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Doing gender in physiotherapy education : a critical pedagogic approach to understanding how students construct gender identities in an undergraduate physiotherapy programme in the United KingdomHammond, John A. January 2013 (has links)
Gender in physiotherapy education is somewhat ambiguous. Physiotherapy is historically a women’s profession, yet in recent decades there has been a growing proportion of men. The mass media portrays a masculine sporty image of physiotherapy, which notably ignores the presence of women. Previous research in physiotherapy education has shown gender differences in student preferences for work and career pathways. Gender differences in attainment in practice components of the course have also been demonstrated, with men doing less well than women and more likely to fail. As a physiotherapy educator faced with these issues, the aim of this study is to explore the significance of gender in students’ constructions of identity. Social constructionism was adopted as an underpinning theory in this professional practice research involving students from one cohort of undergraduate physiotherapy students at a university in the south east of England. Nine male and female participants were interviewed at the beginning of their second year and were asked to record stories about their experiences both on and off campus throughout the academic year using a digital recording device. Data from the interviews and audio-diary narratives were analysed using Judith Butler’s theorisation of gender as ‘performative’ to understand how gender identities were constructed. Foucauldian and critical pedagogical perspectives were employed to further interrogate the gender discourses that emerged. The findings indicate that gender was rarely explicitly discussed; yet participants’ gender identities were constantly negotiated through relationships that were not limited to the university and clinical settings. A range of discourses of masculinity and femininity were identified illustrating a profound gender orthodoxy in physiotherapy education that simultaneously demanded acceptance, assimilation or resistance. As a consequence, students in this study used a number of discursive strategies in the struggle to be recognised within physiotherapy education and practice. The implications from these findings raise questions about gender tensions and contradictions in the physiotherapy programme under scrutiny and about the pedagogic practices that reinforce them. In this context, there is a need to raise awareness amongst peers and managers of the possible sites of gender inequalities within this curriculum. Also, gender needs to come ‘out of the closet’ and be debated within the classroom and the wider social spaces inhabited by students in order to develop more nuanced understandings of gender within physiotherapy and healthcare. Finally this research indicates the need to provide more inclusive spaces within the curriculum for reflecting on the complexity of identity construction and for challenging its institutional forms.
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A cost evaluation analysis to identify solutions for affordable medicines in Jordan : a comparative study with the UKEl-Dahiyat, Faris Abdelrahim January 2013 (has links)
Background: Health is a core human right. The right of health care includes access to affordable medicines. Affordability of medicines by individual patients in low-income countries is a significant factor influencing access to care and treatment. However, drug prices in low income countries are found to be higher than those in high-income countries. Although the health care system in Jordan is quite advanced in comparison to neighbouring countries, the access to affordable medicines remains problematic. It was reported that almost 80% of the public in Jordan pay for their medications through out-of-pocket payments. High medicine prices are of a great concern to patients and their finances, which can result in poor compliance. Moreover, non-compliance can lead to reduced productivity and increased medical costs. In fact, several studies found that the high out of pocket-costs can be a significant obstacle to medical adherence with prescription medication regimens. Aims: The aim of this thesis is to research medicine prices and policies in Jordan, in order to recommend feasible solutions to make these affordable. To measure the affordability of medicines in Jordan and to assess the extent by which the cost of medicines is high, prices and factors affecting them were compared with the United Kingdom (UK), a high income developed country. Methods: A mixed-method approach was used in this thesis to research medicine prices and policies. The thesis reviewed the relevant literature, followed by reviewing the health care and pharmaceutical systems in both countries and their impact on medicine prices. Quantitative studies to measure the affordability of medicines in Jordan were conducted to assess the extent by which the cost of medicines is high in comparison to the UK and the factors that may affect medicine prices. This was followed by a qualitative study on how and why high unaffordable prices occur in Jordan. Finally, a quantitative survey exploring patients', pharmacists' and prescribing physicians' opinions towards measures that could be used to achieve greater clinical effectiveness and economic efficiency from drug prescribing was conducted. All the findings from the thesis were synthesised to form policy recommendations, designed to ensure affordable medicines for the Jordanian population. Results and discussion: Factors that influence prices of medicines over time were identified. These included; competition, marketing strategies, time in the market, regulations and pricing policy, change of clinical guidelines, epidemiology of disease, change in therapeutic use/value and exchange rate. Although the income per capita is much lower in Jordan (almost 7 fold less) than the one the UK, the studies conducted within this thesis demonstrated that medicine prices were significantly higher in Jordan compared to the UK. Generic medicines are three fold more expensive than the equivalent prices of the same drugs in the UK. However, the difference in prices for many drugs was significantly higher than the 3 fold difference. For example, the average price of pravastatin and amlodipine generics was more than eight fold higher than the UK price. Moreover, the average price of omeprazole, citalopram and fluoxetine generics were around 10 fold higher than the comparable UK price. Additionally, originator brand medicines prices were also found to be 1.5-fold more expensive in Jordan compared to the UK. Many originators were extremely higher than this average. For example, the Jordanian price of misoprostol originator tablets was around 19 times the comparable UK price. The price of ranitidine originator in Jordan was more than seven times the UK price and lansoprasole originator was around 6 times more than the price in the UK. The current pricing policy and its application are believed to be the root causes for the high prices of medicines in Jordan, as revealed by the qualitative interviews. The expected patients' saving by using generic medicines instead of originators in Jordan ranged from 32% up to 74%. The median saving in Jordan was -30.65% compared to - 71.43% in UK. The average savings were 32.68% and 43.54% in both Jordan and UK respectively. This increased to 54.96% in the UK when one outlier was removed. However, the saving calculated in both countries would have been higher if the lowest priced generic was used. An extra saving of 6.86% was identified in Jordan if the lowest priced generics were used for cardiovascular diseases (the calculated saving increased from 32.71% when using the average generic price compared to 39.57% when using the lowest priced generic). The findings also showed a positive attitude of all stakeholders (patients, pharmacists and prescribing physicians) towards generic medications and their willingness and acceptance of strategies that encourage generic utilisation in Jordan such as generic substitution, lnternational. Non-proprietary Name (INN) prescribing and Electronic Prescribing (EP). Such measures will help reduce the high expenditure on drugs in Jordan which accounts for around one-third of the national health care budget. Conclusion: A range of policy measures and changes are required to improve access to medicines in Jordan. Recommendations made included amendments to pharmaceutical policies, better enforcement of the current regulations, encouraging the use of generic medicines by introducing measures such as generic prescribing, generic substitution and public awareness education programs. These changes should result in more affordable medicines in Jordan.
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Maternal and foetal outcomes of deliveries attended to at Emkhuzweni Health Centre in SwazilandWoreta, Fikadu January 2010 (has links)
Thesis (M Med(Family Medicine)) -- University of Limpopo, 2010. / Abstract
AIM The aim of the study was to measure the maternal and foetal outcomes of the deliveries attended to at Emkhuzweni Health Centre, Swaziland.
Objectives The objectives of the study were:
.:. To determine maternal outcomes of the deliveries attended to at Emkhuzweni
Health Centre.
.:. To determine foetal outcomes of the deliveries attended to at Emkhuzweni Health
Centre.
.:. To identify risk factors that affect maternal and foetal outcomes at Emkhuzweni
Health Centre
Methods
A retrospective chart review was performed for all 520 deliveries at Emkhuzweni Health Centre between January 1,2007 and December 31 2007. Labouring mothers were eligible for the study if they met the inclusion criteria. The study was conducted after ethical approvals from the relevant authorities were obtained.
Data were obtained from records for the following variables: age, address, gravidity, parity, health service where ANC was attended, risk factor, mode of delivery, maternal condition after delivery and post-delivery maternal hospital stay.
For each foetus, the APGAR score at the first and fifth minute, weight and sex of the neonate and condition after delivery were recorded.
Results
The results revealed that the maternal outcomes after delivery were normal for 89.85% of the mothers; 3.4% of those who delivered at EHC had PPH, 5.4% developed puerperal sepsis, 1 % PIH and 0.2% cases resulted in maternal death. The majority of mothers (61.7%) were discharged from the maternity ward in less than 24 hrs.
As far as foetal outcomes were concerned, normal babies accounted for 68% of births, early onset neonatal sepsis for 1.9%, congenital malformation (0.6%), stillbirth (1.5%), low birth weight (9.2%), preterm babies (17.8 %) and neonatal death (0.4%0.
Conclusion
This study found that the maternal outcomes at Emkhuzweni Health Centre in 2007 were similar to those in Swaziland as a whole and in other developing countries, except that there was a higher rate of pre-term delivery among pregnant women assisted at Emkhuzweni Health Centre.
The foetal outcomes of Emkhuzweni Health Centre in 2007 were similar to the data from developing countries. Additionally, however; significant numbers of pre-term babies were delivered and a high incidence of neonatal sepsis was observed at the Health Centre.
Some of the risk factors for the observed maternal and foetal outcomes were poor antenatal care attendance, distance of the Health Centre from the home state of the pregnant woman, preterm labour, under age and teenage pregnancies.
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Psychological treatment in the mental health system of the People's Republic of ChinaTom, Jane Chang. January 1981 (has links) (PDF)
Thesis (Ph.D.)--The Wright Institute (Berkeley), 1981. / Includes bibliographical references.
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Negotiating (un)heard voices exploring a fourth generation evaluation approach to examining the wraparound process /Ezechukwu, Rebecca Nneoma. January 2009 (has links)
Title from first page of PDF document. Includes bibliographical references (p. 41-45-Xx).
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Pay for patient satisfaction what is the evidence for quality of improvement? /Lai, Tai-yee, Barbara. January 2009 (has links)
Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 55-64).
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Advocating work an institutional ethnography of patients' and their families' experiences within a managed care health system /Flad, Jennifer. January 2009 (has links)
Thesis (Ph. D.)--Syracuse University, 2009 . / "Publication number: AAT 3381571."
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Viability of concept mapping for assessing cultural competence in children's mental health systems of care a comparison of theoretical and community conceptualizations /Davis, Tamara Sue. January 2003 (has links) (PDF)
Thesis (Ph. D.)--University of Texas at Austin, 2003. / Vita. Includes bibliographical references. Available also from UMI Company.
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Facilitating consumer voice in public mental health : exploring congruence in conceptualizing and prioritizing services and supports /Onken, Steven Justin, January 2000 (has links)
Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 331-353). Available also in a digital version from Dissertation Abstracts.
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National survey of psychological practices across rural and urban communitiesHelbok, Craig M. January 1900 (has links)
Thesis (Ph. D.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains viii, 188 p. Includes abstract. Includes bibliographical references (p. 166-177).
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