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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Exercise compliance and health outcome in a chronic disease management programme

Du Plessis, Riana 07 October 2010 (has links)
In the latter part of the 20th century chronic diseases, especially cardio vascular-related diseases (CVDs) and Type 2 diabetes mellitus (DM) seemed to have emerged as substantial problems. This can be seen in the prevalence and the cost of CVDs in South Africa and worldwide. It was predicted that by the year 2030 more people would be dying from CVDs than from Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/Aids). The reasons for the occurrence of CVDs are linked to biological (i.e. hypertension, hyperlipidemia, obesity, insulin resistance, etc), psychological (i.e. emotional stress), and behavioural or lifestyle risk factors. It is known that physical exercise can aid in the treatment of CVDs. Institutions such as the American College of Sports Medicine (ACSM) recommended an exercise frequency of three times per week for 20 minutes. According to literature, a third of patients in exercise studies do not comply with their exercise protocol, and after three to six months, 50 percent will drop out of organised training groups. Less than a third of South Africans complied with exercising 30 minutes a day on most days of the week. Thus, there has been much interest among health-care providers to manage exercise compliance. Exercise compliance is a complex construct, and thus in the present study the role that behavioural patterns play was also investigated via psychological behavioural models. The major objectives of the study were the following: <ul> <li> Firstly, to determine if exercise compliance or non-compliance had an influence on shifts measured in the clinical parameters (i.e. blood pressure, blood lipid levels, blood glucose levels, body mass index, body fat percentage and cardiac risk percentage) over time.</li> <li> Secondly, to determine whether there were any correlation between the psychological behavioural models and the exercise compliance of the members over the course of the Best Med/Access Health-Disease Management Programme (BM/AH-DM Programme).</li></ul> In the present study, a retrospective data analysis was done on data collected from Best Med Medical Aid members (n = 400) who participated in a chronic disease management programme for three and a half years. The inclusion criteria for participation on the programme were the presence of one or more of the following CVDs namely: hypercholesterolemia, hypertension and DM. The members’ clinical parameters (height, body weight, body fat percentage, blood pressure, finger-prick non-fasting (random) blood cholesterol level, finger-prick non-fasting (random) blood glucose, sub-maximal V02 fitness test) were measured every three months. After a baseline assessment was done, an exercise programme was given to each member and a norm of exercising twice a week was prescribed. If members adhered to the norm they were considered compliant and if they did not adhere to the norm, they were considered as being non-compliant. Their exercise compliance, and relevant clinical parameters were measured over 30 months, although data analysis was only a reflection of the first 12 months’ data. At the beginning of the BM/AH-DM Programme the members’ Level of Readiness (LOR) to make a lifestyle change was measured via a questionnaire and by the end of the programme they completed an Implicit Theory Scale (ITS) questionnaire. Descriptive statistics (means, standard deviation) were used to determine the entire groups’ compliance, and to divide the group into compliant and noncompliant groups. The T-test or the Mann-Whitney Test (an equivalent nonparametric technique) was applied to determine significant differences between groups. Thus did the clinical parameters measured over time (baseline to 3 months, baseline to 6 months and baseline to 12 months), change more in the compliant than in the non-compliant group? And were there correlations between psychological questionnaires answers and the two exercise groups? The results indicated that the group’s exercise compliance trend decreased drastically over time. Statistical significant decreases were demonstrated in systolic (p = 0.007) and diastolic (p = 0.012) blood pressure, BMI (p = 0.072 and p = 0.0003), cardiac risk percentage (p = 0.003), and body weight (p = 0.003 and p = 0.0000). All of these decreases were seen in the exercise compliant group. There were no statistical correlations between the psychological questionnaires and the exercise groups. Limitations were the quality of the clinical data, the exercise compliance data that deteriorated over time, and the LOR and ITS questionnaires was neither valid nor reliable tools in making predictions regarding exercise behaviour/compliance. For future research it is recommended that measurements of blood pressure and cholesterol be done more thoroughly, and dietary fat intake must be monitored. A valid and reliable cardiac risk tool, LOR and ITS questionnaires must be designed. AFRIKAANS : Die voorkoms en kosteïmplikasies van kroniese siektetoestande in Suid–Afrika en wêreldwyd, het in die laaste gedeelte van die 20ste eeu ‘n wesenlike probleem geword. Kardiovaskulêre (KVS) siektes en tipe 2 diabetes mellitus (DM) is veral voorbeelde van sulke siektetoestande. Daar is voorspel dat in die jaar 2030, meer mense wêreldwyd aan KVS sal doodgaan, as aan Menslike Immuniteitsgebrekvirus/Verworwe Immuniteitsgebreksindroom (MIV/Vigs). Die risikofaktore wat met die oorsake van KVS geassosieer word, is die volgende: <ul> <li> Biologiese (met inbegrip van hipertensie, insulienweerstandigheid, hoë bloedcholesteroltellings, ens)</li> <li> Sielkundige (bv emosionele spanning) • Risikofaktore wat verband hou met lewenstyl.</li></ul> Literatuur bevestig dat fisiese oefening help om KVS en diabetes mellitus te behandel. Die American College of Sports Medicine (ACSM) het ‘n oefenriglyn van drie maal per week vir 20 minute lank as ‘n minimumfrekwensie daargestel. Volgens literatuur oefen ‘n derde van pasiënte wat deelneem aan oefeningnavorsingsstudies nie volgens die riglyne wat gestel word nie en binne die eerste drie tot ses maande sal 50% van die pasiënte ophou oefen. Navorsing wat op die Suid-Afrikaanse bevolking gedoen is, toon dat minder as ‘n derde 30 minute lank op meeste dae van die week oefen. Dus is die belangstelling van gesondheidsterapeute rakende die bestuur van gereelde oefeningdeelname geprikkel. Gereelde oefeningdeelname sluit ook die rol van gedragspatrone in en dus is sielkundige gedragsmodelle gebruik om dit ook in die huidige studie te ondersoek. Copyright / Dissertation (MA)--University of Pretoria, 2009 / Biokinetics, Sport and Leisure Sciences / unrestricted
2

Инструменты стратегического планирования внедрения систем оперативно- производственного планирования на промышленном предприятии : магистерская диссертация / Strategic planning tools for the implementation of operational and production planning systems in an industrial enterprise

Никулин, А. Д., Nikulin, A. D. January 2024 (has links)
The relevance of research. In a market that orients each manufacturer and entrepreneur to a high end result, planning acquires new functions at Russian enterprises. Planning is aimed not only at ensuring the production of competitive products, but also at promoting full employment of resources, equitable income distribution and improved quality of life. Production planning is one of the main directions of production management. Its main feature is that the formation of tasks planned by the production unit is strictly related to the organization of their implementation. The relevance of this topic lies in the fact that in order to produce products at the exact time with fluctuations in demand, it is necessary to improve planning at the enterprise. The purpose is to develop methodological tools for the implementation of operational and production planning systems and for assessing the level of readiness of the enterprise. Research objectives: - to study the strategic planning tools used in an industrial enterprise when implementing an operational and production planning system; - to explore the experience of implementing operational and production planning at the enterprise, the effect of implementation; - to develop methodological tools for assessing the level of readiness of the enterprise for the implementation of operational and production planning systems. The object of the study is industrial enterprises implementing an operational and production planning system. The subject of the study is the organizational and economic relations that arise during the implementation of the operational and production planning system. The scientific work carried out made it possible to develop methodological tools for the implementation of operational production planning systems and for assessing the level of readiness of the enterprise, including an assessment of the business processes of the enterprise, determining the current level of readiness of the enterprise for the implementation of operational production planning systems, calculating the effects of implementation, an algorithm for selecting an operational production planning system and a roadmap for its implementation, allows you to take effective management decision on the implementation of operational and production planning systems. / Актуальность исследования. В условиях рынка, ориентирующего каждого производителя и предпринимателя на высокий конечный результат, планирование приобретает новые функции на российских предприятиях. Планирование направлено не только на обеспечение производства конкурентоспособной продукции, но и на содействие полной занятости ресурсов, справедливому распределению доходов и улучшению качества жизни. Производственное планирование является одним из главных направлений управлением производства. Его главная особенность заключается в том, что формирование запланированных производственным подразделением задач строго связано с организацией их выполнения. Актуальность данной темы заключается в том, что для выпуска продукции в точное время при колебаниях спроса необходимо совершенствовать планирование на предприятии. Цель разработка методического инструментария к внедрению систем оперативно-производственного планирования и к оценке уровня готовности предприятия. Задачи исследования: - изучить инструменты стратегического планирования, используемые на промышленном предприятии при внедрении системы оперативно-производственного планирования; - исследовать опыт внедрения оперативно-производственного планирования на предприятии, эффект от внедрения; - разработать методический инструментарий к оценке уровня готовности предприятия для внедрения систем оперативно-производственного планирования. Объект исследования – Промышленные предприятия, внедряющие систему оперативно-производственного планирования. Предмет исследования – Организационно-экономические отношения возникающие при внедрении системы оперативно-производственного планирования. Проведенная научная работа позволила разработать методический инструментарий к внедрению систем оперативно-производственного планирования и к оценке уровня готовности предприятия, включающий оценку бизнес-процессов предприятия, определение текущего уровня готовности предприятия к внедрению систем оперативно производственного планирования расчет эффектов от внедрения, алгоритм выбора системы оперативно-производственного планирования и дорожную карту ее внедрения, позволяет принять эффективное управленческое решение по внедрению систем оперативно-производственного планирования.

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