Objetivo: Describir principales motivos de consulta de pacientes atendidos en el servicio de terapia física en el Centro Universitario de Salud de UPC. Materiales y métodos: Estudio descriptivo de corte transversal analítico. Se evaluó motivo de consulta y cumplimiento de atenciones. Las variables categóricas (sexo, ocupación, actividad física, motivo de consulta, área corporal, tipo de atención recibida y cumplimiento de atenciones) fueron presentadas mediante frecuencia absoluta (n) y porcentaje (%). La única variable cuantitativa (edad), se presentó mediante mediana y rango intercuartílico, ya que, no presentó distribución normal. Análisis bivariado fue dicotomizado (< 6 sesiones y ≥ 6 sesiones), factor categórico utilizó prueba de Chi2 o prueba exacta de Fisher; factor edad, prueba de K medianas para establecer diferencias entre ambos grupos. Ánálisis multivariado, para cálculo de razón de prevalencia (RP), calculando RP cruda y RP ajustada a otras variables, mediante intervalo de confianza (95%). Se determinó p valor < o igual a 0,05. Resultados: Se incluyeron 171 historias clínicas de pacientes atendidos en servicio de terapia física con predominio masculino (54.4%). Prevalencia de motivo de consulta fue dolor en columna lumbar (12.3%) y columna cervical (11.7%). En ocupación, (50.3%) trabajaban y (32.7 %) fueron estudiantes; (42.1%) practicaban al menos un deporte. Tipo de atención recibida (71.9%) fue dada por estudiantes internos. Conclusiones: El principal motivo de consulta es dolor músculoesquelético (78.4%). El cumplimiento de atenciones es (59.1%). El género masculino es el más predominante, (30.4%) eran profesionales. El área corporal más consultado fue columna lumbar (12.3%). No se encontraron factores asociados al cumplimiento de atenciones. / Objective: Describe main reasons for consulting patients treated in physical therapy service at the University Health Center in UPC. Methods: Descriptive study of analytical cross section. The reason for consultation and compliance with attentions were evaluated. The categorical variables (sex, occupation, physical activity, reason for consultation, body area, type of care received and compliance with care) were performed using absolute frequency (n) and percentage (%). The only quantitative variable (age) was presented using the median and interquartile range, since there was no normal distribution. Bivariate analysis was dichotomized (<6 sessions and ≥ 6 sessions), a categorical factor determined by Chi2 test or Fisher's exact test; age factor, median K test to establish differences between both groups. Multivariate analysis, calculation of prevalence ratio (RP), calculation of crude RP and RP adjusted to other variables, using a confidence interval (95%). P value <or equal to 0.05 was determined. Results: This study included 171 medical records of patients attended in physical therapy service with male predominance (54.4%) were included. Prevalence of reason for consultation was pain in the lumbar spine (12.3%) and cervical spine (11.7%). In occupation, (50.3%) worked and (32.7%) were students; (42.1%) practiced at least one sport. Type of care received (71.9%) was given by internal students. / Tesis

The purpose of this study was to replicate a study on consultation skills, done by Knoff, Hines, and Kromrey (1995) while expanding the sample base to include teaching assistants and parents. The Consultant Effectiveness Scale (CES), a questionnaire consisting of 75 consultant skills and characteristics, was used to survey the perceptions of 75 consultants and consultees (18 consultants, 23 teachers, 17 teaching assistants, and 17 parents) regarding the degree to which they believed each skill was important to the effectiveness of consultation. Results were examined for differences across groups, for consistency with the factor structure obtained by Knoff, Hines, and Kromrey (1995), and to determine the impact of demographic variables. A follow-up telephone interview was conducted with 2 consultants, 3 teachers, 3 teaching assistants, and 3 parents to verify questionnaire results. The ratings of respondent groups were compared and contrasted across the top 15 ranked items and several consistencies were found to exist across groups. Parents were found to have rated all items generally lower than consultants or teachers. A factor analysis was completed using the 52 items from the original four factors (Knoff, Hines, & Kromrey, 1995) and resulted in a high degree of consistency with the original factor structure generated by Knoff, Hines, and Kromrey. A one-way ANOVA was conducted and significant differences were found on three of the four factors with the consultants rating the items higher than the parents (p <.05). No significant differences were found across demographic variables. The results of the telephone interviews were consistent with the high ratings of many of the interpersonal and relationship-building skills and content skills identified in the questionnaire responses. Recommendations are made calling for future research to further validate the scale, and to confirm differences between respondent groups. The value of the scale and its contents are highlighted in the context of preservice and in service training for consultants. / Graduate

The purpose of this study was to explore how counselling teams draw on narrative therapy during intersession break consultations in walk-in counselling. Walk-in counselling is a form of single-session therapy (SST) that allows an individual, couple, or family to meet with a counsellor on a drop-in basis. Walk-in counselling clinics are becoming increasingly popular in Canada and globally, with a particularly high number operating in Ontario. Sessions in walk-in counselling typically involve a break partway through, during which the counsellor meets with a team of colleagues for a brief consultation; this is referred to as the “intersession break”. Narrative therapy is a postmodern therapeutic approach commonly used in walk-in counselling. Data collection occurred at two Ontarian walk-in counselling clinics and involved recording and transcribing a total of six intersession break consultations. Transcripts were examined using discourse analysis as a methodological approach. My analysis process identified four conversational practices counselling teams engaged in that drew on various aspects of narrative therapy theory. These practices are as follows: (a) counsellors engaging in externalization, (b) counsellors orienting to possible alternative narratives, (c) counsellors centring the person visiting the clinic, and (d) counsellors demonstrating tentativeness. This research is most directly relevant to counsellors working in walk-in counselling clinics and agencies offering SST involving intersession breaks. For mental health practitioners interested in postmodern therapeutic approaches, it provides a detailed account of how narrative therapy is being applied within a particular context. Finally, it may be of interest to people accessing walk-in counselling services who are curious about intersession break processes.

It is widely acknowledged that patients' emotional expressions and doctors' empathic responses play a key role in providing satisfactory healthcare services and improving doctor-patient relationships. While such affective aspect of medical consultation discourse has been studied in different fields of research with the focus of examining medical consultations that occur in face-to-face settings, this area is extremely under-researched in the field of linguistics, particularly in the non-western context and the online space. While online medical consultation (OMC) has ushered in the new era of e-communication around the beginning of this century, discourse-related research on OMC is still in its infancy and studies on the affective dimension of the OMC discourse in non-western sites are, to my best knowledge, apparently absent in the literature. As China has seen a significant increase in the use of OMC platforms, studying OMC discourse in the China context is not only important but vital. With the support of the Chinese government's "Internet Plus Healthcare" policy issued in 2018, the reliance on the online mode of medical consultation will be further strengthened and the future of OMC service in China will remain promising. In order to have a better understanding of the affective aspect of OMC discourse, this thesis explores the online interaction between doctors and e-patients (including patients' caregivers) from a poststructuralist discourse analysis perspective. The data for this study consists of 300 text-based one-to-one instant messaging OMC cases collected from three popular OMC websites used in China. Each OMC case contains e-patients' emotional expression and doctors' empathic response. The data are analysed by the approach of computer-mediated discourse analysis in terms of two dimensions: the textual dimension and the social practice dimension. At the textual level, the study identifies indirect negative emotional acts by e-patients and empathic acts by doctors (which constitute the affective practice); it also examines the interactional discursive features involved in the affective practice. At the social practice level, it explores the discursive positions of e-patients and doctors within the affective practice context and the power relations that are reflected in the identity positionings. This study finds that the text-based OMC affective practice is rich in various types of emotional expressions and different ways of manifesting empathy, some of which are not mentioned in studies on medial consultation discourse. The study also identifies positions that disrupt the traditional or stereotypical roles of doctor and patient. Besides, it presents dynamic power relations, which problematizes the idea that doctors are always the more powerful party and patients are always powerless in medical encounters. This study sheds light on the importance of examining the affective facet of medical consultation from a discourse analytic perspective, when it comes to identifying non-traditional positions and power relations in clinical communication. The study also provides the implication that e-healthcare platforms, especially those with an e-commercialised model for healthcare services, have potential to produce a type of neo-liberal discourse - the e-commercialised medical consultation discourse - in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged

It is widely acknowledged that patients' emotional expressions and doctors' empathic responses play a key role in providing satisfactory healthcare services and improving doctor-patient relationships. While such affective aspect of medical consultation discourse has been studied in different fields of research with the focus of examining medical consultations that occur in face-to-face settings, this area is extremely under-researched in the field of linguistics, particularly in the non-western context and the online space. While online medical consultation (OMC) has ushered in the new era of e-communication around the beginning of this century, discourse-related research on OMC is still in its infancy and studies on the affective dimension of the OMC discourse in non-western sites are, to my best knowledge, apparently absent in the literature. As China has seen a significant increase in the use of OMC platforms, studying OMC discourse in the China context is not only important but vital. With the support of the Chinese government's "Internet Plus Healthcare" policy issued in 2018, the reliance on the online mode of medical consultation will be further strengthened and the future of OMC service in China will remain promising. In order to have a better understanding of the affective aspect of OMC discourse, this thesis explores the online interaction between doctors and e-patients (including patients' caregivers) from a poststructuralist discourse analysis perspective. The data for this study consists of 300 text-based one-to-one instant messaging OMC cases collected from three popular OMC websites used in China. Each OMC case contains e-patients' emotional expression and doctors' empathic response. The data are analysed by the approach of computer-mediated discourse analysis in terms of two dimensions: the textual dimension and the social practice dimension. At the textual level, the study identifies indirect negative emotional acts by e-patients and empathic acts by doctors (which constitute the affective practice); it also examines the interactional discursive features involved in the affective practice. At the social practice level, it explores the discursive positions of e-patients and doctors within the affective practice context and the power relations that are reflected in the identity positionings. This study finds that the text-based OMC affective practice is rich in various types of emotional expressions and different ways of manifesting empathy, some of which are not mentioned in studies on medial consultation discourse. The study also identifies positions that disrupt the traditional or stereotypical roles of doctor and patient. Besides, it presents dynamic power relations, which problematizes the idea that doctors are always the more powerful party and patients are always powerless in medical encounters. This study sheds light on the importance of examining the affective facet of medical consultation from a discourse analytic perspective, when it comes to identifying non-traditional positions and power relations in clinical communication. The study also provides the implication that e-healthcare platforms, especially those with an e-commercialised model for healthcare services, have potential to produce a type of neo-liberal discourse - the e-commercialised medical consultation discourse - in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged

The purpose of this evaluative study was to develop and implement a program evaluation design for a model of early mental health intervention to primary grade level classrooms .in a public elementary school. The design reflects a formative evaluation study, providing information for current and future programming and is manageable to implement, thus facilitating longitudinal data collection. This therapeutic model of classroom intervention stresses the integration of children’s social, emotional and intellectual development and proposes a collaborative approach between therapist and educator. Levels of intervention for collaborators include (1) children identified as requiring therapeutic approaches to social-emotional difficulties experienced in the classroom, (2) all children in the classroom and, (3) the classroom milieu. The overall goal is to promote optimal growth at all levels. The program evaluation design includes a format for monitoring the service delivery system of the model and to identify procedural and collaborative discrepancies. Information regarding collaborators' perceptions of identified children is collected from written intervention plans. Assessment of the frequency and nature of peer interactions was accomplished in this study through an observational technique in the classrooms. A teacher attitude questionnaire was administered at the end of the school year to obtain information about teacher receptivity of the program and suggestions for future restructuring of service delivery. Additional data was collected from the school's files regarding teachers' rating of children as to their current and anticipated social-emotional and learning difficulties. The results of the information collected reflect a general awareness, acceptance and support of the collaborative approach on the part of teachers participating in the program. As a direct result of the evaluation process, several issues of programming were raised and proposed for future decision-making.

När en detaljplan upprättas måste kommunen enligt lag hålla samråd som en del av processen. Kommunen har en skyldighet att samråda med lantmäterimyndigheten, länsstyrelsen och andra berörda kommuner. Kommunen måste även ge tillfälle till samråd med bland annat kända sakägare, bostadsrättshavare, hyresgäster och boende som berörs av planen. Syftet med samrådet är att skapa ett bättre beslutsunderlag, vilket i sin tur ska leda till en bättre plan. Vidare syftar samrådet till att ge medborgare insyn i planprocessen och även möjlighet att påverka den slutliga planen. Syftet med denna studie är att kvalitativt undersöka hur väl medborgarinflytandet fungerar vid samråd till detaljplan. För att besvara syftet och frågeställningarna används två metoder; dokumentstudie och intervjustudie. I dokumentstudien undersöks 18 samrådsredogörelser från totalt nio olika kommuner. Syftet är att undersöka vad privatpersoner generellt sett har åsikter om vid samråden samt hur kommunerna hanterar och bemöter dessa yttranden. Vidare undersöks vilka brister samråden har idag. Intervjuerna användes för att konfirmera resultatet från dokumentstudien samt för att besvara funderingar som uppkommit vid dokumentstudien. Resultatet visar att vid samråd har privatpersoner generellt sett har åsikter om natur, infrastruktur, utseende eller utformning, otydlig information om planen samt personlig påverkan. Efter samrådet försöker kommunen att ändra planen efter synpunkterna i de fall de anser att det är möjligt. I de flesta fall har det dock inte ansetts möjligt, vilket visar att lagstiftarens syfte med samråd inte uppfylls. Slutligen visar studien att det finns flera brister med hur kommunerna informerar om samråden; dels är sättet ineffektivt, dels behöver kommunerna göra mer än vad lagen kräver för att skapa förutsättningar för ett lyckat samråd. / When a detailed development plan is established, the municipality must conduct consultations as part of the process. The municipality has an obligation to consult with lantmäterimyndigheten, länsstyrelsen and other affected municipalities. The municipality must also provide an opportunity for consultation with, among others, known stakeholders, apartment owners, tenants and residents affected by the plan. The purpose of the consultation is to create a better decision basis, which in turn will lead to a better plan. Moreover, the consultation aims to give citizens insight into and influence on the detailed planning process. The purpose of this study is to qualitatively research how well civic influence functions in consultation for detailed development planning. Two methods have been used to address the purpose: document analysis and interview studies. In the document analysis, 18 consultation reports from nine different municipalities have been studied. The purpose is to analyze what opinions citizens generally have during the consultations and how the municipalities handle and respond to these opinions. Furthermore, the study analyses what flaws the consultations have. The interviews were used to confirm the results from the document analysis and to answer any further questions that had occurred during the document analysis. The results show that citizens generally have opinions about nature, infrastructure, design and shape, unclear information, and personal interests. After the consultation, the municipality try to change the detailed development plan according to received opinions, whenever they find it possible. In most cases, however, it has not been considered possible, which shows that the legislator’s purpose of the consultation is not fulfilled. Finally, the study has shown that there are several flaws with the informing of the plan, such as it is being ineffective and that the municipalities need to do more than what is required by law to create conditions for a successful consultation.

Samråd som del i detaljplanerprocessen tillkom med plan- och bygglagen (1987:10) som idag benämns äldre plan- och bygglag. Engagemanget hos allmänheten hade växt sig starkare under 1960- och 1970-talet då det byggdes mycket och i snabb takt. Samrådet var ett sätt att engagera allmänheten i planering av områden för att kunna skapa mer hållbara projekt och förstärka allmänhetens inflytande i planering. Utöver det lagstadgade samrådet kan kommuner arbeta med tidiga dialoger för att ytterliga samla information och ge möjlighet till inflytande hos allmänheten. Samrådet och processen som helhet har fått kritik för att inte vara tillräckligt demokratisk och det har varit svårt att veta när dialoger ska ske för att ge bästa möjliga effekt. Syftet med kandidatuppsatsen är att undersöka när samråd och dialoger bör äga rum och varför de bör äga rum vid den tidpunkten. Jag undersökte också hur samråd och dialoger bör genomföras för att bidra till en effektiv och hållbar detaljplaneringsprocess.  Först har litteraturstudie genomförts för att efter relevanta teoretiska ramverk ta reda på vad som sagts i tidigare utredningar och studier. Där har det visat sig att samråd och dialoger är nödvändigt för att öka inflytande och minska missnöje bland medborgare. Dialogerna bör föras kontinuerligt genom processen för att förhindra fel som i ett senare skede tar mycket längre tid. Följt av litteraturstudien genomfördes en kvalitativ undersökning i form av intervjuer med semistrukturerade frågor ställda till kommuntjänstemän. Av undersökningen framgick en ytterligare anledning till att samråd och dialoger är viktigt, vilket är kunskapsinhämtning. Tiden för dialogerna varierar mycket från olika projekt, men det är viktigt att informera om varför dialogen förs.   Slutsatsen jag kan dra utifrån studien är således att samråd och dialoger behövs för att medborgare ska ha inflytande över sin omgivning och för att minska missnöje. Dialogerna bör hållas kontinuerligt med rätt information vid dialogerna och det ska göras klart vad som är syftet med dialogerna. Kommunerna bör använda sig mer av planprogram för att inleda detaljplaneprocessen med en tidig dialog och detaljplaner kan i större utsträckning gå ut på samråd innan de är färdigställda med en längre samrådstid. / Consultation as part of the detailed planning process was introduced with the Planning and Building Act (1987:10), which is now referred to as the older Planning and Building Act. Public engagement had grown stronger during the 1960s and 1970s when there was a lot of construction happening at a rapid pace. Consultation was a way to involve the public in the planning of areas in order to create more sustainable projects and increase public influence in the planning process. In addition to the statutory consultation, municipalities can engage in early dialogues to gather more information and provide opportunities for public influence. The consultation and the overall process have been criticized for not being sufficiently democratic, and it has been difficult to determine when dialogues should take place to achieve the best possible effect. The purpose of the bachelor's thesis is to investigate when consultations and dialogues should take place and why they should take place at that time. I did also investigate how consultation and dialogs should be done in order to contribute to an effective and sustainable detailed planned process.  First, a literature review was conducted to identify relevant theoretical frameworks and find out what has been said in previous investigations and studies. It has been found that consultations and dialogues are necessary to increase influence and reduce dissatisfaction among citizens. The dialogues should be conducted continuously throughout the process to prevent errors that would take much longer to address at a later stage. Following the literature review, a qualitative study was conducted in the form of interviews with semi-structured questions addressed to municipal officials. The study revealed another reason for consultations and dialogues, which is knowledge acquisition. The timing of the dialogues varies greatly across different projects, but it is important to inform why the dialogue is being held.   The conclusion I can draw from the study is thus that consultation and dialogues are necessary for citizens to have influence over their environment and to reduce dissatisfaction. The dialogues should be held continuously with the right information provided, and the purpose of the dialogues should be made clear. Municipalities should make greater use of planning programs to initiate the detailed planning process with an early dialogue, and detailed plans can be subjected to consultation to a greater extent before they are finalized, with an extended consultation period.

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