High rates of turnover among truck drivers in the United States limit the abilities of organizations to effectively move freight if organizational leaders cannot efficiently and economically replace drivers. The purpose of this correlational study was to examine the relationship among compensation, benefits, intrinsic motivators, and potential referral recruiting in transportation organizations. Herzberg’s 2-factor theory was the theoretical framework for this study. Secondary data were collected for 566 Class A truck drivers from an Illinois-based partner organization’s 2018 employee satisfaction survey. The results of the multiple linear regression analyses indicated a significant relationship exists, F(3,562) = 258.323, p < .001, R2 = .580, among compensation (β = .231, p < .001), benefits (β = .101, p < .002), intrinsic motivators (β = .554, p < .001), and potential referral recruiting in transportation organizations. Overall, the independent variables accounted for 58% of the variance in the dependent variable with intrinsic motivators having the largest effect. The implication of these findings for positive social change includes equipping business leaders with information about motivational factors for recruiting drivers through referrals, which might increase community employment levels to improve the standard of living.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / In this paper, we propose a mobile solution to optimize the medical referral process for pediatric patients with presumptive cancer diagnosis. This proposal allows the automation of the process through the identification of the main gaps that are covered by the following functionalities: (1) Registration and interaction of the actors in the process, (2) Support for timely diagnosis with first-hand information, (3) Creation of request tickets and personalized medical appointments, and (4) Creation of reports on the response time and compliance with the process. The proposal is described in three sections: (1) The automation of the medical referral process, (2) The functionalities of the mobile solution, and (3) the designed technology architecture. The validation of the proposal was carried out in a social health insurance in Lima-Peru, with data and information of the process obtained by the institution. The measurement was made through the mobile solution which allowed obtaining the response times of the process with the main actors such as the pediatric doctor, an oncology specialist and a pediatric patient's guardian. The results showed that the time of the referral process is optimized between an interval of [95%-97.5%], which mainly generates a social benefit to the community by assuring a timely treatment of the pediatric cancer patient, based on diagnosis and early care.

A survey addressing teacher referral of children with internalizing symptoms was developed and distributed to 883 first- through sixth-grade teachers in the state of Utah. The survey presented vignettes of children exhibiting symptoms of internalizing disorders. Respondents were asked if they would refer the child described in each vignette. The survey also asked respondents for information regarding the number of years they had been teaching, training they had received regarding children's mental health, the types of mental health services available within their schools, and their beliefs regarding types of services schools should provide. Four ANOV As were calculated in analyzing the potential factors influencing teachers' decisions to refer the children in the vignettes. Further, descriptive data were used in illustrating additional information provided by the survey regarding the referral of children with internalizing disorders. Among the factors considered, teacher training was found to be statistically significant. Number of years of experience, teacher beliefs, and number of services available did not reach statistical significance. The majority of teachers supported a variety of school-based mental health services.

Behavioral counseling is integral for the overall health of individuals with a mental health diagnosis. For instance, diabetic patients treated with cognitive behavioral therapy (“CBT”) for depression have been shown to have better glycemic control and patients with coronary artery disease treated with CBT for stress management have decreased risk for recurrent myocardial infarction. Above all, for nearly all mental health diagnoses, behavioral counseling is an effective treatment strategy for achieving remission. In primary care, mental health therapy oftentimes starts with a referral to a counseling center or psychiatric professional. With strong patient commitment, behavioral therapy can ultimately improve health outcomes and the day to day functioning for that patient. Unfortunately, the initial step can be the most difficult and the journey never begins. In our clinic, a residency clinic in a semi-rural area with a high percentage of underinsured, we noticed that a lower than preferred number of patients that we refer to our most accessible behavioral counseling center do not even schedule their first appointment. Additionally, we are limited by a scarcity of affordable psychiatric resources and this counseling center is often our only option for referral. For this purpose, we implemented the following changes consecutively to the referral process. First, our in-house referrals coordinator made the first appointment, instead of the patient having to call themselves. Next, we took this a step further, and an employee from the counseling center came onsite to initiate the intake process on the day of the referral or at the patient’s convenience. We then measured their success by comparing the percentage of patients that completed the intake process before and after each implementation. There was a statistically significant increase in the mean percentage of intakes completed after each intervention. We conclude that although the reason patients are unable to follow-up with a behavioral health referral is often multi-factorial, simplifying the process for the patient seems to help a great deal. While this is encouraging, more evaluation is needed to determine if patient outcomes are improved, and if these interventions are cost effective and sustainable options.

Flickor har under lång tid varit marginaliserade inom forskningen kring den neuropsykiatriskafunktionsnedsättningen och tillika diagnosen ADHD vilket lett till att det vi idag vet om diagnosen oftaär könsspecifikt för pojkar. Då ADHD-symptomen hos flickor och pojkar ofta tar sig olika uttryck blirflickornas problematik svårare att identifiera. Konsekvenser av detta kan ses i att fler pojkar än flickorremitteras och utreds för ADHD och att många flickor som hade behövt stöd inte får det. Lärare står förmajoriteten av alla remitteringar till utredning av barn med förmodad ADHD och är ofta först ut attmisstänka en diagnos, varför det är viktigt att kunskapen om – och förståelsen för Flickor med ADHDväxer. Syftet med denna studie var att synliggöra flickor med ADHD genom att undersöka hur flickorssymptom på ADHD beskrivs inom forskningen, med vilka karakteristika diagnosen tar sig uttryck i enskolkontext samt vilken betydelse lärarens förståelse och förförståelse har för hur flickornauppmärksammas och bemöts. Genom en forskningsöversikt som integrerar befintlig forskning inomämnet söktes svaren på studiens två frågeställningar: Hur identifieras flickor med ADHD? samt Vilkaomgivande faktorer beskrivs som betydelsefulla för flickorna? Forskningen visade på en könsbias ilärares uppskattningar av elevers nedsättningar vilket resulterade i en remmiteringsbias. Forskningenvisade även på att flickors symptomyttringar var kontextuellt bundna och att flickorna utifrån desammanhang de vistas i därför kan uppfattas mer - eller mindre funktionsnedsatta, något som menaskunna bidra till underdiagnostiseringen av flickor med ADHD.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

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Since its inception, cardiac rehabilitation has been effective at reducing risk factors for cardiovascular disease, improving quality of life, and decreasing morbidity and mortality rates. While women benefit as much as men from the therapeutic effects of cardiac rehabilitation, a disparity exists between referral, participation, and completion rates between men and women. The intent of this thesis was to examine recent literature to determine if those disparities still exist, to identify barriers that prevent women from participating, and to determine the role of the nurse in the promotion of cardiac rehabilitation among women. Current literature reveals that women are often older, single, financially unstable, less physically active, and diagnosed with more co-morbidities at the time of their first cardiac event. Women often lack strong physician referral and support, education about cardiac rehabilitation programs, and motivation to attend programs. Evidence gathered from current literature suggests that gender is not the primary reason for the disparity between cardiac rehabilitation participation rates among men and women, but rather the disparity exist~ because of the characteristics of these older women at the time of their first cardiac event. The nurse is the vital component to increasing cardiac rehabilitation participation rates among women. The nurse must serve as a patient advocate- providing information and structure to the referral process, as an educator- teaching women the benefits and safety of cardiac rehabilitation, and as social support- providing women with encouragement and follow-up during a frightening and life-changing experience.

Yes / Aims: Levels of false positive referral to ophthalmology departments can be high. This study aimed to evaluate commonality between false positive referrals in order to find the factors which may influence referral accuracy. Methods: In 2007/08, a sample of 431 new Ophthalmology referrals from the catchment area of Bradford Royal Infirmary were retrospectively analysed. Results: The proportion of false positive referrals generated by optometrists decreases with experience at a rate of 6.2% per year since registration (p < 0.0001). Community services which involved further investigation done by the optometrist before directly referring to the hospital were 2.7 times less likely to refer false positively than other referral formats (p = 0.007). Male optometrists were about half as likely to generate a false positive referral than females (OR = 0.51, p = 0.008) and as multiple/corporate practices in the Bradford area employ less experienced and more female staff, independent practices generate about half the number of false positive referrals (OR = 0.52, p = 0.005). Conclusions: Clinician experience has the greatest effect on referral accuracy although there is also a significant effect of gender with women tending to refer more false positives. This may be due to a different approach to patient care and possibly a greater sensitivity to litigation. The improved accuracy of community services (which often refer directly after further investigation) supports further growth of these schemes. / This study was funded by the University of Bradford.

Yes / Background: Head and Neck Cancer (HNC) is the eighth most prevalent global cancer. Timely recognition of symptoms is crucial for reducing mortality rates. The EVolution of a patiEnt-REported symptom-based risk stratification sySTem to redesign the suspected Head and Neck cancer referral pathway (EVEREST-HN) study aims to develop and evaluate a risk stratification tool using patient reported symptoms, which will be populated remotely in the community before the patient is seen by the clinician to hasten HNC diagnosis. EVEREST-HN will design a patient SYmptom iNput Clinical (SYNC) system to gather patient symptom data and calculate a risk score to aid clinicians in identifying high-risk cases. This identification potentially allows for high-risk patients to be seen sooner, thereby improving patient outcomes. Methods: Three workshop sessions were conducted involving a total of 17 unique participants, with several contributing to multiple sessions: nine in the co-design session, six in the validation session, and nine in the evaluation session. The co-design session employed online collaboration with patients’ representatives. Thematic analysis was used to identify requirements and concerns informing the development of a low-fidelity prototype. The validation session assessed whether the prototype aligned with patient expectations. In the evaluation session, participants interacted with an online prototype and provided further feedback. Results: During the co-design workshop, participants emphasized the need for a concise and clear SYNC system questionnaire for reporting suspected HNC symptoms. Concerns were raised about questionnaire length, language clarity, and the inclusion of probing questions. Participants suggested concise questions using lay language, incorporating visual aids for topics like alcohol and tobacco use, and making the sexual activity question optional. Recommendations included diverse language options, hard copies for non-English speakers, and phone call options for those uncomfortable with screen-based technology. The validation workshop confirmed that the prototype reflected participants’ ideas. Feedback highlighted the need for call-back features to help those not confident with technology and the need to present symptom questions first before social background questions. Feedback from the evaluation demonstrated a commitment to efficiency, and continuous improvement. Conclusion: This study aims to develop the SYNC system to enhance efficiency of suspected HNC referrals. The workshops highlighted the importance of end-user inclusiveness in the system development life cycle, with collaboration with stakeholders and repeated feedback, providing crucial insights for ensuring the SYNC system effectively addresses the needs and concerns of patients in the context of HNC diagnosis. / This study is funded by the NIHR Programme Grants for Applied Research (NIHR202862).