Non-communicable diseases are on the increase worldwide, causing more than 36 million deaths each year. Evidence of the link between the role of nutrition and reducing non-communicable diseases is predominant in the literature. The factors influencing intervention strategies/policies and activities, however, need attention. AIM: The study aims to examine the factors that influence nutrition interventions within the United Arab Emirates’ healthcare system. METHOD: This research adapts an interdisciplinary approach where a triangulation mixed methodology is applied. Both qualitative and quantitative methods are used, through the analysis of ten interviews with policy makers, four case studies and 161 questionnaires. Furthermore, the research framework, which emerged from the literature search and qualitative analysis, is tested and validated by rigorous quantitative analysis using SPSS. The statistical analysis, using factor analysis, MANCOVA and ranking analysis aims to provide solid support for the resulting factors. MAIN FINDING: The study identifies five factors that influence nutrition interventions in a healthcare system, and could enhance the effectiveness of nutrition interventions. The factors are 1) quality and processes, 2) training and use of technology, 3) senior management involvement and responsibility, 4) patient diversity, and 5) multidisciplinary teams. CONCLUSION: This study contributes to the emerging literature on management in nutrition interventions and the theory and importance of preventative measures in relation to nutrition. This study provides a roadmap for policy makers to adopt in order to enhance the role of nutrition interventions in healthcare settings.

As mudanças ocorridas no Sistema Único de Saúde nos últimos anos, associadas às mudanças nas políticas educacionais, forçaram uma modificação na atuação do profissional farmacêutico. Nesse sentido, o farmacêutico necessita adquirir capacitação para atuar em conjunto com a Equipe Multiprofissional de Saúde. O objetivo deste trabalho foi avaliar se o ensino superior em Farmácia no Brasil capacita o farmacêutico a atuar em colaboração com a Equipe Multiprofissional de Saúde dentro dos preceitos do Sistema Único de Saúde. Com base em metodologia quanti-qualitativa, este trabalho analisou projetos político-pedagógicos e o cenário clínico de hospitais universitários de cinco instituições de ensino superior brasileiras, e estudou, a partir de questionários qualitativos, aplicados a diversos profissionais de saúde, as necessidades da equipe em relação à atividade do farmacêutico. Verificou-se inserção ainda modesta do farmacêutico, muitas vezes causada pela falta de conhecimento da equipe sobre sua função ou por uma sensação de falta de preparo do próprio profissional. Também, a análise dos documentos oriundos dos cursos permitiu a constatação da falta de um olhar direcionado para o Sistema Único de Saúde e para a formação clínica. Poucas iniciativas curriculares tem surgido nesse sentido. Por fim, são apresentadas propostas, por meio de mapeamento conceitual, para se pensar um currículo em que coexistam a formação técnica, já tradicional, e a formação clínica, permitindo abarcar essa última, deixada de lado a partir de meados do século XX, que retorna hoje como uma demanda social. / Recent modification in the Brazilian\'s Public Health System, associated with changes in educational policies for higher education, forced a change in the pharmacist\'s professional performance area. Accordingly, the pharmacist needs to acquire capacity to act in conjunction with the Health Multidisciplinary Team. The objective of this thesis was to evaluate whether higher education in Brazil Pharmacy Schools enables the professional to work in collaboration with the Health Multidisciplinary Team within the precepts of National Public Health System. Based on quantitative and qualitative methodology, this study analyzed political-pedagogical projects and the clinical setting of university hospitals of five Brazilian higher education institutions, and studied from qualitative questionnaires applied to various health professionals the needs of the Multidisciplinary Health Team in having as a team member the pharmacist. There was verified a still modest insertion of the pharmacist in health teams, often caused by lack of staff knowledge about their function or by a sense of lack of readiness of the professional himself. Also, the analysis of documents from Pharmacy courses led to confirmation of the lack of educational policies directed to the National Public Health System and clinical training. Few curriculum initiatives have arisen in this regard. Finally, proposals are developed through conceptual mapping, to think of a Pharmacy course curriculum that can coexist in both the technical training as clinical training, allowing embrace this professional area of actuation that was set aside from the mid-twentieth century and returns today as a social demand.

La recherche opérationnelle (RO) joue un rôle important dans les systèmes de santé. Au cours des dernières années, l'hospitalisation à domicile comme les hôpitaux de réhabilitation ont émergé pour pallier aux coûts du système de santé et à la qualité de vie des patients. Dans les secteurs de la réhabilitation, la gestion des soins de santé est sous-développée et la plupart des hôpitaux de réhabilitation sont gérés uniquement par l’expérience. Dans cette thèse, nous traitons d'abord le problème de la planification des traitements dans les hôpitaux de réhabilitation afin de les optimiser. Notre travail vise à réduire le temps d’attente des patients hospitalisés et ainsi améliorer leur satisfaction. Afin de résoudre efficacement ce problème de planification de traitements complexes, nous proposons une approche basée sur un algorithme de recherche hybride de coucou qui est testée et validée dans un cas réel. Nous nous intéressons ensuite à l'hospitalisation à domicile qui constitue un autre problème réel compte tenu du vieillissement de la population. Dans la plupart des régions, un nombre croissant d’organisations à but lucratif et à but non lucratif s’associent pour offrir des soins aux patients. Elles ont tendance à atteindre un niveau hospitalier tant en quantité et qu'en qualité avec une flexibilité accrue par rapport aux services hospitaliers. Nous étudions les problèmes de planification et d'acheminement des soins à domicile en tenant compte de nombreuses contraintes liées à la fois aux patients et aux soignants. Le problème est un scénario pratique motivé et vise à minimiser les coûts d'exploitation totaux. Nous utilisons le solveur commercial Gurobi pour résoudre et valider le modèle avec des données réelles. / Operations research (OR) plays an important role in healthcare system. In recent years, rehabilitation hospitals have been emerging to meet the increasing needs for rehabilitation services due to the ageing population trend. However, the healthcare management in rehabilitation sectors is undeveloped and most of the rehabilitation hospitals (departments) are managed by experience. In this thesis, we deal with a treatment scheduling problem in rehabilitation hospitals. The objective is to facilitate the scheduling process. More importantly, our work aims at reducing the waiting time of inpatients so as to improve inpatients’ satisfactions. In order to solve the complex treatment scheduling problem efficiently, we propose an approach based on a hybrid cuckoo search algorithm which is tested and validated in a real case. Moreover, home healthcare (HHC) is another real-world issue considering the aggravating trend of ageing population. In most areas, an increasing number of social-profit & non-profit organizations are joining in providing healthcare services to patients at their homes and it has a tendency to reach the hospital-level in both quantity and quality for the added flexibility than hospital's service. We investigate home healthcare scheduling and routing problem with consideration of many real-life factors, especially lunch break requirement. The problem is practical scenario motivated and aims at minimizing the total operating cost. We use the commercial solver Gurobi to solve and validate the model with real data.

Healthcare reforms and restructuring have been a global phenomenon since the early 1980s. The major structural reforms in the healthcare system in New South Wales (NSW) including the introduction and implementation of the area health management model (1986), the senior executive service (1989) and performance agreements (1990), heralded a new era in management responsibility and accountability. It is believed that the reforms, the process of the reforms, and the instability brought about by the reforms may have not only resulted in the change of senior healthcare management practices, but also in the change of competencies required for senior healthcare managers in meeting the challenges in the new era. However, limited studies have been conducted which examined how health reforms affected its senior health executive workforce and the above changes. Moreover, no study on senior healthcare managers has focused specifically on NSW after the major reforms were implemented. The purpose of this research was to examine how reforms in the NSW Health public sector affected its senior health executive workforce between 1990 and 1999 in terms of their roles and responsibilities, the competencies required, and the challenges they faced. This study, from a broad perspective, aimed to provide an overview of the NSW reforms, the forces behind the reforms and the effects the reforms may have had on senior health managers as predicted by the national and international literature. This study also explored the changes to the senior health executive workforce in the public sector during the period of rapid change in the 1990s and has provided indications of the managerial educational needs for future senior healthcare managers. Both quantitative and qualitative data have been collected by this study using triangulated methods including scientific document review and analyses, a postal questionnaire survey, and in-depth telephone interviews. The findings from the two quantitative methods informed and guided the development of the open-ended questions and overall focus of the telephone interviews. This study found differences in the characteristics and employment-related aspects between this study and previous studies in the 1980s and 1990s, and identified four major tasks, twelve key roles and seven core competencies required by senior health executives in the NSW Health public sector between 1990 and 1999. The study concludes that the demographic characteristics and the roles and responsibilities of the NSW Health senior executive workforce since the reforms of the 1980s have changed. This study also identified seven major obstacles and difficulties experienced by senior health executives and suggested that during the introduction and implementation of major healthcare reforms in NSW since 1986, barriers created by the ‘system’ prevented the achievement of its full potential benefits. Although this study did not focus on detailed strategies on how to minimise the negative impact of the health reforms on the senior health executives or maximise the chance of success in introducing new changes to the system, some suggestions are proposed. Most significantly, the study has developed a clear analytical framework for understanding the pyramidal relationships between tasks, roles and competencies and has developed and piloted a new competency assessment approach for assessing the core competencies required by senior health managers. These significant findings indicate the need for a replication of the study on an Australia-wide scale in order to extend the generalisability of the results and test the reliability and validity of the new competency assessment approach at various management levels in a range of healthcare sectors. This is the first study acknowledging the impact of the introduction of the area health management model, the senior executive service and performance agreements in the NSW public health system through an original insight into the personal experiences of the senior health executives of the reforms and examination of the major tasks that senior health executives performed and relevant essential competencies required to perform these tasks. The possible solutions identified in this study can guide the development of strategies in providing better support to senior healthcare managers when large-scale organisational changes are proposed in the future.

Made available in DSpace on 2014-12-17T14:46:56Z (GMT). No. of bitstreams: 1 DeboraDSM.pdf: 318175 bytes, checksum: 69936c4287b18c346f645bf8926587de (MD5) Previous issue date: 2006-06-06 / This study analyzes the point of view of nurses working at a pediatric teaching hospital on their work process within the scope of the Brazilian unified healthcare system SUS, in order to identify factors that interfere with its development and find out how work relations are taking place between nurses, other nursing professionals and the multidisciplinary staff. It is a descriptive and analytical study, qualitative in nature, which starts with a consideration of a nurse s current practices and moves on to reflect on a perspective of transformation aiming at rethinking their work process pursuant to the principles of SUS. In order to attain these objectives, we decided on using the focal group as a data-collecting technique, which took place from November to December 2005, by using as instruments a questionnaire for the characterization of the persons being researched and a discussion outline. Theoretical support has approached transformations in the world of work, placing it in the context of healthcare and nursing and has tried, specifically, to understand the work process of a nurse engaged in the production of health services. Therefore, the discourse analysis of participants, in the light of theoretical support, has evinced an ambiguity inasmuch as though identified as such in their work process, nurses are also fulfilling multiple functions in health services. Through this study it has also been possible to identify several factors that interfere with the work of these professionals, including poor working conditions and excessive hiring of high school graduate interns as an attempt to make up for a meager nursing workforce, as well as reveal the possibilities brought about by the SUS in retargeting its professional practice to interdisciplinarity and integrality / Este estudo analisa a vis?o das enfermeiras de um hospital pedi?trico de ensino acerca do seu processo de trabalho no contexto do Sistema ?nico de Sa?de (SUS), com vistas a identificar os fatores que interferem na sua efetiva??o e a forma como v?m se estabelecendo as rela??es de trabalho entre estas, os demais profissionais da enfermagem e a equipe multidisciplinar. ? um estudo descritivo/anal?tico de natureza qualitativa, que parte da reflex?o da atual pr?tica das enfermeiras para a perspectiva de transforma??o, no sentido de repensar o seu processo de trabalho em conson?ncia com os princ?pios do SUS. Para atingir tais objetivos, optou-se pelo grupo focal, como t?cnica de coleta de dados, o qual se realizou entre novembro e dezembro de 2005, utilizando-se como instrumentos um question?rio de caracteriza??o dos pesquisados e o roteiro de discuss?o. O referencial te?rico abordou as transforma??es no mundo do trabalho, contextualizando o trabalho na sa?de e na enfermagem e, especificamente, buscou compreender o processo de trabalho do enfermeiro inserido na produ??o dos servi?os de sa?de. Assim, as falas das participantes, analisadas ? luz das refer?ncias te?ricas, evidenciaram ambig?idade no reconhecimento do enfermeiro acerca do seu processo de trabalho, que, apesar de identific?-lo, assume m?ltiplas fun??es nos servi?os de sa?de. Este estudo ainda permitiu a identifica??o de diversos fatores que v?m interferindo na pr?tica desses profissionais, dentre os quais, as deficientes condi??es de trabalho e a excessiva contrata??o de bolsistas de n?vel m?dio, como alternativa de recompor a insuficiente for?a de trabalho da enfermagem, al?m de revelar as possibilidades trazidas pelo SUS na reorienta??o do seu fazer profissional com vistas ? interdisciplinaridade e a integralidade

This report is about double documentation in health care. In today's healthcare, there is a problem with the staff entering the same information in several different systems. It creates more work and takes precious time for an already strained business. The healthcare professionals are feeling more stressed with the increasing workload. Double documentation is today a work problem for healthcare professionals. The purpose of the report is to make a current report on how and why duplicate documentation occurs in the health care sector in the region of Gävleborg. A descriptive case study was conducted focusing on how healthcare professionals insert patient data into multiple information systems. The case study has been conducted in cooperation with Tieto, a software company in Luleå. The study resulted in several different findings. A major reason why double documentation exist depends on the lack integration between the information systems used in today´s healthcare. It is also caused by the fragmented state Swedish healthcare is currently in. Double documentation occurs mostly in cases when healthcare personnel need register patient information in. Healthcare personnel is liable to register the same information in the information system handling medical records as well as the information system used hospital department. / Nej

There is a new trend of shifting the provision of health care from hospitals to the patient?s natural environment. We are increasingly aware of the expensive and sometimes ineffective late hospital treatment; therefore, there are stronger efforts for early diagnosis, prevention and health education from an early age. It is necessary to keep the future generations focused on their health and the health of their family members who live in the community. The initiative must originate not only in families but also in the school environment in which children find themselves almost every day. A school nurse is an expert in the field of community care working in school environment. The work load of the school nurse rests in maintaining and improving physical and mental health. The school nurse supports pupils in their responsibility for their health and she creates a system of formalized school activities, prepares and implements the school?s educational program focused on prevention. The data in the research part of the thesis was obtained through quantitative and qualitative research survey. The quantitative research was carried out using the technique of an anonymous questionnaire. The questionnaire was intended for general practitioners for children and adolescents, as well as nurses working with general practitioners for children and adolescents. The qualitative research data was collected through semi-structured interviews with the head teachers of elementary and secondary schools on the basis of which casuistries were created resulting in categorized charts. The objective of this thesis was to find out about the position of general practitioners for children and adolescents, and paediatric nurses working with general practitioners for children and adolescents on introducing the function of school nurses in the healthcare system of the Czech Republic. The research in this thesis showed a low level of awareness about the position of school nurses. The primary controversies related to the introduction of school nurses can be described as follows: the method of financing, the issues of authority of such nurses, and the way of preparing for this occupation. The main positive aspect of school nurses can be seen by the respondents in comprehensive care for pupils, prevention and better public education. School head teachers, general practitioners and nurses believe that school nurses should be placed in schools according to the number of school pupils and school head teachers assume greater use school nurses in primary schools than in secondary ones. The method of financing school nurses should be, according to the respondents, from multiple sources. This thesis may be used as a basis for further research work focused on the position of school nurses, and also as a proposal of establishing the school nurse position in the healthcare system of the Czech Republic, or as informative material for professional as well as lay public.

In this modern world, healthcare has becoming a popular word in human life. People pay their attention on their health protection and treatment, but at the same time, they need to bear the high expenditure for their healthcare processing. It is a serious problem that the government income can not afford the large expense in healthcare industry. Especially in some developing countries, healthcare problem has become the problem for the nation development. We would like to choose this basic way to solve this problem directly, to provide the channel to improve the efficiency of healthcare system, Cambio COSMIC. The aim to analysis COSMIC for my case study is to find out the conclusion that how does the architect design the system from the stakeholders requirement to achieve the success of improving the efficiency of healthcare system. And how to measure the success for the system achieving to improve the efficiency of healthcare system is still required to indicate.

The thesis aims to critically compare liberal and mandatory health systems, and based on detected advantages and disadvantages of each, propose certain solutions and recommendations to optimize the health care system. During this task it also puts into context historical, legal and ethical backgrounds which strongly influence the system set up. Optimal adjustment of the health care system is an issue that worries most of the world's countries and this thesis, with it's unbiased evaluation, proposes suggestions on potential better functionality and effectiveness of health care. The theoretical part of the thesis deals with the major economical terms connected to health care and the typology of healthcare systems. In the following practical part, the US and the Czech healthcare systems are analyzed as the representatives of the liberal and the traditional mandatory health care systems by the international comparison method and the result shows positive experiences from the systems, applicable especially for the Czech Republic.

Magister Commercii - MCom / Information and communication technologies (ICT) have changed the way healthcare processes are being documented. This results in better quality and ethical vigilance to ensure a more accurate form of data recordkeeping (Stevenson, Nilsson, Petersson & Johansson, 2010). Health care in South Africa, is facing major issues relating to patient care, such as delays in patients receiving medical care. According to the national Department of Health, the improvement of public healthcare facilities is crucial (McIntyre & Ataguba, 2017). Information and communication technology (ICT) has the ability to significantly alter the status of healthcare services in the Western Cape, which can be achieved through the role of an electronic healthcare record (EHR).