This thesis describes research into the facilitation of mediated communication of health updates and support needs across the social network, on behalf of individuals experiencing acute or chronic health problems. This led to the user-centred design, development and evaluation of a prototype software tool. Investigatory applied research was conducted with the parents of sick newborn infants who were (or had previously been) cared for in a Neonatal Unit, and their social networks of family, friends, colleagues and neighbours. The thesis makes contributions to knowledge within Social Networks, Health Informatics, Adaptive Systems and User Modelling. The user-centred research was conducted using a Grounded Theory approach, progressively focussing on developing themes. An iterative approach was taken to evaluation of the resulting theory. In the Social Networks domain, a novel, intuitive mechanism for capturing the membership and structure of an individual’s personal social network has been defined and developed, grounded in the work of evolutionary anthropologist Robin Dunbar. Use of the highly visual mechanism requires low levels of literacy and computer skills. It is cross-culturally applicable, and makes no prior assumptions about an individual’s relationships. In the domains of Health Informatics, Adaptive Systems and User Modelling, a model has been defined for adaptive information sharing across the personal social network. This model provides a number of new insights about information sharing choices made by an individual experiencing a health crisis (the ego) and their supporters (alters).

No description available.

O crescente e desordenado aumento da população mundial e seus avanços tecnológicos, muitas vezes conseguido com violentas agressões à natureza, têm trazido conseqüências amargas que levam a sociedade a refletir como um todo sobre que tipo de futuro esperamos legar às próximas gerações e até onde podemos progredir sem desrespeitar as leis imutáveis do meio ambiente. Uma das principais preocupações modernas relacionadas a este tema é o aumento progressivo da geração de resíduos resultantes da produção, prestação de serviços e consumismo descontrolado. Dentre estes resíduos, ocupam lugar de importância os resíduos de serviços de saúde (RSS), por caracterizarem um desequilíbrio de caráter epidemiológico, com potencial de infecção altamente conhecido, tornando-se um assunto de interesse mundial no impacto ambiental gradativamente acumulado. Atitudes estão sendo tomadas por autoridades governamentais, sanitárias e científicas, que procuram minimizar estes impactos e encontrar saídas para o gerenciamento seguro destes resíduos, que estão cada dia mais volumosos e trazendo preocupações sociais e ambientais. Esta tese de doutorado focou atenção no potencial de contaminação ambiental e humana, causada pelos resíduos de serviços de saúde gerados em estabelecimento hospitalar, estabelecendo o objetivo de contribuir com medidas que, em associação com o manejo adequado dos RSS, promovam a prevenção e minimização dos efeitos infectantes e agressivos destes resíduos em relação ao meio ambiente, à infecção hospitalar, e à saúde dos trabalhadores em ambiente hospitalar. As atividades de pesquisa de campo foram desenvolvidas em um hospital de grande porte, voltado ao tratamento do câncer, que apresentou um modelo de gerenciamento dos RSS, antes da promulgação das leis federais atualmente em vigor sobre o assunto – Anvisa 306/2004 e Conama 358/2005. Constatou-se, após uma metodologia investigativa e exploratória, que é possível gerenciar corretamente os RSS – conforme as regras atuais de manejo previstas em lei - e contribuir para um maior alcance de preservação da saúde ambiental e humana, através de medidas de prevenção e minimização frente ao potencial infectante dos RSS. Para tanto, esta tese foi construída no sentido de contribuir para a discussão técnico-científica da difícil tarefa de reorganizar e reverter o processo de contaminação de nosso “casa por excelência" - o nosso planeta / The developed and disordered increasing of the world population and your technologies progress, sometimes obtained with violent aggressions to the nature, it has brought severe consequence that take society thinking about what kind of future we hope to leave the next generation and how far we can progress without disrespect the immutable laws from the environment. One of the most moderns preoccupations related to this topic is the progress increase from the generation of residues resultant from the production, useful service, and consumption out of control. Inside these residues, take the important places the residues from the health services (RSS), for characterize one instability from the epidemiologic character, with the high potential infection well-known, being a subject of the world-wide concern of the environmental impact gradually accumulated. Attitudes are being taken by governmental authorities, sanitarians and scientifics, which they are searching to minimize these impacts and find out the ways to the secure management of these residues, which they are being more voluminous and brining out social and environmental concerned. It had searched, with this work, to realize bibliographies analysis and practices of the potential infection from the service residues of health to the men and environment, as well as the current model of management (determined in the federal rule) and its narrows relation with the active participation from the workers concerned at the handling from RSS, to come up with that by the environment of the work teams and administration of the hospital institutions, could reach the significant positive results from the combat of the hospital infection, human contamination and environmental from the infecting residues originated by the services attention of health. This project brings back the attentions for this important current topic and conducts its methodology in the direction to contribute for the scientific technical discussion from the hard work to reorganize and revert the pollution of our “house from excellence" – our planet

Introduktion: Våld i nära relationer är ett globalt fenomen och utgör ettåterkommande inslag i arbetet inom hälso- och sjukvården, polismyndigheten ochsocialtjänsten. Våld i nära relationer förekommer i alla samhällsklasser, åldrar,oavsett sexuell läggning och är inte relaterad till vare sig etnicitet, kulturell ellerreligiös bakgrund. Det finns flertal myndigheter som ger skydd och stöd tillvåldsutsatta. För att säkerställa ett professionellt omhändertagande av denvåldsutsatta måste de olika myndigheterna samverka. Forskning visar dock attsamverkan ofta brister vilket kan resultera i ett försämrat omhändertagande av dendrabbade individen.Syfte: Att undersöka vilka faktorer som är av betydelse för myndigheterssamverkan vid vuxnas utsatthet för våld i nära relationer, utifrån hälso- ochsjukvårdens, polismyndighetens, och socialtjänstens perspektiv.Metod: Studien är en integrativ litteraturstudie. Litteratursökningarna eftervetenskapliga artiklar genomfördes i databaserna Cinahl, Pubmed, Criminal justiceabstracts, Social services abstracts, Psycinfo och Social science premium collection.De för studien relevanta artiklarna har kvalitetsgranskats, kodats, kategoriserats ochanalyserats enligt gällande metod.Resultat: Resultatet baseras på tio vetenskapliga artiklar och visar att det finns ettflertal faktorer som har betydelse för myndigheters samverkan vid våld i närarelationer. Faktorer som kunskap, organisation, kommunikation och kultur har idenna studie visat sig vara särskilt utmärkande. Dessa faktorer kan verka bådehämmande och främjande beroende på rådande omständigheter inom respektivemyndighetSlutsats: Samverkan mellan myndigheter är en absolut förutsättning för ett adekvatomhändertagande av den individ som utsatts för våld i en nära relation. Fenomenetmedför en komplex problematik. Det finns ett uppenbart utbildningsbehov för flerayrkeskategorier, främst gällande identifikation och bemötande av den våldsutsattasamt klargörande kring de olika myndigheternas olika ansvarsområden ochbefogenheter. Arbetet bör i framtiden organiseras utifrån den drabbades behov avolika hjälpinsatser istället för att som idag utgå från de olika myndigheternasrespektive kompetensområde.

The rising complexity in healthcare, exacerbated by an ageing population, results in ineffective decision-making leading to detrimental effects on care quality and escalates care costs. Consequently, there is a need for smart decision support systems that can empower clinician's to make better informed care decisions. Decisions, which are not only based on general clinical knowledge and personal experience, but also rest on personalised and precise insights about future patient outcomes. A promising approach is to leverage the ongoing digitization of healthcare that generates unprecedented amounts of clinical data stored in Electronic Health Records (EHRs) and couple it with modern Machine Learning (ML) toolset for clinical decision support, and simultaneously, expand the evidence base of medicine. As promising as it sounds, assimilating complete clinical data that provides a rich perspective of the patient's health state comes with a multitude of data-science challenges that impede efficient learning of ML models. This thesis primarily focuses on learning comprehensive patient representations from EHRs. The key challenges of heterogeneity and temporality in EHR data are addressed using human-derived features appended to contextual embeddings of clinical concepts and Long-Short-Term-Memory networks, respectively. The developed models are empirically evaluated in the context of predicting adverse clinical outcomes such as mortality or hospital readmissions. We also present evidence that, surprisingly, different ML models primarily designed for non-EHR analysis (like language processing and time-series prediction) can be combined and adapted into a single framework to efficiently represent EHR data and predict patient outcomes.

Made available in DSpace on 2016-04-28T20:19:28Z (GMT). No. of bitstreams: 1 2008 - Jocelio de Souza Maciel.pdf: 540920 bytes, checksum: 59313a3c8b27e9ddb1b998574d525703 (MD5) Previous issue date: 2008-08-28 / The quality concept was developed throughout the years for studious as Juran, Ishikawa, Feigenbaum, Crosby, Deming, amongst others. Respected the had partner-cultural contexts in which the cited theoreticians met inserted, all had been unanimous in choosing the emphasis in the customer as the main component of the theory of the quality. Although the concepts and techniques directed to the quality if have initiated in the industrial context, later, by means of complex and personalized adaptations, was transferred to also use it such concepts in the area of the health. The objective of the present dissertation consists of evaluating the quality of the services given for the Clinic of Physiotherapy and Rehabilitation of the University Center of Barra Mansa - RJ. The study it was developed next to 347 patients. In the development of the research an adaptation of the Servqual scale was used, instrument consecrated in studies on evaluation of quality in health services. Amongst the evaluated dimensions, the users had indicated "Reliability" as the most important parameter to evaluate the services given for the clinic. The dimension "Tangibles", that it says respect to the aspects of physical structure and equipment received the lesser indices from satisfaction amongst the other evaluated dimensions. / O conceito de qualidade foi desenvolvido ao longo dos anos por estudiosos como Juran, Ishikawa, Feigenbaum, Crosby, Deming, dentre outros. Respeitados os devidos contextos s?cio-culturais nos quais os te?ricos citados encontravam-se inseridos, todos foram un?nimes em eleger a ?nfase no cliente como o principal componente da teoria da qualidade. Embora os conceitos e t?cnicas voltados ? qualidade tenham se iniciado no contexto industrial, posteriormente, por meio de adapta??es complexas e personalizadas, passou-se a utilizar tais conceitos tamb?m na ?rea da sa?de. O objetivo da presente disserta??o consiste em avaliar a qualidade dos servi?os prestados pela Cl?nica de Fisioterapia e Reabilita??o do Centro Universit?rio de Barra Mansa - RJ. O estudo foi desenvolvido junto a 347 pacientes. No desenvolvimento da pesquisa foi utilizada uma adapta??o da escala Servqual, instrumento consagrado em estudos sobre avalia??o de qualidade em servi?os de sa?de. Dentre as dimens?es avaliadas, os usu?rios indicaram a "Confiabilidade" como o mais importante par?metro para se avaliar os servi?os prestados pela cl?nica. A dimens?o "Tangibilidade", que diz respeito aos aspectos de estrutura f?sica e equipamentos recebeu os menores ?ndices de satisfa??o dentre as outras dimens?es avaliadas.

Thesis (Ph.D.)--McMaster University, 2006. / Supervisor: Wayne Warry. Includes bibliographical references (p. 154-164).

Thesis (Ph. D.)--State University of New York at Binghamton, School of Nursing, 2006. / Includes bibliographical references.

<p>According to the United Nations, more than half a billion people (about 650 million) worldwide are disabled. Disability can have a vast impact on both the individual and the family. Rehabilitation is therefore a fundamental need for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it is important to seek clients&rsquo / perspectives of the rehabilitation services and to incorporate these perspectives into the planning and delivery of rehabilitation services. In areas where rehabilitation services are available in South Africa, minimal research has been done to explore the clients&rsquo / experiences regarding provision of these services. The aim of this study&nbsp / therefore was to explore the persons with physical disabilities&rsquo / experiences of the rehabilitation services they received at community health centres (CHCs) in the Cape Town Metro Health&nbsp / District. Data was collected using a mixed methods design in the form of a sequential exploratory strategy. Qualitative data collection was done using in-depth interviews and this was followed&nbsp / by administration of an interview questionnaire. The questionnaire was developed using results from the in-depth interviews together with information from literature. Ten persons with physical&nbsp / isabilities, who had received rehabilitation services at participated in the in-depth interviews and 95 responded to the interview questionnaire. The interviews were tape-recorded and&nbsp / transcribed verbatim and they were analysed using predetermined themes. The SPSS version 16.0 was used to analyse the quantitative data which was presented in frequencies, medians, quartiles and percentages. The results&nbsp / of the study revealed that the participants experienced problems with getting transport to travel to the community health centres and getting adequate information from the service providers,&nbsp / &nbsp / particularly information regarding disability and support services available for them. Experiences regarding participants&rsquo / involvement in their rehabilitation were generally positive. Generally, the&nbsp / participants reported positive experiences regarding their interaction with service providers and family support and involvement and this study recommends the staff to maintain their standards&nbsp / &nbsp / regarding these two dimensions of rehabilitation. However most of the participants were not concerned about whether the service providers gave them an opportunity to express their preferences or not. The results indicate the need to improve transport services for persons with physical disabilities and to give them more information regarding support services. The service providers&nbsp / should also give the clients more opportunities to get involved in their rehabilitation and educate them about the benefits of them getting involved.</p>

Thesis (doctoral)--Universidad de Zaragoza, 1982. / Includes bibliographical references (p. 247-249).