O Atendimento pré-hospitalar (APH) móvel é uma modalidade de assistência recente no Brasil e, em especial, no município de Ribeirão Preto-SP, tendo sido criada em 1996, com a finalidade de atendimento a toda e qualquer solicitação de ajuda, fora do âmbito hospitalar, visando a manutenção da vida e/ou a minimização das seqüelas, podendo ser oriunda do próprio cidadão ou ainda de instituições de saúde. Tendo em vista a recente implantação deste serviço, os objetivos do presente estudo são descrever a epidemiologia do atendimento pré-hospitalar móvel primário e secundário de urgência e emergência, o fluxo de atendimento pré-hospitalar móvel secundário e o fluxo do atendimento pré-hospitalar móvel da unidade de suporte avançado no município de Ribeirão Preto. Nossa pesquisa trata-se de um estudo de natureza descritiva, em que utilizamos dados de fonte secundária com transcrição de informações específicas do Serviço de APH do Município em Ribeirão Preto-SP, quando da solicitação de atendimento em situações de agravos à saúde. Os dados referentes ao objeto de estudo, foram coletados junto ao Programa de Assistência Médica Emergencial da Secretaria Municipal da Saúde. A base de dados analisada permitiu delinear a caracterização da atenção pré-hospitalar móvel da Secretaria Municipal da Saúde. Os resultados da pesquisa revelam o perfil das solicitações de atendimento das urgências e emergências com análises importantes que poderão subsidiar futuras reorganizações do serviço de APH móvel primário e secundário. O estudo poderá subsidiar ainda decisões dos atores sociais envolvidos na promoção, prevenção, recuperação e reabilitação aos agravos à saúde, tais como: conselhos de saúde, gestores de saúde, prestadores de serviços, usuários, conselhos de classes, órgãos de educação, promoção social, segurança social, transporte e outros. / The pre-hospital mobile attendant is a recent modality of assistance in Brazil, in special, at the District of Ribeirão Preto – SP, created since 1996, with the intention of attending any help of solicitation of care outside the hospital environment, looking for a life maintenance and/or a sequel minimization, and still looking to be accepted for the health institutions or the own patient. Because of the this new system implementation of service, the goals for the recent studies are to describe the pre-hospital assistance mobile of Epidemology for the first and second degrees of emergency and urgent care, the overflowing of the system now settle at this district of Ribeirão Preto for this type of help/ work with patients. Our research is about a descriptive nature where we can use secondary sources of database with transcription of specified information of the APH Service in the District of Ribeirão Preto-SP, when in need of care the solicitation of worst problems for health at own. The database collected for the goals of this research were taken at the Emergency Medical Assistance Program of the Health Minister of Care. The base studied let us create a line of attention in characterization of the pre-hospital mobile assistance from the Health Municipal Secretary . The results of the research reveals the profile of each assistance solicitations of emergencies and urgent cases with very important analyses which can create future reorganizations of the first and secondary mobile APH service. This study will subside many important decisions of the social actors involved at this promotion, prevention, recover, rehabilitation of the worst problems in health care such as: health counseling, health managers, services, utilitarian, class counseling, education organism, social promotion, social security, transportation and others.

Thesis (Ph.D.)--McMaster University, 2006. / Supervisor: Susan J. Elliott. Includes bibliographical references (leaves 166-171).

Thesis (Ph.D.)--McMaster University, 2006. / Supervisor: Wayne Warry. Includes bibliographical references (p. 154-164).

The purpose of this work is to find out how present manager contracts are set up in Landstinget Västmanland (the county council of Västmanland), explore managers’ perception of these contracts and why managers have chosen leadership. The work has also reviewed the question if managers need to have a relationship or expertise to the activities they lead and which qualifications are needed in such case. The survey was conducted in two divisions in which nine interviews were held with managers at all levels. In addition to this a questionnaire including the 87 managers in the divisions were held. Based on the result of the interviews and the questionnaire the study revealed five main areas : form of employment, content of manager contracts, relationships and expertise towards the operations, clinical work and profession. By applying theories the results were interpreted and the conclusion is that there is a complexity in leadership in a county organisation with strong professions and several levels of decision making. However, clear manager contracts may be a step towards successful leadership and organizational development.

Technology plays an increasingly important role in modern health care. This thesis presents an approach to usability evaluation of mobile information and communications technologies designed for diabetes patients&rsquo / use in their daily lives. According to our study conducted on 60 diabetes patients, several important findings are obtained. Fifty nine (98.3%) diabetes patients were highly satisfied with the mobile health technology and expressed that they would use it, and found the measured values reliable. For 57 (95%) diabetes patients / measuring, checking and accessing the blood glucose level easily anytime and anywhere were very important. Fifty six (93.3%) said that they would wish to send their blood glucose levels to their physicians via e-mail. When participants were asked to provide a decision on future health care, predominate number of participants said they would change their lifestyle rather than visit a doctor regardless of their blood glucose level. In conclusion, little is known about such effects of mobile information and communications technologies in self-management care situations. It is clear that usability studies in the field are more difficult to conduct than laboratory evaluations. Further studies with larger sample sizes are needed to further evaluate these initial findings.

Over the past 100 years the average life span of humans has increased in developed countries. Mortality rates have changed because of the virtual eradication of infectious diseases, such as polio and smallpox, and the increase in chronic diseases. Chronic diseases, such as coronary heart disease, are related to lifestyle behaviour, a factor over which the individual has some control. Matarazazo (1984) believes that 'behavioural pathogens are the key to understanding health behaviours of the individual and subsequently designing more effective methods of dealing with chronic disease and illness. Fries (1980) suggests another approach to dealing with chronic disease, through the strategy of 'compressed morbidity'. This refers to the postponement of chronic infirmity relative to average life duration. By achieving compressed morbidity, it is expected that health costs will decrease and improvement of quality of life will occur. This may be possible in at least two ways: firstly, by self-empowerment of the individual and secondly by the development of health self-efficacy. Thus giving the individual the power to act upon certain health-damaging behaviours as well as the confidence to influence behavioural change and persistence to cope with difficulties whilst the process of change is occurring. Thirdly, as a result of this, behaviour changes will occur and this would lead to a reduction in health cost which would be of overall benefit to the community. One method of reducing these health care costs is through health promotion and health education. Improvements in health knowledge and skills through health education and health promotion has been shown to facilitate changes in lifestyle and so reduce the incidence of various diseases. This study examined the effectiveness of two types of self-care models, health self-care and medical self-care. Health self-care refers to individuals assuming more responsibility for prevention, detection and the treatment of health problems using self-care information. Medical self-care involves the use of General Practitioners (GP) offering advice to their patients and subsequently patients making informed decisions about their health. The health self-care model Healthtrac, attempts to provide an effective use of the Australian health care system. Healthtrac is an information and skills based mail delivery program designed to assist individuals in elevating their perceptions of health self-efficacy and improve their lifestyle behaviours. Better Health is the medical self-care model which is designed with the perspective that GP's are the best suited as the initiators of change in individual health self-care. Participants (N = 864) are adult males and females. The methodology for this study involved 864 high risk of chronic disease participants who have been identified using the Healthtrac Health Risk Assessment (HRA) instrument. There were (n = 343) participants in the health self-care group, (n =66) in the medical self-care group and (n = 455) in the control group. This instrument was designed to identify individuals who have or are at high risk of developing chronic disease. These participants were part of the Better Health promotion program of a Health Insurance company. All the participants received a letter of advice detailing the presence of certain risk factors as determined by their health risk appraisal. They were requested to visit their local GP who recommended the necessary behavioural changes and medical support required for medically satisfactory outcomes. They were encouraged to follow the advice of the GP and received a second HRA after 6 months and again12 months after the start of the project. The Healthtrac component of the study involved 343 subjects who completed the HRA instrument. Participants in this group were matched with the Better Health subjects for variables such as age, gender, employment, disease or lifestyle and educational level. Baseline impact variables were calculated and compared with the same variables at 6 monthly intervals during the 12 month period of the study. Process variables such as user satisfaction were determined by a questionnaire. Investigation of the Health Benefits Organisation records were used to gather data on the number of claims for hospitalisation and other medical costs. A control group of 455 participants were matched with the same variables as those participants in the health self-care model and medical self-care groups. The analysis of results indicate that variables such as number of doctor's visits, days spent in hospital and total risks scores for the health self-care model were lower than the Medical model scores. The variable, cost of disease findings indicate that there were no significant differences between the two experimental groups, from the baseline data (Q1) to the 12 month period (Q3). The cost of diseases for heart disease was able to be lowered more by participants in the health self-care than the medical self-care model. The opposite occurred for the blood pressure condition. The health self-efficacy questionnaire results indicate that the health self-care group participants reported higher self-efficacy scores, therefore they were more confident about the self-management of their health behaviours than the members of the medical self-care group. No significant differences occurred among the experimental and control groups on such variables as achievement of outcomes and management of disease on self-efficacy scores. Both experimental groups, health self-care and the medical self-care model philosophies have strengths and weaknesses. Health self-care provides health information and support through printed materials whereas the medical self-care model provides health information through GP's. Both health promotion programs are important in making the individual aware of methods needed to improve health and in developing the knowledge necessary to modify clients health behaviours. This in turn is an important factor in the reduction of medical costs and the prevention of some diseases.

Mémoire (M.Adm.)-- Université du Québec à Chicoutimi, 1994. / Résumé disponible sur Internet. Ce mémoire a été réalisé à l'Université du Québec à Chicoutimi dans le cadre du programme de maîtrise en gestion des petites et moyennes organisation de l'UQAC extensionné à l'UQAT. CaQCU CaQCU Document électronique également accessible en format PDF. CaQCU

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.P.H.)--University of Michigan, 1945.

Thesis (M.S.P.H.)--University of Michigan, 1943. / Accompanied by "Initial report of Committee on Medical Care" (9 p.) prepared by the Maryland State Planning Commission, March 1943.