The purpose of this paper is to provide an overview of how cooperation functions between the health services and social services within Sollentuna County Municipal area regarding clients and simultaneous or double diagnoses. Focusing more specifically; the paper also aims to provide additionally, an inquiry as to how the implementation of the Gemensam Individuell Vårdplan (GIVP) (The Integrated Individual Service Care Programme or (GIVP) functions within the Sollentuna Municipal County Area. The questions asked in the paper are: How do the Municipal and County Council personnel experience how the (GIVP) system functions in Sollentuna? How do the Municipal Council and County Council personnel respectively describe their own and their cooperative sister services rolls in terms of the implementation of the GIVP system in practice? The projection activates a hypothesis and tries to explain how the cooperation functions and provides an assessment as to how it functions or not as may be the case in practise. The authors attempt to achieve this using a combination of methodologies. Partly through data based collection and collation through the use of a vignette-focus-study and partly through the use of a questionnaire. A combination of methods has been used to collate both quantitative and qualitative data. The analysis and interpretation of the data is managed through the use of Bengt Berggren’s (1982) cooperative model, incorporating both cognitive theory as well as meta-cognitive theory. The purpose and application of the theories is designed both to individually and collectively nuance interpretations of the relevant data. The investigations primary results show the existence of a strong willingness to cooperate. It shows that cooperation is widely regarded as being important, and that in addition, GIVP is regarded as a useful system for an improved integrated service. It additionally suggests that cooperation can be improved amongst the relevant services to an even greater extent.

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 340-375).

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 1992. / Typescript. Includes bibliographical references (leaves 112-117).

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 127-142). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

abstract: This study aimed to understand the factors that influence Chinese American older adults’ advance care planning (ACP) on end-of-life care. The Theory of Planned Behavior (TPB) and Health Belief Model (HBM) were primarily applied to explain Chinese American older adults’ intentions toward two behaviors: 1) discussion of end-of-life care plans with family members and 2) completion of an advance directive (AD). Additionally, acculturation and family cohesion were considered to examine their impacts on the TPB and HBM. A cross-sectional survey was conducted through face-to-face interviews on a sample of 298 community-dwelling Chinese-American adults aged 55 and older living in the metropolitan Phoenix area of Arizona. Based upon random assignment, 161 participants answered questions regarding discussing end-of-life care plans with family members, while 137 participants answered questions related to the completion of an AD. Hierarchical multiple regression analysis was used to focus on the influence of TPB and HBM measures on behavioral intentions toward the two behaviors. Results indicated that both the TPB and HBM had predictive power to explain the target population’s intentions. However, the predictability of TPB and HBM measures varied across the two behaviors. Acculturation moderated the relationship between attitudes and intentions to complete an AD negatively. Family cohesion moderated the relationship between perceived benefits and intentions to discuss end-of-life care plans with family members negatively. These findings would help inform future interventions for improving the target population’s ACP awareness and engagement. / Dissertation/Thesis / Doctoral Dissertation Communication 2018

Resumo: Trata-se de uma pesquisa qualitativa, com os objetivos de: compreender o processo interacional planejamento-implementação da Sistematização da Assistência de Enfermagem (SAE), na perspectiva de dois grupos amostrais: Enfermeiros e Técnicos/Auxiliares de Enfermagem de um hospital universitário de grande porte, do interior paulista e desenvolver uma síntese dos modelos teóricos representativos dessas experiências. A saturação teórica se configurou, mediante a análise de 24 entrevistas, sendo de: 12 enfermeiros e 12 Técnicos/Auxiliares, lotados em unidades de internação clínicas e cirúrgicas. A entrevista não diretiva foi a técnica de coleta de dados, tendo como questão norteadora: - Como tem sido a sua experiência com a SAE? As entrevistas foram gravadas e transcritas na íntegra e analisadas, segundo os passos da Teoria Fundamentada em Dados, denominada internacionalmente por Grounded Theory. Desta análise emergiu dois modelos teóricos, referentes às experiências que deram origem a um terceiro, resultado da síntese. O primeiro refere-se à experiência interacional do enfermeiro, a qual reúne dois fenômenos: idealizando operacionalizar a SAE na sua plenitude, vislumbrando o reconhecimento social da profissão e frustrando-se com a falta de apoio da instituição no processo de trabalho da equipe de enfermagem. Da interrelação dos seus componentes (temas, categorias, subcategorias e elementos), configurou-se a categoria central - entre a idealização e a frustração no processo de trabalho do enfermeiro: recursos humanos como componente interveniente para operacionalização da SAE e visibilidade da profissão. O segundo modelo retrata a experiência de Técnicos/Auxiliares, composta de dois fenômenos: legitimando a SAE e não legitimando a SAE, dos quais emergiu a categoria central... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This is a qualitative study developed according to the comprehensive approach. It was approved by the Research Ethics Committee with the purpose to understand the planning-implementation interactional process of Nursing Care Systematization (SAE) at a university hospital in the perspective of two sample groups, namely nurses and nursing technicians/auxiliaries, in order to develop a synthesis of the theoretical models that are representative of the experiences lived. Theoretical saturation occurred through the analysis of 24 interviews with 12 nurses and 12 technicians/auxiliaries stationed in the clinical and surgical inpatient units of a large university hospital in inner São Paulo state. Non-directive interviews were used for data collection with the following guiding question: - What has your experience with SAE been like? The interviews were taped, fully transcribed and analyzed according to the steps the Grounded Theory. From such analysis, two theoretical models emerged with reference to the experiences. They originated a third model which was the result of the synthesis. The first refers to nurses' interactional experience, which gathers two phenomena: idealizing SAE operationalization in its fullness, expecting the social recognition of the profession and becoming frustrated with the lack of support from the institution in the nursing team's work process. From the inter-relation of its components (themes, categories, sub-categories and elements), the core category was formed - between idealization and frustration in nurses' work process: human resources as an intervenient component for SAE operationalization and the profession's visibility. The second model depicted technicians/auxiliaries' experience, which consisted of two phenomena: legitimating SAE and not legitimating SAE, from which the core category emerged... (Complete abstract click electronic access below) / Orientador: Silvia Crisitna Mangini Bocchi / Coorientador: Magda Cristina Q. Dell'Acqua / Banca: Emilio Carlos Circelli / Banca: Raquel Rapone Gaidzinski / Banca: Wilza Carla Spiri / Mestre

A cirurgia ortognática moderna utiliza-se de medidas do perfil tegumentar para estabelecer uma relação direta com as bases ósseas. Sabe-se, entretanto, que métodos digitais vêm sendo empregados para auxiliar na precisão e predição do planejamento cirúrgico. O presente estudo comparou as medidas, obtidas da análise cefalométrica dos tecidos moles de brasileiros da região nordeste com as obtidas por SantAna et al. (2009). O trabalho foi realizado utilizando telerradiografias em norma lateral, digitalizadas e medidas pelo programa Dolphin Imaging, versão 11.0. Vinte e seis indivíduos (5 homens e 21 mulheres) satisfizeram os critérios de inclusão e constituíram a amostra do trabalho. Os resultados obtidos foram inseridos em uma planilha do programa Microsoft Excel e foram submetidos à análise estatística com o teste t paramétrico não pareado. Os resultados mostraram que os brasileiros da região nordeste apresentam terço médio menos proeminente, lábio inferior mais espesso, ângulo nasolabial mais obtuso, ângulo do lábio superior menor e o incisivo superior menos protruído em relação aos brasileiros da região sudeste. A conclusão do trabalho foi a existência de diferenças estatisticamente significantes no perfil mole quando comparou-se os brasileiros do nordeste com os do sudeste. / Orthognathics surgery modern uses the measure of soft tissue profile to stablish a relation with osseous basis. However, digital methods have been used to aid the prediction and accuracy of surgical planning. The present study compared the measures obtained from the cephalometric analysis of the soft tissues from brazilian northeast with the ones obtained by Sant´Ana et al. (2009). The work was performed by using cephalometric radiograph and measured by the Dolphin Imaging 11.0 version. Twenty-six individuals (5 male and 21 female) were the sample of this study. The results were inserted in an Excel program and were analyzed with the non paired parametric t test. The results showed that the brazilian northeast have the medium third less prominent, thicker lower lip, more obtuse nasolabial angle, smallest angle of the upper lip and less protruding upper incisor in relation to the brazillian southeast. The conclusion of this study was the existence of statistically significant differences in the soft tissue profile compared to the brazilian northeast to the southeast.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13327号 / 論医博第2195号 / 新制||医||1044(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 古川 壽亮, 教授 伊達 洋至, 教授 佐藤 俊哉 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Advance care planning is a conversation about personal values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on advance care planning have taken place outside of home health among populations with HIV/AIDS, cancer, dementia, and end stage renal disease. The U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses, and hospitalization is a poor outcome. In 2016, Medicare implemented the Home Health Value-Based Purchasing Model, in which reimbursement rates for agencies in 9 regionally representative states were dependent on quantitative measures of quality performance. Part of the program was a process-level mandate requiring agencies to report on advance care planning. The aim of this study was to examine the relationship of home health advance care planning protocols with hospitalization rates. Descriptive and regression analyses were conducted on survey data of protocols and agency data of demographics and outcomes. Statistical significance was found in the positive correlation between advance care planning protocols and hospitalization. Recommendations are made for broadening the scope of evaluation of quality in home health to include goal-concordant care and transitions to appropriate services.