This thesis examines the problem of utilitarian ageism in Quality-Adjusted Life Years and contrasts it with the biblical principles of community and honor that are to characterize treatment of the elderly. Chapter 1 provides a general orientation into the issue of health care allocation. Attention is given to the history of modern health care allocation and describes its rapid evolution. Chapter 2 provides a more detailed analysis of health care allocation demonstrating the necessity for some system of allocation in modern American health care. It concludes by presenting the QALY model as a potential basis for modern health care allocation decision making. Chapter 3 examines the problems of QALYs as a basis for health care allocation. After the use of quality of life and health life years is evaluated the relationship between utilitarianism and QALYs is explored, focusing on QALYs' discrimination against elderly. Chapter 4 examines the biblical perspectives of elder care, identifying the principles of honor and community as foundational. The underlining principles of justice and biblical love provide a foundation for biblical elder care. Chapter 5 compares the QALY and biblical models. The comparison is accomplished by noting the contrasts in philosophical foundations, economic strategies and priorities in the distribution of limited health care resources. Chapter 6 concludes by contending that QALY calculations are ageist and therefore an unjust basis on which to base decisions regarding the distribution of limited health care resources. This work contends that a potentially less efficient, but a better moral basis for resource allocation are the biblical principles of honor and community. These two principles enable a more holistic approach to dealing with the needy elderly in health care allocation. / This item is only available to students and faculty of the Southern Baptist Theological Seminary. If you are not associated with SBTS, this dissertation may be purchased from <a href="http://disexpress.umi.com/dxweb">http://disexpress.umi.com/dxweb</a> or downloaded through ProQuest's Dissertation and Theses database if your institution subscribes to that service.

M.Comm. / PPPs have developed out of a realisation by governments that in order to improve health systems efficiency there is a need to involve the private sector. Governments throughout the world have opted for PPPs to deliver public services, share risks and attain common goals. While the idea of PPPs is not new, it nonetheless has grown in application in recent years especially in developing countries such as South Africa. The neo-liberal GEAR macro-economic policy, that seeked to reduce government spending and to accelerate investment, catalysed the formation of PPPs in South Africa after 1996. The South African health system is a two-tier system consisting of the public sector and private sector. The public health sector is under resourced in terms of health personnel, health resources and funding compared to private healthcare. As a consequence, public health outcomes in South Africa are poor relative to its funding and have deteriorated since 1996, reportedly mainly due to the HIV/AIDS epidemic. On the contrary, private healthcare outcomes are amongst the best in the world. As a result, the demand for private healthcare is higher than that of public healthcare, because it is better resourced and offers better quality care. The research investigates the contribution of PPPs to access quality healthcare in South Africa. The study follows the policy, financial and governance approach to review health PPPs. It suggests that the 7 implemented health PPPs contributed directly and indirectly to improved access to quality healthcare. It recommends the implementation of health PPPs particularly at local government level, to improve access to quality healthcare.

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts in Applied Ethics For Professionals, July 2017 / Health and, by extension, healthcare is accepted to be a valuable and important social good that is both a good in and of itself, as well as necessary to achieve life’s goals. Its fair distribution is therefore properly the subject of ethical concern and in the era of modern medicine where costs and potentially limitless treatments exceed available resources, rationing healthcare has become an unavoidable necessity. Since such rationing implies that not everyone’s needs or preferences can be met, a fair and just way of rationing healthcare is a widely debated and controversial topic that, to date, remains unresolved. Where third-party private funding organisations are tasked with these rationing responsibilities, the ethical complexities are compounded by perceived conflicts between the ethical frameworks that govern corporate organisations versus those that govern healthcare. Given the apparent inability of normative theories to resolve the problem of how to ration healthcare fairly, there has been a shift in thinking to considerations of procedural justice and a dominant model, Accountability for Reasonableness (AFR), has emerged as the favoured procedure for healthcare decision-making. The report shows why health is an important social value and examines the key models and principles that dominate the rationing debate as well as why the conflict between healthcare ethics and organisational ethics create additional complexities that must be considered when making these funding decisions. Furthermore it explores the rationales for resorting to procedural accounts with specific emphasis on the parameters and validity of AFR. The report concludes that even though the AFR framework may be a legitimate and just process that can effectively frame decision-making and provide a platform to drive transparency and consistency, like most procedural accounts, it does not guarantee that the outcomes it produces are necessarily fair or just. Therefore a straightforward application of AFR cannot resolve the healthcare rationing debate which should, given its ethical complexity, continue to appeal to the important ethical principles that currently govern the field. / XL2018

The majority of persons within South Africa (of whom 16% have claimed to have suffered from common mental disorders such as depression) that use medical treatment do so through primary care (Patel et al., 2007; Williams et al., 2007). However, studies have shown that general practitioners (GPs) often overlook, ignore, misdiagnose and even offer inappropriate treatment for mental illness (c.f. Lotrakul & Saipanish, 2009; Qwabe, 2009). Since South Africa is comprised of a multitude of diverse peoples from varying culture backgrounds, cultural diversity needs to be considered within every interaction, especially when GPs consult with individuals with depression. This study, thus, aims to explore GPs’ management of depression by investigating diagnosis or detection, treatment and referral patterns of GPs where their considerations of patient’s cultural worldviews are also investigated. This study utilised a semi-structured interview schedule on a convenient sample of six GP’s. Thematic content analysis was used to analyse salient themes from the data. Eight themes were found, namely: diagnosing, treating and referring patients with depression, cultural implications in general practice, training of GPs, the evolution of the medical field and its practices, disadvantaged communities and access to health care resources as well as the ethics of practice. These results are discussed in relation to local and international literature in the field.

Approximately 1.76 million men and women have served in the Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) military campaigns since October 2001. The transition from living in a war zone to resuming a fulfilling life at home is often difficult for veterans. The purpose of this mixed methods study was to gain understanding of the issues that complicate health for veterans and approaches veterans used to resolve complicating health issues associated with the challenge of coming home from war. Qualitative data collection and analysis was guided by story inquiry method. Quantitative data was collected using the 36-item Short-Form Health Survey, Version 2 (SF-36v2) and analyzed using QualityMetric Health Outcomes[TM] Score Software, Version 4.0. Seven OEF/OIF veterans who had completed at least one tour of duty in Iraq since October 2001 participated in this study. Three themes emerged from the qualitative data that capture the complicating health issues that participants encountered when coming home from war: flipping the switch, figuring out how to belong, and living the stress of a new normal. Two themes emerged from the qualitative data that capture approaches used to resolve complicating health issues associated with returning home from war: connecting with others and choosing a positive attitude. Quantitative data revealed that the majority of participants scored at or above general population norms on three of the subscales that measure physical health, as well as on two of the subscales that measure mental health; however a significant percentage scored below norms on the subscale that measures social functioning (57%) and on the subscale that directly measures mental health (43%). / All three themes describing complicating health issues that emerged during qualitative data analysis resonated with the SF-36v2's measures of mental health, especially social functioning which inquires about experiences with social interactions. Both themes describing movement toward resolving resounded strongly with the SF-36v2's measures of mental health. From this study's findings, changes to policy and practice, education of nurses and post-secondary faculty, and future research have been recommended to continue to assist the war veteran who is coming home. / by LisaMarie Wands. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

In this thesis I explore the circumstances in which pregnant Guatemalan Mayan women in South Florida communities found themselves. A local non-profit organization, the Guatemalan Maya Center (GMC), offered assistance to pregnant Mayan women to secure biomedical prenatal care, yet many continued to underutilize these services. The decision to utilize this form of care largely depended on whether a woman received care from a traditional midwife in the community. Women receiving care from a midwife generally did not seek biomedical care until late in their pregnancies. Women unable to locate a midwife often incorporated biomedical care once they suspected pregnancy. Due to the difficulties accessing the GMC's services prior to enrollment many of these women did not obtain "timely" care. A better understanding of the ways in which Guatemalan Mayan women incorporated biomedical prenatal care into their lives is the first step towards increasing their participation in these services. / by Colleen Supanich. / Thesis (M.A.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

Healthcare organizations, realizing the potential of the Internet of Things (IoT) technology, are rapidly adopting the technology to bring signi cant improvements in the quality and e ectiveness of the service. However, these smart and interconnected devices can act as a potential \back door" into a hospital's IT network, giving attack- ers access to sensitive information. As a result, cyber-attacks on medical IoT devices have been increasing since the last few years. It is a growing concern for all the stakeholders involved, as the impact of such attacks is not just monetary or privacy loss, but the lives of many patients are also at risk. Considering the various kinds of IoT devices one may nd connected to a hospital's network, traditional host-centric security solutions (e.g. antivirus, software patches) are at odds with realistic IoT infrastructure (e.g. constrained hardware, lack of proper built-in security measures). There is a need for security solutions which consider the challenges of IoT devices like heterogeneity of technology and protocols used, limited resources in terms of battery and computation power, etc. Accordingly, the goals of this thesis have been: (1) to provide an in-depth understanding of vulnerabilities of medical IoT devices; (2) to in- troduce a novel approach which uses a microservices-based framework as an adaptive and agile security solution to address the issue. The thesis focuses on OS Fingerprint- ing attacks because of its signi cance for attackers to understand a target's network. In this thesis, we developed three microservices, each one designed to serve a speci c functionality. Each of these microservices has a small footprint with RAM usage of approximately 50 MB. We also suggest how microservices can be used in a real-life scenario as a software-based security solution to secure a hospital's network consisting of di erent IoT devices. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

Promoting healthcare and wellbeing requires the dedication of a multi-tiered health service delivery system, which is comprised of specialists, medical doctors and nurses. A holistic view to a patient care perspective involves emotional, mental and physical healthcare needs, in which caring is understood as the essence of nursing. Properly and efficiently capturing and managing nursing knowledge is essential to advocating health promotion and illness prevention. This thesis proposes a document-indexing framework for automating classification of nursing knowledge based on nursing theory and practice model. The documents defining the numerous categories in nursing care model are structured with the help of expert nurse practitioners and professionals. These documents are indexed and used as a benchmark for the process of automatic mapping of each expression in the assessment form of a patient to the corresponding category in the nursing theory model. As an illustration of the proposed methodology, a prototype application is developed using the Latent Semantic Indexing (LSI) technique. The prototype application is tested in a nursing practice environment to validate the accuracy of the proposed algorithm. The simulation results are also compared with an application using Lucene indexing technique that internally uses modified vector space model for indexing. The result comparison showed that the LSI strategy gives 87.5% accurate results compared to the Lucene indexing technique that gives 80% accuracy. Both indexing methods maintain 100% consistency in the results. / by Sucharita Vijay Chichanikar. / Thesis (M.S.C.S.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

Hospital readmission rates are considered to be an important indicator of quality of care because they may be a consequence of actions of commission or omission made during the initial hospitalization of the patient, or as a consequence of poorly managed transition of the patient back into the community. The negative impact on patient quality of life and huge burden on healthcare system have made reducing hospital readmissions a central goal of healthcare delivery and payment reform efforts. In this project, we will focus on COPD (Chronic Obstructive Pulmonary Disease) which is one of the leading causes of disability and mortality worldwide. This project will design and develop a prognostic COPD healthcare management system which is a sustainable clinical decision-support system to reduce the number of readmissions by identifying those patients who need preventive interventions to reduce the probability of being readmitted. Based on patient’s clinical records and discharge summary, our system would be able to determine the readmission risk profile of patients treated for COPD. Suitable interventions could then be initiated with the objective of providing quality and timely care that helps prevent avoidable readmission. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

The purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and/or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participant's meaning of their experience. The theoretical framework that was used to explore the nurses' experience o caring for women who abuse or are dependent on alcohol and/or drugs was Boykin and Schoenhofer's Nursing as Caring (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection