This study evaluated the relationship of varying body mass index and average annual health care costs and absenteeism in a group of 524 municipal employees. The 269 employees with health care claims and the 487 employees with attendance records were categorized into five different BMI categories based on self-reported weight and height. Findings from the study suggest that as BMI increases, average annual health care costs and average annual absenteeism increase. However, BMI was only significantly related to absenteeism. The study also found significant relationships between education and health care costs and absenteeism. No significant differences for health care costs or absenteeism were found based on race, age, gender, wellness center membership, or smoking status.

The study sought to research and develops a universal palliative care measurement tool that will track the performance of informal caregivers to dying persons across the diversity of the South African cultural and religious groupings. The major inferences drawn from this study was that a generic domain, sub-items and intervals could be identified for palliative care; that a reliable measurement tool could be developed and that outcomes of care programs for dying persons in terms of effectiveness and efficiency could be numerically quantified. With the ability to measure now been realised, the ability to manage the outcomes became the new challenge. / Nursing Sciences / M.A. (Health Studies)

The Legislation of Providing Health Care of Residents in the Czech Lands from 1918- 1966 Thesis deals with the development of the legislation of providing health care of residents in Czech Lands from 1918 to 1966, which was effective only in Bohemia. The introductory chapters are about the legislation since 1848 due to reception of the legislation from the Austria-Hungary (often referred to as the Austro-Hungarian Empire in English-language sources). This inherited legislation is mainly about the right of the domicile, health and social care and public health. The authoress divided this thesis into three main chapters about public health care according to timely periods. The main chapters contain subchapters specializing in specific legislation of the individual components of public health. First chapter is about reception of the health care legislation from the Austria- Hungary, about public health care legislation, health system from the perspective of the administrative law, the legislation of the medical service, about the rights and duties of doctors and patients, and finally about funeral legislation. Second chapter is about short excursion to health care legislation in Protectorate Bohemia and Moravia whereby thesis intentionally omits this period closer, because its specific legislation...

As the economic hub of South Africa, Johannesburg attracts cross-border migrants in search of improved livelihoods; over half the population of some of its inner-city suburbs are made up of cross border migrants. Globally as well as locally, foreigners have been blamed for the spread of diseases such as HIV. As a result, they have suffered challenges in accessing public healthcare, particularly antiretroviral treatment (ART) for HIV. Studies have shown that despite these challenges - foreigners experienced better ART outcomes than nationals. There is a need to explore the ways in which cross border migrants use to access and to stay on treatment, given the wide-range of challenges that they face during their stay in Johannesburg. Semi-structured interviews with five nurses and ten cross-border migrants currently receiving ART, along with non-participant observations, were used to collect data from two public clinics in inner-city Johannesburg. Analysis suggests that the family network in the country of origin remains critical, as cross border migrants are not disclosing their status in the city in which they live, but do so to their families in their countries of origin. Data shows that when it comes to accessing and staying on treatment, cross-border migrants go to the clinic every month as do nationals; ask for more treatment from nurses when going home temporarily; eat healthily; but hide when taking medication, and negotiate confidentiality and trust within their families in countries of origin. Some are found to access treatment in their countries of origin while staying in Johannesburg. Despite the lack of social networks in the inner city, this data suggests that cross-border migrants are successful in accessing and continuing with ART. There is need for future research to look at social networks for internal migrants, so as to compare results.

A Dissertation in fulfillment of the requirements for the Degree of Master of Commerce by Research in Information Systems / Electronic Medical Records (EMR) systems aim to provide an integrated solution to a number of hospital processes, including supporting administrative functions such as patient billing, providing clinical guidelines, and allowing clinicians to order and view lab reports. Yet with all these possible benefits, like many other types of information systems and technologies, their impact on hospital performance has been a key area of interest and a source of debate. This study examines the extent to which EMR systems are available across South African hospitals as well as how well they have been integrated into the processes of the said hospitals. The diffusion of EMR systems means they are available in the relevant clinical units whilst their infusion suggests they are comprehensively embedded into the processes that they are meant to support. The most important question answered in this study was whether the diffusion and infusion of these systems had any impact on the performance of hospitals. Answering this question would aid decision makers on whether more effort is indeed needed to ensure their availability across units and their embedding into hospital processes. The study collected data from a number of hospitals in the private and public sector with multiple informants providing data on diffusion and infusion of these systems as well as on hospital performance. Performance measures included the hospitals’ economic efficiency, their clinical effectiveness, patient safety, and patient satisfaction. Key findings were that while there are performance benefits in the diffusion of EMR systems across units, the impacts are not always positive for some hospitals. Large hospitals were less likely to benefit from the diffusion of these systems. However the comprehensive use of these systems provided benefits for all types of hospitals, suggesting that while availability may be important, it is the comprehensive embedding of the EMR system into the hospital’s processes that is more beneficial to all types of hospitals. These results present further opportunity for research into why the impact of EMR systems is not always positive for some hospitals. / MT2017

Holčapek, T., Evidence in Civil Litigation with Emphasis on Disputes Arising from Medical Care, doctoral thesis, Charles University in Prague, Law Faculty, 2010. The doctoral thesis focuses on the issues of fact-finding in general and evidence in particular, all within the framework of rules of civil proceedings and with regard to lawsuits that result from the providing of medical care. It analyses the factual prerequisites which need to be found (proven) in order to establish liability of the health care provider for personal injury or interference with personality rights of the patient, and discusses who bears the evidentiary burden in their respect, how persuasive the proof has to be and what techniques for the lightening of such burden (e. g. factual presumptions or utilisation of loss of chance or other concept of proportional liability) are employed by various legal systems. The thesis builds on the comparison between Czech law and rules used in other legal areas, including both continental law and common law countries. Keywords: health, medical care, civil liability, civil proceedings, evidence

atisfaction with diabetes care, perceived feelings of empowerment to participate in self-care management, and glycemic control in a sample of older African American men and women with diabetes. A descriptive correlational quantitative design was used. The participants in this study were 73 men and women of African descent who were at least 50 years, English speaking, and diagnosed with diabetes for at least one year. The participants were asked to complete three survey instruments: the Patient Satisfaction Questionnaire-18 (PSQ-18), which measured how satisfied the participants were with their medical care; the Diabetes Empowerment Scale-Short Form (DES-SF), which measured attitudes towards diabetes and self-management of diabetes; and a demographic form, which collected data on the demographics of each participant. The most recent hemoglobin A1c (HbA1c) of each participant was obtained from the medical records. The correlations between HbA1c, DES, and the PSQ-18 subscales were exam ined. The study data indicated all correlations were statistically significant and negative with one exception. There was no correlation between HbA1c and time spent, a satisfaction subscale. Approximately half the participants were high school graduates, married, and reported being born in the Caribbean. Most had primary care physicians, but less than half reported attending a diabetes education program. The average BMI was 33.0. The findings of this study indicated older African adults who reported higher satisfaction with the care provided by their health care provider reported feeling more empowered to participate in diabetes self-care and reported lower HbA1c levels, suggesting better glycemic control (R2 = .39; P=<.001). / The implications of this study are that feeling empowered to participate in diabetes self-care management may result in improved glycemic control. Positive diabetes outcomes have been linked in the literature with persons feeling empowered to participate in diabetes self-care. The significance of the findings from this study is that given the relationship between empowerment and glycemic control, nurses should support the empowerment model of diabetes teaching. Diabetes education should provide written materials that are culturally sensitive for African American elders. / by Bridgette M. Johnson. / Thesis (Ph.D.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.

Background: A global cervical cancer health disparity persists despite the demonstrated success of primary and secondary preventive strategies, such as cervical visual inspection (VI). Cervical cancer is the leading cause of cancer incidence and death for women in many low resource areas. The greatest risk is for those who are unable or unwilling to access screening. Barriers include healthcare personnel shortages, cost, transportation, and mistrust of healthcare providers and systems. Using community health workers (CHWs) may overcome these barriers, increase facilitators, and improve participation in screening for women in remote areas with limited access to clinical resources. Aim: To determine whether the accuracy of VI performed by CHWs was comparable to VI by physicians or nurses and to consider the affect components of provider training had on VI accuracy. Methods: A systematic review and quantitative meta-analysis of published literature reporting on VI accuracy, provider type, and training was conducted. Strict inclusion/exclusion criteria, study quality, and publication bias assessments improved rigor and bivariate linear mixed modeling (BLMM) was used to determine the affect of predictors on accuracy. Unconditional and conditional BLMMs, controlling for VI technique, provider type, community, clinical setting, HIV status, and gynecological symptoms were considered. Results: Provider type was a significant predictor of sensitivity (p=.048) in the unconditional VI model. VI performed by CHWs was 15% more sensitive than physicians (p=.014). Provider type was not a significant predictor of accuracy in any other models. Didactic and mentored hours predicted sensitivity in both BLMMs. Quality assurance and use of a training manual predicted specificity in unconditional BLMMs, but was not significant in conditional models. Number of training days, with ≤5 being optimal, predicted sensitivity in both BLMMs and specificity in the unconditional model. Conclusion: Study results suggest that community based cervical cancer screening with VI conducted by CHWs can be as, if not more, accurate than VI performed by licensed providers. Locally based screening programs could increase access to screening for women in remote areas. Collaborative partnerships in “pragmatic solidarity” between healthcare systems, CHWs, and the community could promote participation in screening resulting in decreased cervical cancer incidence and mortality. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

Health care systems consist of various individuals and organizations that aim to meet the health care needs of people and provide a complete and responsive health care solution. One of the important aspects of a health care delivery system is nursing. The use of technology is a vital aspect for delivering an optimum and complete nursing care to individuals; and also for improving the quality and delivery mechanism of nursing care. The model proposed in this thesis for Nursing Knowledge Management System is a novel knowledge-based decision support system for nurses to capture and manage nursing practice, and further, to monitor nursing care quality, as well as to test aspects of an electronic health record for recording and reporting nursing practice. As a part of a collaborative research of the Christine E. Lynn College of Nursing and the Department of Computer Science, a prototype toolset was developed to capture and manage nursing practice in order to improve the quality of care. This thesis focuses on implementing a web based SOA solution for Automated Classification of Nursing Care Categories, based on the knowledge gained from the prototype for nursing care practice. / by Sughomoy D. Dass. / Thesis (M.S.C.S.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

The highly complex role of the Chief Nursing Officer (CNO) requires the refinement of a multitude of competencies and leadership skills in this unprecedented time of healthcare reform. As the senior most patient advocate in our medical centers the CNO is responsible for translating research into practice, policy development and implementation creating value based patient-centric strategies to transform health care. The ability to sustain and thrive in this role is essential in repositioning nursing as a knowledgeable discipline actively contributing to the redesign of healthcare. This exploratory descriptive phenomenological study was designed to explore and describe the elements that contribute to the sustainment of CNOs in their practice of nurse executive leadership. Ray’s (1989) Theory of Bureaucratic Caring, Authentic Leadership Theory (Wong & Cummings, 2009), and Resiliency Theory (Earvolino- Ramirez (2007) provided the theoretical lens through which this study was grounded. Semi-structured telephonic interviews were conducted with twenty CNOs all with two consecutive years experience in their current role. Six themes emerged after thorough content analysis which describes the lived experience of sustainment. Each theme was supported by several subthemes. Themes emerged as: Loving the Profession, Having a Broader Impact Reflecting on One’s Own Work, Learning to Manage Conflict, Maintaining Work/Life Balance Working with Supportive Leaders. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection