Issued also as thesis, Columbia University. / Bibliographical references in foot-notes at end of most of the chapters.

Issued also as thesis, Columbia University. / Bibliographical references in foot-notes at end of most of the chapters.

Thesis (Ph.D.) - University of St Andrews, November 2009.

Topic of the diploma paper: Nursing Documentation in the Czech Republic. The paper compares nursing documentations used in various health-care establishments. Examining their printed form, it takes their main parts and focuses on the contents of individual components and on the records of implementation of the nursing process. These areas are analyzed and compared in the practical part of the paper. The objective of the diploma paper was to ascertain what documentation is used by health-care establishments in the Czech Republic and to compare these internal materials. From 49 contacted establishments in all regions of the Czech Republic, the research covered 15 establishments that consented to cooperation and provided nursing documentation in a printed form. All obtained materials were analyzed and used in research. In order to attain the objectives, qualitative research was used. A record sheet, based on 12 areas of the Gordon{\crq}s model, was made up for the purposes of the comparison. Individual documentations were kept and processed, and are referred to in the paper under letters of the alphabet so that anonymity of the research is maintained. Individual materials were analyzed. The contents of the sheets were compared and evaluated. The collected data were processed by means of Microsoft Office Word program. From the results of the research it is apparent that the documentations maintained by all the health-care establishments have a similar composition. They contain the nursing anamnesis, nursing care plan and other documents examined in detail in the paper. The nursing anamnesis is divided into individual fields that are not based on any mode and whose number varies. Measuring techniques are used in the documentations. The most widespread was Barthel{\crq}s test of activities of daily living. A nursing anamnesis is connected with a nursing care plan. All 15 documentations contain this plan. Six health-care establishments decided for a free form, six establishments for a preprinted form and the last three establishments combined the printed and the free form into one. According to the findings, all the examined samples are on a comparable level and comply with all the criteria of quality care of a patient, given by the needs of practice. The results of the paper will be provided to the cooperating establishments that may use them in order to achieve better quality of patient records.

Made available in DSpace on 2016-08-11T14:41:30Z (GMT). No. of bitstreams: 1 VilcelaniaAC_DISSERT.pdf: 1435007 bytes, checksum: 316a2c9597f70db916224d377a46696d (MD5) Previous issue date: 2015-02-26 / The issues related to animal welfare (BEA) and bioethics has been the subject of much debate, especially when referring to the Zoonosis Control Centers (CCZ). That body is responsible for controlling the population of animals and, consequently, existing zoonoses in cities. In this context, can be seen problems due to a variety of factors that often affect not only public health but also animal welfare and the possibility of conflict between professionals of the institution and the population they served. Whereas, therefore, such a reality, aimed to analyze the CCZ serving Mossoró / RN, its relationship with the community and animal welfare. For this, we conducted field research on site CCZ, with observation and monitoring of the activities developed by the institution, as well as a questionnaire with open and closed questions to 36 employees of the CCZ. The research is still extended to five districts of the city, where questionnaires were applied, also with open and closed questions, the 385 residents of their neighborhoods. The data obtained after the questionnaires were subjected to statistical analysis using the R program, using the chi-square test, Fisher exact test, with a 5% significance level. From the observation of the activities developed by the local CCZ was found that this does not meet all the specific objectives set by the National Health Foundation (FUNASA), and its physical structure is not consistent with the proposed guidelines also for this, which compromises the welfare of the animals housed. Furthermore, although most professionals (78%) know what is animal welfare, only a small portion (28%) know issues related to bioethics, and 30% of those who know what bioethics has completed higher education, 10% have incomplete higher education, 50% have completed secondary level and 10% have completed secondary level. Regarding the perception of the community, the majority of respondents do not know what are the animal disease control centers, their purpose and which existing programs. Regarding the perception of the CCZ professionals about their relationship with the community conflicting data were highlighted, since they consider that their relationship is harmonious, but report that there is resistance from the population for their work. It follows that there is a perceived need on the expansion of services offered by the CCZ to the population in order to enable it to participate and collaborate in the control of zoonoses and control of stray animals. In addition, it is necessary to improve with regard to working conditions in the institution in order to ensure animal welfare and staff. However, this will only become feasible with efforts and interest of the government / As questões relacionadas ao bem estar animal (BEA) e a bioética tem sido alvo de grandes discussões, principalmente quando se referem aos Centros de Controle de Zoonoses (CCZ). O referido órgão é responsável pelo controle da população de animais e, consequentemente, de zoonoses vigentes nas cidades. Nesse contexto, podem-se observar problemas decorrentes de uma série de fatores que, muitas vezes, afetam não apenas a saúde pública, mas também o bem estar animal e a possibilidade de haver conflitos entre os profissionais dessa instituição e a população por eles atendida. Considerando, pois, tal realidade, objetivou-se analisar o serviço do CCZ do município de Mossoró/RN, sua relação com a comunidade e com o bem estar animal. Para isso, foi realizada pesquisa de campo no CCZ local, com observação e acompanhamento das atividades desenvolvidas pela instituição, bem como aplicação de questionário com perguntas abertas e fechadas aos 36 funcionários do CCZ. A pesquisa se estendeu ainda para cinco bairros da cidade, onde foram aplicados questionários, também com perguntas abertas e fechadas, a 385 moradores dos respectivos bairros. Os dados obtidos após a aplicação dos questionários foram submetidos à análise estatística com auxílio do Programa R, utilizando-se os testes qui-quadrado, exato de Fisher, com um nível de significância de 5%. A partir da observação das atividades desenvolvidas pelo CCZ local constatou-se que este não atende a todos os objetivos específicos estabelecidos pela Fundação Nacional de Saúde (FUNASA), e que sua estrutura física não condiz com as diretrizes preconizadas também por esta, o que compromete o bem estar dos animais alojados. Além disso, embora a maioria dos profissionais (78%) saiba o que é bem estar animal, apenas uma pequena parcela (28%) conhece assuntos relacionados à bioética, sendo que 30% dos que sabem o que é bioética tem ensino superior completo, 10% tem ensino superior incompleto, 50% tem nível médio completo e 10% tem nível médio incompleto. No tocante a percepção da comunidade, a maioria dos pesquisados não sabe o que são os centros de controle de zoonoses, sua finalidade e quais os programas existentes. Quanto à percepção dos profissionais do CCZ sobre a sua relação com a comunidade foram evidenciados dados conflitantes, uma vez que os mesmos consideram que a sua relação é harmoniosa, porém relatam que existe resistência por parte da população para com seu trabalho. Conclui-se que há uma necessidade perceptível quanto à ampliação dos serviços ofertados pelo CCZ à população a fim de que esta possa participar e colaborar no controle de zoonoses e no controle de animais errantes. Além disso, faz-se necessária a melhoria no que diz respeito às condições de trabalho na instituição, a fim de garantir o bem estar animal e dos funcionários. Todavia, isso só se tornará viável com esforços e interesse do poder público

Cancer is emerging as a major problem globally and effective cancer care services are needed to lessen its burden on the community. In Greece, oncology health service provision is not located efficiently, resulting in only few patients receiving high quality care. Furthermore, shortages of health professionals and underdeveloped services such as primary care, home care and palliative care in the Greek NHS have aggravated the problem. The limited resources for healthcare have led to the absence of a national cancer registry, thus the extent of cancer incidence cannot be evaluated effectively. The dissatisfaction of the population regarding the Greek NHS is well established, despite the numerous reforms proposed by consecutive Greek governments. It remains that limited research exists in the area of oncology, especially on cancer services and cancer care. The aim of this study was to identify the key areas of cancer care and services that needed to be developed or improved in Greece and their prioritisation within the Greek healthcare system. Once identified, these areas of improvement could be used in a policy making context for the provision of effective services to cancer patients and might provide areas for further research A new Delphi technique (Q-Delphi) was introduced as an extension of the classical Delphi and implemented in two settings to collect data from a sample of 30 healthcare providers and 30 healthcare users. This was to reduce the potential subjectivity that may be introduced by the researcher in generating themes as an essential part of a successful Delphi outcome. The Q-Delphi of healthcare providers consisted of three rounds while that of the healthcare users was based on two rounds. The response rates for all rounds in both Q-Delphi studies were over 77%. The priorities for healthcare providers were focused on staff shortages, working conditions, pain management, home care, day units and communication. Healthcare users' highest priorities included the provision of and research on effective treatment, lessening the financial costs involved and the organisation of cancer services. Despite the separate Delphi studies, there were areas that both healthcare providers and users identified and prioritised. However, for the areas that both panels shared, there was a significant difference between their prioritisation. The World Health Organisation (WHO) suggestions for controlling cancer were used to triangulate, explain and discuss the results from this study (WHO 2002). The areas identified by healthcare providers and users were within those recommended by WHO. Based on the priorities provided by the participants and the suggestions by WHO, the establishment of a national cancer registry, the employment of nurses in order to develop primary care, home care, day care and palliative care services, education in communication skills and redistribution of the bio-medical technology are recommended in order to reduce the burden of cancer hi Greece. More research is needed to validate the actual level of cancer services provided in Greece. In addition, Q-Delphi is suggested as a valid and objective research method. For the benefit of Greek researchers, copies of documents used in conducting the research are also presented in Greek (Appendices 3 to 13 and 15).

Resumo não disponível / Telemedicina

Resumo não disponível / Telemedicina

abstract: Due to the history of colonization, disruption of Indigenous life ways, and encroachment of external Western ideals and practices upon tribal peoples in New Mexico, the protection and preservation of tribal customs, values, traditions, and ways of thinking are critical to the continued existence of the tribes. It has taken many years for tribal communities, such as the 19 Pueblos of New Mexico, to get to where they find themselves today: In a paradoxical situation stemming from the fact that Pueblo people are told to pursue the iconic American Dream, which was not actually designed or intended for tribal peoples and that always seems to be just out of reach for many community members. Yet many of them do their best to emulate the capitalistic consumption and the Western way of life. What is troubling about this is that perhaps many of these people are starting to forget that it was the strength of their ancestors and their dreams that allowed Pueblo people to be here today. So, how do Pueblo people address this paradox? How do they begin to give newer generations, such as the youth, the tools to question and to assess future programs and the future of the tribal communities? Furthermore, what does such a process of preserving and reclaiming mean for future governance? Are these communities prepared to accept the outcomes? This compilation seeks to address these issues by examining a) the creation and delivery of Western medicine for American Indians in New Mexico and b) a discussion of Pueblo culture and belief systems. The exploration will include not only discussing health and health care concerns, but it will also engage the future considerations that tribal governments in New Mexico, specifically Pueblo Indian communities, must reflect on to ensure the preservation of the culture and values of Pueblo people. Finally, specific recommendations for action and discussion will be delivered in the form of a policy paper that is designed for tribal leadership and tribal administrative audiences and suggested for implementation. / Dissertation/Thesis / Doctoral Dissertation Social Justice and Human Rights 2015

Made available in DSpace on 2014-06-11T19:28:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2006Bitstream added on 2014-06-13T19:36:27Z : No. of bitstreams: 1 fonseca_crb_me_botfm.pdf: 2425384 bytes, checksum: 80fa4a5bebd717d9956ee5a3a1878468 (MD5) / Frente à classificação do HC da FMB da Unesp no SUS, como Hospital Universitário e terciário objetivou-se estudar a interface da enfermaria do PS de Pediatria do HC, com o Sistema de Saúde local e regional, por meio da caracterização de suas internações, e do estudo dos recursos de saúde dos municípios da DIR-XI. Estudou-se 658 internações no período de 01 de junho a 31 de dezembro de 2003, aplicando protocolo com entrevista semi-estruturada, e coleta de dados de registros de anotações médicas e de enfermagem, além dos dados das unidades de saúde, dos municípios de procedência das internações, cadastrados no SUS. Para a classificação das doenças utilizou-se a CID-10 e para os medicamentos a lista de Denominações Comuns Brasileira (DCB) e, a dos genéricos, propostas pela ANVISA. Os protocolos foram digitados e analisados pelo Epiinfo 6.04d. Nas internações houve predomínio de meninos (53%), com a freqüência de 61,3% entre menores de cinco anos, sendo 19.9% menores de um ano; 26,5% de cinco a dez anos e 12.2% de adolescentes. De Botucatu procederam 54%, e dos demais municípios 46%. Dentre as doenças mais freqüentes, as do aparelho respiratório foram 26,4% e as conseqüentes a causas externas 16,7%. Das internações 70,9% tiveram um diagnóstico. Os exames mais solicitados foram: Hemograma 56,9%, Raios-X de tórax 42% e PCR 36,3%. Os medicamentos mais utilizados foram antibióticos (47,7%) e analgésicos e antitérmicos (29,8%). A média de permanência foi um dia. Necessitaram especialidades 43%: Neuropediatria 22,3%; Cirurgia Infantil 17,7%; Hematologia 12,7%. Foram encaminhados para enfermaria de Pediatria do HC, 25,1%, e para UTI, 1,1%. O estudo da trajetória prévia mostrou procura por serviços de saúde em 68,1%, sendo 56,9% PS e 26,2% UBS. A média do período entre a procura e a internação foi de 3,1 dias. Espontaneamente vieram 56,4%... / Based on the classification of the Clinic Hospital of the Medical School of Botucatu, Unesp at SUS - Unique Healthcare System, as a tertiary University Hospital, this work studied the interface of the pediatric ward at the Emergency Room at the Clinic Hospital with the local and regional Health System through the characterization of its hospitalizations, and the resources of health in the cities of DIR-XI (administrative region of Botucatu). A total of 658 hospitalizations, between June 1st and December 31st, 2003, were studied. Besides the protocol with semi-structured interviews, and collect of data from the medical and nursing registers, data from the health unit in the cities, registered at SUS, where the hospitalizations originated were also used. The International Classification of Disease - ICD - 10 was used to classify the diseases; the Brazilian Common Denomination (BCD) and the generic list proposed by ANVISA (Brazilian National Health Vigilance Agency) classified the medications. The protocols were typed and analyzed by Epiinfo 6.04d. Boys (53%) prevailed the hospitalizations; with 61,3% under 5 years of age where 19.9% were under one year old; 26.5% from 5-10 years of age and 12.2% adolescents. Fifty-four percent were from Botucatu and 46% from other cities. Among the most frequent diseases, the respiratory ones were 26.4%, and the ones due to external causes were 16.7%. Among the hospitalizations, 70.9% had one identified diagnoses. The most requested exams were: Blood Count - 56.9%, Thorax X-ray - 42% and PCR - 36.3%. The most often medications were: antibiotics (47.7%) and analgesic and antipyretic (29.8%). One day was the average permanence in hospital. Forty-three percent patients needed specialties: Neuropediatrics - 22.3%; Infantile Surgery - 17.7%; Hematology - 12.7%... (Complete abstract click eletronic access below)