O Desenvolvimento de Novos Serviços (DNS) tem recebido atenção crescente, tanto por parte de gestores de operações de serviço, quanto por parte dos acadêmicos do setor. Esta dissertação parte do pressuposto que os modelos DNS, desenvolvidos a partir de experiências com serviços em massa e loja de serviços, não abordam na sua totalidade os desafios de operações de serviços marcadas por maior dinamismo, especialmente serviços profissionais. Partindo de um referencial teórico montado com o objetivo de identificar quais são as características dos serviços profissionais que potencialmente influenciam positivamente ou negativamente o desenvolvimento de novos serviços, esta dissertação utiliza uma metodologia de pesquisa baseada em estudos de caso múltiplo para avaliar se o panorama teórico construído anteriormente é condizente com dois casos de inovação em serviço profissional público. A partir destas conclusões, destacamos algumas implicações práticas que pudemos observar e analisamos de que forma o modelo DNS proposto por Edvardsson et al (2000) está preparado ou não para lidar com estas questões. / New Service Development (NSD) has received increasing attention from either service managers or service marketing researchers. This dissertation firstly discuss that NSD models developed from mass services or services shop experiences, do not totally comprehend more dynamic services challenges, specially professional services. Following a literature review that aims to identify which professional services characteristics may influence positively or negatively the new service development process, this dissertation uses a multiple case study research to evaluate if the theoretical framework built before is related to two public professional services innovations case. From theses conclusions, we point out some practical implications that we could observe and after that we analyze if the NDS model proposed by Edvardsson et al (2000) is or is not prepared to deal with theses questions.

Sammanfattning   Bakgrund: Inom skolsköterskans arbetsfält ingår hälsofrämjande arbete med sexuell hälsa. I utbildningen till skolsköterska saknas antingen ämnet helt eller ges bristfälligt. Kunskap kring sexuell hälsa samt utformningen av det hälsofrämjande arbetet inhämtas istället via vidareutbildning som arbetsplatsen erbjuder. Tidigare studier har visat att utbildningsinterventioner inom arbetsområdet sexuell hälsa kan ge skolsköterskor ökad kompetens, liknande studier saknas i Sverige.   Syfte: Syftet var att beskriva om en utbildningsintervention om sexuell hälsa påverkat skolsköterskornas arbetssätt med det hälsofrämjande arbetet inom sexuell hälsa.   Metod: Studien var en enkätstudie bestående av slutna och öppna frågor och utgjordes av en jämförelse av svaren från två identiska enkäter som skickades ut före respektive efter en utbildningsintervention. De slutna frågorna i enkäten analyserades med hjälp av deskriptiv statistik och de öppna frågorna med hjälp av konventionell innehållsanalys.   Resultat: Utbildningsinterventionen bidrog dels till att skolsköterskorna fick ökad kunskap i olika områden inom sexuell hälsa samt dels en känsla av ökad trygghet i samtalet kring sexuell hälsa. Skolsköterskorna ansåg även att samverkan med andra professioner var betydelsefullt för ett framgångsrikt hälsofrämjande arbete med sexuell hälsa.   Slutsatser: Utbildningsinterventioner av liknande slag kan öka kompetensen och därmed öka tryggheten i arbetet kring sexuell hälsa.   Nyckelord: distriktsköterska, elevhälsa, kompetenshöjning, sexuell hälsa / Summary   The school nurse’s health promoting work with sexual health. A survey study.   Background: The school nurse's field of work includes health promotion work concerning sexual health. In school nurse education, either the subject is completely missing or given deficiently. Previous studies have shown that educational interventions in the area of sexual health can increase competence, similar studies are lacking in Sweden.   Objective: The aim was to describe how an educational intervention on sexual health effect school nurses´ work procedure in the health enhancing work in sexual health.   Method: The study was a questionnaire consisting of closed and open questions and consisted of a comparison of the answers from two identical questionnaires that were sent out before and after an educational intervention. The closed questions in the questionnaire were analyzed by using descriptive statistics while the open questions were analyzed using a qualitative, conventional content analysis.   Results: The educational intervention has helped the school nurses to gain increased knowledge in various areas of sexual health, as well as having created a sense of increased security in talking about sexual health. The school nurses also considered that a collaboration with other professions was important for successful health promoting work within sexual health.   Conclusions: Education interventions can increase competence and thus increase security in work on sexual health.   Keywords: district nurse, increase competency, school health service, sexual health

The purpose of the study was to explore perceptions of PLWHA towards using traditional medicines (TM) together with antiretroviral therapy (ART). The study was conducted in two ART health facilities in the Manzini Region in Swaziland. Audiotaped individual interviews were conducted to collect data. The study population was PLWHA using TM and ART and were aged 18-49 years. Voice recording was used to capture data during the in-depth interviews until saturation was reached. One grand tour question was asked and follow-up probing questions were asked dependent on participant responses and study objectives. Findings of the study revealed that PLWHA are still searching for a cure, and the preexistence of TM prior to ART is influencing them to combine TM and ART. Several reasons for combining the two treatment modalities were, to boost the immune system, enhancing appetite, to treat opportunistic infections and ART side effects. There was stigma associated with long-life ART and discrimination for using TM experienced by PLWHA. It could benefit the country to repeat the similar research at National level, to include all the four regions, in both rural and urban settings. / Health Studies

SAMMANFATTNING Introduktion: Barnhälsovården i Sverige når nästan alla barn och föräldrar. Föräldrastöd är en av de viktigaste insatserna samhället kan bistå med för att minska negativa utfall hos barn och unga. Implementering av föräldrastöd i grupp är komplext och modellen kan behöva utvärderas utifrån komponenterna faciliterare, innovation, kontext och mottagare.  Syfte: Syftet var att beskriva främjande och hindrande faktorer för deltagande i föräldrastöd i grupp i svensk BHV utifrån kontext, föräldrastödets innehåll, samt erfarenheter från föräldrar och BHV-sjuksköterskor. Metod: Litteraturstudie med deduktiv ansats. Implementeringsmodell i-PARISH användes i en riktad innehållsanalys. Artikelsökningar gjordes i CINAHL och PubMed. Sammanlagt inkluderades 18 vetenskapliga artiklar.  Resultat: Resultatet presenteras under fyra kategorier och 13 subkategorier utifrån i-PARIHS. Ledaren var avgörande för att gruppen skulle utveckla en sammanhållning och delta aktiv. För att lyckas med detta behövde ledaren vara bekväm i sitt ledarskap, påläst och uppdaterad. Föräldrarna uppskattade när de hade en ledare som uppmuntrade dem att prata i gruppen och som såg till att diskussion flöt på. Föräldrar uttryckte flera skäl och förklaringar till varför de inte ville eller kunde delta i en föräldrastödgrupp. Slutsats: Både främjande och hindrande faktorer med föräldrastöd i grupp i svensk BHV framkom. BHV behöver få fler föräldrar att känna sig inkluderade i föräldrastödsutbildningen samt vara lyhörd för deltagarna olika behov. Det är också viktigt att BHV-sjuksköterskors behov av utbildning och fortbildning tillgodoses för att kunna leda grupperna på ett professionellt sätt. / ABSTRACT Background: The child health services (CHS) in Sweden reach almost all children and parents. Parental support is one of the most important initiatives society can assist in reducing negative outcomes in children and young people. Implementation of parental support in groups is complex and the model may need to be evaluated on the basis of the component facilitator, innovation, context and recipient. Aim: The aim was to describe promoting and hindering factors for participation in parental support in group format in the Swedish CHS based on context, the content of parental support, and experiences from parents and CHS nurses. Method: Literature study with deductive approach. The implementation model i-PARISH was used in a targeted content analysis. Articles were searched for in CINAHL and PubMed. A total of 18 scientific articles were included. Results: The results are presented under four categories based on i-PARIHS. The leader was crucial for the group to develop cohesion and participate actively. To succeed in this, the leader needed to be comfortable with the leadership, read and updated. The parents appreciated when they had a leader who encouraged them to speak in the group and who made sure that discussion flowed. Parents expressed several reasons and explanations to why they did not want or could not participate in a parent support group. Conclusion: Both promoting and hindering factors regarding Swedish parental support in group format emerged. CHS needs to make more parents feel included in the parental support education and be sensitive to the participants' different needs. It is also important that CHSnurses' needs for education and training are met in order to be able to lead the groups in a professional manner.Keywords: Parent education, Child health service, experiences, implementati

Title: Analysis of circumstances, which affect attacks on rescuers during a service. Objectives: Objective of the thesis is to analyze and describe in detail circumstances and possible risks, which can happen during a duty of health service employee. Methods: This thesis is conceive as quantitative research with using constructed enquiry, which tries to find out set data. In theoretical part is used description of current situation. Results: Result of the thesis is elaborated analysis of circumstances, which affect attacks on rescuers during a service. Data and results, which were collected, were transformed into graphs with description. Keywords: Health service, Agression, Patient, Private defense

Many individuals experience barriers to accessing medical care, especially in rural areas. Some barriers are attitudinal and represent perceptions of quality care. Patient satisfaction and perceived need for medical care are two such attitudinal barriers related to health care utilization, yet the relationship between these variables has not been explored. Using data from an online survey, the current study examined the association between these variables, and further, whether rurality status moderated this association. Results indicated a significant correlation between patient satisfaction and perception of need. Although the overall moderation model was significant, perception of need was not significantly associated with patient satisfaction, and rurality status did not significantly moderate the relationship. However, the covariates of sexual orientation and income did significantly predict patient satisfaction. This study highlights the complex associations of patient satisfaction, as well as the importance of social determinants of health in patients’ perceptions of quality of care.

Criminal aspects of assisted reproduction Abstract The work deals with one of the most dynamically developing medical disciplines - assisted reproduction, the introduction and development of their technologies are considered one of the greatest advances in medicine in the 20th century. The purpose of this thesis is to provide the consistent overview of criminal law relations which may arise within providing assisted reproduction and to analyze the individual facts of crimes related to assisted reproduction, which should verify whether their wording provides sufficient protection for relations, interests and values covered by the Criminal Code. The thesis is composed of six chapters. The first chapter presents the fields of criminal law and medical law and examines the relationship between criminal law and health care system. The second chapter lists the conditions of criminal liability of natural and legal persons and lists the ground establishing the absence of criminal liability. The third chapter defines the concept of assisted reproduction, characterizes its methods, provides a historical overview of events that preceded the current interpretation of the concept. The third chapter also provides an overview of the principles that apply in this field of medicine and a list of sources governing the issue....

Master of Public Health - MPH / Non-communicable diseases (NCDs) are the leading cause of death globally, affecting a significant proportion of the economically active population, the majority of these occurring in low- and middle-income countries (LMICs). In South Africa, over 40% of deaths are attributable to NCDs. The use of healthcare services by individuals who have NCDs is putatively high but has yet, not been adequately quantified. Furthermore, there is a paucity of research data on factors that influence healthcare services use among those experiencing NCDs in South Africa.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The aim of this dissertation is to explain how elective surgery patients choose between the public and private hospital sectors in the United Kingdom, and to analyze government policy changes which affect this choice. First the choice between the public and private sectors is modeled for the case where there is no private insurance available. The model takes into account the different rationing mechanisms used by National Health Service (NHS) and private hospitals to allocate surgery among patients. Private hospitals charge a price and ration on the basis of willingness to pay , while NHS hospitals , which face budget limits, ration on the basis of clinical need and require patients to wait for surgery. Consequently, a patient's choice of sector depends on her income and her level of clinical need. A simulation model is used to compare the efficiency and equity of two policy measures designed to raise the number of people receiving elective surgery : an increase in NHS funding and a subsidy to the price of private surgery. The subsidy is shown to be more efficient and the NHS funding increase more equitable. Within the same framework an expected utility model of the demand for private health insurance is developed. Two cases are analyzed: the case where individuals have no information about their future need for elective surgery and the case where they have partial information. In each case it is shown that for a given insurance premium there is a threshold level of income above which people buy insurance. It is also shown by simulation that in each case the insurance company can set a premium that allows it to break even. Finally the two models are combined. This enables the efficiency and equity of an increase in NHS funding, a subsidy to private care and a subsidy to private insurance to be compared in a situation where some private patients have insurance to cover the cost of their surgery. The NHS funding increase is shown to be most equitable , and depending on the definition of efficiency chosen, one of the two subsidies is most efficient. / 2031-01-01

This thesis was undertaken to assess the characteristics of individuals who smoke crack cocaine and to examine the health-related risks and healthcare needs of this population. A literature review of 147 published articles was conducted to synthesize evidence regarding behaviours associated with crack use and to assess the risks of disease transmission through crack smoking behaviours. Qualitative interviews were subsequently conducted with thirty Ottawa residents who smoke crack to learn about their experiences with healthcare and harm reduction services. Results identified barriers related to accessing primary healthcare and drug treatment programming among people who smoke crack and gaps within existing harm reduction services. Individuals who smoke crack represent a marginalized population who are often missed through traditional health promotion and harm reduction programming. There is a need for increased coverage of current programming and a reduction of factors which currently hinder the delivery and effectiveness of crack-specific harm reduction programs.