Advantages of applying information and communication technologies to support complex team practices in healthcare domain have often been supported in the extant literature. The primary assumption is that before putting any technologies in place to support team functions, the team-based environment should be completely modeled. To date, many frameworks have been proposed for modeling healthcare teams; however, most of the frameworks only focus on single or a few aspects of teamwork and the outcomes usually present overlaps, limitations and inconsistencies. As a result, there is an increasing demand for offering an overarching framework that integrates the multiple dimensions of healthcare teamwork into a synthetic whole and clearly conceptualizes the potentially important relationships and dependencies that exist over those dimensions. In order to properly address the aforementioned challenge, this thesis applies ontological engineering to develop an overarching framework for integrating the multiple dimensions of teamwork concept in healthcare domain. For this purpose, we first illustrate a set of four stage methodological approach to provide explicit details on how to incorporate a theatrical foundation into the ontology. Then, the proposed approach is used to develop a derived ontological framework. Finally, accuracy and completeness of the proposed ontology based framework is validated to show that it is able to accurately represent the domain is it being employed for. The values and capabilities of ontology have already been studied and approved, and this technology is known as the best sources to represent a knowledge domain by means of concepts and accurately define the relationships among them. Our aim in this thesis is to further research how to develop and evaluate a standard ontology based framework to facilitate the healthcare team modeling.

This thesis is about impairment, disability and health. Placed in the context of Disability Studies, it engages with the theoretical debates about how disability and impairment should be conceived. In doing so it pays particular attention to the embodiment of impairment and its relation to health matters. It also identifies and discusses the reasons for the apparent reluctance of Disability Studies to engage with health issues. The main source of data is interviews with 28 disabled people from Edinburgh and the Lothians. Using semi structured interviews, participants were encouraged to talk about their experiences of using healthcare including the access barriers they faced, the expertise they developed to manage their health care encounters and how these encounters mediated and were mediated by their lived experience as disabled people. A secondary source of data is autoethnographic writing. Through reflexivity, an assessment is made of the value and validity of using this method to explicitly incorporate the researcher’s own experiences in to the data and its analysis. Similarly reflexivity is deployed to consider the methodological issues that arise from the researcher being disabled and encountering access barriers during the research process. There were three sets of findings from the research. First, participants’ body talk suggested that in everyday life impairment and maintaining good health can be understood as something which is done by the embodied self to the body. This doing is often a taken-for-granted activity. It is also mediated through a number of factors including emotions, disabling barriers and broader social and economic structures. Second, participants’ accounts of the access barriers they faced when using the NHS suggested that there are two categories of access needs, the macro and micro. While macro needs such as ramped or flat access to premises were anticipated and routinely met without participants having to take any action, participants often felt they had to take the initiative to ensure their micro needs, such as the need for a hoist, were met. Some micro access needs were particular to a healthcare context and often emerged during diagnostic tests or treatment procedures. Healthcare professionals had to have sufficient skills and confidence to respond effectively to these clinical micro needs. The third set of findings was that some participants developed expertise to enable them to access the appropriate services to meet their needs and form a high quality relationship with healthcare professionals. However, other participants recalled situations where their expertise was not respected and felt abandoned by the NHS. The first set of findings has implications for theoretical development in Disability Studies. More work is needed to connect the doing of impairment to theoretical approaches found in sociology of the body and to empirically explore the nature and scope of impairment doing, The second and third set of findings have implications for current healthcare practice particularly in the context of the NHS’ responsibility under the Disability Discrimination Act.

This thesis examines the contribution that geographical analysis can make to the study of the variation in the patterns of human health and subsequently to the discussion on the type and level of use of the public health service in a rapidly developing country. The current study was conducted in Jeddah Governorate, Kingdom of Saudi Arabia during the period 1994 and 2000. One of the main aims was to examine the pattern of health services provided in Saudi Arabia and this aim was achieved by investigating the provision and use of the Public Healthcare services. An attempt was made to clarify the complex web of relations that existed between, on the one hand, the different socioeconomic and geographic factors and on the other, the distribution of common ailments together with the level of utilization of health services. Shortcomings in the nature of the official health statistics regarding socioeconomic conditions of the patients were remedied through the use of a questionnaire. A tot al of 1000 patients from the eight PHCCs were surveyed for their use of the public health service. Data was collected from the same patients on their socio-economic, education and habitation details. This sample was used to supplement the data collected from the official government health statistics. These two data sets permitted an evaluation of the occurrence of different ailments and the variations in geographic distribution among the eight selected PHCCs. Difficulties persisted in the availability of official 1992 census data until publication of census data became available in 1999. In contrast to the problems of the census data, the availability of accurate and up-to-date patient records compiled by Ministry of Health staff was of considerable benefit to this research project. Use was made of Geographic Information Systems software for the analysis of data collected at the level of the PHCC. This allowed visual identification of the spatial variation in the use of the different health services and also allowed the identification of gaps in healthcare provision. The study showed that a density of habitation index used as a prime indicator of socio-economic status could be used as an indicator of the occurrence level for a number of common diseases. A pattern of disease was observed that suggested that the number of visits to PHCCs was substantially higher in low socio-economic districts compared to medium and higher socio-economic districts. It can be shown that the most common ailment was Upper Respiratory Tract Infections followed by Dental and Gingival diseases. Persons aged between 15 and 44 years made most visits to PHCCs although children under 15 years made proportionately greater use of PHCC facilities. No difference could be found between Saudi and Non Saudi as regards the occurrence of the most common ailments and diseases. The lack of difference was probably due to the close integration of the two population groups and the sharing of the same local environment. This similarity occurred despite considerable differences in income levels and socio-economic status. The level of utilisation of health centers in the selected districts showed differences, being higher in those districts categorized as low socio-economic in the south of Jeddah when compared to higher socio-economic districts in the north of the city. It was evident that the difference in socio-economic factors had an impact on the occurrence of some frequently occurring diseases e.g. URI, Dental, Ophthalmic, musculoskeletal and skin diseases. Although not primarily concerned with private health care facilities, for completeness sake some information was collected on the use of private health care in conjunction with public health care facilities. The author was surprised to discover that greatest use of private facilities occurred among women and children patients from Al Nuzla al Yamaneyyah and Al Thaalebah, districts that were characterised by low socio-economic conditions. The use of traditional folk healing was also briefly studied as this form of treatment remains important for some patients. Results showed that there was no difference between the educational standards of patients and their use of traditional folk healers. Again, children and women constituted the majority (86.6%) of users of traditonal healing with Saudi users (18.9%) higher than non Saudi (11.4%). There remains the supposition that alternative medicine may be of far greater importance than the sparse official data suggests. The unquantified illegal immigrant population may be totally reliant on unofficially operating alternative medicine centres. The thesis concludes by recommending a number of improvements to the existing public health care system. Some changes in the policy and practice of PHCC services will inevitably require more financial resources. These include an extension of the opening times of PHCCs and an increase in the number of specialist facilities such as dental surgeries. Other changes may not require more finances. These include a strengthening of communication and co-operation between PHCCs and hospitals to improve the referral of patients. Expansion of the existing computer network connecting PHCCs with hospitals should be given high priority.

Class of 2010 Abstract / OBJECTIVES: To examine the potential differences in attitudes between the colleges of pharmacy, nursing, medicine, and social work relating to the “Culture and Communication” IPE activity at the University of Arizona in 2007. METHODS: This was a retrospective study comparing the opinions and attitudes of different groups of healthcare students concerning the IPE activity “Culture and Communication” at the University of Arizona. The independent variable in this study was academic discipline: medicine, pharmacy, nursing, law, or social work. The dependent variables were the attitudes and opinions of the effectiveness of this IPE activity on Culture and Communication. RESULTS: A total of 589 questionnaires (medicine=119, pharmacy=89, nursing=77, social work=21) were completed and included in 2007. Overall, students felt the Culture and Communication IPE activity improved their knowledge of how to identify barriers to communication and reduce the likelihood of miscommunication with other healthcare professionals. The percent of students who believed they had a very high understanding of the barriers to effective communication among health care providers increased from 11.3% before the IPE activity to 34.5% after. The percent of students who believed they had a very high knowledge of how to reduce the likelihood of miscommunication increased from 6.6% before the IPE activity to 37.4% after. There were differences between the groups relating to the different questions that the questionnaire focused on. CONCLUSIONS: There were significant differences between the various healthcare professionals relating to the usefulness and effectiveness of the Culture and Communication IPE activities at the University of Arizona. Overall, students seemed to benefit from and enjoy the IPE activity and would recommend having future students participate in the activities. The majority of students felt the Culture and Communication IPE activity was benificial and allowed for the improvement of relationships and attitudes between the health care professions. There were similar responses between the medicine, nursing, pharmacy, and social work students.

L'administration du système de santé s'est profondément renouvelée avec l'instauration d'agences sanitaires. La mise en place de l'ARS en 2009 participe à l'unification de l'action sanitaire au niveau régional qui faisait défaut sous l'emprise de l'ARH. L'introduction de l'ARS ne traduit qu'une simplification apparente du dispositif de l'action sanitaire, à la confluence du modèle de l'agence sanitaire et de l'Administration territoriale de l'Etat. Cette nouvelle agence apparait alors comme une agence territoriale inédite qui trouve une expression particulière dans son intervention sur le système de santé. L'appropriation des instruments de la régulation par l'ARS, incarnée par le contrat atteste d'un renouvellement des procédés de l'action sanitaire. L'ARS procède à une régulation territoriale du système de santé qui présente un caractère original. Cette rénovation de l'action sanitaire est pour autant loin d'être achevée. Les rapports entre l'ARS et les établissements publics de santé expriment cette efficacité contrastée des modes d'administration du système de santé. Le cumul de fonctions attribué à l'ARS nuit à la lisibilité et l'efficacité de son intervention sur le système de santé. L'ARS devra disposer d'une autonomie accrue pour s'imposer comme le régulateur privilégié du système de santé / The administration of the health care system was deeply changed with the introduction of health agencies. The implementation of the ARS in 2009 contributes to unify the health action at the local level, what was missing under the influence of the ARH. The introduction of the ARS solely expresses a supposed simplification of the health care system, at the confluence of a classic health agency and of a local administration of the State. This new agency appears then as an unprecedented territorial agency what is proved by its intervention on the health care system. The appropriation of regulating instruments by this agency, which can be embodied in the contract, shows a renewal in health action. The ARS carries out a local regulation of health system which is original. This reform of health action is far away from being completed. Relationships between the ARS and public health institutions reveal this partial efficiency. The addition of functions awarded to the ARS harms the readability and the efficiency of its intervention on the health care system. The ARS has to be self-sufficient to become the main regulator of the health care system

Thesis advisor: Richard McGowan / This paper addresses the disparities in the quality of women’s health across the United States in order to determine which factors are causing these disparities and what policies and actions can be taken to improve the quality of women’s health. In order to construct a comprehensive measure of women’s health quality, a model based on Morgan and Morgan (2010) is used to assign each state an individual quality rating. Regression analysis points to a wide range of factors as being statistically significant in determining the quality of a woman’s health in America. The data suggests that exercise rates, preventive screenings, primary care coverage, the level of emotional support, and regular oral care positively influence the level of health. Factors such as the caesarian section delivery rate, the uninsured rate, unemployment rate, and pollution levels are shown to negatively influence overall health. Concrete policies and actions can be taken to positively alter the statistically significant factors. It is my hope that this paper contributes to the field of women’s health and to the work that aims to improve the quality of women’s health in the United States. / Thesis (BA) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Economics Honors Program. / Discipline: Economics.

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Thesis (MPH)--University of Limpopo, 2010. / Relationships have been reported between job satisfaction, productivity, absenteeism and turnover among healthcare employees and as such it affects employees’ organizational commitment and the quality of healthcare services. The aim of the study was to determine the factors influencing job satisfaction among healthcare professionals at South Rand Hospital. The study was conducted among 103 participants. Self-administered questionnaires were used to collect data from the participants. Data was then analyzed using statistical software SPSS 17.0. The results showed a low level of job satisfaction. Almost 80% (79.6%) of participants were not satisfied with their jobs, and there was no association between job satisfaction and socio-demographic characteristics. Variables such as opportunity to develop, responsibility, patient care and staff relations were found to be significantly influencing job satisfaction and there was a significant positive medium association between job satisfaction and opportunity to develop, responsibility, patient care and staff relations for both clinical and clinical support staff. Satisfaction with one’s job can affect not only motivation at work but also career decisions, relationship with others and personal health. Those who are working in a profession that is extremely demanding and sometimes unpredictable can be susceptible to feelings of uncertainty and reduced job satisfaction. Job satisfaction is also an essential part of ensuring high quality care. Dissatisfied healthcare providers give poor quality, less efficient care. Interventions need to be implemented in order to improve the level of job satisfaction among healthcare professionals at South Rand Hospital.

Access control is a key feature of healthcare information systems. Access control is about enforcing rules to ensure that only authorized users get access to resources in a system. In healthcare systems this means protecting patient privacy. However, the top priority is always to provide the best possible care for a patient. This depends on the clinicians having access to the information they need to make the best, most informed, care decisions. Care processes are often unpredictable and hard to map to strict access control rules. As a result, in emergency or otherwise unexpected situations, clinicians need to be able to bypass access control. In a crisis, availability of information takes precedence over privacy concerns. This duality of concerns is what makes access control in healthcare systems so challenging and interesting as a research subject. To create access control models for healthcare we need to understand how healthcare works. Before creating a model we need to understand the requirements the model should fulfill. Though many access control models have been proposed and argued to be suitable for healthcare, little work has been published on access control requirements for healthcare. This PhD project has focused on bridging the gap between formalized models and real world requirements for access control in healthcare by targeting the following research goals:RG1 To collect knowledge that forms a foundation for access control requirements in healthcare systems.RG2 To create improved access control models for healthcare systems based on real requirements.This PhD project has consisted of a number of smaller, distinct, but relatedprojects to reach the research goals. The main contributions can be summarized as:C1 Requirements for access control in healthcare: Studies performed onaudit data, in workshops, by observation and interviews have helped discoverrequirements. Results from this work include methods for access controlrequirements elicitation in addition to the actual requirements discovered.C2 Process-based access control: The main conclusion from the requirementswork is that access control should be tailored to care processes. Care processesare highly dynamic and often unpredictable, and access control needs to adaptto this. This thesis suggests how existing sources of process information, bothexplicit and implicit, may be used for this purpose.C3 Personally controlled health records (PCHR): This thesis explores theconsequences of making the patient the administrator of access control andproposes a model based on these initial requirements. From a performedusability study it is clear that the main challenge is how to keep the patientinformed about the consequences of sharing.

Smartphones are used by incredibly many people, and in 2011 there where a total of 491.4 million units soled worldwide. This makes it a relevant technique for performing dietary studies when the test patients are on the move. This thesis shows how to create a back end environment for an Android application with existing techniques linked together, using MSSQL database, Visual Studio Web Service, web pages and C# classes and ASP.NET security. The back end development is used in a dietary study on Gothenburg University, butcould be applied on many similar back end projects using databases and server development.Techniques used in this thesis are: REST (Representational State Transfer) -client implementation and development inside the Android application, using HTTP methods to set and get information from the server and database, and JSON-format to read and transferinformation in an easy and understandable way, both from the Android application and from the database. FileMaker is also used in this project as a third part programme tovisualise the information in the database.