Made available in DSpace on 2016-04-29T13:31:10Z (GMT). No. of bitstreams: 1 Aline Alves da Silva Travaglia.pdf: 989678 bytes, checksum: 3fae9b0f0e9ffd9d13b73713dcd94847 (MD5) Previous issue date: 2014-03-25 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Within the topic of mental health and the field of psychoanalysis, we shall think about the children s assistance and the position of the analyst, with that practice as inserted in the institutional environment. Taking as a ground the method of clinical vignettes, we will use some clinical cases as markers to put in question the position of the psychoanalyst s position before the child's suffering. It is mandatory the understanding of some clinical tools as well as their expansion to the analyst s political job, in public and institutional spaces, it is necessary to furnish the idea of an ethical and political listening. We proceed then criticizing the hegemonic understanding of mental healthcare and their references in contemporary psychopathology, in order to understand the addressing of the subjects using the medical speech to prompt care via mental health institutions. Charting a critique of contemporary psychopathology, we intend to comprehend how the symptoms becomes something difficult to be evaluated when the suffering is obturated into diagnostic nomenclatures, but instead, the work of the analyst appears as a hearing that raises the subject to put himself in his uniqueness. To welcome the complaint referred to the medical and psychiatric field and to put ahead the uniqueness of a symptom, as something that returns and which has no name provided in the DSM this is one of the roles of the analyst in a mental health institution. We intend to elaborate how the attention and the management of transferential position are necessary for the child's treatment, both the transfer with responsible adults and the transfer at the institutional level, with the team which also takes care of her. To face the transferring in a broad clinical listening becomes essential to remove the reference to the individual clinic and to provide theoretical and technical information to understanding the analyst s social, collective and political role. Children s assistance in the institutional context demands from us to doubly bending toward a broadening of the analytical listening: first because the child brings with her other people who speak about her and for her; secondly because, in the institutional environment, the treatment happens in the polyphony of various knowledges. To hear these diverse voices in the clinical work is what we consider essential both for the subject to be contemplated and for the analyst s activity to reach a scope beyond the individual, understanding the child as a subject of desire formed in a close relationship with the familiar, social and political context she is immersed / Dentro do tema da saúde mental e do campo da psicanálise partimos pra pensar a posição do analista com sua práxis no espaço institucional e o atendimento à infância. A partir do método de vinhetas clínicas usaremos alguns casos como balizas para questionar a posição do analista diante do sofrimento da criança. A compreensão de algumas ferramentas clínicas assim como a ampliação destas para o trabalho político do analista nos espaços públicos e institucionais se faz necessário, para com isso aparelhar a proposta de um escuta ético-política. Procederemos com a crítica à forma hegemônica de compreensão de saúde mental assim como as referências em psicopatologia contemporânea, para com isso compreender a forma de endereçamento dos sujeitos que usam do discurso médico para solicitar cuidados na saúde mental. Traçando uma crítica à psicopatologia contemporânea pretendemos compreender como o sintoma se torna algo difícil de ser visado na medida em que o sofrimento se obtura em nomenclaturas diagnósticas, mas que nesse interim o trabalho do analista se marca como uma escuta que suscita o sujeito a se colocar em sua singularidade. Acolher a queixa referida ao campo medico-psiquiátrico e aí colocar a singularidade de um sintoma, como algo que retorna e que não tem nome previsto no DSM, esse é um dos papéis da escuta do analista na instituição de saúde mental. Pretendemos elaborar como que a atenção e o manejo da posição transferencial são necessários para o tratamento da criança, tanto a transferência com os adultos responsáveis por ela quanto a transferência no âmbito institucional com a equipe que dela também se ocupa. Pensar a transferência numa escuta clínica ampliada se torna fundamental para desmontar a referência à clínica individual assim como nos fornece subsídios teóricos e técnicos para compreender o papel social, coletivo e político do analista. O atendimento às crianças no âmbito institucional nos convoca duplamente a pensar em direção a uma ampliação da escuta analítica, primeiramente porque a criança trás consigo outras pessoas que falam dela e por ela, segundamente porque no meio institucional o tratamento se dá na polifonia de vários saberes. Escutar essas diversas vozes no trabalho clínico é o que consideramos fundamental para que o sujeito seja visado e para que a atividade do analista alcance um âmbito para além do individual, compreendendo a criança como um sujeito do desejo que se forma em íntima relação com contexto tanto familiar, quanto social e político em que está imersa

Esta dissertação de mestrado trata de uma investigação teórica por entre as conceituações da Clínica da Atividade e da Ergologia, na direção da produção de uma clínica-crítica do trabalho tomado enquanto experiência. Partimos de leituras a respeito de como o trabalho tem se configurado no contemporâneo, procurando compreender seus desafios e pensar uma clínica do trabalho afeita a fazer frente aos mesmos. Empreendemos um mergulho conceitual pelas abordagens da Ergologia e da Clínica da Atividade, a fim de rastrear os limiares entre os conceitos de atividade e experiência, buscando extrair a potência de tal discussão para o desenvolvimento das clínicas do trabalho. Contamos, ainda, com a contribuição das formulações de Walter Benjamin a respeito da íntima relação entre a experiência e a narrativa, como forma de produção e transmissão de uma história coletiva aberta, criadora de novos sentidos e transformadora dos sujeitos e do mundo. Concluímos que o conceito de atividade, quando inflexionado pelo conceito de experiência, nos permite expandir as possibilidades de análise e intervenção no campo do trabalho. Ao explorarmos a intimidade entre os conceitos de narrativa e experiência, tal como proposta por Walter Benjamin, esta inflexão nos permite, ainda, produzir dispositivos de intervenção junto aos trabalhadores na direção de uma clínica do trabalho que se vale da produção da própria história dos ofícios para produzir expansão das potências de ação coletiva e, por consequência, da produção de saúde no e pelo trabalho. Neste ponto da discussão, encontramos em Michel Foucault e suas formulações a respeito de experiência e de crítica, potentes operadores conceituais a dialogarem com as formulações clínicas do trabalho, de maneira a nos dirigirmos a uma clínica-crítica neste âmbito, aquela capaz de fazer frente aos poderes subjetivantes que marcam o trabalho no contemporâneo. / This Masters thesis consists of a theoretical research which passes through the conceptualizations of the Clinic of Activity and Ergology approaches, aiming at the critic-clinic production of work as experience. Our starting point are analysis concerning how work has been set on contemporaneity, trying to comprehend its challenges, in order to think a clinic of work which is interested in facing them. We employ a conceptual immersion in the Ergology and the Clinic of Activity approaches, tracking the boundaries of the concepts of activity and experience, in an effort to bring out the potency this discussion can impart in the development of the clinics of work. We also lay hold of Walter Benjamin's formulations regarding the intimate relationship between experience and narrative, as a mean of production and transmission of an open and collective story; a story which create new senses/meanings and transform the subjects and the world. We conclude that the concept of activity, when inflected by the concept of experience, allows us to expand the possibilities of analysis and intervention in work. By exploring the intimacy between the concepts of narrative and experience, as Walter Benjamin proposed, this inflection allows us the production of intervention apparatuses together with the workers in the direction of a clinic of work which relies on the production of the craft's own history to expand the powers of collective action and, therefore, of the production of health at and by work. At this point in our discussion, we find powerful conceptual operators in Michel Foucault and his formulations regarding experience and critic, conceptual operators which we put in dialogue with the clinic formulations of work, aiming at a critic-clinic of work, a clinic capable of facing the subjectifying powers that mark the work on contemporaneity.

Thesis. 1975. M.C.P.--Massachusetts Institute of Technology. Dept. of Urban Studies and Planning. / Bibliography: leaves 103-109. / by Georgia A. Lovett. / M.C.P.

ABSTRACT:Healthcare management is a field that is related to management, leadership, and service of anorganization. Due to high competition and change in the environment of healthcare organizations,managers need to embrace the innovation to respond to those changes and make the organizationsuccessful by improving the process, structure, and culture of the organization as well as to provideefficient and effective care that will lead to achieve patient satisfaction. Service quality is one ofthe key factor among the service innovations that contribute to business development and leadingposition in the business world with high competition. Patient satisfaction is important for anyhealthcare organization. Patient satisfaction improves hospital/clinic image, which changes into anincrease in the use of services provided by the healthcare systems and increases market share.Patient satisfaction is dependent on the service quality which is the main factor in healthcareinnovations.Purpose: The purpose of this study is to understand experience levels of the patient satisfaction ofservice quality in Swedish dental clinics, based on the factors affecting dental service quality.Data Sources: Interviews with staff from six clinics in Sweden, 240 patient surveys from twopublic and two private Swedish dental clinic, group interviews with three Swedish dental clinics,Science-Direct, Research Gate, ABI Inform, Google Scholar, Academia.edu.Method: This study is based on the quantitative and qualitative analysis (i.e., mixed methodapproach) and abductive approaches to measure patient satisfaction in Swedish dental clinicsthrough service quality. The problem is analyzed through interviews with the staff in private andpublic dental clinics. The factors affecting the dental service quality are analyzed throughtheoretical and empirical analysis. The patient’s satisfaction was measured by SERVQUAL toolthrough using patients’ survey that consists of 12 questions based on the four factors (tangibility,empathy, responsiveness, and Assurance). Patient survey is conducted in four dental clinics. SPSSwas used to calculate mean and standard deviation for the survey’s result. After analyzing the result,group interviews with clinic 1, clinic 3 and clinic 5 was conducted to understand different valuesin the tool i.e., the value created, value destroyed, and value missed based on the customerperception to analyze the service quality of the dental clinics.Findings: The result from the surveys showed that the factor empathy has highest positive affectand responsiveness has the lowest effect in four dental clinics. The lowest effect in the factorresponsiveness is based on the waiting time to meet a dentist. The group interviews gave us thedifferent values which are based on the idea of the value mapping tool in customer perspective.The value that the clinics gained trust from their patients. The value missed\destroyed is the waitingtime to meet a dentist. The new opportunities are to improve the services by installing newtechnology products and changing the appearance of the clinic.

In the U.S., the number of persons who cannot afford health care continues to rise. Providing a "safety net" for such persons is becoming increasingly important. Medical professional volunteerism provides access to health care for people who have little or no access to health care otherwise. At a not-for-profit free health clinic in Tampa, Florida, hundreds of physicians have volunteered their time in an attempt to reduce the health care gap in their community. The clinic sees thousands of persons who have very limited options in regards to their health care. This study investigates the reasons physicians volunteer and the barriers physicians face when providing free medical service. Through a survey, shadowing sessions, and focused in-depth videotaped interviews with volunteer physicians concerning the risks, rewards, experiences, and barriers of professional volunteering, a greater understanding of this important topic was obtained. This applied visual anthropological project was developed in collaboration with the free clinic in order to provide a product which would be of use to the organization at the end of the research process. This research led to an enhanced understanding of this population as well as recommendations in volunteer physician recruitment strategies.

Management of chronic disease requires a different service delivery model from that of acute illness. The uninsured population experience poorer health status and increased incidence of chronic disease than do the insured population. The purpose of this study was to identify the supports and barriers present in providing chronic disease management to patients at Ohio free clinics. Wagner's theory of chronic disease management served as the theoretical lens. The sequential, exploratory mixed methods study collected data from 13 free clinics belonging to the Ohio Association of Free Clinics (OAFC). Quantitative questions focused on processes in clinics with high and low fidelity to the chronic care model (CCM) determined by the Assessment of Chronic Illness Care (ACIC) survey. A backwards stepwise logistic regression was used. The quantitative analysis determined the 3 highest and lowest scoring clinics on the ACIC survey who then participated in a 2 tiered multi-case study series. Qualitative questions examined supports present in high fidelity clinics and barriers present in clinics with low fidelity. Qualitative findings identified 5 support areas that centered on progressive vision and patient-centered care themes that existed in high fidelity clinics. Four barriers were identified in low fidelity clinics that focused on the theme of capacity building. These findings provide evidence to guide the OAFC's work in improving adherence to the CCM constructs, thereby elevating the quality of care to the uninsured with chronic disease to the level of those providers governed by accrediting organizations. Changes in quality of care may result in an improvement to the health status of the individual and the communities in which they live.

Healthcare business leaders in a rural clinic setting can enhance profitability by implementing strategies to ensure timely payments. The purpose of this multiple case study was to examine strategies applied by healthcare leaders in rural clinics to improve profitability. The population included 10 rural clinic managers and billing staff from 5 rural clinics in the southwestern region of the United States. The conceptual framework for this study was Wernerfelt's resource-based value theory. Implementing Yin's multiple-step data analysis process, data from semistructured interviews were transcribed, coded, and analyzed to identify strategies used by rural clinic managers and billing staff to enhance profitability. Four primary themes emerged regarding revenue cycle management that could increase profitability, including developing effective communication between medical providers and billing staff, implementing payment plan strategies, ensuring accuracy of billing claims, and consistently reviewing open receivable accounts. The implications of this study for positive social change include insights for clinic managers in the development of strategies to increase cash from accounts receivables, which may contribute to the financial stability of the clinic and improve the provision of healthcare for citizens of the southwestern region of the United States.

Thesis (MPH.) --University of Limpopo, 2012 / The purpose of the research was to explore the factors that affect the performance of nurses in the Makhuduthamaga Sub-district. The Research Design was quantitative descriptive. The population consisted of all categories of nurses working in the eighteen clinics of the Makhuduthamaga Sub-district that render a 24-hour service, seven days a week. The Stratified Random sampling technique was used to obtain the sample. Data were collected by means of designed performance instrument questionnaires. The study revealed that nurses were dissatisfied with their work, something that had a tremendous influence on their performance.

The Muscatine Pediatric Dentistry Clinic (MPDC) at the Muscatine Center for Social Action (MCSA) was established January 4th, 2005. It is a partnership between the MCSA and The University of Iowa's Department of Pediatric Dentistry. MPDC operates Tuesdays (care provided by senior dental students) and Thursdays (care provided by pediatric dentistry residents). Students and residents are supervised by a pediatric dentistry faculty member. MPDC's mission is to provide dental care to low income children residing in Muscatine and Louisa counties, in Iowa. Care includes diagnostic, preventive, restorative, and emergency services. MPDC targets a population that has been traditionally underserved by local dentists including Medicaid-enrolled children and low income children without dental insurance. MPDC offers dental students the opportunity to gain experience treating children with the ultimate goal of increasing the number of practicing general dentists who serve pediatric populations. MPDC completed 6 years of operation on January 4th, 2010. The main goals of this study were to describe patient characteristics, clinical activities and parental satisfaction at the Muscatine clinic and to compare characteristics of the Muscatine clinic to those of the University of Iowa's pediatric dentistry clinic at the College of Dentistry. Clinical activities and patient profile variables for MPDC were reported for the entire fiscal year 2009-10 year. Variables include patient age, gender, type of insurance, number of dental procedures completed, type of treatment received, and number of visits per patient. A satisfaction survey was given to the parent of each patient presenting to the MPDC clinic between November 16th, 2009 and January 17th, 2010. Two broad research questions were addressed in this study: 1) Are parents satisfied with MPDC and the treatment provided to their children? 2) Are there are differences in the population served and treatment provided at the Muscatine clinic and the University of Iowa pediatric dentistry clinic at the College of Dentistry? The results of this study provide information that contributes to a fuller understanding about the population served by MPDC, the treatment received, and parental satisfaction with the clinic. It also compares characteristics of the Muscatine clinic to the University of Iowa's pediatric dentistry clinic at the College of Dentistry. The results of this study may help guide MPDC staff and the University of Iowa's Department of Pediatric Dentistry in future decision-making regarding clinic activities and dental school curriculum.

This thesis describes an internship for the Department of Anthropology that was part of the Florida Health Literacy Study (FHLS) conducted at the University of South Florida College of Public Health, Department of Community and Family Health in the spring and summer of 2003. The FHLS implemented Pfizer Inc.'s For Your Health program, a type 2 diabetes and hypertension education programs, at 14 community health clinics across the state of Florida. The internship was designed to elicit the experiences of 10 bilingual health educators about their experiences and their perceptions of the experiences of their Latino patients with type 2 diabetes with the Spanish version of Pfizer'ts For Your Health or Para Su Salud type 2 diabetes education program. This internship examined the Para Su Salud program for its cultural appropriateness for the diverse Latino population in the community health clinics in Florida. This internship combined the fields of anthropology and public health to provide a holistic analysis of the issues important to the Latino Health Educators participating in Pfizer's Para Su Salud type 2 diabetes education program. Through anthropological methods including in-depth interviews, class and clinic observations and patient satisfaction surveys, this internship found that the program was well-liked in the community health clinics and it could provide more culturally appropriate themes and food options for type 2 diabetic Latinos in Florida. This thesis makes nine specific recommendations for improving the appropriateness and ultimate success of the Para Su Salud educational program.