of services with a clear definition of responsibilities. Problems related to relationships... (Complete abstract click electronic access below)