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

Thesis (M.H.A.)--University of Michigan, 1972.

Thesis (M.S.)--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. / Learning problems present major theoretical and practical issues for the field of mental health. This thesis represents an inquiry into the causes of learning problems in children. Relevant theoretical themes viewed in the literature were compared with data collected from case records of school referred children. Review of the literature on learning problems is presented and six major contributing factors are discussed. The research sample was obtained from 26 school-referred children in a follow up study conducted by a child guidance clinic. Children presenting organic deficiencies or psychosis were ruled out. Information relating to psychodynamic issues, family and peer relationships, and school performance was obtained from case records. This information is tabulated and analyzed and compared with the six factors found in the literature on learning problems. Relative significance of each factor is assessed. In this study, the inappropriate handling of aggressive impulses was found to be the most significant factor in problems in learning. Additional conclusions are offered. Research limitations are acknowledged; recommendations for further study are suggested. / 2031-01-02

Class of 2016 Abstract / Objectives: Analyze trends in prescribing extended dual antiplatelet therapy (DAPT) with aspirin and clopidogrel between men and women patients at El Rio community health center. Methods: Patients at a community health center who were on DAPT for longer than one year were identified through retrospective chart review. Demographic and descriptive data were recorded, including patient age, gender, indication for therapy, and type of prescriber. Based on prescribing guidelines, acute coronary syndrome (ACS) with bare-metal stent or drug-eluting stent, and drug-eluting stent without ACS were considered to be appropriate indications of extended DAPT. All other indications were considered inappropriate. Results: Data was collected for 27 men (mean age = 68; SD = 9.82; 70.4% hispanic or latino) and 31 women (mean age = 70; SD = 10.49; 83.9% hispanic or latino). Dual antiplatelet therapy was appropriately prescribed for 17 men and 20 women (63% and 64.5%, p=0.08). Conclusions: Overall, the difference in adherence to prescribing guidelines for men and women was not significant.

Class of 2011 Abstract / OBJECTIVES: To assess the outcomes of care for patients enrolled in a pharmacist-run anticoagulation clinic. METHODS: A retrospective chart review was conducted of patients who received warfarin anticoagulation therapy management at the pharmacist-managed clinic at a community health center. To be eligible for the study patients had to be between the ages of 18-80 and have at least 6 recorded INRs during the first 6 months of treatment in the clinic. The patient data were reviewed for a time period of 24 weeks from the initial visit. The primary dependent variable was whether or not a patient’s INR is within range. Secondary outcomes included frequency of adverse events (blood in urine or stool). A data extraction form was used to collect patient demographics and initial INR values from the patient charts. An odds ratio was used to compare the proportion of INRs in range upon entry into the clinic and after 6 months of care in the clinic. In addition, outcomes were evaluated for differences by gender and age. RESULTS: Sixty-six patients were included in the study; 50% (33) were men and the average age was 55.9 years old (SD = 12.9 years). At baseline, 24 patients had INRs within the therapeutic range. Patients were 5 times more likely to have INRs in range (N = 49; OR = 5.04; p < 0.001) after 6 months of treatment in the pharmacist-managed clinic than at baseline. About 59% of men and 54% of women had INRs in range during 6 months of therapy in the clinic (p=0.326). Patients under 55 were in range about 55% of the time over 6 months, while patients over 55 were in range about 59% of the time (p=0.366). CONCLUSION: Patients enrolled in the pharmacist-run anticoagulation clinic were more likely to have therapeutic INRs after 6 months of care in the clinic compared to baseline.

When the deadly EF-4 tornado devastated the Winston County in 2014, the local hospital and various doctors’ offices and clinics were destroyed. Win School District (WSD) had already realized the need to reestablish health care services within the school, and now county health professionals realized they were unable to meet the health care needs of the county. A partnership emerged with the Winston County Health Foundation and established a School-Based Health Clinic (SBHC) on the lower elementary school campus. The purpose of this research study was to investigate the lived experiences of school administrators, teachers, parents, and health professionals related to the SBHC in a rural school district. An exploratory qualitative research design was selected for the study to answer the central, overarching research question: How do teachers, parents, health professionals, and administrators describe their experiences related to an SBHC in a rural school district? Overall, as experienced by school administrators, teachers, parents, and health professionals, and evidenced by official school records, the SBCH met a tremendous health need in the community and had a positive impact on students’ academic achievement, students’ attendance, and teachers’ attendance. This study focused on the benefits and advantages, disadvantages and challenges, impact on student and teacher attendance, impact on student achievement, and suggested improvements. Lessons learned and insights are provided for educational leaders that can be used to promote and implement SBHC programs in Mississippi as well as throughout the country.

No description available.

Syftet med denna studie är att ta reda på hur de privata och offentliga vårdcentralerna i Hallands län hanterar sina varumärken. Genom denna studie kan vi se hur vårdcentralerna utmärker sig från varandra i vårdmarknaden samt vilka likheter och skillnader som finns mellan de två olika verksamhetsformernas, de privata och de offentliga, hantering av varumärke.Studien är baserad på en kvalitativ metod och det empiriska materialet har inhämtats genom semistrukturerade intervjuer. Sex vårdcentraler, varav tre offentliga och tre privata, från Hallands län har deltagit i undersökningen. Resultatet har sedan analyserats med hjälp av tidigare forskning och relevanta begrepp inom områdena varumärkesuppbyggnad och varumärkeskommunikation.Resultatet visar att varumärkesarbete är något som både de offentliga och de privata vårdcentralerna, medvetet och omedvetet, arbetar med. Vissa vårdcentraler anser att varumärkesarbete är något som är viktigt för deras verksamhet medan andra vårdcentraler ser det som mindre viktigt. Det som dock framkommer tydligt är att samtliga undersökta vårdcentraler vill associeras med värdeorden gott bemötande, hög kvalitet och god tillgänglighet.

Sjuksköterskor verksamma på barnavårdscentral (BVC) möter dagligen flyktingbarn och deras föräldrar i sitt arbete och dessa möten ser olika ut beroende på olika faktorer. Syftet med studien var att beskriva BVC- sjuksköterskors arbete med flyktingbarn och deras föräldrar. Semistrukturerade intervjuer genomfördes och analyserades med kvalitativ innehållsanalys. Ur resultatet kom tre kategorier: att skapa trygghet, att vara lyhörd och att ge stöd. I kategorin att skapa trygghet beskrev BVC- sjuksköterskor hur de arbetade för att skapa jämlik vård, öka tillgängligheten samt belyste de vikten av kontinuitet i vården för flyktingbarnen. Kategorin att vara lyhörd innefattade sjuksköterskors sätt att se det enskilda barnets behov. Detta tillämpades med respekt, förståelse och acceptans för kulturella skillnader. Att ge stöd genom behjälplighet vid språk-och kommunikationssvårigheter, rätt anpassad information och samverkan med andra professioner gav flyktingbarnen tryggare och snabbare integrering i det svenska samhället. Svårigheter som BVC- sjuksköterskorna beskrev var kommunikation via tolk, brist på resurser och brist på kontinuitet i arbete med flyktingbarn. Fortsatt forskning behövs för att få ökad kunskap och förståelse kring flyktingbarns behov. Det behövs även fortsatta studier i utveckling, organisation och samordning av verksamheter som bedriver vård och omsorg för flyktingbarn. / Nurses working in Child Health Centers (CHC-nurses) face daily refugee children and their parents in their work and these meetings vary depending on various factors.The aim of this study was to describe CHC-nurses experience of working with refugee children and their parents. Semi-structured interviews were conducted and were analyzed using qualitative content analysis. From the result three categories emerged; to create security, to be responsive and to provide support. In the category to create security the CHC-nurses described how they worked to create equal care, increase accessibility, and highlight the importance of the continuity in the health care of refugee children. Category to be responsive comprised nurses' approach to the individual child's needs which was applied with respect, understanding and acceptance of cultural differences. Providing support through helpfulness with language and communication difficulties, the right customized information and collaboration with other professions gave refugee children safer and faster integration into the Swedish society. Difficulties described by the CHC-nurses were communication through interpreters, lack of resources and lack of continuity in the work with refugee children. Continued research is needed to increase knowledge and understanding of refugee children’s needs. Further studies in development, organization and coordination of activities engaged in health care for refugee children are needed.

Bakgrund: En av sjuksköterskans grundläggande uppgifter är att lindra patientens lidande i samband med vård. Lugn musik har visat sig vara ett effektivt verktyg för att minska patienters upplevelser av stress och smärta vid flera procedurer inom sjukvården. Parametrar som hjärtfrekvens och blodtryck kan påverkas av musiken. Frisättning av hormoner och signalsubstanser kan minska patientens känslor av obehag av olika slag. Venös blodprovtagning utförs rutinmässigt på vårdcentraler över hela landet. Inom primärvården saknas dock riktlinjer för hur lugn musik kan användas för att öka patientens välmående i denna vårdsituation.  Syfte: Denna studies syfte var att undersöka huruvida lugn bakgrundsmusik påverkar patienters skattning av stress och smärta i samband med venprovtagning på vårdcentral samt att undersöka skillnader i skattning av stress och smärta vid venprovtagning beroende av patientkarakteristika.  Metod: En kvantitativ interventionsstudie med enkätundersökning på vårdcentral genomfördes. Frågeformulär delades ut direkt efter provtagningstillfället till 70 patienter. Av dessa hade 35 exponerats för lugn bakgrundsmusik under proceduren och 35 fått venprovet genomfört utan musik.  Resultat: Inga signifikanta skillnader kunde påvisas mellan musikinterventionsgruppen och kontrollgruppen. Signifikanta skillnader kunde påvisas i skattning av stress och smärta mellan patienter relaterat till åldersgrupp där yngre patienter skattade stress och smärta högre än äldre patienter. Mellan manliga och kvinnliga patienter kunde en signifikant skillnad i smärtskattning påvisas där kvinnor skattade högre än män. De patienter som uttryckte stickrädsla skattade stress och smärta högre än övriga patienter. Ingen skillnad i skattning av stress eller smärta kunde påvisas mellan de patienter som ansågs vana och de som ansågs ovana vid venprovtagning.  Slutsats: Ingen signifikant skillnad i skattning av stress och smärta relaterat till bakgrundsmusiken i interventionen kunde genom denna studie påvisas. Mot bakgrund av tidigare forskning kan dock tänkas att mer omfattande studier på samma ämne kan leda till ett annat resultat. Majoriteten av de fynd som relaterades till patientkarakteristika verkar stämma överens med tidigare forskning. / Background: One of the basic tasks of the nurse is to alleviate the patient’s suffering associated with health care. Relaxing music has proven to be an effective tool to reduce patients’ experiences of stress and pain during many health care procedures. Parameters as heart rate and blood pressure can be affected by the music. Release of hormones and signal substances can reduce the patient’s feelings of different kinds of discomfort. Venous blood sampling is performed as a routine at health care centers across Sweden. In primary health care there are no guidelines on how relaxing music can be used to increase the patient’s well-being in this care situation.  Aim: The aim of this study was to investigate whether relaxing background music has an impact on the health center patient’s grading of stress and pain during venipuncture, and to examine differences in grading of stress and pain during venipuncture dependent on patient characteristics.  Method: A quantitative intervention study with a survey at a health center was performed. Questionnaires were distributed immediately after venous blood sampling to 70 patients. Of these, 35 had been exposed to relaxing background music during the venipuncture, and 35 had not been exposed to any music during the procedure.  Main results: No significant differences were found between the music intervention group and the control group. Significant differences were found in grading of stress and pain between patients dependent on their age group, younger patients ranked their stress and pain higher than older patients. Between male and female patients a significant difference in grading of pain were found, women ranked their pain higher than men. The patients who expressed a fear of needles ranked their stress and pain higher than other patients. No difference in grading of stress or pain could be found between those patients who were considered accustomed, and those who were not considered accustomed to venipuncture.  Conclusion: No significant difference in grading of stress and pain could be found related to the music intervention in this study. Based on previous studies, there is still a possibility that more extensive research on the same topic can produce a different result. The majority of findings related to patient characteristics seems to be aligned with previous research in this field.