Although Grenada has an extensive health care infrastructure and cervical cancer screening rates are relatively high, Grenada also has a disproportionate rate of morbidity and mortality from cervical cancer. The aim of this study was to explore factors that contribute to these disproportionate rates in Grenada. Using a phenomenological qualitative approach, Andersen's behavioral model of health care utilization and a systems based model for assessing care were used as a guide to explore Grenadian women's follow-up experiences with Pap test and cervical cancer screening. Purposive sampling was used to recruit 8 women for semi-structured in-depth interviews. Data were collected on enabling, need, process and quality factors and coded using apriori and open strategies. Results showed that communication strategies used by private practitioners and good interpersonal relationships with nurses enabled follow-up whereas inadequate treatment services, delays in the receipt of test results, and lack of trust in the government clinics were hindrances. This research identified gaps in the follow-up system and is, therefore, significant for the Grenada Ministry of Health to inform planning and restructuring in order to increase system effectiveness. Implications of positive social change include broadening the knowledge base and skill sets of nurses, highlighting strengths of the public system, and identifying target areas for resource allocation. These changes can result in increased workforce efficiency, improved accessibility and quality, a more user-friendly follow-up process and, thus, reduced morbidity and mortality from cervical cancer.

As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, 95% of the time. Additionally, gender and race were explored in relationship to adherence to radiation treatment and follow-up appointments. Demographic data were first extracted from the Cancer Registry of a Midwestern Hospital. Then radiation appointments and follow-up appointments were examined for each patient, in paper and/or computerized charts, to determine adherence rates. McNemar's test was used to compare young adults and older adult oncology patients' adherence rates, and Chi-square analysis was used to explore gender and race in relationship to adherence. Results indicated a lower adherence rate to follow-up appointments for younger adults as compared to older adults, with older adults adhering 3 -½ times more than younger adults. Gender was also related to follow-up appointment adherence, with males adhering better than females. This study contributes to positive social change by increasing the knowledge base of healthcare providers on adherence rates of young adult patients and reducing the dollars spent on treatment for re occurrences.

Healthcare costs have risen from 13.8% in 2000 to 17.9% in 2009 (Gordon, Leiman, Deland, & Pardes, 2014). Poor transitional care has been identified as a cause of the high healthcare costs (Naylor et al., 2013; Obama, 2013). In 2009, the Department of Veterans Health Administration (VHA) implemented a national reform of outpatient care to create Patient-Aligned Care Teams (PACTs) with a goal to improve transitional care and reintegration into outpatient care through registered nurse case managers conducting discharge telephone follow-up calls. However, discharge telephone follow-up calls have not been explored within the VHA. This study explored the relationships among discharge telephone follow-up calls, selected Veteran characteristics including the length of index hospital stay, and 30-day all cause hospital readmissions between fiscal years 2011 and 2013. Hospital readmissions were explored in parallel time periods to the timing of the discharge telephone follow-up calls. Study data were collected retrospectively from VHA inpatient and outpatient records. Descriptive statistics, measures of central tendency, bivariate statistics, and logistic regression were used to analyze the data. The study found 124,069 Veterans were discharged from the VHA from 2011 to 2013. Of those discharges, 15,954 (12.86%) were readmitted to the hospital within 30 days and 35.06% of the readmissions occurred within the first seven days after discharge. Discharge telephone follow-up calls increased from 312 in 2011 to 26,549 in 2013. Increasing Veteran age, number of comorbidities, length of index hospital stay, and being identified as frequently hospitalized in the previous year were significantly related to hospital readmissions at each of the hospital readmission time frames (within two days, between three and seven days, and between eight and thirty days after hospital discharge). This study identified a relationship between discharge telephone follow-up calls and the parallel hospital readmission time period. However, only discharge telephone follow-up calls within two days were found to decrease the likelihood of hospital readmissions and only hospital readmissions within two days after discharge (OR=0.595). The relationships between discharge telephone follow-up calls and hospital readmissions potentially explains previously mixed results and suggests two potential explanations. One, discharge telephone follow-up calls have a limited relationship to hospital readmissions and a short duration of protective effects preventing hospital readmissions. The second explanation is self-selection bias confounds the relationship between discharge telephone follow-up calls and hospital readmissions. Both explanations suggest future research and clinical practice should focus on exploring bundled transitional care interventions as a method to reduce hospital readmissions.

The 1969 through 1976 graduating classes of the business education program at Utah State University were surveyed in this study. The questionnaire was designed to ascertain the work experience of the graduates, the educational status of the graduates, and the value the graduates place on the courses contained in the business education program according to the occupations of the graduates. Graduates are employed in a large variety of occupations, and the majority of the graduates hold teaching certificates. The majority of the graduates have not completed advanced degrees, and are undecided as to whether or not they will continue their education. In all but five courses, the graduates; occupations were found to be unrelated to their response concerning the value of a course when the chi square test was applied. The courses in which a significant difference at the .05 level of significance was found were: (1) methods of teaching typewriting, (2) methods of teaching shorthand, (3) economics I, (4) office practice, and (5) office management. The majority of the graduates indicated their preparation was "excellent" or "good". The members of the department of Business Education were listed as the greatest strength of the program by the graduates.

Dresher reported that today there is an increased and growing interest among the lay population as well as among educators in the appreciation of the drop-out problem of the public schools of the United States. Some educators believe that one of the most important issues facing education today is the problem of determining ways by which the high school pupil might be encouraged to finish his secondary trainings.

Grief is a life changing and universal experience, expressed through individual sets of responses and behaviours. Society and health workers’ interpretation and beliefs regarding grief and bereavement have changed throughout the decades. This is a continually evolving process. As we move into a new century, so too does grief move into a new era where a new postmodern paradigm is arising. We are thus deviating away from stage theories that are time limited, linear and predictable. Emphasis in this new wave of thought is placed upon grief as an oscillating and highly unique experience, one that encourages a continuation of a bond and lifetime relationship with the deceased. This current qualitative study explores the new phenomenon in relation to both the grief process and bereavement support programs, by extensively reviewing the literature and analysing data from a number of interviews with the bereaved. Furthermore the supports offered by society, with particular focus on a Melbourne Community Bereavement Follow Up Program, are reviewed. By observing and discussing expressions of grief it was found, although unique and varying, some patterns or common behaviors emerged. Supports and comforts that assisted the bereaved are explored. Issues, including inappropriate comments and problems with bureaucratic departments, are also developed and discussed. There is an emphasis placed upon the need of health care staff and the community in general to increase their understanding of the grief process and bereavement support, so as to enhance care and practice when working with people who have suffered loss.

<p><strong>Sammanfattning</strong></p><p>En uppföljning av betydande miljöpåverkan ska genomföras för miljöbedömda planer och program. Forskning visar att uppföljningen är eftersatt, både praktiskt och teoretiskt. Denna studie bidrar med erfarenheter och bygger upp kunskap om miljöuppföljning av de kommunala planerna, översiktsplan och detaljplan. Uppföljning är viktigt för en erfarenhets-återföring och miljöhänsyn i den kommunala planprocessen. Utifrån undersökningens mål ställdes fyra frågeställningar upp som behandlar: förekomsten av uppföljningar av miljöbedömda planer i kommuner (1), hur organisations- och ansvarsfrågor är fördelat (2) hur väl lämpade kommuners miljöövervakning är för uppföljning (3), samt vad som är centralt vid genomförande av uppföljning (4). Inom ramen för undersökningen har olika aktörer intervjuats, där kommuner utgjorde den största källan. Studien kom fram till att uppföljningsarbetet fortfarande bara är i sin linda i undersökta kommuner samt att vissa justeringar av befintliga miljöövervakningssystem behövs för att använda dessa för uppföljning av planer. Befintliga problem utgörs främst av oklarhet i fråga om ansvar inom kommun och/eller mellan kommunen och exploatörer samt att det råder brist på uppföljningsmetoder. Viktiga förutsättningar är därför att klargöra ansvarsfördelning och bestämma avstämningstillfällen där uppföljningen ska behandlas. Ett annat verktyg är utvecklandet av ett uppföljningsprogram. Ett sådant program föreslås också kunna omfatta miljöåtgärder och tillsynsaktiviteter i byggskedet. Ett gemensamt miljö- och uppföljningsprogram kan ge möjlighet att säkerställa en enhetlig hantering av miljöhänsyn i det kommunala planarbetet.</p> / <p><strong>Abstract</strong></p><p>A follow-up of the significant environmental impacts is required for plans and programs, which are affected by SEA-regulations. Research shows that follow-up is neglected, both practically and theoretically. This study aims to compile experience and knowledge to build understanding of follow-up of municipal plans, specifically land use plans (översiktsplan, detaljplan). Follow-up is important as feedback and to integrate environmental concerns into the municipal planning process. Based on the aim, four questions were raised concerning: the occurrence of follow-up of plans in municipalities (1), organizational and responsibility issues (2) how well suited the existing environmental monitoring in the municipalities is for follow-up (3), and what is important when working with follow-up in a municipality (4). Various stakeholders were interviewed, in which municipalities were the main source. The study shows that follow-up work is still only in its infancy in the surveyed municipalities, and that adjustments to the existing environmental monitoring systems are needed for use in follow-up of plans. Existing problems are uncertainties in responsibility questions and lack of methods to follow-up. Key conditions are to clarify responsibilities within municipalities and with landowner/developer and decide occasions where follow-up is handled. Another tool is the development of a follow-up program. Such program is also proposed to include environmental measures and other activities in the building phase. A common program could ensure a comprehensive management of environmental concerns in the municipal planning process.</p>

<p>Bakgrunden är att vi har identifierat brister i lärandet för ambulanspersonal, det föreligger ett dåligt utvecklat lärande i form av feedback/uppföljning efter ambulansuppdrag. Vi har, efter litteraturgenomgång, skapat en modell med de komponenter som behövs för att organisationen och individernas lärande skall fungera och lärandet ska bli lyckat.</p><p>Syftet med studien är att genom intervju av fyra ambulansöverläkare inom femklöverns ambulansorganisationer, jämföra vår modell om optimalt lärande med hur feedback/uppföljning för ambulansbesättningar ser ut i vekligheten i en kvalitativ undersökning med en deduktiv ansats. Studien innefattar fyra intervjuer av ambulansöverläkarna inom region femklövern. Ambulansöverläkarna är garanter för vårdkvalitén och därmed ansvariga för utbildningsinsatser och de anställdas kompetens/kompetensutveckling. Studien visade att inom femklövern sker det idag ingen kontinuerlig uppföljning eller feedback efter ambulansuppdragen. Däremot finns det sporadisk uppföljning i form av avvikelsehantering och uppföljning efter större händelser. Denna uppföljning fokuserar dock oftast på annat än patientomhändertagandet. Vår modell för optimalt lärande skiljer sig alltså från verkligheten. Uppföljning och feedback måste ingå i patientuppdragen och ske i samband med avlämnandet på mottagande sjukvårdsenhet. Insatser krävs för att förändra synen på lärande och integrera det i organisationen, först då kan man skapa bra vägar för feedback och uppföljning och lära sig av sina erfarenheter.</p> / <p>The background to this study is that we have identified deficiencies in learning for ambulance personnel. Learning in the form of feedback/follow-up after ambulance commissions is none existent. The aim with the study is through interview of ambulance senior physicians within the “femklöverns” ambulance organizations, compare our model about optimized learning with how feedback/follow-up for ambulance crews works in reality. This is a qualitative survey with a deductive approach. The study includes four interviews with the ambulance senior physicians within region of “femklövern”. The ambulance senior physicians are guarantors for the care quality and thereby responsible for educational initiatives and the employees competence/skill development. We have, after literature review, created a model with the components that is needed for both the organization as well as the individuals' to learn properly and that itself will result in successful learning. The study showed that within the “femklövern” there are no continuous feedback or follow-up after ambulance commissions. On the other hand, it exists sporadic follow-up due to incident reports and follow-up after bigger accidents. These kind of follow-ups focuses mostly on other things then the patient care treatment. Our model for optimized learning differs from how the reality presents itself. Follow-up and feedback have to be a part of every ambulance commission and be used every time a patient is admitted to a hospital or another institution. Initiatives are required in order to change the opinion of learning and how to integrate it in the organization, first then can feedback and follow ups be a successful tool for optimized learning.</p>

<p><p>Syftet med denna studie var att beskriva hur patienterna upplevde Brännskadeteamets ettårsuppföljning. Studien har en deskriptiv design med såväl kvalitativa som kvantitativa data. Som underlag för studien har en utvärderingsenkät använts, svaren är insamlade under tidsperioden 2001- juni 2008. Svarsfrekvensen var hög (81,4%), 57 patienter av 70 hade besvarat enkäten.</p><p>Bemötandet skattades av samtliga patienter som mycket bra (77,2%) eller bra (22,8%). Samtliga patienter som hade ställt frågor ansåg att de hade fått svar på sina frågor (93%) medan en mindre grupp svarade att de ej hade ställt några frågor (7%). Informationen innan besöket ansågs som dålig eller mindre bra av 4 patienter (7,1%), bra/tillräcklig av 33 patienter (57,9%) och mycket bra av 19 patienter (33,3%). Informationen under besöket ansågs vara bra eller mycket bra av samtliga patienter utom en som klassade den som mindre bra. Fyra av de fem kommentarerna som skrivits till frågorna gällde brister i information och förberedelse. Majoriteten av patienterna (93%) ansåg att tiden för besöket var lagom.</p><p>Brännskadeteamets ettårsuppföljning är unik och den anpassas i möjligaste mån efter varje patients behov. Svaren på enkäten visar att detta lyckats ganska bra, men att informationen innan besöket behöver förbättras.</p></p> / <p><p>The purpose of this study was to describe the burn patients´ experience of the one-year follow-up, with a multidisciplinary team. The study has a descriptive design with both qualitative and quantitative data. An evaluation questionnaire was used to collect data. The answers are collected in the period from 2001 until June 2008. The response rate was high (81.4%), 57 patients out of 70 had responded to the survey.</p></p><p>The patients replied that they were treated very good (77.2%) or good (22.8%). All patients that had asked any questions felt that they had received answers to their questions (93%) a smaller group replied that they had not asked any questions (7%). The information before the visit was considered as poor or less good by 4 patients (7.1%), good/sufficient by 33 patients (57.9%) and very good by 19 patients (33.3%). Information during the visit was considered to be good or very good by all patients except one who rated it as less good. Four out of the five written comments was about issues related to gaps in information and preparation. The majority of all patients (93%) were satisfied with the length of time of the visit.</p><p>The multidisciplinary one-year follow-up, at the Burn Center, is unique and the aim is to adjust the follow-up visit after each patient's needs. The results show that it has succeeded quite well, but that the information given before the visit needs to be improved.</p>

<p>Den tekniska tjänsten är idag av stor betydelse för att Försvarsmakten skall fungera. Uppgifter inomden tekniska tjänsten är bland annat att hantera driftstörningar som inträffar på materiel och hantera uppföljningar av dessa inträffade fel. Syftet med den här uppsatsen är att undersöka två olika uppföljningssystem för driftstörningar, ett system från armén och ett system från flygvapnet. Utifråndetta diskuteras systemen ur olika synvinklar med fokus på bland annat fördelar och nackdelar. Under bakgrundsbeskrivningen av de olika systemen visade det sig att ARGUS och DA-flyg följer upp i två olika riktningar vid driftstörningar. ARGUS fokuserar på den materiella feluppföljning och DA-Flyg fokuserar på att göra en uppföljning på individnivå. Vidare under bakgrunden framgick det även att generellt sett så använder man samma typ av rapporteringsprocedur, en fyrastegsprocess. Bakgrunden följdes upp av en analys av två olika typfall med utgångspunkt i de båda uppföljningssystemen och därefter diskuterades resultatet. Utifrån diskussionen drogs det slutsatser kring de olika systemen. Några av dessa var bland annat att inledningsvis var ARGUS ett krångligt system att använda då man var tvungen att rapportera i två olika system. Sedermera korrigerades detta och i dagsläget är det en förenklad version av ARGUS som används i ett system. DA-Flygbygger på att man är lojal mot systemet då rapporten som skrivs är helt anonym, sånär som på en otydlig signatur i de flesta fall. Författarens avslutande ord är att en sammanslagning alternativt ett nytt system där både materiel och individuppföljning ingår eventuellt skulle effektivisera hela processen med feluppföljning.</p> / <p><p>The Technical Service is one of the cornerstones that make the Swedish armed force operational. Handle and manage failure within technical materials are, among other tasks, something that technical service needs to deal with. The aim with this paper is to examine two different systems that handle the follow-up of different failures, one system from the army and one system from the airforce. Based on the aim, the systems will be compared and discussed through different points of view, focusing on the advantage and disadvantage. Looking at the background description of the systems, it shows that ARGUS and DA go two different tracks when they do a follow up. ARGUS focus on the follow up of the material, while DA focuses on the follow up in an individual aspect. Further in the background, it shows that, the same procedure isused in the report process, a four-step-model. The background is followed up by an analysis of two different cases where the follow up systems is the main point and after that, a discussion around the result was made. During the discussion, the writer of this paper made up some conclusions, and those are as follows. In the beginning, the ARGUS system was complicated to use. The fact that you needed to type in the report twice in two different kinds of systems made it complicated to use. However, this problem, were fixed due the integration of the system within another system. In the DA system, everyone that uses this system needs to be loyal against the system, due the lack of connection between report and report writer. As a summary of the whole paper, the writer recommends a system that has both of these parts, in other words, both individual follow up and materials follow up, might make the system more effective.</p></p>