Thesis (M.H.A.)--University of Michigan, 1973.

Thesis (M.H.A.)--University of Michigan, 1973.

Thesis (M.S.)--University of Wisconsin--Madison, 1990. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 82-87).

Thesis (Ph.D.)--Indiana University, Dept. of Sociology, 2005. / Source: Dissertation Abstracts International, Volume: 66-01, Section: A, page: 0362. Adviser: Jane D. McLeod. Title from dissertation home page (viewed Oct. 11, 2006).

Orientador: Antonio Carlos Pereira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-05T20:23:32Z (GMT). No. of bitstreams: 1 Lourenco_EloisiodoCarmo_M.pdf: 1224969 bytes, checksum: a7fb337d60c093775ae10720922459d1 (MD5) Previous issue date: 2005 / Resumo: A implantação de Equipes de Saúde Bucal (ESB) no Programa Saúde da Família (PSF) representa uma possibilidade de mudança no modelo de atenção. Os modelos assistenciais em saúde bucal implantados anteriormente não conseguiram dar uma resposta satisfatória às necessidades da população. Buscou-se neste trabalho analisar o perfil de implantação e atuação das ESB no PSF em municípios do Estado de Minas Gerais, identificando aspectos administrativos e operacionais destas equipes. Foram encaminhados a 292 municípios, do Estado de Minas Gerais, dois tipos de questionários: um abordando aspectos administrativos e o segundo abordando aspectos operacionais das ESB, sendo que 56,8% dos municípios (166) retornaram os questionários. O percentual de ESB respondentes correspondeu a 52,3% (278). 66,9% dos municípios relataram formas de contratação instáveis e 82,5% dos dentistas recebiam salário abaixo de R$ 2.200,00 para uma jornada de oito horas diárias de trabalho; 75,9% dos municípios relataram uma proporção de até 4.000 habitantes por ESB, sendo que 74,1% utilizavam mais de uma forma de agendamento dos usuários. Em média, 79,6% das ESB relataram atender todas as faixas etárias e 48,9% dos dentistas relataram não ter participado de nenhum curso de capacitação para PSF; a maior parte dos dentistas (76,2%) relatou haver integração entre os profissionais das ESB e Equipes de Saúde da Família. No entanto, apenas 54% realizam reuniões freqüentes e 69% não utilizam prontuários únicos. Observou-se como pontos positivos o princípio da universalidade, a jornada de trabalho de oito horas e a ampliação quantitativa, possibilitando um maior acesso aos serviços de saúde bucal e, como pontos negativos, a falta de capacitação das ESB, a demanda excessiva, a precarização do trabalho com baixos salários e contratações instáveis e a falta de envolvimento entre ESB e Equipe de Saúde da Família / Abstract: The insertion of the Oral Health Team (OHT) in the Family Health Program (FHP) represents a possibility in changing the current health attention model in Brazil. The attendance models in oral health management, previously applied in Brazil, not achieved a satisfactory result for community needs. Thus, the objective of the present study is to evaluate administrative and operational aspects of OHT in Minas Gerais State until 2004. Coordinators of community dentistry or responsible for health planning in 292 cities from Minas Gerais State received a questionnaire including questions about administrative and operational aspects of OHT. 56.8% (n=166) of questionnaires were returned. 66.9% of the health coordinators related instable forms of engagement; 82,5% of the dentists received income lower than R$ 2,200.00 for full-time work; 75% of the cities used a proportion of 4000 habitant per OHT; 75.9% used more than one form of schedule patients. A total of 79.6% of OHT responsibles related to attend patients in any age-group; 48.9% of the dentists related not to have participated of capacitation courses for working in FHP. The most of dentists (76.2%) related an integration between professionals of OHT and others professionals from Family Health Team (FHT), however only 54% accomplished frequent meetings. In conclusion, as positive aspects were observed: the universility principle is being followed, the fulltime work and the quantitative extension of OHT have admitted a more access to oral health and, as negative aspects: a lack of professional capacitation, an excessive demand for attendance and a lack of relationship between OHT and FHT / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia

In South Africa, which has the largest HIV infected population world-wide, more than 5 million individuals presently live with HIV and AIDS (Evian, 2002:20; LINAIDS, 2004:19). These HIV-infected patients in turn affect the family structure within which they find themselves in a specific community. According to Saleeby (1992:54) and Barnett and Blaikie (1992:34), several families in South Africa are affected by the challenges posed by AIDS. This research forms part of the group research project, Tswaragano, which deals with an investigation into the competencies, abilities and strengths of the family of the HIV-positive patient while supporting the patient at home (Wessels, 2003:54). Problems such as unemployment, poverty, crime and changed demands in the community where these families live and increased challenges place a tremendous amount of stress on the families (Saleeby, 1992:54; Barnett & Blaikie, 1992:34). A vicious circle of AIDS and poverty is clearly confirmed and it has been found that people who live with HIV and AIDS need more support than health care alone (Booysen et al,. 2004:817-826). It is evident from the literature that, although information regarding HIV and AIDS is conveyed during pre- and post-HIV and AIDS test counselling, the transmission of information is not necessarily successful (Parker et al., 1998:18). A question which hence arises is whether the HIV positive patient and his family who support him at home fully grasp the necessary information. Greeff and Du Plessis (2001:2) confirm that health workers in the North-West Province do not convey the information effectively. Several factors probably contribute to defective information transfer between the health worker and the patient. One factor is that if the environment within which information is conveyed is not comfortable and mutual respect and trust between the health worker and the HIV positive patient is limited, the interpretation of information on HIV and AIDS is impaired (Allender & Spratley, 2001:163). A further aspect that should be taken into consideration is that HIV and AIDS-related information can be understood and internalised by the HIV positive patient in different ways, since several interpretation possibilities exist for information that is conveyed (Parker et al., 1998:20). Health workers who convey the information to the patient does however not always determine whether the HIV positive patient understands and internalises the information correctly (Parker et al., 1998:21). The facts mentioned above not only limit the HIV positive patient's understanding but also eventually the understanding of the family who have to support the HIV positive patient at home, regarding HIV and AIDS. The family can be seen as a primary core support resource for the HIV positive patient (Uys, 1999:2), and limited understanding impairs support at home (Hartman, 1981:10). With this is meant that the family is the "social service agency in meeting the social, educational and health care needs" of its members. The aim of this research was to investigate and describe the understanding of the HIV positive patient and the family regarding HIV and AIDS-related information. Guidelines were formulated to promote the understanding of the family of the HIV positive patient regarding HIV and AIDS-related information with the view to empower the family of the HIV positive patient in order to be able to support the patient at home. The research design was quantitative and descriptive by nature. It entails a pilot study in the Kagiso district, Vryburg area (Bophirima) of the North-West Province. The actual research study was performed in the Primary Health Clinics in the Potchefstroom district of the southern area of the North-West Province. Purposive sampling was performed (Burns & Grove, 2001:376; Brink, 1996:141; Abramson & Abramson, 1999:70; Bainbridge, 1989:46). Selected health workers acted voluntarily as go-betweens to identify HIV positive patients and their families who are prepared to participate in the research and who answer to the criteria, and to assist in filling out the questionnaires. The questionnaires were analysed by means of the frequency method with the assistance of the Statistical Consultation Services of the North-West University, Potchefstroom Campus and reported on by means of tables and graphs (Brink, 1996:499; Burns & Grove, 1997:430). From the research it was found that, although information transfer regarding HIV and AIDS does take place, there still are many voids in respect of the understanding of this information and this pertains to HIV positive patient as well as the families. The researcher has come to the conclusion that the proposed guidelines in order to empower families of the HIV-positive patients to support these patients at home therefore is obvious and important. Furthermore, the researcher is of opinion that families midst the difficult circumstances will realise their own strengths if they could acquire the necessary knowledge and skills. Recommendations were made for nursing education, for the practice of the community nurse as well as for nursing research. Guidelines were formulated to empower the family of the HIV positive patient to be able to support the patient at home. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2008.

<p> Major depression disorder (MDD), also known as clinical depression, is classified as a type of affective disorder (also called mood disorder) that goes beyond the day's ordinary ups and downs. It is a serious medical condition and important health concern. In the US there is an estimated 16.1 million people living and suffering from major depressive disorder in a given year, the majority of whom may not adequately respond to initial antidepressant treatment and psychotherapy. OC Ketamine Therapy will introduce a new form of treatment for individuals suffering from major depression to the Orange County (OC) region. Ketamine infusion therapy is known to be effective and efficient in dramatically reducing symptoms of major depression. Our OC Ketamine Therapy practice will provide ketamine infusion along with nutritional guidance and psychotherapy (&ldquo;talk&rdquo; therapy) to care for our patients. Our an innovative approach to treatment for depression will empower individuals to make informed healthcare decision while offering a unique treatment option. Our goal will be to care for the whole individual throughout their journey with us in receiving treatment. Our dedicated staff of nurses, receptionist, marriage family therapist or psychologist, nutritionist and anesthesiologist will work together to serve our patients and their families.</p>

A proposta de Reforma Psiquiátrica vem modificando a assistência ao portador de transtorno mental nas últimas décadas. Com a desinstitucionalização do doente mental, emergem novos paradigmas com grandes desafios a todos os atores sociais envolvidos na construção da cidadania e na busca da reabilitação psicossocial. Surgem novos conceitos do processo saúde-doença, novas redes de assistência, alocação de recursos como também a implantação de Centros de Atenção Psicossocial CAPS e ainda diretrizes do Ministério da Saúde determinando que as ações, no campo da saúde mental, sejam realizadas na atenção básica, ou seja, nas Unidades Básicas de Saúde (UBS) e por meio da Estratégia Saúde da Família (ESF). A ESF passa a ser uma importante ferramenta no processo saúde-doença no que diz respeito ao cuidado integral do ser humano visando à promoção, prevenção, proteção e recuperação tanto das doenças físicas, sociais quanto mentais. Assim, o objetivo deste trabalho é compreender as necessidades da ESF para desenvolver as ações de saúde mental na comunidade e identificar as ações desenvolvidas pelas equipes da ESF frente aos portadores de transtornos mentais e seus familiares. Trata-se de uma pesquisa qualitativa, que foi desenvolvida por meio de entrevista semiestruturada realizada com os membros das equipes da ESF, as entrevistas foram gravadas e transcritas na íntegra para análise. O material foi analisado por meio da Análise Discurso sob a ótica do referencial teórico do materialismo histórico e dialético. Emergiram das entrevistas três categorias: Processo Saúde Doença-Mental; Família; Processo de Trabalho. Os discursos dos informantes revelaram que os profissionais ESF mantêm a prática da psiquiatria tradicional centrado nas consultas, na medicação e nos exames, sendo esse o principal instrumento para a produção de saúde, e exercício das práticas destes profissionais está baseado no diagnóstico psiquiátrico; é incipiente o numero de profissionais que se mobiliza a desenvolver ações voltas ao acolhimento e a escuta; realizam atividades grupais e relatam que existe a necessidade de ampliar seus conhecimentos na área de saúde mental. / The proposed Psychiatric Reform has changed how mental health patients have been assisted in recent decades. With the deinstitutionalization of mental health patients, new paradigms have emerged offering great challenges to all social actors involved in constructing citizenship and to the search for psychosocial rehabilitation. New concepts of the health-disease process have appeared, along with new assistance networks, allocation of resources, as well as the creation of Psychosocial Care Centers CAPS, and Health Ministry guidelines stipulating that actions in the mental health field be undertaken at the basic care level at Basic Health Units (UBS) and through the Family Health Strategy (ESF). ESF has become an important tool in the health-disease process with regard to integral care aiming for the promotion, prevention, protection and recovery of physical, social and mental illness. Thus, the objective of this work is to comprehend the needs of ESF to develop mental health actions in the community and identify the actions developed by ESF teams with regard to mental health patients and their relatives. It is a qualitative research, to be developed through semi-structured interviews with members of the ESF teams; the interviews were recorded and fully transcribed for analysis. O material foi analisado por meio da Análise Discurso sob a ótica do referencial teórico do materialismo histórico e dialético. The material was analyzed through discourse analysis under the theoretical framework of historical and dialectical materialism. Three categories emerged from the interviews: Health-Mental Illness process; Family; Work Process. The discourses of the informants revealed that ESF professionals keep traditional psychiatric practice centered on consultations, medication and exams, making it the main tool for health production, with the exercise of these professionals practice based on psychiatric diagnosis; the number of professionals who mobilize to develop actions focusing on welcoming and listening is still incipient; they perform group activities and report the need to broaden their knowledge on the field of mental health.

Na construção de políticas sociais atribuiu-se um papel central à família na proteção social e no cuidado com os seus membros. Na saúde, a família assume essa centralidade na Estratégia de Saúde da Família (ESF), sendo compreendida como objeto da atenção em saúde. Essa centralidade se deu a partir de uma pretensão de mudança no modelo assistencial que visasse a integralidade do cuidado e um olhar para as condições de vida como fundamentais no processo saúde-doença. Tais transformações nos sentidos e práticas de saúde têm sido desafiadoras. A partir da perspectiva Construcionista Social, que orienta esse estudo, compreendemos que os sentidos são construídos nas interações entre as pessoas e que esses configuram práticas sociais. Diante deste quadro de desafios na ESF e a partir da perspectiva adotada, temos como objetivo compreender os sentidos produzidos por profissionais de equipes de saúde sobre famílias em contextos de reuniões de discussão de família/caso na ESF, buscando analisar como esses configuram a produção de práticas de cuidado e também como se dá a dinâmica de construção desses sentidos a partir das negociações entre os participantes. A constituição do corpus foi feita a partir da observação e registros em áudio de 16 reuniões de duas equipes de saúde da família, contando com 26 participantes, dentre eles profissionais e estagiários de diferentes especialidades. A análise foi feita a partir da perspectiva das práticas discursivas, com os seguintes passos: 1) transcrição do material; 2) leitura intensiva e organização do material; 3) construção de sentidos sobre a família, e análise dos repertórios interpretativos, discursos usados, e implicações para ação; e 4) narrativa ilustrativa da dinâmica dos sentidos. Os sentidos construídos na análise foram: a) Família como pessoas que moram juntas: os repertórios usados descreviam os modos de ser família a partir do ambiente em que ela vive, entendendo a família como informante e cuidadora dos seus membros; b) Família como responsável pelo cuidado: repertórios de família como aquela que dá suporte aos seus membros e é responsável por eles; e, por vezes, está sobrecarregada com esses cuidados; c) Família como problema: repertórios que configuravam a família como aquela que é responsável pelo problema de saúde dos seus membros, como aquela que funciona como um estressor para eles ou como aquela que está em situação de risco; e d) Família como rede de relações, sentido que foi usado, mais comumente, em conversas sobre casos complexos, com discussões voltadas para configurações, estruturas e dinâmicas familiares. A partir da análise do processo de discussão da equipe em torno de um \"caso\", foi possível ilustrar o dinamismo desses sentidos nas conversas e como esses são negociados a todo momento. A análise nos permite considerar que há esforços dos profissionais em voltar a atenção do cuidado para a família, porém ainda são comuns práticas centradas no indivíduo e pouco pautadas no contexto e nas condições de vida das famílias. Compreendemos que dar visibilidade a esses diferentes sentidos e seu uso permite reflexões sobre como cada forma de descrever as famílias possibilita a construção de práticas distintas, o que pode contribuir para uma maior reflexão dos profissionais de saúde sobre sua prática cotidiana (Apoio Capes e Fapesp- 2014/08618-6). / In constructing social policies, a central role has been assigned to the family regarding its social protection and care for its members. In Health, the family assumes such centrality in the Brazilian Family Health Strategy (FHS), being understood as a health care object. This centrality is given from an intention of changing the health care model, which should aim integrality of care and a look at/attention towards the living conditions as fundamental in the health-illness process. But the changes in the meanings and health practices have been challenging. From the social constructionist perspective, which guides this study, we understand that the meanings are built in interactions among people and that such constitute social practices. Given these elements - challenges in the FHS and the said perspective - we aim to understand the meanings produced by health team professionals about families in contexts of FHS family discussion meetings. We seek to analyze how these meanings shape the production of care practices and also how these senses are dynamically constructed from the negotiations among participants. The corpus construction was structured from observation and audio records from 16 FHS teams meetings, with 26 participants, including professionals and trainees from different specialties. The analysis was based on the discursive practices perspective, with the following steps: 1) material transcription; 2) intensive reading and material organization; 3) construction of meanings about family, and analysis of interpretative repertoires, discourse use, and implications for action; and 4) illustrative narrative of meanings dynamics. Meanings constructed in the analysis were: a) family as people who live together: the repertoires described the ways of being family considering the environment they live, understanding family as informant and caregiver of its members; b) family as responsible for care: Family repertoires as that which supports its members and holds accountability for them; also, sometimes becomes overloaded with such stewardship; c) Family as problem: repertoire that conceived family as being responsible for members\' health problems, acting as a stressor to them or as one that is at risk; d) Family as relationships network, meaning more commonly attributed in conversations about complex cases, with discussions oriented to settings, structures and family dynamics. From the analysis of a team discussion process on one \"case\", it was possible to illustrate the dynamism of these senses in conversations and how they are negotiated at all times. The analysis demonstrates that professionals endeavor to turn their efforts towards the family, but practices are still commonly centered on the individual and less grounded in context and living conditions of families. We understand that giving visibility to these different senses and their use allows reflections on how each way of describing families allows the construction of different practices, potentially contributing to greater reflection of health professionals about their daily practice (Support Capes and FAPESP- 2014 / 08618-6).

This thesis deals with the communication of cancer risk in genetic counselling sessions. There are two primary foci that form threads throughout both the theoretical and empirical chapters of the dissertation. The first concerns the meaning of risk as it manifests in familial cancer. In particular, there is a lack of a sound theoretical grounding for the probabilistic aspect of risk that is evident in many forms of risk communication. The thesis aims to illustrate the problem constituted by this lack of theoretical clarity. As most decisions faced by clients arise from attending genetic counselling, it is concluded that clients ' agency is highly constrained when genetic counselling is understood as a process of assisting decision - making. However, genetic counselling can be seen to enable agency when it is conceptualised as a process aimed at making available new medical technologies for the purpose of addressing clients ' own concerns. / Thesis (Ph.D.)--Faculty of Health Sciences, Dept. of Psychology, 2005.