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Idag är unga kvinnor den grupp som utgör majoriteten av ätstörningsdrabbade, där anorexia nervosa, bulimia nervosa och EDNOS (eating disorder not otherwise specified) är de vanligast förekommande diagnoserna. Mando Group AB behandlar patienter med ätstörningar och har till patienternas hjälp utformat datorprogrammet Doktor Cecilia som är en virtuell behandlare till vilken patienterna kan ställa frågor. Användandet ligger enligt Mando Group AB inte på önskvärda nivåer och programmet har inte heller tidigare genomgått en utvärdering. Syftet med detta arbete var att ta fram potentiella förbättringar av programmet och att av patienterna få dessa tillsammans med programmet utvärderade. Vidare utfördes en enkätundersökning på två Mandometerkliniker för att kartlägga patienternas åsikter om programmet och de framtagna potentiella förbättringarna. Resultatet visade att patienterna var positivt inställda till implementerandet av bland annat röstsvar, tvåvägskommunikation och möjlighet till att se till programmet vanligt ställda frågor. Detta resultat användes sedan för att framställa rekommenderade implementationer som skulle kunna förbättra programmet och på sikt kunna öka dess användning. / Today, adolescent females represent the majority of people suffering from eating disorders with anorexia nervosa, bulimia nervosa and EDNOS (eating disorder not otherwise specified) being the most common diagnoses. Mando Group AB treats patients with eating disorders and has for the sake of the patients developed the computer software ‘Doctor Cecilia’ which is a virtual caretaker to whom patients may direct their queries. Mando Group AB has stated that the usage of the software has not reached the desirable level amongst their patients. Moreover, the software has not been subject to an evaluation. The purpose of this thesis has been to produce suggestions of potential improvements for ‘Doctor Cecilia’ by consulting patients in order to evaluate these improvements as well as the software in general. As such, an investigation was conducted at two Mandometer-clinics in order to clarify the opinions of the patients regarding the software itself and the potential improvements which are presented by this thesis. The results showed that the patients were in favor of the implementation of for instance voice response, two-way communication and the opportunity to see frequently asked questions. The results of this thesis have been used to produce recommended implementations that could improve the software and eventually increase its usage.

The aim of this thesis is to explore how public relations contributes to organizational culture at Carilion Clinic, a large health organization based in Roanoke, Va. Using the excellence theory combined with organizational culture perspectives as a lens, the study interviewed Carilion Clinic communications employees to uncover the presence of excellence principles in their public relations. A second part of the study analyzed employee posts on the organization's internal website to identify the congruency of organizational value meaning and manifestation between the organization and its employees. Results from the study found presence of five of the seven excellence principles in Carilion's public relations and that three of the five organizational values are congruent between the organization and its employees. Results suggest that Carilion Clinic's public relations efforts are contributing to organizational culture. Efforts by Carilion's public relations successfully communicate organizational values and foster a participative culture. This case study shows that public relations is beneficial to fostering organizational culture and that excellence principles as developed by the excellence theory can serve as a guide for organizations when implementing and evaluating public relations practices. / Master of Arts

[pt] A finalidade desta dissertação é a de refletir acerca das dimensões do trauma e do tempo, da importância do entrelaçamento entre ambos na tessitura da obra freudiana e das suas repercussões na clínica psicanalítica contemporânea. O tema do trauma surge na teoria freudiana desde os primeiros escritos, porém perde relevo em prol da teoria da fantasia na etiologia das neuroses, reaparecendo com toda a sua força em 1920, em conexão com a pulsão de morte. Em nossa análise, damos ênfase a este retorno da noção de trauma, em 1920, com o ensaio Além do princípio do prazer. Neste período, a teoria freudiana passou a ser guiada por um olhar da subjetividade individual e grupal, cujo funcionamento é imperado por um além do princípio do prazer. Este momento, também chamado de segunda tópica, possui dois pontos nevrálgicos: as neuroses traumáticas e a pulsão de morte, que se diferenciam das bases de investigações até então vigentes. Ao ampliarmos a questão do trauma para o cenário contemporâneo, nos questionamos onde essa noção se encaixa hoje. No debate psicanalítico atual, observamos um incremento de configurações de base traumática, chamados de casos-limite, que possuem uma grande relevância para o campo, por apontarem a presença de uma base traumática. Todavia, definir o que está em jogo nas novas configurações da atualidade se apresenta como um complexo desafio que implica trabalhar a relação com o trauma e outras dimensões, como o tempo. Nessa direção, os casos-limite representam uma via através da qual uma dimensão outra da temporalidade aparece, que possui consonâncias com o tempo do traumático. Propõe-se, portanto, investigar a noção de tempo, a fim de compreender que na psicanálise não há somente uma, mas diversas formas de expressão da temporalidade. / [en] The purpose of this dissertation is to reflect on the dimensions of trauma and time, the importance of their intertwining in the fabric of the freudian work, and their repercussions in contemporary psychoanalytic practice. The theme of trauma emerges in the freudian theory from the earliest writings but loses prominence in favor of the theory of fantasy in the etiology of neuroses, reappearing with full force in 1920 in connection with the death drive. In our analysis, we emphasize this return of the notion of trauma in 1920, with the essay Beyond the Pleasure Principle. During this period, freudian theory began to be guided by a perspective of individual and group subjectivity, whose functioning is governed by a beyond the pleasure principle. This moment, also called the second topography, has two pivotal points: traumatic neuroses and the death drive, which differ from the investigative bases that were prevalent until then. When we expand the question of trauma to the contemporary scene, we wonder where this notion fits today. In the current psychoanalytic debate, we observe an increase in configurations of traumatic origin, called borderline cases, which are highly relevant for the field as they point to the presence of a traumatic basis. However, defining what is at stake in the new contemporary configurations presents itself as a complex challenge that implies working with the relationship with trauma and other dimensions, such as time. In this direction, borderline cases represent a path through which another dimension of temporality appears, which resonates with the time of trauma. It is therefore proposed to investigate the notion of time in order to understand that in psychoanalysis there are not only one but several forms of expression of temporality.

The scourge of HIV and AIDS can no longer be underestimated. Its devastating effects have been translated into immeasurable monetary and human costs. Women and children, particularly among the rural communities, have borne most of the brunt accruing from the devastating socio-economic consequences of the disease. PURPOSE This study is intended to highlight the plight of rural communities who are constantly besieged by the demand and supply disequilibrium in the provision of primary health care and preventive interventions. OBJECTIVES To describe, compare and analyse HIV / AIDS health care services provided by fixed and mobile clinics in the Madibeng Sub-District of the North West Province. POPULATION The sampled participants were selected from a universal population among pregnant women. SAMPLING A sample of 100 pregnant women from the fixed and mobile clinics participated in answering the questionnaires during their antenatal care visits. RESEARCH SETTING The Madibeng Sub-District in the North West Province been selected as a suitable research site, as it met most of the selection criteria developed by the researcher's judgement sampling. RESEARCH DESIGN The data recorded on the questionnaires by the participants was used to compare and analyse the pregnant women's feelings about HIV / AIDS services of fixed and mobile clinics. Group discussions were also held prior self completion of questionnaires. Questionnaires were administered by the researcher and the two health promoters. FINDINGS It was found that participants in both mobile and fixed clinic have attended HIV / AIDS health care services. Fixed clinic and mobile clinic are respectively viewed as offering better health care services to pregnant women. CONCLUSIONS The research results from this study indicate that HIV / AIDS services provided at both the fixed clinic and mobile service points, including antenatal or prenatal care, are almost similar. RECOMMENDATIONS It is recommended for improving HIV / AIDS health care services that health care providers at Jericho mobile clinic and Jericho fixed clinic intervene by slowing the progression of HIV infection because it has a negative impact on the lives of women. The Jericho clinic and mobile clinic staff should be encouraged to adopt the perspective that HIV / AIDS is not a death sentence, but a preventable disease, not withstanding its deadly consequences on families and communities. The staff at these clinics is also to be motivated to adopt co-operative health care and psycho-social strategies, in which team work and the involvement and participation of all relevant stakeholders is viewed as an integral part of the struggle against HIV / AIDS and its devastating spread. / Health Studies / M.A. (Health Studies)

Made available in DSpace on 2016-04-04T18:29:32Z (GMT). No. of bitstreams: 1 Regina Celia Furigo.pdf: 8832692 bytes, checksum: 54938673017ec631e8aa17d399c05061 (MD5) Previous issue date: 2006-12-05 / The purpose of the present study was to analyze the Psychologic Attention available on the Emergency Psychological Attendance to the users of a Universitary Clinicschool generated from the experiences of emergency psychologists, patients, and Supervisor-researcher. The used methodology was based on a phenomenologic research from the study of ten cases in clinic attendance of individuals who spontaneously sought the cited service. It is important to note that the emergency attendance was offered for free by a convenant between the cited University and the Brasilian Public Heath System (SUS). The cases were treated and analyzed in the light of Jungian referencial. The attendance was carried out by six emergency psychologists previously selected and with a minimum of one year experience in clinical attendance. Three sessions were carried out for each patient and also a follow-up interview, was performed a month after the end of the Emergengy psychological attendance process. The group of emergency psychologists had a weekly supervision during the six month the research was performed. A detailed report of the clinical work as well as the personal perceptions of the emergency psychologists was delivered for each case of the program. The same has occurred with the supervisor-researcher who was responsible for the follow up interviews which reflected the patients feelings about the research. As a result, it was generated pool of ten reports from the psychologists about the attended patients?processes, ten follow-up interviews and ten perception reports from the supervisor-researcher about her personal understanding of the process as a whole. The emergency psychologists? reports, as well as the data obtained on the follow-up interview were divided in unities of significate which possibilitate the elaboration of specific syntheses, both from the emergency psychologist and the patient and from the supervisor-researcher. Thus, it was obtained three general syntheses refering to the lived element related to the research focus. The main results obtained show that, when the Emergency Psychological Attendance empathizes with the patient who needs psychological care, in the exact moment of his (her) crysis, treats with different times: one internal ( the patient time) and other external (the chronological time) and thus reaches such relevant results as to the contention of anguish in a brief time. Both Emergency Psychologists and patients experience a highly rich moment for their psyche, which makes viable the archetype of the wounded physician which, when constelating, assists the patient to recapture the hability to carry out his (her) autocure. Therefore, it is considered that Intervention Model used in the Emergency Psychological Attendance arises as an enormous hope of speeding and dinamizing the clinical services delivered by Psychology, enhancing the resources of this science for people who needs it within the health care field. / O presente estudo teve como objetivo analisar a Aten??o Psicol?gica disponibilizada no Servi?o de Plant?o Psicol?gico, aos usu?rios de uma Clinica-Escola Universit?ria, a partir das experi?ncias de Plantonistas, Clientes e Supervisora-Pesquisadora. Quanto ? quest?o metodol?gica, foi conduzida uma pesquisa fenomenol?gica a partir do estudo do atendimento cl?nico de dez casos referentes a pessoas que recorreram ao Servi?o de forma espont?nea. Ressalte-se que o acompanhamento foi oferecido de forma gratuita pelo conv?nio estabelecido entre a Universidade em quest?o e o SUS. Os casos foram atendidos e analisados ? luz de referencial junguiano. O atendimento foi realizado por seis plantonistas previamente selecionados e com no m?nimo um ano de experi?ncia em interven??es dessa natureza. Ocorreram tr?s sess?es por paciente mais uma entrevista de follow up, realizada um m?s ap?s o t?rmino do processo do Plant?o. O grupo de plantonistas foi supervisionado semanalmente durante os seis meses de realiza??o da pesquisa. Entregou relat?rio pormenorizado do seu trabalho cl?nico bem como de suas percep??es pessoais sobre o significado do Plant?o para cada caso. O mesmo ocorreu com a supervisora pesquisadora, encarregada das entrevistas de follow up, que no caso constituiu-se na voz do paciente dentro da pesquisa. Gerou-se ent?o um conjunto de dez relatos dos plantonistas sobre os processos dos clientes atendidos, dez entrevistas de follow up e dez relatos de percep??o da supervisora pesquisadora sobre seu entendimento pessoal daquele processo como um todo. Os relatos dos plantonistas, assim como os dados obtidos na entrevista de follow up foram divididos em unidades de significado que possibilitaram a elabora??o de s?nteses espec?ficas, tanto do plantonista, como do paciente e da supervisora pesquisadora. Obteve-se desse modo tr?s s?nteses gerais referentes ao elemento vivido, em rela??o ao foco da pesquisa. Os principais resultados foram que o Plant?o Psicol?gico ao colocar-se ao lado do paciente que necessita de atendimento psicol?gico no exato momento de sua crise lida com tempos diferentes: um interno (o tempo do paciente) e outro externo (o cronol?gico) e por isso consegue resultados t?o relevantes em termos de conten??o de ang?stias em um breve tempo. Plantonistas e Pacientes vivenciam um momento de encontro altamente fecundo para a psique de ambos, o que viabiliza a constela??o do arqu?tipo do curador ferido que, ao constelar-se, ajuda o paciente na retomada de sua capacidade de se autocurar, entre outros. Considera-se ent?o que o Modelo de Interven??o utilizado no Servi?o de Plant?o Psicol?gico desponta como uma grande esperan?a de agiliza??o e dinamiza??o dos servi?os cl?nicos prestados pela Psicologia, vindo a contribuir com uma gama maior de recursos que esta Ci?ncia pode colocar a servi?o de quem dela precisa dentro da ?rea da Sa?de.

The scourge of HIV and AIDS can no longer be underestimated. Its devastating effects have been translated into immeasurable monetary and human costs. Women and children, particularly among the rural communities, have borne most of the brunt accruing from the devastating socio-economic consequences of the disease. PURPOSE This study is intended to highlight the plight of rural communities who are constantly besieged by the demand and supply disequilibrium in the provision of primary health care and preventive interventions. OBJECTIVES To describe, compare and analyse HIV / AIDS health care services provided by fixed and mobile clinics in the Madibeng Sub-District of the North West Province. POPULATION The sampled participants were selected from a universal population among pregnant women. SAMPLING A sample of 100 pregnant women from the fixed and mobile clinics participated in answering the questionnaires during their antenatal care visits. RESEARCH SETTING The Madibeng Sub-District in the North West Province been selected as a suitable research site, as it met most of the selection criteria developed by the researcher's judgement sampling. RESEARCH DESIGN The data recorded on the questionnaires by the participants was used to compare and analyse the pregnant women's feelings about HIV / AIDS services of fixed and mobile clinics. Group discussions were also held prior self completion of questionnaires. Questionnaires were administered by the researcher and the two health promoters. FINDINGS It was found that participants in both mobile and fixed clinic have attended HIV / AIDS health care services. Fixed clinic and mobile clinic are respectively viewed as offering better health care services to pregnant women. CONCLUSIONS The research results from this study indicate that HIV / AIDS services provided at both the fixed clinic and mobile service points, including antenatal or prenatal care, are almost similar. RECOMMENDATIONS It is recommended for improving HIV / AIDS health care services that health care providers at Jericho mobile clinic and Jericho fixed clinic intervene by slowing the progression of HIV infection because it has a negative impact on the lives of women. The Jericho clinic and mobile clinic staff should be encouraged to adopt the perspective that HIV / AIDS is not a death sentence, but a preventable disease, not withstanding its deadly consequences on families and communities. The staff at these clinics is also to be motivated to adopt co-operative health care and psycho-social strategies, in which team work and the involvement and participation of all relevant stakeholders is viewed as an integral part of the struggle against HIV / AIDS and its devastating spread. / Health Studies / M.A. (Health Studies)

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Introduction Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows. Aim The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC implementation process at the ETSU-FM clinic, identify gaps, and provide recommendations to address those gaps. Methods A scoping review was conducted using three databases (PubMed, Web of Science, and PsycINFO) searches while following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist to identify different components of TCCs and the associated outcomes. Additionally, a mixed-methods study was conducted using patients and providers from the ETSU-FM clinic to identify different factors associated with patients’ no-shows to scheduled TCC appointments. Results Eighteen studies were analyzed and TCC components and patients’ outcomes were assessed. Predischarge communication with patients and caregivers, early post-discharge contacts, etc. were identified as some of the effective components of TCC. Our review also highlighted that TCC resulted in lower readmissions, lower ED visits, and cost-effectiveness. For the mixed-methods study, we included 520 patients in our quantitative analysis and interviewed 10 providers for the qualitative analysis. Several patient-level and system-level factors were found to be associated with TCC no-shows. A few of the factors that were deemed modifiable by the clinic have been identified and recommendations provided accordingly. Conclusion TCCs play a vital role in ensuring smooth care transitions of patients following discharge. It is crucial to conduct context-level studies to identify factors that are associated with TCC no-shows and design interventions accordingly. Doing so could lead to pursuit of the triple aim of healthcare: improving patients’ experience of care, improving the health of populations, and reducing the per capita cost of health care.