Bakgrund: Telefonrådgivning är ett område som ständigt växer inom sjukvården. Telefonrådgivningens syfte är att göra en bedömning avseende vilket vårdbehov som finns, ge råd, samt hänvisa den vårdsökande till rätt vårdinstans. Arbetet som telefonsjuksköterska kan vara komplext med höga krav. Klinisk erfarenhet kan således underlätta i många avseenden. Syfte: Syftet var att sammanställa sjuksköterskors erfarenheter av telefonrådgivning.Metod: En kvalitativ litteraturstudie har genomförts innehållande tio vetenskapliga artiklar som har granskats, analyserats och sammanställts. Databaserna CINAHL och PubMed användes för datainsamling. Resultat: I resultatet framkom sex teman. Exempel på teman som fångats är bland annat att ge och ta råd, dokumentation och datoriserade beslutsstöd och att medvetandegöra stressen. Att visa empati och bygga tillit med den vårdsökande var viktigt för att vinna dennes förtroende och på så vis underlätta samtalet. De datoriserade beslutsstöden lovordades men ansågs även vara ett hinder vissa gånger när den personliga erfarenheten var av annan åsikt. Konklusion: Sjuksköterskorna upplevde ofta arbetet med telefonrådgivning som givande och något som gynnade deras kompetensutveckling. Det kunde emellertid även vara stressigt och upplevas som problematiskt då resurserna var begränsade. Att läsa in och tolka vad den vårdsökande förmedlade var essentiellt eftersom de visuella ledtrådarna saknades. / Background: Telephone consulting is a field that constantly grows within health care. The aim of telephone consulting is to make an assessment regarding which health needs that exists, give advice, and refer the care seekers to the appropriate healthcare provider. The work as a telenurse can be complex with high demands. Clinical experience can therefore facilitate in many regards.Aim: The aim was to compile nurses experiences of telephone consulting.Method: A qualitative literature review was done containing ten scientific articles that has been reviewed, analyzed and compiled. The databases CINAHL and PubMed was used for data collection.Findings: In the result six different themes emerged. Examples of themes caught are among others to give and receive advice, documentation and compututerized decision support and to be aware of the stress. To show emphaty and to build trust with the care seeker were important to win their confidence and in that way facilitate the telephone consulting. The computerized decision supports were commended but was also seen as an obstacle when the personal experience were of a different opinion. Conclusion: Nurses often experienced the work of telephone consulting as rewarding and something that benefited their skills development. However, it could also be stressful and experienced as problematic as resources were limited. To read in and interpret what the care-seeking was conveyed was essential because the visual clues were lacking.

Bakgrund: Psykisk ohälsa är ett växande hälsoproblem i samhället och en av vår tids folksjukdomar. Covid 19-pandemin kan ha bidragit till ökad psykisk ohälsa. Primärvården bedriver första linjens vård och behandlar majoriteten av dessa patienter. Distriktssköterskan i telefonrådgivning har ofta den första kontakten med patienten och ska på kort tid få en bild av besvären, göra en bedömning och hjälpa patienten vidare i vårdkedjan.  Syftet: Syftet med studien var att beskriva distriktssköterskors upplevelser av att möta och bedöma psykisk ohälsa hos patienter i primärvårdens telefonrådgivning.  Metod: Semistrukturerade intervjuer utfördes med 17 stycken sjuksköterskor och distriktssköterskor på 9 olika vårdcentraler rekryterade via snöbollsurval. Data analyserades utifrån kvalitativ innehållsanalys.   Resultat: Distriktssköterskorna skapade en relation till patienten per telefon. De försökte få tydlig information så att de kunde göra en första bedömning. De kände en otillräcklighet på grund av tidspress men försökte ta sig tid för dessa samtal. Distriktssköterskorna upplevde också en brist på tydliga riktlinjer. De kände ett behov av mer utbildning, beslutsstöd samt fler tider till läkare och psykolog.  Slutsats: Distriktssköterskor i telefonrådgivning hade en viktig roll vid första mötet med patienten som sökte för psykisk ohälsa.  Det fanns ett behov av tydligare riktlinjer, rutiner och hjälpmedel för att underlätta bedömningen. En förbättrad arbetsmiljö i form av minskad tidspress kunde också öka patientsäkerheten. / Background: Mental illness is a growing health problem in society and one of the public diseases of our time. The Covid 19 pandemic may have contributed to increased mental illness. Primary care provides first-line care and treats the majority of these patients. The district nurse in telephone counseling often has the first contact with the patient and must get a picture of the problems in a short time, make an assessment and help the patient further in the care chain. Purpose: The purpose of the study was to describe district nurses' experiences of meeting and assessing mental illness in patients in primary care telephone counseling. Method: Semi-structured interviews were conducted with 17 nurses and district nurses at 9 different health centers recruited via snowball sampling. Data were analyzed based on qualitative content analysis. Results: The district nurses created a relationship with the patient over the phone. They tried to get clear information so they could make an initial assessment. They felt an inadequacy due to time pressure but tried to make time for these conversations. The nurses also experienced a lack of clear guidelines. They felt a need for more education, decision support and more appointments with doctors and psychologists. Conclusion: District nurses in telephone counseling had an important role at the first meeting with the patient who applied for mental illness. There was a need for clearer guidelines, routines and aids to facilitate the assessment. An improved work environment in the form of reduced time pressure could also increase patient safety.

Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag—age group: ag 1: 35–50 years, ag 2: 70–84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients’ native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.

No description available.

Ce mémoire est un des segments d'une recherche de plus grande envergure sur le service Info-Santé, et qui se déroule au Centre de Santé et de Services sociaux de Laval. / Les services téléphoniques de consultation en soins infirmiers sont en progression partout dans le monde. On sait que les infirmières qui possèdent une plus longue expérience de pratique au téléphone obtiennent davantage d’informations sur la condition de santé du client qui les consulte que celles qui comptent moins d’années d’expérience. Nous pouvons présumer que les niveaux d’expertise décrits par Benner (1984) expliquent cette différence. Toutefois aucune étude à ce jour ne décrit comment se manifeste cette différence entre les niveaux d’expertise dans la conversation au cours d’une intervention entre l’infirmière et l’appelant. Le but de cette étude descriptive était d’identifier les manifestations de cette expertise dans la communication, lors de la consultation téléphonique. À l’aide du Roter Interaction Analysis System (RIAS), 190 enregistrements d’appels, entre infirmières (N = 15), de divers niveaux de compétence selon la nomenclature de Benner (1984) et les appelants qui les ont consultées, ont été analysés. Les appels étudiés, issus d’une étude de plus grande envergure, devaient être faits par le parent d’un enfant de moins de cinq ans, et devaient faire l’objet d’une première consultation. Il a été possible de nommer des caractéristiques, des forces et des faiblesses communes aux infirmières de chaque niveau d'expertise à l’étude. Bien qu’il existe des différences entre les moins expérimentées et celles qui ont une longue expérience clinique au téléphone, les résultats semblent indiquer que les infirmières de tous les niveaux d’expertise sont fortement centrées sur la tâche d’évaluation de la situation de santé de l’appelant, mais que leurs interventions incluent peu d’énoncés orientés vers l’établissement d’un réel partenariat avec l’appelant. Les résultats obtenus fournissent des informations qui pourraient être utilisées pour élaborer des stratégies de développement professionnel, et guider les administrateurs de ce service dans le choix des indicateurs d’évaluation de la qualité du service et de ses retombés sur sa clientèle. Toutefois un plus grand nombre d’infirmières participantes et un plus grand nombre d’appels permettraient de confirmer les résultats obtenus à partir de ces 190 appels. / Nurse telephone consultation services are rapidly progressing throughout the world. It is known that nurses with a greater experience in telephone practise obtain more information on the client’s health condition when in consultation, than nurses with less experience. We can presume that Patricia Benner’s «levels of nursing experience», (1984), will provide us with an explanation for these differences. Yet, to this day, no study describes how these differences between levels of experience are manifested in conversation during an intervention between the nurse and the client. The object of this descriptive study was to identify the manifestations of this communication expertise during a telephone consultation. Using the Roter interaction analysis system (RIAS), 190 recorded calls between nurses (N = 15) with differing levels of expertise, according to Benner’ nomenclature (1984), and the callers who have consulted them were analyzed. The calls that were studied, from a larger study, were first calls from parents regarding their child aged five years or less. It was possible to observe characteristics, strengths, and weaknesses common to nurses within each level of expertise in this study. Despite the fact that there are differences between nurses with fewer years of experience and nurses with more clinical telephone experience, results seem to indicate that, regardless of their experience, nurses are strongly centered on the task of assessing the caller’s health situation; however, their interventions include few phrases aimed at establishing a true partnership with the caller. Results obtained provide information that could be used to elaborate professional developmental strategies, and guide administrators in their choice of indicators when evaluating service quality and its effect on clientele. Nevertheless, an increased number of nurse participants and a greater number of calls would enable us to confirm the results obtained from these 190 calls.

The thesis explains the concept of crisis, crisis intervention and telephone crisis intervention, its procedures and techniques. It's focused on history of Helplines not only in Czech Republic but also in the world. It looks closely at the format and principles involved in Helpline call management. The thesis identifies requirements that are imposed on trained specialists and presents some of the institutions that organize training in telephone crisis intervention. Not only Czech but also international organizations focusing on telephone crisis interventions are introduced. A telephone counselors might be at risk for so-cold "burnout syndrome", therefore, the thesis includes chapters devoted to supervision practice and mental hygiene. Finally, the specific Helpline calls are listed.

Les services téléphoniques de consultation en soins infirmiers sont en progression partout dans le monde. On sait que les infirmières qui possèdent une plus longue expérience de pratique au téléphone obtiennent davantage d’informations sur la condition de santé du client qui les consulte que celles qui comptent moins d’années d’expérience. Nous pouvons présumer que les niveaux d’expertise décrits par Benner (1984) expliquent cette différence. Toutefois aucune étude à ce jour ne décrit comment se manifeste cette différence entre les niveaux d’expertise dans la conversation au cours d’une intervention entre l’infirmière et l’appelant. Le but de cette étude descriptive était d’identifier les manifestations de cette expertise dans la communication, lors de la consultation téléphonique. À l’aide du Roter Interaction Analysis System (RIAS), 190 enregistrements d’appels, entre infirmières (N = 15), de divers niveaux de compétence selon la nomenclature de Benner (1984) et les appelants qui les ont consultées, ont été analysés. Les appels étudiés, issus d’une étude de plus grande envergure, devaient être faits par le parent d’un enfant de moins de cinq ans, et devaient faire l’objet d’une première consultation. Il a été possible de nommer des caractéristiques, des forces et des faiblesses communes aux infirmières de chaque niveau d'expertise à l’étude. Bien qu’il existe des différences entre les moins expérimentées et celles qui ont une longue expérience clinique au téléphone, les résultats semblent indiquer que les infirmières de tous les niveaux d’expertise sont fortement centrées sur la tâche d’évaluation de la situation de santé de l’appelant, mais que leurs interventions incluent peu d’énoncés orientés vers l’établissement d’un réel partenariat avec l’appelant. Les résultats obtenus fournissent des informations qui pourraient être utilisées pour élaborer des stratégies de développement professionnel, et guider les administrateurs de ce service dans le choix des indicateurs d’évaluation de la qualité du service et de ses retombés sur sa clientèle. Toutefois un plus grand nombre d’infirmières participantes et un plus grand nombre d’appels permettraient de confirmer les résultats obtenus à partir de ces 190 appels. / Nurse telephone consultation services are rapidly progressing throughout the world. It is known that nurses with a greater experience in telephone practise obtain more information on the client’s health condition when in consultation, than nurses with less experience. We can presume that Patricia Benner’s «levels of nursing experience», (1984), will provide us with an explanation for these differences. Yet, to this day, no study describes how these differences between levels of experience are manifested in conversation during an intervention between the nurse and the client. The object of this descriptive study was to identify the manifestations of this communication expertise during a telephone consultation. Using the Roter interaction analysis system (RIAS), 190 recorded calls between nurses (N = 15) with differing levels of expertise, according to Benner’ nomenclature (1984), and the callers who have consulted them were analyzed. The calls that were studied, from a larger study, were first calls from parents regarding their child aged five years or less. It was possible to observe characteristics, strengths, and weaknesses common to nurses within each level of expertise in this study. Despite the fact that there are differences between nurses with fewer years of experience and nurses with more clinical telephone experience, results seem to indicate that, regardless of their experience, nurses are strongly centered on the task of assessing the caller’s health situation; however, their interventions include few phrases aimed at establishing a true partnership with the caller. Results obtained provide information that could be used to elaborate professional developmental strategies, and guide administrators in their choice of indicators when evaluating service quality and its effect on clientele. Nevertheless, an increased number of nurse participants and a greater number of calls would enable us to confirm the results obtained from these 190 calls. / Ce mémoire est un des segments d'une recherche de plus grande envergure sur le service Info-Santé, et qui se déroule au Centre de Santé et de Services sociaux de Laval.

Cette thèse s'intéresse aux problèmes d'allocations des ressources et de puissance dans les réseaux cellulaires de quatrième génération (4G). Pour faire face à la demande continuellement croissante en débit des utilisateurs mobiles, les opérateurs n'ont d'autre choix que de densifier leurs infrastructures d'accès au réseau radio (RAN), afin de maximiser l'utilisation de la bande passante disponible dans l'espace. Un des défis de cette nouvelle architecture est la coexistence de nombreuses cellules voisines et la gestion des interférences co-canal qu'elles génèrent entre elles. De telles contraintes ont amené la communauté scientifique à s'intéresser aux réseaux auto-organisés et auto-optimisés (SON), qui permettent aux réseaux de s'optimiser localement via des décisions décentralisées (sans planification statique). L'intérêt principal de tels réseaux est le passage à l'échelle des algorithmes distribués et la possibilité de s'adapter dynamiquement à de nouveaux environnements. Dans cette optique, nous proposons l'étude de deux problèmes d'allocation de ressources. La première partie de cette thèse se concentre sur l'optimisation de l'usage des ressources, dans un contexte de transmission coordonnée par plusieurs stations de base (CoMP). Les performances de la coordination de stations de base sont évaluées, selon le critère de capacité uniforme, ainsi que le compromis entre l'efficacité spectrale et l'équité entre les utilisateurs. Nous proposons également une méthode généralisée et distribuée de sélection de l'ensemble de stations en coopération, afin d'optimiser le compromis efficacité-équité. Dans une seconde partie, nous nous intéressons à l'optimisation de l'allocation des ressources et de puissance, dans le but de minimiser la consommation électrique du réseau. Nous présentons deux algorithmes dont les décisions sont décentralisées. Le premier est basé sur une optimisation stochastique (via l'échantillonneur de Gibbs) et permet une optimisation globale du système. Le second quant à lui est basé sur l'adaptation de la théorie du contrôle et utilise des modèles prédictifs et la poursuite de cibles pour allouer les ressources et les puissances dans un contexte de canaux et d'interférences dynamiques. Dans de nombreux cas, plusieurs objectifs concurrents sont à considérer pour évaluer les performances d'un réseau (capacité totale, équité, consommation électrique, etc.). Dans le cadre de cette thèse, nous nous efforçons à présenter les résultats sous la forme de compromis multi-objectifs. / This thesis focuses on resources and power allocation problem in the fourth generation (4G) of cellular networks. To face the continuous growth of mobile users capacity requirements, operators need to densify their radio access network (RAN) infrastructure, to maximize the use of the available bandwidth in space. One of the major issues of this new architecture is the proximity of many base stations (BS) and the management of the interference they generate on each other's cell. Such constraints makes scientific community focus on Self-Optimized, Self-Organized Networks (SON) that allow network elements to optimize them-selves through decentralized decisions (no static network planning is required). A major interest of SON is their capability to scale to large and non-organized networks, as well as being able to adapt them-selves dynamically, by using distributed algorithms. In this context, this thesis proposes the study of two resource allocation problems. The first part of this thesis focuses on the optimisation of resource sharing, in the context of coordinated multi-points transmissions (CoMP). Performances of BS coordination are evaluated, using the uniform capacity criterion, as well as the trade-off between total capacity and fairness among users. We also propose a generalized and distributed method to select the set of coordination of BS, to optimize the capacity-fairness trade-off. In the second part of this thesis, we focus on optimizing the transmit power and resource allocation, in order to reduce electric consumption. We present two distributed algorithms: the first one is based on a stochastic optimisation (using Gibbs sampling), and tries to reach the global optimum state through decentralized decision. The second one is based on control theory, and uses target tracking as well as model predictive control to allocate resources and power in a dynamic channel scenario. In many cases, trade-offs are to be maid between opposite objectives when evaluating network performances (total throughput, fairness, energy consumption, etc.). In this thesis, we present most of the network performances using multi-objectives evaluations.

Thesis (MBA (Business Management))--Stellenbosch University, 2008. / ENGLISH ABSTRACT: The motive for this research was to provide clarity on the increasingly divergent opinions on the role and behaviour of South African companies in the rest of the African continent. The key question that can be asked is: “Are South African investments, saviour or villain of African Development” (Thomas, 2007)? Are they “exporting Apartheid” (Mkhabela, 2007) or are the fears raised against South African companies unfounded? The primary research objective of this study is to assess MTN-C’s contribution to the economic development of Cameroon. The specific research questions addressed in this study are: 1. What are the possible areas of economic impact? 2. How can the effects of MTN-C’s presence in Cameroon be measured—both qualitatively and quantitatively? 3. What recommendations can be made to MTN-C? To answer these questions, the researcher takes a multi-dimensional view of the economic impact across eight areas, viz., inflow of foreign direct capital, interaction with government, training and development of local staff, employment creation, local procurement, spread of local shareholding, the local mobile communications sector and corporate social investment initiatives. She assesses each of the above-mentioned eight elements and then draws some conclusions on what is perceived to be the true effect of MTN-C’s investments in Cameroon. After close to three years of in-depth research, which included several trips to Cameroon, in-depth interviews with key stakeholders, direct observation, group discussions and survey research, it can be concluded that MTN-C has indeed had a positive impact in areas like Corporate Social Investment, training and development of local staff, employment creation and the inflow of foreign capital. However, much still needs to be done. The areas that have been identified as weak include the development of local suppliers, the interaction with government and the spread of local shareholding. / AFRIKAANSE OPSOMMING: Die studie is gemotiveer deur die soeke na groter helderheid met betrekking tot uiteenlopende beoordelings van die rol en optrede van Suid-Afrikaanse ondernemings in die res van die Afrika-kontinent. Die kernvraag is: “Are South African investments saviour or villains of African development?” (Thomas, 2007) Is hulle besig om apartheid “uit te voer” (Mkhabela, 2007) of is dié vrese teenoor Suid-Afrikaanse ondernemings ongegrond? Die primêre navorsingsoogmerk is die beoordeling van MTN Cameroon se bydrae tot die ekonomiese ontwikkeling in Kameroen. Spesifiek drie vrae word aangespreek. 1. Watter dimensies word ingesluit in ‘n studie van die “ekonomiese impak”? 2. Hoe kan die invloed van MTN Cameroon se teenwoordigheid in dié land gemeet word – sowel kwalitatief asook kwantitatief? 3. Watter aanbevelings kan op grond van dié beoordelings aan die maatskappy gemaak word? Om hierdie vrae te beantwoord word ‘n multi-dimensionele benadering gevolg, gebaseer op agt verskillende invloed-gebiede. Hulle sluit in die invloei van buitelandse kaptiaal, interaksie met die regering, opleiding en ontwikkeling van plaaslike werknemers, werkskepping, plaaslike aankope, die verspreiding van plaaslike aandeelhouding, die mobiele kommunikasiebedryf en sosiale investerings-inisiatiewe. Elkeen van dié elemente word ontleed op grond van vraelys-reaksies en ander insigte. Dit lei tot gevolgtrekkings op elkeen van die vlakke, wat tesame die volle omvang van die betrokkenheid weerspieël. Na drie jaar se interaksie van die navorser met Kameroen, diepte-onderhoude met vername rolspelers, direkte waarnemings, groepbesprekings en 40 voltooide vraelyste kom sy tot die gevolgtrekking dat MTN Cameroon wel ‘n positiewe rol speel in gebiede soos korporatiewe sosiale investerings, opleiding, werkskepping en die invloei van kapitaal, maar dat daar nog heelwat ruimte vir verbeterings is, veral wat plaaslike aankope, interaksie met die regering en plaaslike aandeelhouding betref.

Thesis (MBA (Business Management))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The mobile phone has not only changed the way the world works today, but also changed the direction the world is moving toward. The mobile phone changed the face of communication and enabled more people to reach more other people than ever before. The big four banks in South Africa represent 83.5 per cent of the total asset value of all banks in South Africa. Traditionally, banking customers (or potential customers) could be reached through the current 2 786 branches, 19 451 ATMs and potentially 4.59 million internet users. There are 47.9 million mobile phone subscribers in South Africa – increasing the number of potential contact points by order of magnitude. The possibilities for banks utilising the mobile phone are endless, however online banking and offering banking services through a mobile phone is increasingly more subject to fraud attacks. Online banking and credit card fraud is still on the increase. Today, SMS is used to alert customer of movements on their bank account. This keeps the customer informed and enables them to notify their banks and prevent subsequent fraudulent transactions. SMS can be sent from one mobile phone to another (P2P) or from a computer system to a mobile phone (A2P). In 2007, 2 trillion SMS's were sent worldwide and was responsible for 75 to 80 per cent of all mobile phone revenues. South Africa sent 34 billion A2P SMS in 2009 of which 29 per cent were sent as transactional SMS by the top three banks in South Africa. SMS-based transactional alerts are SMS sent each time a change occurs in a bank account, for example, when your credit card is used then you will get an SMS on your mobile phone. Each bank makes different functionalities available. Absa reported 2 million customers receiving SMS alerts in 2008. FNB reported 67 million transactional SMS per month in 2009. The core advantages for using transactional SMS are the cost, reliability and ubiquity. Research was conducted among five of the six largest banks. Data revealed that banks send between 16 million and 69.4 million SMS per month and have approximately between 4.5 and 5.1 million customers using this service. The impact was tested through personal interviews. The two common factors were fraud reduction and customer retention. The two key challenges the banks identified are: i) Capacity/throughput with the mobile network operators; and ii) Getting internal systems and processes defined and working together for the alerts. The advantages identified are competitive positioning, customer interaction, empowerment of people and revenue. Key findings of the research were: SMS-based transactional alerts offer strategic importance; Any system is as good as it is being utilised; Security controls are extremely complex; SMS capacity is a common challenge and big risk; Internal processes cause the most complexity; Return on investment is not adequately measured; Transactional alerts is a potential revenue stream; There is no interaction between the bank and the customer; SMS in South Africa create high dependencies; SMS-based transactional alerts are successful.